Tetrodotoxication with Nassauris glans:: A possibility of tetrodotoxin spreading in marine products near Pratas Island

Tetrodotoxication was observed in six patients who ate gastropods from the South China Sea near Pratas Island. The pathogenic gastropod was Nassauris glans, which had not been previously mentioned in human tetrodotoxication. An extremely high level of tetrodotoxin was found in the causative gastropods, and a variety of clinical signs were observed in the survivors. The postmortem autopsy of two patients showed severe distension and hypersecretion of the alimentary tract, suggestive of a cholinergic crisis as the cause of their early death. A recognition of education regarding the risk of tetrodotoxication by N. glans in the study area is important to prevent further tragedy. A retrospective review of the tetrodotoxication in this region may aid in understanding the changes and route of tetrodotoxication in marine products, and provide valuable information for preventive measures.