The state is warning residents to not eat monkfish for the time being because of shipments from China that were labeled as containing the seafood actually may be puffer fish, which can cause serious illness or death when consumed.

State Department of Health spokeswoman Janice Okubo said about 64 cases of the fish distributed by Hong Chang Corp. were imported into Hawai'i, most of which have been located.

"The majority of that we were told were retained by the local distributor," Okubo said, noting the company was tracing and trying to retrieve the other boxes. She said there have been no reports of illnesses attributed to eating the fish.

The Hawai'i alert came as the U.S. Food and Drug Administration issued warnings of the mislabeled shipments into the U.S.

It said 282 of the white 22-pound boxes marked "Frozen Monkfish Gutted and Head-Off'' were imported into the U.S. starting in September, and were distributed to wholesalers here, in Illinois and California. The fish were then sold to restaurants and stores, the FDA said.

Two people who ate soup made with the fish became ill. One of them was hospitalized.

"Consumers concerned that they may have purchased this fish should contact their retailer and ask if the product was received from Hong Chang Corp.," the FDA said in a statement. The fish in the box are individually wrapped in unlabeled plastic bags.

The FDA said anyone possessing the product should throw it away because puffer fish carry tetrodotoxin, a potentially deadly toxin that is not destroyed by cooking.

Poisoning by tetrodotoxin includes symptoms that begin with tingling of lips and tongue followed by similar sensation in the face and extremities.

This can be followed by headache, problems balancing, nausea and in severe cases, muscle paralyzation and death, the FDA said.

Reach Greg Wiles at gwiles@honoluluadvertiser.com.