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High risk of shellfish poisoning in Auckland and Northland – 27 people ill, 3 in hospital

Press Release – Bay Of Plenty DHB
The number of people affected by paralytic shellfish poisoning toxin has increased by seven since Tuesday. In total, 27 people have been poisoned by eating shellfish collected from the Bay of Plenty coastline.

Thirteen people have been admitted to hospital after suffering symptoms ranging from tingling around the mouth to difficulty walking. Three people remain in hospital.

The toxin that causes the illness comes from algae in the ocean. Shellfish feed on the algae and concentrate the toxin in their flesh. Algae levels are extremely high in the Bay at present so shellfish toxin is expected to rise. This underlines the seriousness of the current Medical Officer of Health warning.

“Paralytic shellfish poisoning can be a very serious illness, which can even be fatal. People have been really sick after eating shellfish from the Bay of Plenty. Please don’t collect or eat shellfish from the affected areas these summer holidays,” says Medical Officer of Health, Dr Neil de Wet.

As a reminder the Medical Officer of Health strongly advises against the collection of shellfish from Tairua on the east coast of the Coromandel Peninsula, south to Waihi Beach and along the Bay of Plenty coast to Whakatane Heads in the Eastern Bay of Plenty. The warning includes Tairua Harbour as well as Tauranga Harbour, Maketu and Waihi estuaries, Matakana and Motiti Islands, and all other islands along this coastline.

The health warning applies to all bi-valve shellfish including mussels, pipi, tuatua, cockles, oysters, scallops as well as cat’s eyes, snails and kina (sea urchin). Shellfish in the affected area should not be taken or eaten. Shellfish containing toxic levels of paralytic shellfish poison don’t look or taste any different from shellfish that are safe to eat. Cooking or freezing the shellfish does not remove the toxin. Paua, crayfish and crabs can still be taken but as always, the gut should be removed before consuming. “Commercially supplied shellfish are safe to eat, so if you want shellfish on the menu over the holidays visit your supermarket or seafood retailer,” says Dr de Wet.

Consumption of shellfish affected by the paralytic shellfish toxin can cause numbness and tingling around the mouth, face, hands and feet; difficulty swallowing or breathing; dizziness; double vision; and in severe cases, paralysis and respiratory failure. These symptoms can start as soon as 1-2 hours after eating toxic shellfish and usually within 12 hours. Anyone suffering illness after eating shellfish should seek urgent medical attention.

Shellfish and seawater samples around New Zealand are tested regularly by the Ministry for Primary Industries to ensure they are not contaminated. Public health warnings are issued when shellfish are not safe to eat. For more information about marine biotoxin alerts visit www.foodsmart.govt.nz.

For up to date information on health warnings in the Bay of Plenty please visit www.ttophs.govt.nz and click on health warnings or call 0800 221 555 and select option 7 to speak to the on call health protection officer.

Press Release – Auckland Regional Public Health Service
The recent spate of hospitalisations in the Bay of Plenty due to paralytic shellfish poisoning, serves as a reminder of key health issues this summer. “We know this is the time of year that people want to be at the beach and in the sun,” says Dr Julia Peters, Clinical Director of the Auckland Regional Public Health Service, “we want people to have the information they need to make choices for their own and their families’ good health.”

Shellfish poisoning
* Twenty people have been poisoned in the last week by eating shellfish collected in the Bay of Plenty. The very same danger exists in the Auckland and Northland region.
* The public are advised not to eat shellfish collected from Motunui (Taranaki) north to Maunganui Bluff (just north of Dargaville), including the Raglan, Kawhia, Manukau and Kaipara Harbours.
* Symptoms of toxic shellfish poisoning include numbness and tingling around the mouth, face, fingers and toes, difficulties in swallowing or breathing, dizziness, double vision and, in severe cases, paralysis and the stopping of breathing.
* If someone you know does eat shellfish and becomes sick, seek urgent medical attention, keep any shellfish you have left over, and contact your local Public Health Unit.
* For further information see the full media release: http://www.arphs.govt.nz/news/articletype/articleview/articleid/157/19112012-update–biotoxin-in-shellfish-public-health-warning [1]

Safe Swimming
* Check the Auckland Council’s Safeswim monitoring programme, which provides regular updates of water quality at beaches in the region: http://www.aucklandcouncil.govt.nz/EN/environmentwaste/researchmonitoring/beach_water_quality_safeswim/Pages/home.aspx [2]
* Wait at least 48 hours after heavy rainfall before swimming to avoid pollutants, and avoid swimming near stormwater drains or sewage outfall pipes.
* Avoid swimming in beach water that is cloudy or smells bad. If you can’t see your feet, don’t put your head under the water.
* Swim between the flags, and keep small children within arms reach.
* Learn to swim and make sure children, friends and whanau learn too. See http://www.watersafety.org.nz/ [3] for more advice.

Sun Safety
* New Zealand has the highest rates of melanoma and skin cancer in the world. Melanoma killed 326 people in 2009 and the trend is going upwards.
* Cover up well, use sunglasses and wear a hat to protect your face, ears, and neck and stay in full shade as much as possible between 11am and 4 pm.
* Use a sunscreen of SPF 30+ or higher at least 20 minutes before going into the sun and reapply every two hours and after swimming. Use sunscreen in addition to shade and clothing.
* For more information and resources see: http://sunsmart.org.nz/ [4]

Food handling
* It is important to remember that there is an increased risk of food poisoning during the Christmas and BBQ season, due to the warmer weather. This means that good hand hygiene and careful food preparation is important.
* Keep in mind the four Cs of food safety: clean, cook, cover, chill. Wash and dry hands adequately before and after preparing food, cook food well (especially chicken) and ensure food is appropriately covered and chilled (included raw, prepared and leftover food).
* See further information here: § http://www.foodsmart.govt.nz/food-safety/tips/ [5] § http://www.health.govt.nz/our-work/environmental-health/food/foodborne-illnesses [6] § http://www.arphs.govt.nz/health-information/communicable-disease/hand-hygiene [7]

Alcohol safety
* Make nonalcoholic and low alcoholic options available at all times. * Always have alcohol with food.
* Don’t feel pressured to drink or serve alcohol if you don’t want to.
* Make sure that alternative transport options are available for those who have had too many alcoholic drinks or don’t wish to drive.
* Find out how much alcohol you are drinking at: http://www.alac.org.nz/alcohol-you/whats-standard-drink/guide-standard-drinks [8] * Find out how much you can safely drink at: http://www.alac.org.nz/alcohol-you/your-drinking-okay/low-risk-alcohol-drinking-advice * Remember, the more you drink on one occasion, the greater your risk of injury or harm.

* During summer, Auckland Regional Public Health Service (ARPHS) sometimes receives reports of swimmers suffering from rashes caused by stings from jellyfish on Auckland’s beaches.
* Generally, those affected have an itchy red rash in the swimwear-covered areas. The rash can vary from being mild (slight discomfort) to severe. It can last for a week or more. Calamine lotion, antihistamines and mild steroid creams may be helpful. Children are more at risk. * If you or your family develop a rash like this, please contact ARPHS and let us know. * For further information see the fact sheet http://www.arphs.govt.nz/health-information/healthy-environments/fact-sheets [9]

In summary, Dr Peters says “make health and safety an important part of your summer plans, take hand hygiene seriously and be sun, beach and alcohol safe.”

Press release from Waikato Hospital Board
Paralytic shellfish poisoning (PSP) warnings are in place on both the east and west coasts of the North Island. Twenty-six people have been admitted to hospitals in Tauranga and Rotorua so far this month with presumed shellfish poisoning, after eating pipi or tuatua they had gathered around Papamoa. Two ended up in the Intensive-Care Unit.

A separate health warning, also because of the presence of PSP toxin, on the west coast
extends from Taranaki to Kaipara Harbour and has been in place for a month. “I’m a little concerned that the spate of poisonings being reported from the east coast may be overshadowing the presence of an even more extensive area on the west coast where a ban is also in force, also for PSP toxin,” said Waikato Medical Officer of Health Dell Hood.

“Many people will be heading for their holiday homes at places like Marokopa, Kawhia and Raglan and
they may not be aware of the seriousness of the risk, or they may think it is an issue only on the east coast.

“There is signage on both coastlines but as events show, some people may ignore them,” Dr Hood said.

The toxins get into shellfish from naturally occurring algae growing in the sea water. This is a natural process, but the toxin becomes concentrated in shellfish because they feed by filtering seawater. There are many different poisons produced by these algae which is why the
severity of illness varies. PSP is known to be one of the most serious toxins produced by marine algae.

Waikato-based health protection officer David Cumming said weekly monitoring had shown continuing high levels PSP toxin present in shellfish along the west coast.

“The affected area includes the entire coastline from Motunui (Taranaki) north to Maunganui Bluff (just north of Dargaville), including Kawhia, Aotea, Raglan, Manukau and Kaipara harbours.”

The health warning applies to all bi-valve shellfish including mussels, pipi, tuatua, cockles, oysters, scallops as well as kina.

Paua, crayfish and crabs can still be taken but the gut should be removed before cooking.
Eating shellfish affected by the toxin can cause numbness and tingling around the mouth, face or extremities; difficulty swallowing or breathing; dizziness; double vision; weakness, difficulty walking and in severe cases, paralysis and respiratory failure. There can also be vomiting and or diarrhoea. These symptoms usually occur within 12 hours of a person consuming affected shellfish.