Scombroid Fish Poisoning

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What is scombroid fish poisoning?

Scombroid fish poisoning, or histamine fish poisoning, is a syndrome resembling an allergic reaction that occurs after eating fish contaminated with high levels of histamine.

What are the symptoms?

Symptoms begin within 2 minutes to several hours after eating the fish. The most common symptoms are tingling and burning sensations around the mouth, facial flushing, sweating, nausea, vomiting, headache, palpitations, dizziness, and rash. Sometimes people report that the fish has a peppery or metallic taste.

How long does it last?

Most people have mild symptoms that resolve within a few hours. In some cases, symptoms may last for several days. Treatment is generally not needed; however, for severe cases, or in people with underlying medical conditions, antihistamines may be beneficial.

How do people get scombroid fish poisoning?

Fish in the Scombridae family (tuna, mackerel, skipjack, and bonito) are the most common sources of illness. Other fish, such as mahi mahi, bluefish, marlin, and escolar can also cause scombroid fish poisoning.

When these types of fish are not properly refrigerated, bacteria begin to break down the flesh of the fish and histamines are formed. Histamines are heat-resistant; therefore, illness can occur even with fish that is properly canned or cooked. While some contaminated fish will not show any outward signs of spoilage, others will have a bad odor or a “honey-combed” appearance when cooked. Fish that looks spoiled should not be consumed. Histamine levels may be unevenly distributed throughout the fish, and the amount of histamine needed to cause symptoms may vary from person to person. Therefore, people who share a single contaminated portion of fish may show a wide range of symptoms.

What should I do if I have symptoms?

• Contact your health care provider if your symptoms are severe.

How can I prevent scombroid fish poisoning?

• Refrigerate fish (at 41 o F or less) from the time of capture to the time it is cooked.
• Fish with a bad odor or “honey-combed” appearance should not be consumed.
• Purchase fish only from reputable retail outlets.

How common is scombroid fish poisoning in Minnesota?

The Minnesota Department of Health investigates several outbreaks of scombroid fish poisoning every year.

To report a suspected foodborne illness, call the Minnesota Department of Health Foodborne Illness Hotline at 1-877-FOOD-ILL (or 651-201-5655 from the Twin Cities).