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Scombroid Fish Poisoning – The Tale of the Funky Fish

You are on a blind date at a new Hawaiian restaurant. You order the Ahi tuna poke bowl. Thirty minutes into eating you suddenly feel stomach cramps, and your head begins throbbing. Your date asks if you are okay and are allergic to fish because your face is beet red. You feel the sudden urge to defecate, and as you get up to run to the bathroom you note the name of the restaurant, “Scombroid Sam’s”. Scombroid is the common term for histamine fish poisoning. It gets its name from the family of fish Scombridae (tuna, mackerel, other species) which typically cause the poisoning. However, a large variety of fish can cause scombroid, most of them dark meat fish. These fish have high levels of histidine…

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 'Allergic Reactions' to Fish Usually Aren't

This is a relatively new toxicity: Histamine was not proven to be the culprit of scombroid poisoning until 1991. It was previously thought that orally ingested histamine could not be absorbed in sufficient amounts to cause symptoms. Bacteria that normally reside in fish contain an enzyme, histidine decarboxylase, which converts benign histidine to histamine. A variety of bacteria have histidine decarboxylase activity. The exact type and composition of these bacteria vary according to geographic location, fish feeding habits, water temperature, and the handling process. Once the histamine has been formed, it is resistant to cooking, smoking, freezing, canning, and subsequent refrigeration none of these can prevent histamine fish poisoning. The fish will smell or appear fresh, but those with scombroid poisoning might report that it tasted metallic, peppery, spicy, or bubbly.

 Preventing Fish Food Poisoning: Mitigating Histamine Risks in Red Fish Through Proper Refrigeration

One of the significant challenges in mitigating histamine poisoning lies in its inconspicuous nature. Unlike other foodborne illnesses, histamine-contaminated fish typically exhibit no discernible odor or appearance changes, making it difficult for consumers to detect contamination before consumption. Moreover, its symptomatology, often resembling allergic reactions, further complicates prompt recognition and reporting.

 Scombroid Poisoning, Watch Out!

I was given some frozen Albacore yesterday that had been processed by someone in San Diego and frozen. I don't know who yet though. I cooked some tonight and sampled a little of it when it was done. The first bite made my tongue burn. I thought that was a little weird. Then my tongue and whole mouth started to burn. I didn't eat anymore of it. Then about 10 minutes after that my head started hurting really bad and my heartbeat started going really fast. Then my face got red and I started sweating really bad too. Then I realized it was what I had heard about. Scombroid Poisoning.

 Something's Fishy: What You Need to Know About Histamine Poisoning

Imagine for a minute you’ve just gone grocery shopping. You bought canned tuna without checking the sell-by date, and it’s past its prime. You decide to risk it and eat it for dinner. Within an hour, you get a stomachache, hives, and nausea: all symptoms common to allergic reactions. Do you have an undiagnosed fish allergy? Maybe, or it could be something else entirely: histamine poisoning. However, there are several foods that contain already-formed histamine, like fish and fermented foods. When we eat these foods, we usually aren’t ingesting enough histamine to cause harm, as those enzymes in our intestine (primarily DAO) can get rid of a decent amount before it enters the bloodstream. However, if the DAO can’t keep up with the histamine, you’re at risk of histamine poisoning. This can either happen because you’ve eaten excess amounts of histamine—like in expired tuna—or because you have a histamine intolerance, a condition where your body either has insufficient or malfunctioning DAO.

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Catfish With a Side of Scombroid

In the meantime, rather than swearing off fish altogether, remember that excellent seafood is being produced domestically, often in ecologically sound ways, often at only a slight premium over imported prices. American aquaculturists are farming organic shrimp in the desert, growing tilapia in indoor tanks and reseeding the Chesapeake Bay with oysters. Now is the perfect time to splurge on quality.

Explainer: what is scombroid fish poisoning?

Scombroid poisoning arises from the consumption of fish that contains a high level of histamine, a chemical normally produced within our cells in response to an allergen. Not surprisingly, therefore, the symptoms generated are often mistaken for an allergic reaction to the fish itself. High levels of histamine are generated in the flesh of the fish due to bacterial contamination, usually resulting from poor storage conditions, and particularly from inadequate refrigeration. These conditions allow bacteria to proliferate and convert an amino acid called histidine, naturally present in the flesh of the fish, into histamine.

Food Poisoning from Fish: Scombroid

Scombroid poisoning is caused by eating spoiled fish. Ciguatera fish poisoning is caused by eating fish which have themselves eaten fish contaminated with ciguatera. Neither type of fish poisoning can be detected by taste or appearance or prevented by cooking or freezing the fish. Treatment is available but symptoms may last for months or years.

Histamine (Scombroid Poisoning) Fact Sheet

Scombroid food poisoning is caused by ingestion of fish containing high concentrations of histamine, which is a product of the degradation of the amino acid histidine.

Histamine poisoning is not uncommon

Earlier in 2014 two people met a tragic death after eating fish. The culprit was found to be scombroid poisoning. Scombroid poisoning is a now-outdated term for histamine fish poisoning. It is also sometimes known as pseudoallergic fish poisoning, histamine overdose, or mahi-mahi flush. Histamine is colorless, odorless and tasteless. Scombroid fish histamine poisoning is hard to detect without scientific equipment, and can be fatal.

How to manage Scombroid Poisoning

Scombroid poisoning follows eating contaminated fish of the scombroid family and includes mackerel, tuna, albacore, swordfish and bonito. The muscle of all these fish is rich in the amino acid histidine. Contamination due to improper preservation or canning allows bacteria entrance to the flesh of the fish. These bacteria break the histidine down to a poisonous amine called saurine, which has many of the properties of histamine.

Is Rockfish High In Histamine

In addition to its potential histamine levels, rockfish is also valued for its nutritional profile. It is an excellent source of various essential nutrients that are beneficial for overall health and well-being. Rockfish, scientifically known as Sebastes, is a type of fish that belongs to the Scorpaenidae family. It is commonly found in the Pacific Ocean, particularly along the coasts of North America. This versatile fish has gained popularity not only for its delicious taste but also for its impressive nutritional content

Molecular Mechanisms of Scombroid Food Poisoning

Scombroid food poisoning (SFP) is a foodborne disease that develops after consumption of fresh fish and, rarely, seafood that has fine organoleptic characteristics but contains a large amount of exogenous histamine. SFP, like other food pseudo-allergic reactions (FPA), is a disorder that is clinically identical to allergic reactions type I, but there are many differences in their pathogenesis.

Scombroid (Histamine) Poisoning

Symptoms: Burning pepper taste in the mouth and throat, flushing of the face and neck or over heating sensation, edema, face, eyes, intra oral, skin surface, headache, diaphoresis, generalized pruritus, palpitations and nausea.

Scombroid Food Poisoning

Always defrost fish in the refrigerator under controlled temperature conditions. The outside temperature of the fish will easily rise to 16°C if defrosted in a sink of water or a warm kitchen.

Scombroid Poisoning

Scombroid poisoning occurs after the ingestion of fresh, canned or smoked fish with high histamine levels due to improper processing or storage. First described in conjunction with fish in the suborder Scombroidea (e.g., tuna and mackerel), it has since been described with other dark-fleshed fish (e.g., sardines and anchovies). Scombroid poisoning is one of the most common causes of morbidity associated with fish intake.

Scombroid Poisoning: A Practical Approach

Scombroid poisoning is a common cause of food poisoning worldwide. It is caused by ingestion of oily fish contaminated with bacteria that trigger the formation of high concentrations of histamine. Scombroid poisoning manifests mainly as a skin complaint (flushing that spreads downward and/or an erythematous urticarial rash affecting the face and upper trunk). Although the clinical course is usually self-limiting and benign, vascular compromise, bronchospasm, and arrhythmias have been described.

Scombroid Poisoning: Histamine and Bad Fish

The source of scombroid poisoning is from the chemical histamine, which comes naturally from decaying fish. Its name, scombroid, is derived from the fish family Scombroidea, which is comprised of mackeral and tuna, fish most highly linked to scombroid poisoning due. These fish, and others, have high amounts of the amino acid histidine. When the captured and dead fish are exposed to temperatures above 60 ºF (16 ºC) histidine is enzymatically decarboxylated to histamine. This is why fish need to be kept below 40 ºF (4 ºC), to prevent formation of histamine. Histamine, once formed, is not removed or destroyed during cooking, and the signature “honey comb” like flesh and metallic taste can be masked by sauces.

Severe scombroid fish poisoning: An underrecognized dermatologic emergency

An allergic-like reaction in unrelated persons after consuming the same fish should raise the suspicion of scombroid fish poisoning. This disorder is presumably highly underreported and may account for up to 5% of food-borne disease outbreaks.1 The most important differential diagnosis is acute IgE-mediated fish allergy, occasionally also bacterial food contamination.

What you need to know about Scombroid fish poisoning

Scombroid poisoning is frequently misdiagnosed because it can so closely resemble a severe food allergic reaction (anaphylaxis). Symptoms usually appear 10–60 minutes after a person eats contaminated fish. Signs and symptoms include abdominal cramps and diarrhea, blurred vision, flushing of the face and upper body resembling sunburn, severe headaches, itching, and palpitations. Id. One of the differentiating factors between the urticarial rash of scombroid poisoning and allergy is the lack of wheals (patchy areas of skin swelling typically known as hives). Scombroid poisoning usually responds well to antihistamines. Left untreated, symptoms usually resolve within 12 hours but can last up to 48 hours.

When fish poisoning is not a true seafood allergy

Scombroid fish poisoning is an interesting phenomenon in the study of allergies. This is because it is actually a foodborne illness derived from eating spoiled fish instead of a true fish/seafood allergy.

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Life in the Fastlane

The amino acid, histainde, is found in fish cutis and intestines. Histidine is decarboxylated to histamine by primarily enteric gram-negative bacteria (e.g., Morganella morganii, Escherichia coli, Klebsiella species and Pseudomonas aeruginosa). When fish are incorrectly stored, more histamine is produced as a result of bacterial overgrowth. Histamine does not change the smell or appearance of the affected fish and his heat-stable, remaining present after cooking, freezing, canning or smoking.

Resus

The disease is usually self limiting. Supportive treatment and the use of antihistamines H1 and H2 blockers. There may be a place for charcoal early in the presentation and if symptoms are severe and if large quantities of fish have been consumed. So watch that dark fleshed fish.

CalPoison.org

Scombroid poisoning, or histamine fish poisoning, is a type of food poisoning that is similar to symptoms of seafood allergies. The term “scombroid” derives from the type of fish (i.e. Scombridae) first implicated, such as tuna and mackerel. The first report of scombroid poisoning was published in 1830.

Histamine Poisoning from Ingestion of Fish or Scombroid Syndrome

The scombroid syndrome is a pseudoallaergic poisoning caused by the consumption of contaminated fish belonging to the Scombridae family. It is the most common fish poisoning in Europe and in the world since this kind of fish is consumed in large quantities in all the continents: tuna, bonito, and mackerel. The syndrome can also be triggered by different species from the Scombridae family. Examples include mahi-mahi (dolphin fish), sea urchins, herring, sardines, anchovies, and bluefish.

StatPearls

Scombroid poisoning results from eating fish that have been improperly stored. The primary toxic agent implicated in scombroid toxicity is histidine, which is normally found in the dark meat of fish, and breaks down to histamine. In temperatures warmer than 4 degrees Celsius, the fish undergo bacterial overgrowth and subsequently convert histidine to histamine, resulting in very high levels of histamine.