Steve Outlaw is not the only one now!!!

[Ryan S]

Only Steve would try to get high from palys.

[jaddc]

Gotta respect the natural defenses and offenses! There are a lot of marine toxins. Most of them are quite nasty. Doctors treat all toxins in about the same way if the source is not precisely known. Stabilize the patient's vitals. Treat the symptoms. Go from there. Even if they knew it was palytoxin poisoning, that's pretty much all they can do.

 

What makes palytoxin stand out is that it is hard to pinpoint a source. Not all zoanthids produce palytoxin and the ones that do produce them, do so in varying amounts. Some people are very sensitive, others not so much. There is research going on right now to figure this out. That is contrasted to other toxins we know well such as saxitoxins in tainted shellfish (don't harvest your own shellfish), tetrodotoxin in pufferfish (don't prove your manhood by eating puffers), ciguatera in carnivorous reef fish (don't eat lionfish), cnidaria toxins, conotoxin in cone snails... the list goes on.

Edited July 30, 2012 by jaddc

[Jan]

http://www.plosone.o...al.pone.0018235

 

Makes reference to Deeds research above

http://blogs.discove...store-near-you/

 

See Marine Biotoxins in link below. Click on "open access" to read abstract.

http://www.seaweb.or...-2011.php#seven

Tubaro, A., Durando, P., Del Favero, G., Ansaldi, F., Icardi, G., Deeds, J.R., and Sosa, S. Case definitions for human poisonings postulated to palytoxins exposure. Toxicon 57(3): 478-495, 2011.

Read Abstract >> A series of case reports and anecdotal references describe the adverse effects on human health ascribed to the marine toxin palytoxin (PLTX) after different exposure routes. They include poisonings after oral intake of contaminated seafood, but also inhalation and cutaneous/systemic exposures after direct contact with aerosolized seawater during Ostreopsis blooms and/or through maintaining aquaria containing cnidarian zoanthids. The symptoms commonly recorded during PLTX intoxication are general malaise and weakness, associated with myalgia, respiratory effects, impairment of the neuromuscular apparatus and abnormalities in cardiac function. Systemic symptoms are often recorded together with local damages whose intensity varies according to the route and length of exposure. Gastrointestinal malaise or respiratory distress is common for oral and inhalational exposure, respectively. In addition, irritant properties of PLTX probably account for the inflammatory reactions typical of cutaneous and inhalational contact. Unfortunately, the toxin identification and/or quantification are often incomplete or missing and cases of poisoning are indirectly ascribed to PLTXs, according only to symptoms, anamnesis and environmental/epidemiological investigations (i.e. zoanthid handling or ingestion of particular seafood). Based on the available literature, we suggest a "case definition of PLTX poisonings" according to the main exposure routes, and, we propose the main symptoms to be checked, as well as, hemato-clinical analysis to be carried out. We also suggest the performance of specific analyses both on biological specimens of patients, as well as, on the contaminated materials responsible for the poisoning. A standardized protocol for data collection could provide a more rapid and reliable diagnosis of palytoxin-poisoning, but also the collection of necessary data for the risk assessment for this family of toxins.

Edited July 30, 2012 by Jan

[steveoutlaw]

No kidding Jan. When I went to the ER I was coughing up blood and my lungs were collapsing. They said they had no idea what was causing it. I had printed off something that I found on the internet about it and I was basically told I was on my own. They had no idea how to treat it......so they treated my like I had pneumonia. It's been years since that happened and I still have lung issues.

[jaddc]

Two more thoughts:

1) There is some scientific debate as to whether or not Zoas actually produce the toxin (as opposed to bioaccumulate it from another source). The question arises because palytoxin, or its analogs, is also present in Ostreopsis (an algae) and also other reef creatures (zoa predators would make sense...but they also found it in sponges...curious). One hypothesis is that bacteria produce the palytoxin and it bioaccumulates in the reef fauna (makes sense to me). The initial bacteria data was published in 2009, so hopefully more findings will be published soon to complete the picture (the 2009 paper illustrated finding consistent with palytoxin, but did not directly identify the toxin). If the source is bacteria and if Zoas don't produce palytoxin themselves, then perhaps some aquacultured zoas become less toxic over time since they are not continually exposed to it as they would be in the wild. Maybe that could explain the hobby's inability to nail down Zoas which are toxic? Or why people have been fragging these things forever and only a few people get sick?

2) A Google search of "Ostreopsis and aquarium" reveals that some tanks have had confirmed blooms of this dinoflagellate. This could be another source of the toxin. If a tank has blooms of this dino, would that mean the Zoas would become more toxic? Hmmmm. Maybe this could explain mysterious illnesses when working with the tank?

[Jan]

Someone should do a study to include a treatment protocol with algorithms and all for acute exposure to Marine toxins. I can tell you from years of teaching pre hospital emergency care that the knowledge CFR's, EMT's, Paramedics have when treating Enivironmental emergencies and exposures like this is very very limited. We teach support Airway, Breathing, Circulation and transport to the closest 911 receiving hospital. In New York 911 receiving hospitals are capable of treating pretty much any emergency short of the bends (we only have 2 hyperbaric chambers in NY so patients would have to be taken to one of the two). In NY 911 hospitals are filled with all kinds of specialists so they can treat pretty much anything that is brought in. I don't know if this system exists anywhere else outside of New York. I know you have INOVA Hospital center which is a trauma center. Don't know what that means in terms of specialists on call, etc.

 

I wonder if medical staff is more knowledgable along the shores; Virginia (V. Beach, Norfolk), Maryland, Delaware, New Jersey, etc?

 

No kidding Jan. When I went to the ER I was coughing up blood and my lungs were collapsing. They said they had no idea what was causing it. I had printed off something that I found on the internet about it and I was basically told I was on my own. They had no idea how to treat it......so they treated my like I had pneumonia. It's been years since that happened and I still have lung issues.

[jaddc]

I can say that there is always active research on how best to handle toxin related acute illness. Right now, it takes about 1-3 days for palytoxin (or other toxins) to be identified in the lab. Certainly, not in the few minutes when critical decisions by medical staff can save a life.

 

That said, what you wrote is pretty much current protocol, Jan. Neurotoxins act quite fast and in low dosages. The best medical staff can do is to provide basic and advanced life support and IV fluids until the toxin is naturally excreted from the body. Can't breath? Intubate. Heart beat is erratic? Administer appropriate drug. There is no drug that will speed recovery from these toxins.

 

The only thing that can really improve? Post-illness reporting. Patients, doctors and staff should report the case to the health agencies. Clinical samples should be properly collected, stored and shipped to the labs for proper diagnosis and recording. Save evidence so we can work backward to figure out what went wrong. That requires a lot of training and awareness by hospital staff who are often over worked.

Edited July 30, 2012 by jaddc

[Vadim]

I can say that the location of the hospital will make an impact of what the hospital specialize more in. I used to be an EMT in MD, VA, DC. Just in my experience, I've seen the difference in hospitals.

[Jan]

Too bad the DOH and or CDC or some University hasn't taken this on. Would be good to monitor for better intervention and long term effects. May help to dictate how to treat better. Steve has respiratory issues. Interstitial damage? Could it have been avoided with some additional intervention?

 

Could make for a great project for a Scuba Doctor or a Marine Biologist.....even a Marine Biologist in the making, maybe.

 

I can say that there is always active research on how best to handle toxin related acute illness. Right now, it takes about 1-3 days for palytoxin (or other toxins) to be identified in the lab. Certainly, not in the few minutes when critical decisions by medical staff can save a life.

 

That said, what you wrote is pretty much current protocol, Jan. Neurotoxins act quite fast and in low dosages. The best medical staff can do is to provide basic and advanced life support and IV fluids until the toxin is naturally excreted from the body. Can't breath? Intubate. Heart beat is erratic? Administer appropriate drug. There is no drug that will speed recovery from these toxins.

 

The only thing that can really improve? Post-illness reporting. Patients, doctors and staff should report the case to the health agencies. Clinical samples should be properly collected, stored and shipped to the labs for proper diagnosis and recording. Save evidence so we can work backward to figure out what went wrong. That requires a lot of training and awareness by hospital staff who are often over worked.

[Jan]

Always the case everywhere you go. Are there 911 receiving hospitals here with trauma center designation who have specialists on call 24/7? Do you have replantation hospitals, hyperbaric hospitals, etc. nearby? Most places outside of NY patients requiring specilty treatment have to be Medevaced.

 

I can say that the location of the hospital will make an impact of what the hospital specialize more in. I used to be an EMT in MD, VA, DC. Just in my experience, I've seen the difference in hospitals.

[Origami]

Okay, Just to clarify. Only the 2nd pic right? the other 2 are standard button paly that are not toxic?

All zoanthids have some level of toxin in them. It may not be palytoxin and it may not be strong enough to kill you. Since you often won't know, protect yourself with appropriate personal safety equipment and handling procedures. These other ones are just nasty, nasty, nasty. Plus, the picture I referenced is just a "looks like," not necessarily exactly the same. It was just to show you what the ones I was dealing with looked like.

 

I just saw the pictures that Steve linked to. Yep, those are them. Ugly buggers.

[jimlin]

good way to get out of work for a couple of days?

[jaddc]

I do believe there are better ways to get out of work.

[Vadim]

Always the case everywhere you go. Are there 911 receiving hospitals here with trauma center designation who have specialists on call 24/7? Do you have replantation hospitals, hyperbaric hospitals, etc. nearby? Most places outside of NY patients requiring specilty treatment have to be Medevaced.

 

 

 

 

There are centers like that here in DC and MD. I don't believe there are any in VA. I am fairly certain there's only one PARC, I believe 1 level I trauma center 4 trauma II centers and 3 trauma III centers. In my honest opinion If a hospital is a trauma center. you're in good hands. Because the biggest difference in levels of trauma, is dedicated doctors or on call doctors guaranteed to arrive in 30 minutes. PARC is different because it is dedicated facilities and dedicated specialists 24/7. I am not sure if any of the info has changed or not since I was a Volunteer EMT/Firefighter.

[surf&turf]

I do believe there are better ways to get out of work.

 

+1!!