ABSTRACT
Tetrodotoxin (TTX) is an extremely toxic marine neurotoxin naturally present in certain marine 1–5 and terrestrial species. 6–8 Although puffer fish (Tetraodontidae family) is the best-known source of TTX, 9 this compound is not produced by puffer fish itself, but most likely originates from a symbiosis of bacteria with marine animals. 10 The usual route of toxicity in humans is the consumption of contaminated puffer fish, considered one of the most delicious fish in Japan. While intoxication produced by TTX is more typical in Asian countries, the possibility of the migration of these toxic species from the Red Sea to the Mediterranean Sea through the Suez Canal has been reported. 11,12 In addition, tetrodotoxin poisoning outbreaks were described from imported puffer fish or other seafood products worldwide (see the following text).
