Suspected Palytoxin Inhalation Exposures Associated With Zoanthid Corals in Aquarium Shops and Homes — Alaska, 2012–2014

Ali K. Hamade, PhD; Sandrine E. Deglin, PhD; Joe B. McLaughlin, MD; Jonathan R. Deeds, PhD; Sara M. Handy, PhD; Ann M. Knolhoff, PhD


Morbidity and Mortality Weekly Report. 2015;64(31):852-855. 

In This Article

Abstract and Introduction


On August 12, 2014, an Anchorage hospital notified the Alaska Section of Epidemiology (SOE) that a middle-aged male resident of Anchorage (patient A) had arrived in the emergency department with possible palytoxin exposure. Patient A complained of a bitter metallic taste, fever, weakness, cough, and muscle pain 7–8 hours after introduction of live zoanthid coral into his home aquarium. Palytoxin, a potent toxin known to produce the reported effects, is contained in zoanthid marine corals.[1,2]

This call prompted SOE to launch an epidemiologic investigation, during which investigators interviewed exposed persons, obtained environmental specimens for testing, and provided advice about avoiding continued exposure. Patient A reported that two persons (patients B and C) who lived with him experienced similar symptoms around the same time. Patient A also reported that the owner of a local aquarium shop knew of numerous reported aquarium-related poisonings associated with suspected palytoxin-containing zoanthids, both through personal experience and through online marine aquarium forums.[3] Patient A reported that the shop's owner believed that he and several of his employees and customers had been previously exposed, some multiple times.

A specimen obtained from patient A's introduced coral, as well as a specimen obtained from the shop, were both positive for palytoxin. An extended investigation identified seven additional Anchorage residents who appeared to have experienced acute palytoxin-related illness during the preceding 2 years. Many aquarium store employees and marine aquarium hobbyists are not aware of palytoxin as a potentially serious hazard associated with handling some zoanthid corals sold in aquarium stores or exchanged by hobbyists. Persons who are likely to handle such organisms should be made aware of the potential health risks so that they understand how to prevent exposure to this potent toxin.