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Kellys Fish 1

Fish Allergy or Food Poisoning?

Kelly's fish-1

So you ate that delicious mahi mahi, and had an allergic reaction…so did the others at the table who ate it to!  Was this really an allergic reaction?

Not exactly.  This is called histamine poisoning and can result from the ingestion of foods with high histamine content.  The best example is “Scromboid poisoning” due to the group of fish that is to blame.

  • Scromboid fish include:  tuna, mackerel, skipjack and bonito.
  • Non-scromboid fish that have also been implicated include: mahi mahi, bluefish, amberjack, herring, sardines, marlin and anchovies.

When these fish are not properly refrigerated and they begin to spoil, marine bacteria change histadine in the fish to histamine!   You then are eating histamine!   Symptoms begin within 1 hour of ingestion of such fish and can last for several hours.

What are the symptoms of scromboid/histamine poisoning?

  • Flushing and sweating
  • Nausea, vomiting, abdominal cramps and diarrhea
  • Headache and dizziness
  • Hives
  • Palpitations
  • Metallic, sharp or peppery taste

Diagnosis of scromboid poisoning:

Typically made by a detailed history of symptoms and if others who ate the same food suffered the same fate.  A blood test obtained during the reaction will show elevated histamine levels, but this is not necessary for the diagnosis.

Treatment of scromboid poisoning:

  • Antihistamines:  both H1 antihistamines such as Benadryl® and H2 antihistamines like ranitidine (Zantac®) can be used.
  • Supportive care:  this is a general term that can include rest, intravenous fluids, oxygen, epinephrine, steroids, etc.

Scromboid poisoning is one of those “Restaurant Syndromes” where individuals become sick after eating at a restaurant.  There are other foods that can release histamine, but spoiled fish is the classic prototype.

At Family Allergy & Asthma Care of Montana, we want that holiday tradition of enjoying sardines and herring to be remembered merrily and not as the year the party goers found themselves in the ER.

This information is solely for informational purposes and not intended as a substitute for consultation with a medical professional.

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