Something Fishy: Puffer fish, the toxic delicacy which killed a Malaysian woman

An 83-year-old woman in Malaysia has died while her husband lies in a coma after the two of them ate a puffer fish.

The incident took place in Johor on 25 March when the 84-year-old man bought the fish unknowingly from a fishmonger as there were only a few selections left.

Soon after eating the fish, he and his wife experienced shortness of breath and shivering. They were rushed to hospital but halfway through the journey, the wife passed away.

Puffer fish, aka fugu or blowfish, have spines on their skin to ward off predators. With their large eyes, protruding teeth and colourful bodies, puffer fish are found in Asia, Africa, and the Americas.

There are 120 different species of puffer fish and they range from one-inch long to two feet. They are scaleless fish and usually have rough to spiky skin. 

Puffer fish are considered to be the second most poisonous vertebrate in the world, after the golden poison frog.

Its internal organs, and sometimes the skin, contain tetrodotoxin, which is potent to other fish and also to humans. It is up to 1,200 times more poisonous than cyanide.

The fish contains enough Tetrodotoxin to kill 30 adult humans. There is still no known antidote to this toxin.

Despite this, there are about 22 types of puffer fish used for food in Japan as they are high in protein and low in calories, and have nutrients such as vitamins and minerals.

Wild torafugu is often found at high-end restaurants across the world, where it’s served as perfectly thinly sliced sashimi, deep-fried, and even used to make a hot sake called hirezake.

The Japanese government tightly control who can prepare fugu, and chefs need to take an extensive exam before they’re legally allowed to serve the fish.

Out of total 295 puffer fish poisoning incidents, three people died after eating fugu between 2008 and 2018 in Japan. In Malaysia, there have been 58 poisoning incidents in the last 38 years, 18 of which resulted in death.

The US FDA says symptoms of poisoning start within 20 minutes-two hours after eating. It includes tingling of the lips, mouth, dizziness, speaking problems, muscle weakness, paralysis, vomiting, and diarrhoea. In severe cases, death can result from respiratory paralysis.

The most horrifying and deadly component of the neurotoxin is that it impedes the body’s muscle function, which means your muscles freeze up and don’t function anymore.