Scombroid Fish Poisoning

Scombroid Fish poisoning is an illness characterized by tingling sensation around the lips, generalized red flushing, especially around the face accompanied by nausea, vomiting and diarrhea. The illness is caused by chemical called histamine and is seen soon after ingestion of suspect fish like tuna, mackerel, skipjack, bonito, mahi-mahi, and blue fish.

Where does it occur?

It occurs worldwide, especially in fish like tuna, mackerel, skipjack, bonito, mahi-mahi, bluefish caught and transported from tropical or semi-tropical areas or by recreational fisherman.

How is it transmitted?

By ingestion of fish like tuna, mackerel, skipjack, bonito, mahi-mahi, bluefish etc containing high levels of hisitidine that is converted to histamine which causes the illness. As fish decompose over time due to inadequate cold storage bacteria convert histidine to histamine.

Is it contagious from person to person?

It is not contagious from person to person.

What is the risk for travelers?

The risk is generally low. It is higher if ingesting above categories of fish kept in unrefrigerated settings allowing the formation of histamine as the flesh degenerates. This is seen with recreational fishing as well.

How soon after exposure will I develop symptoms?

Symptoms develop within 5 minutes to an hour after ingestion.

What are the signs and symptoms?

Shortly after ingestion, one can develop a tingling or burning like sensation around the lips. This can be accompanied by reddish flushing of the face, stomach cramps, headache, nausea, vomiting and diarrhea. In severe cases one can see hives and shortness of breath with wheezing.

Are there any lab tests to diagnose the illness?

There are no specific labs tests, but detection of histamine in suspect fish confirms the diagnosis.

Is there any treatment?

Treatment is supportive with fluids and anti-histamine medications like Benadryl.

What preventive measures can be taken?

Avoid eating improperly refrigerated fish especially tuna, mackerel, mahi-mahi, etc.
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