Once cleaned and sliced for sale, pufferfish is almost impossible to correctly identify. [Representation image] Elena Kuzovkova / EyeEm/Gettyimages

A Malaysian elderly couple died after eating poisonous pufferfish, leading their family to urge for stricter limitations on the dish.

On Mar. 25, according to officials in the southern state of Johor, Ng Chuan Sing and his wife Lim Siew Guan unknowingly purchased at least two pufferfish from an online dealer.

Once cleaned and sliced for sale, pufferfish is almost impossible to correctly identify.

Guan cooked the fish and served it for lunch after the customers had taken their order home.

Soon after, they both experienced "breathing difficulties and shivers," which caused them to be taken to the hospital.

Sing slipped into a coma before dying on Saturday morning, while Guan was declared dead at 7 p.m. local time on the same day despite being admitted to intensive care. Both were in their early 80s.

Ng Ai Lee, the couple's daughter, who gave a news conference at the couple's home on Sunday before their funeral, claimed that Sing was in a coma for eight days until his condition deteriorated and he died on Saturday morning, CNN reported.

At least 30 species of pufferfish are frequently observed in the nearby waters of Malaysia, where Ng requested accountability for her parents' deaths as well as tougher restrictions.

"Those responsible for their deaths should be held accountable under the law and I hope the authorities will speed up investigations," Ng said.

"I also hope the Malaysian government will beef up enforcement and help to raise public awareness on pufferfish poisoning to prevent such incidents from happening again."

"As for sellers, it is debatable on their (part) if they are aware (of the risks)."

"There needs to be more awareness about the risks of consuming puffer fish – maybe authorities need to look at special certifications for vendors and suppliers," she said.

The selling of hazardous and deadly food, such as pufferfish meat, is illegal under Malaysian law, and violators are subject to a fine of RM10,000 ($2,300) or a two-year maximum prison sentence.

Despite the dangers, poisonous pufferfish are sold at many Malaysian wet markets, experts said. "It's considered exotic and tends to attract consumers," said Aileen Tan, a marine biologist and director at the Universiti Sains Malaysia Centre for Marine and Coastal Studies.

In many nations, cooking pufferfish, also known as fugu, is prohibited by strict regulations.

Only chefs with at least three years of expertise are permitted to legally prepare pufferfish in Japan and Korea, where the fish is also prized for its flavor.

The fish, which has high tetrodotoxin levels, continues to be hazardous without the aforementioned training or preparation.

Even though Malaysian law forbids even the selling of hazardous and deadly food, such as pufferfish meat, it is alleged that many wet markets still sell it, Forbes reported.

Records show that between 1985 and 2023, 58 cases of pufferfish poisoning were registered in the nation; 18 of these cases resulted in fatalities.

Public indignation over the couple's deaths has prompted officials to launch an investigation.

"The state district health office has opened investigations under the Food Act 1983... and carried out an investigation on the ground to identify the supplier, wholesaler and seller of the pufferfish," said Ling Tian Soon, chief of the Johor Health and Unity Committee.

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