More public education is required about poisonous species of puffer fish, say officials, following the hospitalisation of several individuals in Kampong Chhnang province.

Ten people from four families in Phnom Kraing Dey Meas commune’s Dambok Kak village of Rolea Bier district shared a meal containing the dangerous creature, with seven of the diners, including three children, requiring treatment at the provincial referral hospital.

Commune chief Chhorn Senglin said the seven were admitted to hospital on July 4. All but one of the poisoned victims had been discharged by the morning of July 8, he added.

Despite widespread public information campaigns, he noted that puffer fish poisonings continue to occur because people are​​ still unaware of which species are dangerous.

He noted that some vendors and consumers still appear to be ignorant of what type of puffer fish they are dealing with. Senglin believed the fish at the centre of the latest outbreak was purchased at Kampong Chhnang Leu Market.

“Some people still eat dangerous fish. In general, it appears the public are unaware which species are poisonous and which are not. They do not know,” he said.

“The doctors at the hospital identified the type of fish these people ate, and we are sharing this vital information with the public, so we can avoid similar cases in the future,” he added.

In May last year, a 43-year-old man died after consuming puffer fish Tbong Khmum province. Two others who shared the meal with him were also admitted to hospital.

Following the recent incident, the Ministry of Health issued fresh public warnings, including ways to identify the most dangerous species.

“In order to avoid poisoning which could cause health problems or even loss of life, people should avoid certain species of puffer fish. The poison in these fish cannot be eliminated, even when they are cooked or frozen,” the ministry warned, in a July 6 notice.

According to the ministry, five of the nine species of puffer fish found in Cambodia are highly poisonous.

They include carinotetraodon lorteti or redeye, tetraodon biocellatus or eyespot and tetraodon nigroviridis or spotted green, as well as monotrete cochinchinensis and tetraodon fluviatilis.

The poison in these species penetrates the central nervous system and can cause death. The highest levels of toxins are present during the mating seasons, which usually occur in February and March and between July and September.

Symptoms, including itching in the lips and mouth, then headaches, dizziness, a loss of balance, weak muscle, numbness, vomiting and diarrhoea, typically occur from 20 minutes to two hours after consuming the fish.

The ministry added that vomiting may help prevent a victim from absorbing additional toxins, and urged that medical attention be sought as quickly as possible should poisoning be suspected.