Puffer fish poisoning, or tetrodotoxication from the ingestion of “butete” resulted in three of the four “food poisoning” fatalities in the Western Visayas region on the Philippines, according to officials at Department of Health-6.

Puffer fish Public domain photo/Jh12 via wikimedia commons
Puffer fish
Public domain photo/Jh12 via wikimedia commons

The region saw 37 events of food-borne illnesses in the first eleven months of 2016, which sickened 666 total people and killed four. In a addition to the three tetrodotoxication deaths, one other individual died from shellfish poisoning. All these incidents happened in Negros Occidental, health officials note.

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.

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 flacid paralysis and respiratory failure.

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

Tetraodotoxin is also found in salamanders, newts and other types of animals.

In Cebu, a province in the Central Visayas, the Provincial Health Office (PHO) is reporting a 264 percent increase in dengue fever cases and a 160 percent increase in fatalities.

From Jan. 1 to Dec. 24, 2016, PHO reported 8,969 cases of dengue fever, compared with 2,461 in the same period in 2015, averaging two dozen a day.

Toledo City saw the most cases with 676, followed closely by Carcar City (577), Balamban (554), Talisay city (441) and Consolacion (427).

Cebu declared a dengue outbreak in October.