Chapter 9 : and Human Health

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Ebook: Choose a downloadable PDF or ePub file. Chapter is a downloadable PDF file. File must be downloaded within 48 hours of purchase

Buy this Chapter
Digital (?) $15.00

Preview this chapter:
Zoom in

and Human Health, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555818418/9781555811686_Chap09-1.gif /docserver/preview/fulltext/10.1128/9781555818418/9781555811686_Chap09-2.gif


Presumptive exposure to toxins produced by , a small dinoflagellate found in mid-Atlantic estuarine waters, emerged as the cause of a novel human health syndrome of impaired cognition associated with skin rash, headache, gastrointestinal symptoms, and respiratory complaints following fish-kill events in Maryland's Chesapeake Bay in 1997. Dinoflagellates meet their nutritional needs either by photosynthesis (autotrophy), phagocytosis of food sources (heterotrophy), or combinations of these strategies (mixotrophy). Blooms of populations of these and other organisms that affect environmental quality and, at times, human health are often considered collectively under the general topic of harmful algal bloom (HAB). Toxin production by marine and estuarine dinoflagellates is responsible for four human health syndromes. Many fish collected during Pfiesteria-related fish-kill events display aberrant swimming behavior and have diffuse epithelial injury, with hemorrhage and necrosis. No consistent or unexpected abnormalities were found on physical examination. As outlined in this chapter, much remains to be learned about the organism, its presumed toxins, the environmental conditions which promote toxin expression, and the mechanisms by which these toxins might cause disease in humans. At the same time, there is an increasing convergence of data which support the idea of a link between exposure to toxins produced by this and related dinoflagellates and the occurrence of illness in humans.

Citation: Oldach D, Grattan L, Morris J. 1999. and Human Health, p 135-151. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 3. ASM Press, Washington, DC. doi: 10.1128/9781555818418.ch9

Key Concept Ranking

Lugol's Iodine
Scanning Electron Microscopy
Positron Emission Tomography
Magnetic Resonance Imaging
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


Image of Figure 1
Figure 1

Scanning electron micrograph of (toxic zoospore, ventral view). Bar, 1 µm. From H. Glasgow and J. Burkholder, North Carolina State University.

Citation: Oldach D, Grattan L, Morris J. 1999. and Human Health, p 135-151. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 3. ASM Press, Washington, DC. doi: 10.1128/9781555818418.ch9
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 2
Figure 2

The Chesapeake Bay and Tangier Sound region (Maryland and Virginia). Fish-kill events associated with human health problems occurred on the Pocomoke, Manokin, and Chicamacomico Rivers during the late summer and fall of 1997. The Chicamacomico River is a small tributary of Fishing Bay.

Citation: Oldach D, Grattan L, Morris J. 1999. and Human Health, p 135-151. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 3. ASM Press, Washington, DC. doi: 10.1128/9781555818418.ch9
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Color Plate 1
Color Plate 1

Characteristic external lesions observed in Atlantic menhaden () collected from the Chicamacomico River during a fish-kill event associated with the toxin-producing dinoflagellate Fish with similar external lesions were observed throughout this region ( Fig. 2 ) during 1997. As noted in the text, histologic evaluation of such lesions has frequently revealed the presence of opportunistic bacterial and fungal pathogens in granuloma formations. Photo courtesy of Ernest Brown.

Citation: Oldach D, Grattan L, Morris J. 1999. and Human Health, p 135-151. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 3. ASM Press, Washington, DC. doi: 10.1128/9781555818418.ch9
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 3
Figure 3

Percentage of study participants with exposure to -related fish kill events scoring below the 8th and 2nd percentiles (in comparison with age- and edutcation-matched national normative data) on the Rey auditory, verbal, learning and memory test. grouped by degree of exposure to waterways with activity.Controls were watermen who worked on ocean waters without potential exposure. Data are from reference .

Citation: Oldach D, Grattan L, Morris J. 1999. and Human Health, p 135-151. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 3. ASM Press, Washington, DC. doi: 10.1128/9781555818418.ch9
Permissions and Reprints Request Permissions
Download as Powerpoint


1. Barker, R. 1998. And the Waters Turned to Blood: the Ultimate Biological Threat. Touchstone Books, New York, N.Y.
2. Boesch, D, E.,, D. M, Anderson,, R. A. Horner,, S. E. Shumway,, P. A. Tester,, and T. E. Whitledge. 1996. Harmful Algal Blooms in Coastal Waters: Options for Prevention, Control, and Mitigation. NOAA Coasral Oceans Program Decision Analysis Series no. 10. Coastal Oceans Office, National Oceanic and Atmospheric Administration, Silver Spring, Md.
3. Boesch, D. E. 1999. Special Report of the Technical Advisory Committee on Harmful Algal Outbreaks in Maryland: Causes and Significance of Menhaden Lesions. Horn Point Environmental Laboratory, University of Maryland, Cambridge.
4. Burkholder, J. M.,, and H. B. Glasgow, Jr. 1997. Trophic controls on stage transformations of a toxic ambush-predator dinoflagellate. J. Eukaryot. Microbial. 44:200205.
5. Burkholder, J. M.,, and H. B, Glasgow, Jr, 1997. Pfiesteria piscicida and other toxic Pfiesteria-like dinoflagellates: behavior, impacts, and environmental controls. Limnol. Oceanogr. 42:10521074.
6. Burkbolder, J. M.,, H. B, Glasgow, Jr.,, and C. W. Hobbs. 1995. Distribution and environmental conditions for fish kills linked to a toxic ambush-predator dinoflagellate. Mar. Ecol. Prog. Ser. 124:4361.
7. Burkholder, J, M.,, E, J. Noga,, C. W, Hobbs,, H. N, Glasgow, Jr.,, and S. A, Smith. 1992. New "phantom" dinoflagellate is the causative agent of major fish estuarine fish kills. Nature 358:407410. (Erratum, 360:768.)
8. Burkbolder, J, M.,, and H, B, Glasgow, Jr. 1995. Interactions of a toxic estuarine dinoflagellate with microbial predators and prey. Arch. Protistenkd. 145:177188.
9. Burkholder, J. M.,, H, B, Glasgow, Jr.,, and A. J, Lewitus, 1998. Physiological ecology of Pfiesteria piscicida, with general comments on 'ambush-predator' dinoflagellates. NATO ASI Ser. Ser. G 44:175191.
10. Burkholder, J, M, 1998. Implications of harmful microalgae and heterotrophic dinoflagellates in management of sustainable marine fisheries. Ecol. Appl. 8(Suppl.):S37S62.
11. Burkholder, J. M.,, M. A. Mallin,, and H. B. Glasgow, Jr. 1999. Pish kills, bottom-water hypoxia, and the toxic Pfiesteria complex in the Neuse River and Estuary. Mar. Ecol. Prog. Sec. 179:301310.
12. Burkholder, J. M.,, H. B. Glasgow, Jr.,, N. J. Deamer-Melia,, and E. K. Hannon. 1999. The 1998 fish kill season: tracking a toxic Pfiesteria outbreak in the Neuse Estuary, North Carolina, USA. In Proceedings of the Winter Meeting of the American Society of Limnology and Oceanography. (Abstract.)
13. Burkholder, J. M.,, and H. B. Glasgow, Jr. Unpublished data.
14. Dykstra, M. J.,, J. F. Levine,, and E. J. Noga. 1989. Ulcerative mycosis: a serious menhaden disease of the southeastern coastal fisheries of the United States. J. Fish Dis. 12: 175178.
15.ECOHAB. 1994. The ecology and oceanography of harmful algal blooms: a national research agenda. Report of a workshop held at Snow Mountain Ranch, Colo., 23 to 28 Augus 11994. [Online.] http://www.redtide.whoi.edu/hab/nationplan/ECOHAB. [12 July 1999, last date accessed.]
16. Englcberg, N. C.,,, J. G. Morris, Jr.,, J. Lewis,, J. P. McMillan,, R. A. Pollard,, and P. A. Blake. 1983, Ciguatera fish poisoning: a major common source outbreak in the U.S. Virgjn Islands, Ann. Intern. Med. 98:336337.
17. Fairey, E. R.,, J. S. Edmunds,, N. J. Deamer-Ylelia,, H. B. Glasgow. Jr.,, F. M. Johnson,, P. R. Moeller,, J. M. Burkholder,, and J. S. Ramsdell. Reporter gene assay for fish-killing activity produced by Pfiestcria piscicida. Environ. Health Perspect.. in press.
18. Gessner, B. D.,, P. Bell,, G. J. Doucette,, E. Moczydlowski,, M. A. Poli,, F. Van Dolah,, and S. Hall. 1997, Hypertension and identification of toxin in human urine and serum following a cluster of mussei-associated paralytic shellfish poisoning outbreaks. Toxicon 35:711722.
19. Gessner, B. D.,, and J. P. Middaugh. 1995. Paralytic shellfish poisoning in Alaska: a 20-year retrospective analysts. Am. J. Epidemiol. 141:766770.
20. Gillespie, N. C.,, R. J. Lewis,, J. H. Pearn,, A. T. C. Bourke,, M. J. Holmes,, J. B. Bourke,, and W. J. Shields. 1986. Ciguatera in Australia: occurrence, clinical features, pathophysiology and management. Med. J. Aust. 145:584590.
21. Glasgow, H. B., Jr.,, J. M, Burkholder,, D. E. Schmechel,, P. A. Ruhlee,, and P. A. Tester. 1995. Insidious effects of a toxic estuarine dinoflagellate on 11sh survival and human health. J. Toxicol. Environ. Health 46:501522.
22. Grattan, L. M.,, D. Oldach,, T. M. Perl,, M. H. Lowitt,, D. L. Matuszak,, C Dickson,, C, Parrott,, R. C. Shoemaker,, C. L. Kauffman,, M. P. Wasserman,, J. R. Hebel,, P. Charache,, and J. G. Morris, Jr, 1998. Learning and memory difficulties after environmental exposure to waterways containing toxin-producing Pfiesteria or Pfiesteria-like dinoHageliates. Lancet 352:532539.
23. Greenberg, D. R.,, J. K. Tracy,, and L. M. Grattan. 1998. A critical review of the Pfiesteria hysteria hypothesis. Md. Med. J. 47:133136.
24. Halegraeff, G. M. 1993. A review of harmful algal blooms and their apparent global increase. Phvcologia 32:7999.
25. Hudnell, H. K. 1998. Human visual function in the North Carolina clinical study on Pfiesteria piscicida. In Abstracts of the Ceres Forum on Pfiesteria and the Environment.
26. Jordan, S. J.,, and E. B. May. 1998. Histological and Microbiological Study Findings on Fish Taken from the Pocomoke River and Adjacent Tributaries. Cooperative Oxford Laboratory, Maryland State Department of Natural Resources, Oxford.
27. Kane, A. S.,, D. Oldach,, and R. Reimschuessel. 1998. Fish lesions in the Chesapeake Bay: Pfiesteria-like dinoflagellates and Olher etioiogies. Md. Med. J. 47:106112.
28. Kempton, J. W. 1999. PCR and FISH assays for the detection of P. piscicida. M.S. thesis. University of North Carolina. Greensboro.
29. Krishnamurthy, T.,, W. W. Carmichael,, and E. W. Sarver. 1986. Toxic peptides from freshwater cyanobacteria (blue-green algae). I. Isolation. purification and characterization of peptides from Microcystis aeruginosa and Anabaena flos-aquae. Toxicon 24:865873.
30. Lange, W. R.,, F. R. Snyder,, and P. J. Fudala. 1992. Travel and ciguatera fish poisoning. Arch. Intern. Med. 152:20492053.
31. Levin, E. D.,, D. E. Schmeehel,, J. M. Burkholder,, H. B. Glasgow, Jr.,, N. J. Deamer.Melia,, V. C. Moser,, and G. J. Harry. 1998. Persisting Ieaming deficits in rats after exposure to Pfiesteria piscicida. Environ. Health Perspect. 105: 13201325.
32. Levin. E. D.,, B. B. Simon,, D. E. Schmechel,, H. B. Glasgow, Jr.,, N. J. Deamer-Melia,, J. M. Burkholder,, V. C. Moser,, K. Jensen,, and G. J. Harry. 1999. Pfiesteria toxin and learning performance. Neurotoxicol. Teratol. 21:215221.
33. Lewitus, A. J.,, R. V. Jesien,, T. M. Kana,, J. M. Burkholder,, H. B. Glasgow, Jr.,, and E. May. 1995. Discovery of the "phantom" dinoflagellate in Chesapeake Bay. Estuaries 18:373378.
34. Lewitus, A. J.,, H. B. Glasgow, Jr.,, and J. M. Burkholder. 1999. Kleptoplastidy in the toxic dinoflagellate Pfiesteria piscicida (Dinophyceae). J. Phycol. 35:303312.
35. Lowitt, M. H.,, and L. Kauffman. 1998. Pfiesteria and the skin: a practical update for clinicians. Md. Med. J. 47:124126.
36. Magnien, R. E.,, J. M. Burkholder,, and H. B. Glasgow, Jr. 1998. Pfiesteria in Chesapeake Bay in 1997, In Proceedings, Annual Summer Meeting, American Society of Limnology and Oceanography. (Abstract.)
37. Marshall, H. (Old Dominion University, Norfolk, Va.). Personal communication.
38. Morris, J. G..Jr. Harmful algal blooms: a model for emergence of pathogenic microorganisms under conditions of ecologic stress. Annu. Rev. Energy Environ., in press.
39. Morris, J. G., Jr., 1995. Natural toxins associated with fish and Shellfish. p. 251256. In M. J. Blaser,. P. D. Smith,, J. I. Ravdin,, H. B. Greenberg,, and R. L. Guerrant (ed.), Infections of the Gastrointestinal Tract. Raven Press, New York, N.Y
40. Morris, J. G., Jr.,, P. Lewin,, N. T. Hargrett,, C. W. Smith,, P. A. Blake,, and R. Schneider. 1982. Clinical features of ciguatera fish poisoning: a study of the disease in the US Virgin Islands. Arch. Intern. Med. 142:10901092.
41. Morris, J. G., Jr.,, P. Lewin,, C. W. Smith,, P. A. Blake,, and R. Schneider. 1982. Ciguatera fish poisoning: epidemiology of the disease on St. Thomas. U.S. Virgin Islands. Am. J. Trap. Med. Hyg. 31:574578,
42. Morris, P. D.,, D. S. Campbell,, T. H. Taylor,, and . J.L. Freeman. 1991. Clinical and epidemiological features of neurotoxic shellfish poisoning in North Carolina. Am. J. Public Health 81:471474.
43. Morris, P. D. 1996. Acute Symptoms Reported by Persons Exposed 10 Fish Kills Associated with Pfiesteria piscicida. Occupational and Environmental Epidemiology Section, Division of Epidemiology, North Carolina State Department of Environment, Health. and Natural Resources. Raleigh.
44. Music, S. I.,, J. T. Howell,, and C. L. Brumback. 1973. Red tide: its public health implications. J. Fla. Med. Assoc. 611:2729.
45. Noga, E. J.,, and M. J. Dykslra. 1986. Oomycete fungi associated with ulcerative mycosis in menbaden, Brevoortia tyrannus (Latrobe). J. Fish Dis. 9:4753.
46. Noga. E. J.,, L, Khoo,, J. B. Stevens,, Z. Fan,, and J. M. Burkholder. 1995. Novel toxic dinoflagellate causes epidemic disease in estuarine fish. Mar. Pollut. Bull. 32:219224.
47. Noga, E. J.,, S. A. Smith,, J. M. Burkholder,, C. Hobbs,, and R. A. Bullis. 1993. A new ichthyotoxic dinoflagellate: cause of acute mortality in aquarium fishes. Vet. Rec. 133:9697.
48. Oldach, D. W.,, E. Brown,, and P. Rublee. 1998. Strategies for environmental monitoring of toxin producing phantom dinoflagellates in the Chesapeake. Md. Med. 1. 47: 113119.
49. Perl, T., M L. Bedard,, T. Kosalsky,, J. C. Hockin,, E. C. D. Todd,, and R. S. Remis. 1990. An outbreak of toxic encephalopathy caused by eating muss.els contaminated with domok acid. N. Engl. J. Med. 322:17751780.
50. Pfiester, L. A.,, and J. Popovsky. 1979. Parasitic, amoeboid dinoflagellates. Nature 279:421424.
51. Popovsky, J.,, and L. A. Pfiester. 1990. Dinophyceae (Dinoflagellida). Gustav Fischer Verlag, Jena, Germany.
52. Shimizu, Y. 1996. Microalgal metabolites: a new perspective. Annu. Rev. Microbial. 50:431465.
53. Smith, S. A.,, E. J. Noga,, and R. A. Bullis. 1998. Mortality in Tilapia aurea due to a toxic dinoflagellate bloom, p. 167168. In Proceedings of the Third International Colloquium on the Pathology of Marine Aquaculture.
54. Steidinger, K. A.,, J. M. Burkholder,, H. B. Glasgow, Jr.,, C. W. Hobbs,, J. K. Garrett,, E. W. Truby,, E. J. Noga,, and S. A. Smith. 1996. Pfiesteria piscicida (Pfiesteriaceae), a new toxic dinoflagellate with a complex life cycle and behavior. J. Phycol. 32:157164.
55. Steidinger, K. A.,, and K. Tangen,. 1996. Dinoflagellates, p. 387584. In C. R. Tomas (ed.), identifying Marine Phytoplankton. Academic Press, Inc., New York, N.Y.
56. Teitelbaum, J. S.,, R. J. Zatorre,, S. Carpenter,, D. Gendrean,, A. C. Evans,, A. Gjedde,, and N. R. Cashman. 1990. Neurologic sequelae of domole acid intoxication due to ingestion of contaminated mussels. N. Engl. J. Med. 322:17811787.
57. Tester, P. A. 1994. Harmful marine phytoplankton and shellfish toxicity. Potential consequences of climate change. Ann. N. Y. Acad. Sci. 740:6976.
58. Todd, E. C. D. 1994. Emerging diseases associated with seafood toxins and other water-borne agents. Ann. N. Y. Acad. Sci. 740:7794.

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error