A Japanese city issued an emergency warning Tuesday to prevent people from consuming a type of pufferfish known as fugu, after poisonous parts of the fish were sold by mistake.

A local supermarket in Gamagori city mistakenly sold five packets of fugu fish without taking out the livers, which are extremely poisonous, according to a report by the Japan Times. The poison was reported to be so lethal that if the fish was not cleaned and cooked properly, its consumption can result in death.

The name of the supermarket was not released.

Three fugu fish packets were found, but two were still missing, local official Koji Takayanagi said.

Takayanagi added, “We are calling for residents to avoid eating fugu, using Gamagori city’s emergency wireless system. … Three packages will be retrieved today, but we still don’t know where the remaining two are.”

According to the report, fugu fish is one of the most expensive winter food items in the country and it is served in thin slices with sashimi or hot pot.

However, various parts of the fish which include the skin, intestines, liver and ovaries contain a poison named tetrodotoxin, which can prove fatal. According to a report by Centers for Disease Control and Prevention, the strong neurotoxin found in fugu fish can result in death in 60 percent of the people who consume it.

After 10-45 minutes of ingestion of the fish, the symptoms of poisoning such as lightheadedness, vomiting, dizziness and weakness begin, the report stated. The level of paralysis caused by the poison increases gradually, which leads to death within six to 24 hours.

Other types of manifestations consist of muscle twitching, aphonia, pleuretic chest pain and convulsions. If the body is severely poisoned, the symptoms would include hypotension, depressed corneal reflexes and fixated diagonal pupils.

With relation to diagnosis, the report said there is no particular antitoxin to combat the poison and treatment is supportive. The report added diagnosis will be done depending on the clinical symptoms and a history of ingestion.

As fugu fishes are lethal, the Japanese chefs are required to get a special permit in order to cook the dish, the Japan Times reported.

It also stated numerous people die each year because of improperly cooked fugu fish, while dozens of people manifest nonfatal side effects, as said by the Japanese health ministry.

Regional officials said in the emergency statement, “Eating fugu liver can paralyze motor nerves, and in a serious case cause respiratory arrest leading to death.”

According to the CDC report, importing fugu fish personally into the United States is prohibited. However, the Food and Drug Administration gave permission for the fish to be imported to some Japanese restaurants that had certified fugu chefs to cook the delicacy. 

There is a collaboration between U.S. and the Japanese Ministry of Health and Welfare, which assures the fugu fish imported to the country are processed efficiently and certified safe for consumption.