Scombroid poisoning (scombroid food poisoning or scombroid) is a foodborne illness that is typically caused by consuming spoiled fish, which contains a chemical called histidine. Bacteria can multiply in fish when stored at warm temperatures (59°F) and turn histidine into scombrotoxin (histamine). Histamine is responsible for the symptoms of scombroid poisoning.
Cooking the fish can destroy the causative bacteria but cannot reduce histamine levels. The amount of histamine in the meat varies depending on the part of the spoiled fish. Hence, everyone who eats the meat may not be affected by scombroid poisoning.
Scombroid poisoning does not happen because of an infection or allergy. It is safe to eat the same kind of fish again if it is freshly caught and stored chilled.
This condition is more common in certain types of fish, which have dark meat and a naturally higher level of histidine, such as:
- Butterfly kingfish
Since these fish have higher levels of histidine, there is a higher risk of it being converted to histamine when bacterial growth occurs, resulting in scombroid poisoning. Occasionally, other species of fish may be responsible.
What are the signs and symptoms of scombroid poisoning?
Symptoms of scombroid poisoning usually appear within 10 to 30 minutes of ingesting the fish and can last for about 10 to 14 hours, rarely lasting longer than a day or two. Those with asthma may be at risk of more serious problems.
Initial signs and symptoms (these may resemble an allergic reaction):
- Flushing of the face
- Burning sensation in the mouth and throat
- Nausea, dizziness
- Increased heart rate
- Cold-like symptoms
Other signs and symptoms:
- Facial rash or over the torso and rest of the body
- Intense itching along with a rash
- Generalized edema (water retention and swelling of the body)
- Diarrhea, which is typically short term
- Abdominal cramps
Serious signs and symptoms:
- Blurred vision
- Difficulty breathing
- Wheezing (noisy breathing)
- Respiratory distress
- Swelling of the tongue
In extremely rare cases, scombroid poisoning may result in death.
How is scombroid poisoning diagnosed?
Doctors can make a clinical diagnosis based on history (such as recent fish consumption) and clinical examination. As scombroid poisoning can present symptoms similar to allergic reactions, your doctor may prescribe certain tests.
Blood tryptase levels may also be done. These levels would be elevated during an allergic reaction and normal in scombroid poisoning.
How is scombroid poisoning treated?
Scombroid poisoning is often self-limiting and the symptoms rarely last more than a day or two, so treatment is mainly supportive. Those with giddiness are advised to lie down and rest with their feet partly elevated.
Administering antihistamines, such as H1 blockers and ranitidine (an antacid or H2 blockade), along with intravenous fluids can help those with mild to moderate symptoms to recover faster. In severe cases, epinephrine combined with a steroid may be used.
How to prevent scombroid poisoning
Cooking, smoking, canning or freezing will not destroy histamine that has already formed in the fish. The best way to prevent scombroid poisoning is by ensuring the fish is caught fresh and stored chilled. Antihistamines may be taken before eating seafood if the source and storage of the fish are not known, especially while eating out.
Health Solutions From Our Sponsors
American Academy of Allergy, Asthma & Immunology. Histamine Toxicity. https://www.aaaai.org/Conditions-Treatments/Related-Conditions/histamine-toxicity
Marcus EN. Scombroid (Histamine) Poisoning. UpToDate. https://www.uptodate.com/contents/scombroid-histamine-poisoning
Hungerford JM. Scombroid poisoning: A review. Toxicon. 2010; 56(2): 231-243. https://www.sciencedirect.com/science/article/abs/pii/S0041010110000450
Top What Causes Scombroid Fish Poisoning Related Articles
dimercaprolDimercaprol is used as an antidote for poisoning from minerals including arsenic, gold, and mercury, and concomitantly with edetate calcium disodium to treat acute lead poisoning. Common side effects of dimercaprol include high blood pressure (hypertension), rapid heart rate (tachycardia), chest pain, headache, fever in children, burning sensation in the lips, mouth and throat; tightness and/or pain in the throat, chest or hands; inflammation of the conjunctiva, spasm of eyelids (blepharospasm), watering eyes (lacrimation), nasal discharge (rhinorrhea), nausea, vomiting, salivation, throat swelling and irritation, sore throat, abdominal pain, tingling of hands (paresthesia), anxiety, nervousness, weakness, burning sensation in the penis, excessive sweating (diaphoresis), pain at injection site, painful sterile abscesses, kidney insufficiency, and low count of leukocyte immune cells (leukopenia).
Food PoisoningFood poisoning is common but can also be life-threatening. Food poisoning symptoms include stomach cramps, diarrhea, and vomiting. Read about different types of food poisoning, treatment, and tips for prevention.
Food Poisoning QuizWhat causes food poisoning? Can it be prevented? Take this quiz to learn about food safety and how to guard yourself against food poisoning.
Healthy Living and Disease PreventionThe importance of a healthy lifestyle in disease prevention is widely understood and most people know that lifestyle changes and choices can be critical to good health. Learn about healthy behaviors that constitute healthy living.
How Do You Store Fish?The best way to store fresh fish is on ice. Ice may need to be placed on top of the fish as well as underneath. The ice isn’t just cold; it’s also dry and allows the meltwater and liquid to run off the fish.
Is It a Stomach Virus or Food Poisoning?A stomach virus is also called stomach flu or gastroenteritis. It is a viral infection that infects the tummy and the gut. Food poisoning is also often called gastroenteritis and may present symptoms like stomach virus/stomach flu. However, food poisoning is caused by consuming food or drinks that may be contaminated with bacteria.
How Do I Know If My Fish Is Contaminated by Ciguatera Toxin?Since ciguatoxin is odorless and tasteless, as well as harmless to fish, it is not possible to know if a particular fish is contaminated by ciguatera food poisoning.
praziquantelPraziquantel is an anthelmintic medication used to treat diseases caused by parasitic worm infestations, including schistosomiasis, clonorchiasis, and opisthorchiasis. Common side effects of praziquantel include feeling unwell (malaise), headache, dizziness, excessive sweating (diaphoresis), abdominal discomfort and pain, nausea, vomiting, fever, drowsiness (somnolence), appetite loss (anorexia), and cerebrospinal fluid (CSF) reaction syndrome in patients treated for neurocysticercosis. Consult your doctor if pregnant or breastfeeding.
Salmonella Food Poisoning Treatment, SymptomsWhat is Salmonella? What are the best treatments for Salmonella, and what are its symptoms? From food poisoning to typhoid fever, learn about this common pathogen. Discover how to prepare food without Salmonella risk, and what to do if you get a Salmonella infection.
Stomach Flu vs. Food Poisoning
The stomach flu (viral gastroenteritis) and food poisoning are not the same infections. However, they do have a few similar symptoms, for example:
- Abdominal (stomach) pain and cramping.
Symptoms and signs of food poisoning show up earlier (2 hours up to a couple of days) in comparison to the stomach flu in which symptoms may take 4 hours up to 48 hours (2 days) before symptoms begin. Medical treatment for the stomach flu and food poisoning generally is not necessary. A bland diet, drinking plenty of fluids, and rest may be the only treatment necessary.
What Medicine Helps With Food Poisoning?Learn what medical treatments can help ease your food poisoning symptoms and speed up your recovery. Many cases of food poisoning never get an official diagnosis from the doctor. If you need to visit your doctor for food poisoning, they will diagnose you based on your symptoms. Food poisoning is a common illness that usually resolves within one to two days. Learn the signs of food poisoning, what causes food poisoning, and what you can do to treat food poisoning.
Pregnant? Don't Eat ThisDo you know which common foods may be risky during pregnancy? Learn which foods to avoid, while pregnant, such as queso dip, lunch meat, coffee and more.