This toxin, named after its initial isolation from the Alaskan butter clam, causes rapid onset of perioral paresthesias, numbness, a sensation of floating as well muscular weakness and cranial nerve dysfunction was responsible for 31 cases and 2 deaths in the Philippines in 2013.
In July 2013, there was a cluster of 31 cases and two deaths of paralytic shellfish poisoning from Tarangnan, Western Samar. The outbreak was caused by the consumption of green mussel broth contaminated by saxitoxin. (Ching PK et al. Lethal Paralytic shellfish poisoning from consumption of green mussel broth, Western Samar, Philippines, August 2013. Western Pac Surveill Response J 2015. 8; 6(2): 22-26. doi: 10.5365/WPSAR.2015.6.1.004)