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Jan H. Landsberg,¹ Sherwood Hall,² Jan N. Johannessen,³ Kevin D. White,⁴ Stephen M. Conrad,² Jay P. Abbott,¹ Leanne J. Flewelling,¹ R. William Richardson,¹ Robert W. Dickey,⁵ Edward L.E. Jester,⁵ Stacey M. Etheridge,² Jonathan R. Deeds,² Frances M. Van Dolah,⁶ Tod A. Leighfield,⁶ Yinglin Zou,⁷ Clarke G. Beaudry,⁴ Ronald A. Benner,² Patricia L. Rogers,² Paula S. Scott,¹ Kenji Kawabata,¹ Jennifer L. Wolny,^1,8 and Karen A. Steidinger^1,8

¹Fish and Wildlife Research Institute, Florida Fish and Wildlife Conservation Commission, St. Petersburg, Florida, USA; ²Food and Drug Administration, Center for Food Safety and Applied Nutrition, Laurel, Maryland, USA; ³Food and Drug Administration, Office of the Commissioner, Rockville, Maryland, USA; ⁴Food and Drug Administration, Center for Food Safety and Applied Nutrition, College Park, Maryland, USA; ⁵Food and Drug Administration, Center for Food Safety and Applied Nutrition, Gulf Coast Seafood Laboratory, Dauphin Island, Alabama, USA; ⁶National Oceanic and Atmospheric Administration, National Ocean Service, Center for Coastal Environmental Health and Biomolecular Research, Charleston, South Carolina, USA; ⁷Key Laboratory of Science and Engineering for Marine Ecology and Environment, First Institute of Oceanography, State Oceanic Administration, Qingdao, China; ⁸Florida Institute of Oceanography, University of South Florida, St. Petersburg, Florida, USA

Abstract
Background: From January 2002 to May 2004, 28 puffer fish poisoning (PFP) cases in Florida, New Jersey, Virginia, and New York were linked to the Indian River Lagoon (IRL) in Florida. Saxitoxins (STXs) of unknown source were first identified in fillet remnants from a New Jersey PFP case in 2002.

Methods: We used the standard mouse bioassay (MBA) , receptor binding assay (RBA) , mouse neuroblastoma cytotoxicity assay (MNCA) , Ridascreen ELISA, MIST Alert assay, HPLC, and liquid chromatography-mass spectrometry (LC-MS) to determine the presence of STX, decarbamoyl STX (dc-STX) , and N-sulfocarbamoyl (B1) toxin in puffer fish tissues, clonal cultures, and natural bloom samples of Pyrodinium bahamense from the IRL.

Results: We found STXs in 516 IRL southern (Sphoeroides nephelus) , checkered (Sphoeroides testudineus) , and bandtail (Sphoeroides spengleri) puffer fish. During 36 months of monitoring, we detected STXs in skin, muscle, and viscera, with concentrations up to 22,104 µg STX equivalents (eq) /100 g tissue (action level, 80 µg STX eq/100 g tissue) in ovaries. Puffer fish tissues, clonal cultures, and natural bloom samples of P. bahamense from the IRL tested toxic in the MBA, RBA, MNCA, Ridascreen ELISA, and MIST Alert assay and positive for STX, dc-STX, and B1 toxin by HPLC and LC-MS. Skin mucus of IRL southern puffer fish captive for 1-year was highly toxic compared to Florida Gulf coast puffer fish. Therefore, we confirm puffer fish to be a hazardous reservoir of STXs in Florida's marine waters and implicate the dinoflagellate P. bahamense as the putative toxin source.

Conclusions: Associated with fatal paralytic shellfish poisoning (PSP) in the Pacific but not known to be toxic in the western Atlantic, P. bahamense is an emerging public health threat. We propose characterizing this food poisoning syndrome as saxitoxin puffer fish poisoning (SPFP) to distinguish it from PFP, which is traditionally associated with tetrodotoxin, and from PSP caused by STXs in shellfish.

Key words: dinoflagellate, Florida, harmful algae, puffer fish, Pyrodinium bahamense, saxitoxin puffer fish poisoning, saxitoxins, Sphoeroides spp. Environ Health Perspect 114: 1502–1507 (2006) . doi:10.1289/ehp.8998 available via http://dx.doi.org/ [Online 6 July 2006]

Address correspondence to J.H. Landsberg, Fish and Wildlife Research Institute, Florida Fish and Wildlife Conservation Commission, 100 Eighth Ave. SE, St. Petersburg, FL 33701 USA. Telephone: (727) 896-8626. Fax: (727) 893-9840. E-mail: jan.landsberg@myfwc.com

We thank L. Sebastian, R. Paperno, D. Adams, D. Tremain, S. Fisk, S. Stahl, S. Cook, J. D'Urso, and A. Shurtleff, Florida Fish and Wildlife Conservation Commission (FWC) , for technical assistance and D. Bodager and G. Jackow, Florida Department of Health (FDOH) , for specimen collection.

Funding or support for this research was provided by the FWC, FDOH, U.S. Food and Drug Administration, Centers for Disease Control and Prevention, and the National Oceanic and Atmospheric Administration (NOAA) . This article is a result of research partially funded by the NOAA Coastal Ocean ECOHAB Program under award #NA03NOS4780196 to the FWC (ECOHAB contribution #152) .

The authors declare they have no competing financial interests.

Received 11 January 2006 ; accepted 5 July 2006.