The effects of tetrodotoxin poisoning include shortness of breath, numbness, tingling, lightheadedness, paralysis and irregular heartbeat. Symptoms typically onset quickly, minor ones instantaneously. Death may occur in minutes and is the usual outcome. Although the toxin unbinds from channels as its concentration around nerves diminishes, the molecules are exceptionally potent and unbind only very slowly. Treatment usually consists of respiratory assistance. Nothing equivalent to an antivenom has been developed--presumably because the toxin acts quickly and binds with an affinity that isn't easily overcome.
Common causes of tetrodotoxin poisoning include the eating of the puffer fish known as fugu, which is a popular but rare delicacy in Japan and often contains significant amounts of toxin in its liver and other viscera. Cone snail stings represent another common source, which most often affect divers. Blue-ringed octopus, which inhabit tidepools, also sometimes contain the toxin, and people have died from their bites.
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