Paresthesias begin 10-45 minutes after ingestion, usually as tingling of the tongue and inner surface of the mouth. Other common symptoms include vomiting, lightheadedness, dizziness, feelings of doom, and weakness. An ascending paralysis develops, and death can occur within 6-24 hours, secondary to respiratory muscle paralysis. Other manifestations include salivation, muscle twitching, diaphoresis, pleuritic chest pain, dysphagia, aphonia, and convulsions. Severe poisoning is indicated by hypotension, bradycardia, depressed corneal reflexes, and fixed dilated pupils.
Diagnosis is based on clinical symptoms and a history of ingestion.
Although personal importation of fugu into the United States is prohibited, FDA has permitted fugu to be imported and served in Japanese restaurants by certified fugu chefs on special occasions. A cooperative agreement with the Japanese Ministry of Health and Welfare ensures fugu is properly processed and certified safe for consumption before export by the government of Japan. Although arriving travelers are required to declare all food products brought into the United States, control measures rely primarily on the traveler. Persons who travel to countries where fugu is served should be aware of the potential risk of eating this fish. Cornell Maritime Press, 1959.