Scombroid fish poisoning
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Understanding Scombroid Fish Poisoning: Causes, Symptoms, and Prevention
Introduction to Scombroid Fish Poisoning
Scombroid fish poisoning, also known as histamine fish poisoning, is a common seafood-borne illness caused by the ingestion of fish contaminated with high levels of histamine. This condition is most frequently associated with fish from the Scombroidae family, such as tuna, mackerel, and bonito, but can also occur in other fish species1 4 6.
Causes and Pathophysiology of Scombroid Fish Poisoning
Histamine Production in Fish
The primary cause of scombroid fish poisoning is the accumulation of histamine in fish flesh due to bacterial action. When fish are not stored at appropriate temperatures, bacteria such as Escherichia coli and Morganella morganii convert histidine, an amino acid naturally present in fish, into histamine through the action of histidine decarboxylase4 5 6. This process can occur rapidly, sometimes within a few hours if the fish is kept at room temperature3 9.
Histamine as the Causative Toxin
Histamine is identified as the main toxin responsible for scombroid fish poisoning. Studies have shown that individuals who consume contaminated fish exhibit significantly elevated levels of histamine and its metabolites in their urine, confirming histamine's role in the toxicity4. The histamine levels in spoiled fish can far exceed the threshold required to cause symptoms, which is generally considered hazardous at concentrations above 50 mg per 100 g of fish7 9.
Symptoms and Clinical Presentation
Rapid Onset of Symptoms
Symptoms of scombroid fish poisoning typically appear within 10 minutes to 2 hours after consuming the contaminated fish. Common symptoms include flushing, headache, dizziness, rash, nausea, vomiting, diarrhea, abdominal cramps, and a burning sensation in the mouth and throat2 6 7. In severe cases, bronchospasm and respiratory distress may occur, although these are rare9.
Case Studies and Outbreaks
Several case studies and outbreaks have documented the clinical presentation of scombroid fish poisoning. For instance, a 42-year-old man experienced a burning and itching rash, headache, and metallic taste shortly after consuming tuna, with symptoms resolving after antihistamine treatment2. Another outbreak in Taiwan highlighted the rapid production of scombrotoxins in fish stored inadequately, leading to illness after just a few hours at room temperature3.
Prevention and Control Measures
Importance of Proper Storage
Preventing scombroid fish poisoning primarily involves maintaining proper storage conditions for fish. Fish should be kept at low temperatures from the time of capture until consumption to inhibit bacterial growth and histamine production6 9. The EU and US regulations set permissible histamine levels in fish to ensure safety, emphasizing the need for continuous refrigeration and proper handling throughout the supply chain6.
Role of Public Awareness and Safety Standards
Increasing awareness among fishermen, public health officials, restaurant workers, and medical professionals is crucial for preventing scombroid fish poisoning. Establishing and adhering to international safety standards can help mitigate the risk of outbreaks. Public health agencies also play a vital role in monitoring and responding to incidents of scombroid poisoning to protect public health1 6.
Conclusion
Scombroid fish poisoning is a significant food safety concern linked to the consumption of histamine-contaminated fish. Understanding the causes, symptoms, and preventive measures is essential for reducing the incidence of this illness. Proper storage, handling, and increased awareness are key to preventing scombroid fish poisoning and ensuring the safety of seafood consumers worldwide.
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Most relevant research papers on this topic
Histamine (Scombroid) Fish Poisoning: a Comprehensive Review
Scombroid fish poisoning is a common and underrecognized disease, requiring international safety standards and increased awareness to prevent future outbreaks and improve food safety.
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Highly CitedScombroid Fish Poisoning
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Rigorous JournalOutbreak of scombroid fish poisoning, Taiwan.
Scombroid fish poisoning can occur more rapidly than previously thought, with fish stored on ice for two days causing illness after standing at room temperature for only three to four hours.
Case ReportEvidence that histamine is the causative toxin of scombroid-fish poisoning.
Scombroid-fish poisoning is caused by excessive urinary excretion of histamine, likely derived from spoiled fish, with diphenhydramine effectively alleviating symptoms.
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Scombrotoxic fish poisoning (SFP) is caused by consuming contaminated fish from the Scombroid family, with symptoms typically resolving within 24 hours, and is more common during the summer months.
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Scombroid fish poisoning, caused by bacterial degradation of blue fish flesh, can cause severe symptoms and potentially life-threatening complications, with short incubation periods and potential for cross-contamination.
Case ReportAn Outbreak of Scombroid Fish Poisoning Associated with Consumption of Yellowtail Fish in Seoul, Korea
Scombroid fish poisoning outbreak in Seoul, Korea, was linked to yellowtail steak consumption, highlighting the need for detailed food safety guidelines.
Observational StudyRigorous JournalScombroid poisoning from tilapia.
Scombroid poisoning can occur after eating tilapia, a light meat freshwater fish, when inadequate refrigeration allows histidine to convert to histamine, causing acute flushing of the face, upper torso, and back.
Case ReportRigorous JournalScombroid poisoning A report of seven cases involving the Western Australian salmon,: Arripis truttaceus
Scombroid poisoning occurred in seven patients due to ingestion of Western Australian salmon, Arripis truttaceus, caught in South Australian waters in March.
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