J Korean Soc Clin Toxicol.  2019 Jun;17(1):1-6. 10.22537/jksct.2019.17.1.1.

Scombroid Fish Poisoning and Histamine Food Poisoning

Affiliations
  • 1Department of Emergency Medicine, Yonsei University Medical College, Seoul, Korea. emstar@yuhs.ac

Abstract

Scombroid fish poisoning (SFP) is a form of histamine food poisoning caused by the ingestion of improperly stored fish. The term "scombroid" derives from the family name of the fish family first implicated, such as tuna and mackerel. On the other hand, non-scombroid fish species, such as sardine and herring, can also cause histamine poisoning. The histamine is converted from histidine by a bacterial enzyme in the causative fish. Because the symptoms of SFP can easily be confused with food allergies, it is believed to have been significantly under-reported. In 2016, an outbreak of SFP occurred among primary school students who had eaten yellowtail steak in Korea. The most common findings consisted of a rapid onset of flushing of the face and trunk, erythematous and urticarial rash, diarrhea, and headache occurring soon after consuming the spoiled fish. Usually, the course is self-limiting and antihistamines can be used successfully to relieve symptoms, but several life-threatening SFP cases have been reported. Clinical toxicologists should be familiar with SFP and have competency to make a differential diagnosis between fish allergy and histamine poisoning. SFP is a histamine-induced reaction caused by the ingestion of histamine-contaminated fish, whereas a fish allergy is an IgE-mediated reaction. This review discusses the epidemiology, pathophysiology, diagnosis, treatment, and preventive measures of SFP.

Keyword

Scombrotoxin; Histamine; Foodborne diseases

MeSH Terms

Diagnosis
Diagnosis, Differential
Diarrhea
Eating
Epidemiology
Exanthema
Flushing
Food Hypersensitivity
Foodborne Diseases*
Hand
Headache
Histamine Antagonists
Histamine*
Histidine
Humans
Hypersensitivity
Korea
Perciformes
Poisoning*
Tuna
Histamine
Histamine Antagonists
Histidine
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