By NewsDesk  @bactiman63

Officials in the Tabango municipality in northern Leyte in the Philippines are reporting at least three deaths due to puffer fish poisoning, or butete as it is known in the province.

Puffer fish
Public domain photo/Jh12 via wikimedia commons

In addition to the fatalities, four others were also hospitalized with the food poisoning.

According to a CNN report, initial police investigation showed one of those who died cooked puffer fish on Monday, Dec. 28 and offered it for free to customers of his barbeque stand business. They reportedly ate the liver and experienced extreme vomiting and loss of consciousness. They were brought to the Tabango District Hospital but were pronounced dead on arrival.

Puffer fish poisoning, or tetrodotoxication is an acute and potentially life threatening illness after eating puffer fish, or fugu. The mortality rate of this type of food poisoning is around 60%.

Tetrodotoxin is a heat-stable toxin that is concentrated in the liver, intestines and ovaries of the fish. According to the Ishikawa health service association, tetrodotoxin is nearly 100 times more poisonous than potassium cyanide.

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Symptoms usually begin within an hour or so after ingesting the fish. Symptoms include lethargy, weakness, numbness of the face, lips and extremities, a floating sensation and emesis. These early symptoms are usually quickly followed by flaccid paralysis and respiratory failure.

Patients that survive require respiratory support and fully recover within 48 hours.