The threat of paralytic shellfish poisoning means eating shellfish from much of Northland's west coast is akin to playing Russian roulette, Northland's Medical Officer of Health says.
Most shellfish species from the Kaipara Harbour north to Maunganui Bluff remain off limits, Jonathan Jarman said.
Kina, mussels, toheroa, pipi, tuatua, oysters, cockles and scallops in the affected area should not be eaten. Paua, crab and crayfish may be eaten if the gut has been completely removed before cooking.
While there have been no confirmed case of toxic shellfish poisoning in Northland for many years, it can potentially be a very serious disease, Dr Jarman said.
At least 20 people have been poisoned after eating toxin-carrying shellfish collected in the Bay of Plenty last week, with 10 hospitalised and four still seriously ill in hospital.