Scombroid
Encyclopedia
Scombroid
food poisoning is a foodborne illness
that results from eating spoiled (decayed) fish
. It is the second most common type of seafood poisoning, second only to ciguatera
. However it is often missed because it resembles an allergic reaction. It is most commonly reported with mackerel
, tuna
, bluefish
, mahi-mahi
, bonito
, sardine
s, anchovies, and related species of fish that were inadequately refrigerated or preserved after being caught. The syndrome derived its name because early descriptions of the illness noted an association with Scombroidea fish (eg, large dark meat marine tuna, albacore, mackerel); however, the Centers for Disease Control and Prevention (CDC) have identified the largest vector to be nonscombroid fish, such as mahi-mahi and amberjack. Scombroid syndrome can result from inappropriate handling of fish during storage or processing. One of the toxic agents implicated in scombroid poisoning is histamine
. Other chemicals have been found in decaying fish flesh, but their association with scombroid fish poisoning has not been clearly established.
exists naturally in many types of fish, and at temperatures above 16°C (60°F) on air contact it is converted to the biogenic amine histamine
via the enzyme histidine decarboxylase
produced by enteric bacteria including Morganella morganii
(this is one reason why fish should be stored at low temperatures). Histamine is not destroyed by normal cooking temperatures, so even properly cooked fish can be affected. Histamine is a mediator of allergic reactions, so the symptoms produced are those one would expect to see in severe allergic responses.
, diarrhea
, palpitations, a sense of unease, and, rarely, collapse or loss of vision. Symptoms usually occur within 10-30 minutes of ingesting the fish and generally are self-limited. Physical signs may include a diffuse blanching erythema
, tachycardia
, wheezing, and hypotension
or hypertension
. People with asthma are more vulnerable to respiratory problems such as wheezing or bronchospasm
s.
Symptoms of poisoning can show within just minutes, and up to two hours, following consumption of a spoiled dish. Symptoms usually last for approximately four to six hours and rarely exceed one to two days.
with the following symptoms:
s) blocking medications can also be given with some success. Oral anti-histamines are very effective, showing improvement wihin 10-15 minutes.
Scombridae
Scombridae is the family of the mackerels, tunas, and bonitos, and thus includes many of the most important and familiar food fishes. The family consists of about 55 species in 15 genera and two subfamilies...
food poisoning is a foodborne illness
Illness
Illness is a state of poor health. Illness is sometimes considered another word for disease. Others maintain that fine distinctions exist...
that results from eating spoiled (decayed) fish
Fish
Fish are a paraphyletic group of organisms that consist of all gill-bearing aquatic vertebrate animals that lack limbs with digits. Included in this definition are the living hagfish, lampreys, and cartilaginous and bony fish, as well as various extinct related groups...
. It is the second most common type of seafood poisoning, second only to ciguatera
Ciguatera
Ciguatera is a foodborne illness caused by eating certain reef fishes whose flesh is contaminated with toxins originally produced by dinoflagellates such as Gambierdiscus toxicus which lives in tropical and subtropical waters. These dinoflagellates adhere to coral, algae and seaweed, where they are...
. However it is often missed because it resembles an allergic reaction. It is most commonly reported with mackerel
Mackerel
Mackerel is a common name applied to a number of different species of fish, mostly, but not exclusively, from the family Scombridae. They may be found in all tropical and temperate seas. Most live offshore in the oceanic environment but a few, like the Spanish mackerel , enter bays and can be...
, tuna
Tuna
Tuna is a salt water fish from the family Scombridae, mostly in the genus Thunnus. Tuna are fast swimmers, and some species are capable of speeds of . Unlike most fish, which have white flesh, the muscle tissue of tuna ranges from pink to dark red. The red coloration derives from myoglobin, an...
, bluefish
Bluefish
The bluefish , called tailor in Australia, is a species of popular marine gamefish found in all climates. It is the sole species of the Pomatomidae family....
, mahi-mahi
Mahi-mahi
The mahi-mahi or common dolphinfish is a surface-dwelling ray-finned fish found in off-shore temperate, tropical and subtropical waters worldwide. It is one of only two members of the Coryphaenidae family, the other being the pompano dolphinfish...
, bonito
Bonito
Bonito is a name given to various species of medium-sized, predatory fish in the Scombridae family. First, bonito most commonly refers to species in the genus Sarda, including the Atlantic bonito and the Pacific bonito ; second, in Japanese cuisine, bonito refers to the skipjack tuna , which, in...
, sardine
Sardine
Sardines, or pilchards, are several types of small, oily fish related to herrings, family Clupeidae. Sardines are named after the Mediterranean island of Sardinia, around which they were once abundant....
s, anchovies, and related species of fish that were inadequately refrigerated or preserved after being caught. The syndrome derived its name because early descriptions of the illness noted an association with Scombroidea fish (eg, large dark meat marine tuna, albacore, mackerel); however, the Centers for Disease Control and Prevention (CDC) have identified the largest vector to be nonscombroid fish, such as mahi-mahi and amberjack. Scombroid syndrome can result from inappropriate handling of fish during storage or processing. One of the toxic agents implicated in scombroid poisoning is histamine
Histamine
Histamine is an organic nitrogen compound involved in local immune responses as well as regulating physiological function in the gut and acting as a neurotransmitter. Histamine triggers the inflammatory response. As part of an immune response to foreign pathogens, histamine is produced by...
. Other chemicals have been found in decaying fish flesh, but their association with scombroid fish poisoning has not been clearly established.
Causes
Unlike many types of food poisoning, this form is not brought about by ingestion of a bacterium or virus. HistidineHistidine
Histidine Histidine, an essential amino acid, has a positively charged imidazole functional group. It is one of the 22 proteinogenic amino acids. Its codons are CAU and CAC. Histidine was first isolated by German physician Albrecht Kossel in 1896. Histidine is an essential amino acid in humans...
exists naturally in many types of fish, and at temperatures above 16°C (60°F) on air contact it is converted to the biogenic amine histamine
Histamine
Histamine is an organic nitrogen compound involved in local immune responses as well as regulating physiological function in the gut and acting as a neurotransmitter. Histamine triggers the inflammatory response. As part of an immune response to foreign pathogens, histamine is produced by...
via the enzyme histidine decarboxylase
Histidine decarboxylase
Histidine decarboxylase is the enzyme that catalyzes the reaction that produces histamine from histidine with the help of vitamin B6 as follows:C6H9N3O2 → C5H9N3 + CO2...
produced by enteric bacteria including Morganella morganii
Morganella morganii
Morganella morganii is a species of Gram-negative bacillus bacteria. It is oxidase-negative and conducts anaerobic respiration. It causes a disease known as Summer Diarrhea....
(this is one reason why fish should be stored at low temperatures). Histamine is not destroyed by normal cooking temperatures, so even properly cooked fish can be affected. Histamine is a mediator of allergic reactions, so the symptoms produced are those one would expect to see in severe allergic responses.
Symptoms
Symptoms consist of skin flushing, throbbing headache, oral burning, abdominal cramps, nauseaNausea
Nausea , is a sensation of unease and discomfort in the upper stomach with an involuntary urge to vomit. It often, but not always, precedes vomiting...
, diarrhea
Diarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...
, palpitations, a sense of unease, and, rarely, collapse or loss of vision. Symptoms usually occur within 10-30 minutes of ingesting the fish and generally are self-limited. Physical signs may include a diffuse blanching erythema
Erythema
Erythema is redness of the skin, caused by hyperemia of the capillaries in the lower layers of the skin. It occurs with any skin injury, infection, or inflammation...
, tachycardia
Tachycardia
Tachycardia comes from the Greek words tachys and kardia . Tachycardia typically refers to a heart rate that exceeds the normal range for a resting heart rate...
, wheezing, and hypotension
Hypotension
In physiology and medicine, hypotension is abnormally low blood pressure, especially in the arteries of the systemic circulation. It is best understood as a physiologic state, rather than a disease. It is often associated with shock, though not necessarily indicative of it. Hypotension is the...
or hypertension
Hypertension
Hypertension or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. What that means is that the heart is having to work harder than it should to pump the blood around the body. Blood pressure involves two measurements, systolic and...
. People with asthma are more vulnerable to respiratory problems such as wheezing or bronchospasm
Bronchospasm
Bronchospasm or a bronchial spasm is a sudden constriction of the muscles in the walls of the bronchioles. It is caused by the release of substances from mast cells or basophils under the influence of anaphylatoxins...
s.
Symptoms of poisoning can show within just minutes, and up to two hours, following consumption of a spoiled dish. Symptoms usually last for approximately four to six hours and rarely exceed one to two days.
Initial
The first signs of poisoning suggest an allergic reactionAllergy
An Allergy is a hypersensitivity disorder of the immune system. Allergic reactions occur when a person's immune system reacts to normally harmless substances in the environment. A substance that causes a reaction is called an allergen. These reactions are acquired, predictable, and rapid...
with the following symptoms:
- facial flushing/sweating
- burning-peppery taste sensations in the mouth and throat
- dizziness
- nausea
- headache
- tachycardia
- cold like symptoms
Additional symptoms
The above symptoms can advance to the following:- facial rashRashA rash is a change of the skin which affects its color, appearance or texture. A rash may be localized in one part of the body, or affect all the skin. Rashes may cause the skin to change color, itch, become warm, bumpy, chapped, dry, cracked or blistered, swell and may be painful. The causes, and...
- torso or body rash. The rash associated with scombroid poisoning is a form of urticariaUrticariaUrticaria is a kind of skin rash notable for pale red, raised, itchy bumps. Hives is frequently caused by allergic reactions; however, there are many non-allergic causes...
, but most commonly does not include wheals (patchy areas of skin-swelling also known as hives) that may be seen in true allergies. - edemaEdemaEdema or oedema ; both words from the Greek , oídēma "swelling"), formerly known as dropsy or hydropsy, is an abnormal accumulation of fluid beneath the skin or in one or more cavities of the body that produces swelling...
(this is generalized if it occurs at all) - short-term diarrheaDiarrheaDiarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...
- abdominal cramps.
Severe
In the worst cases, the poisoning may cause:- blurred vision
- respiratory stress
- swelling of the tongue
Treatment
Treatment is in the form of supportive care such as fluids and oxygen. H1 and H2 receptor (histamine receptorHistamine receptor
The histamine receptors are a class of G protein-coupled receptors with histamine as their endogenous ligand.There are four known histamine receptors:*H1 receptor*H2 receptor*H3 receptor*H4 receptor-Comparison:...
s) blocking medications can also be given with some success. Oral anti-histamines are very effective, showing improvement wihin 10-15 minutes.
External links
- Overview at Clemson UniversityClemson UniversityClemson University is an American public, coeducational, land-grant, sea-grant, research university located in Clemson, South Carolina, United States....
- Seafood Network Information Center
- Center for Disease Control: Food Poisonings from Marine Toxins