1 Redtide is a marine phenomenon that poses great risk to the health and economic livelihood of people in coastal areas. Paralytic shellfish poisoning develops when a person consumes molluscs containing toxic dinoflagellates and suffers neurological and/or gastrointestinal manifestations. 2 Four redtide incidents in the Philippines are presented. The manner in which the problems were managed are described. 3 The clinical features of redtide poisoning in the Philippines included gastro-intestinal and neurological features with deaths secondary to ventilatory failure. Mortality ranged from 0% to 12% in the different redtide episodes. 4 There are many lessons to be learned in handling this kind of natural disaster. For an effective toxicovigilance programme, there must be a central co-ordinating responsible organization, a clear definition of roles and functions and good inter-agency co-operation. Appropriate surveillance procedures, resources to intensify surveillance at times of risks, prompt warning system, and the ability to impose bans on consumption are also necessary. 5 Poisons centres can play an important role during times of redtide. This may include toxicovigilant activities, such as early warning and educational campaigns to consumers, and seminars in the recognition and management of paralytic shellfish poisoning. 6 The contribution of the epidemiologists in investigating and monitoring the extent of public health damage and patterns of poisoning in a coastal community is emphasized.