Scombroid food poisoning | |
---|---|
Other names | Scombrotoxin fish poisoning, scombroid syndrome,[1] scombroid,[2] histamine fish poisoning,[1] scombroid poisoning[3] |
Histamine | |
Specialty | Emergency medicine |
Symptoms | Flushed skin, headache, itchiness, blurred vision, abdominal cramps, diarrhea[2] |
Usual onset | After 10 to 60 min[2] |
Duration | Up to 2 days[2] |
Causes | Eat fish high in histamine due to improper processing[2] |
Risk factors | Tuna, mackerel, mahi mahi, sardine, anchovy, herring, bluefish, amberjack, marlin.[2] |
Diagnostic method | Typically based on symptoms, blood tryptase[2][1] |
Differential diagnosis | Allergic reaction,[2] fish allergy[1] |
Treatment | Antihistamines, epinephrine[2][3] |
Frequency | Relatively common[2] |
Deaths | Very rare[3] |
Scombroid food poisoning, also known as simply scombroid, is a foodborne illness that typically results from eating spoiled fish.[2][4] Symptoms may include flushed skin, sweating, headache, itchiness, blurred vision, abdominal cramps and diarrhea.[2][5] Onset of symptoms is typically 10 to 60 minutes after eating and can last for up to two days.[2] Rarely, breathing problems, difficulty swallowing, redness of the mouth, or an irregular heartbeat may occur.[2][5]
Scombroid occurs from eating fish high in histamine due to inappropriate storage or processing.[2] Fish commonly implicated include tuna, mackerel, mahi mahi, escolar, sardine, anchovy, bonito, herring, bluefish, amberjack, and marlin.[2][6] These fish naturally have high levels of histidine, which is converted to histamine when bacterial growth occurs during improper storage.[2] Subsequent cooking, smoking, or freezing does not eliminate the histamine.[2] Diagnosis is typically based on the symptoms and may be supported by a normal blood tryptase.[2][1] If a number of people who eat the same fish develop symptoms, the diagnosis is more likely.[2]
Prevention is by refrigerating or freezing fish right after it is caught.[2] Treatment is generally with antihistamines such as diphenhydramine and ranitidine.[2] Epinephrine may be used for severe symptoms.[3] Along with ciguatera fish poisoning, it is one of the most common type of seafood poisoning.[2] It occurs globally in both temperate and tropical waters.[2] Only one death has been reported.[3] The condition was first described in 1799.[1]