A welder from a riverside barangay in Virac died at the provincial hospital last Monday morning just hours after eating “butete” or pufferfish during a drinking session on his mother’s first death anniversary.
Ely Agunday Teruel, who was to turn 32 next month, was declared dead on arrival at the Eastern Bicol Medical Center at about 2 AM of Jan. 27, 2025.
He had shared the pufferfish’s liver (katoy) with his father-in-law, Salvador San Juan, 57, who was also brought to the hospital but is now recovering.
According to the victim’s live-in partner, the family had gone to the sea to swim on Sunday and Teruel was given a “butete” about the size of a man’s leg by a resident of Cabihian.
The fish, cooked in coconut milk and soy sauce, was served as “pulutan” during the drinking session at the family residence in barangay Sto. Cristo as they marked the one-year anniversary of the death of Teruel’s mother.
His wife, their eight-year-old child, and her 56-year-old mother also tasted the cooked fish but ate only the flesh.
It was the internal organs, particularly the liver, which Ely and Salvador divided during the gathering that late afternoon.
Shortly after midnight, Ely reportedly awoke and complained of numbness. His wife went to the neighboring house to inform her father Salvador but also found out that the latter was experiencing the same symptoms.
Teruel was the first to be brought on board a tricycle to the hospital where the contents of his stomach was reportedly pumped out in a bid to remove the toxin but to no avail.
By the time Salvador was rushed to the emergency room, Teruel was already at the morgue.
The victim’s child, who ate the flesh of the fish but did not suffer symptoms along with her grandmother, was checked at the hospital as a precaution.
Representatives of the Bureau of Fisheries and Aquatic Resources (BFAR) went to the Teruel residence to investigate the incident and secure the remaining portion of the cooked “butete” for laboratory examination.
About 20 years ago, the BFAR imposed a permanent ban on the gathering, marketing and consumption of two species of “butete” or pufferfish with scientific names of Lagocephalus lunaris and Lagocephalus lagocephalus to avoid poisoning incidents. The ban likewise covered certain species of goby fish (Gobius criniger) or “biya” in Tagalog.
Both fish, the BFAR directive said, naturally contain tetrodotoxin (TTX), for which there is no known antidote. This renders the fish species not edible and unfit for consumption, it stressed.
For its part, the Department of Health (DOH) has previously advised the public not to eat puffer fish, as they contain the toxins tetrodotoxin and saxitoxin that affect the central nervous system.
The toxins are 1,200 times deadlier than cyanide, it said, with the toxins typically found in the liver, gonads, intestines, and skin.
“Freezing and thawing of the fish prior to removal of the organs containing the toxins may result in the toxin’s migration to the flesh of the fish,” the advisory said, pointing out that the toxins are not eliminated by cooking or freezing.
Symptoms of puffer fish poisoning are tingling sensation in the lips and mouth followed by dizziness; tingling sensation in the extremities; difficulty speaking and maintaining balance; muscle weakness and paralysis; vomiting and diarrhea. In severe intoxications, respiratory paralysis can lead to death.
In Japan, where the pufferfish or “fugu” is eaten as a delicacy, only trained professionals can remove the toxin-containing organs of the fish and special training and certification is provided to establishments that handle the fish. There is no such facility in the Philippines.