Table 1. Cyanobacterial toxins, effects, signs and symptoms of poisoning, and therapy

Toxin	Acute effect	Signs and Symptoms	Therapy
Anatoxin-a	Neurotoxicity	Humans: not documented. Animals: progression of muscle fasciculations, decreased movement, abdominal breathing, cyanosis, convulsions, death. Birds: opisthotonos ("s"-shaped neck).	Supportive care. Respiratory support may allow time for detoxification and respiratory recovery.
Anatoxin-a (s)	Neurotoxicity	Humans: not documented. Pigs: hypersalivation, mucoid nasal discharge, tremors, fasciculations, ataxia, diarrhea, recumbency. Ducks: regurgitation, paresis, opisthotonos, clonic seizures. Mice: lacrimation, hypersalivation, urination, defecation, death from respiratory arrest. Rats: red-pigmented ears.	Supportive care.
Cylindrospermopsin	Hepatotoxicity, renal toxicity, chromosome breakage, aneuploidy	Humans: enlarged liver, malaise, anorexia, vomiting, headache. Mice: huddling, anorexia, slight diarrhea, gasping respiration.	Supportive care.
Microcystins	Hepatotoxicity	Humans: elevated gamma-glutamyl transpeptidase. Humans, mice: elevated alanine aminotransferase. Rats: embryo lethality, teratogenicity. Mammals: weakness, reluctance to move, anorexia, pallor of extremities and mucous membranes, mental derangement, survivors may be photosensitized.	Humans: powdered charcoal, supportive care. Animals: cholestyramine.
Nodularin	Hepatotoxicity	Humans: Skin and eye irritation from skin contact. Experimental systems: inhibition of protein phosphatases, tumor-promoter.	Supportive care.
Saxitoxin, neosaxitoxin	Neurotoxicity	Humans: paresthesia and numbness of lips and mouth within ½ to 3 hours after exposure, extending to face, neck, extremities; motor weakness; incoordination; respiratory and muscular paralysis. Animals: incoordination, death by respiratory failure.	Activated charcoal, artificial respiration. Supportive care.