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Scombroid fish poisoning in Israel, 2005-2007.
Isr Med Assoc J. 2008 Nov; 10(11):789-92.IM

Abstract

BACKGROUND

Scombroid fish poisoning is an acute illness caused by consumption of fish containing high concentrations of histamine. Improper handling of fish leads to bacterial contamination. Bacterial enzymes convert histidine to histamine. Symptoms develop quickly and resemble an immunoglobulin E-mediated allergic reaction. The diagnosis is often missed. Serious complications (e.g., bronchospasm, hypotension) are infrequent.

OBJECTIVES

To evaluate the prevalence and characteristics of scombroid fish poisoning in Israel as reported to the national poison information center.

METHODS

We conducted a retrospective poison center chart review from January 2005 to December 2007.

RESULTS

During the study period, 21 events of scombroid poisoning involving 46 patients were recorded. Tuna was the commonest fish consumed (84.7%). Clinical manifestations developed within 20 minutes in 65.2% of the patients. The main clinical manifestations included rash (41%), flushing (37%), gastrointestinal complaints (37%) and headache (30.4%). About 25% had abnormal vital signs; two patients developed hypotension. Treatment was supportive and included mainly H1-antagonists (65.2%) and fluids (13%). Five patients were initially misdiagnosed as having an allergic reaction and were treated with corticosteroids (four patients) and epinephrine (one patient).

CONCLUSIONS

Scombroid fish poisoning should be suspected in patients with histamine-like manifestations that are temporally related to fish (mainly tuna) consumption, especially in outbreaks. Although scombroid poisoning is often self-limited and responds well to antihistamines, prolonged observation may be required as severe toxicity can supervene. Proper handling of fish and urgent notification of the Ministry of Health are mandatory in order to prevent this potentially serious public heath problem.

Authors+Show Affiliations

Israel Poison Information Center, Rambam Health Care Campus, Haifa, Israel.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19070288

Citation

Lavon, Ophir, et al. "Scombroid Fish Poisoning in Israel, 2005-2007." The Israel Medical Association Journal : IMAJ, vol. 10, no. 11, 2008, pp. 789-92.
Lavon O, Lurie Y, Bentur Y. Scombroid fish poisoning in Israel, 2005-2007. Isr Med Assoc J. 2008;10(11):789-92.
Lavon, O., Lurie, Y., & Bentur, Y. (2008). Scombroid fish poisoning in Israel, 2005-2007. The Israel Medical Association Journal : IMAJ, 10(11), 789-92.
Lavon O, Lurie Y, Bentur Y. Scombroid Fish Poisoning in Israel, 2005-2007. Isr Med Assoc J. 2008;10(11):789-92. PubMed PMID: 19070288.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Scombroid fish poisoning in Israel, 2005-2007. AU - Lavon,Ophir, AU - Lurie,Yael, AU - Bentur,Yedidia, PY - 2008/12/17/entrez PY - 2008/12/17/pubmed PY - 2009/1/7/medline SP - 789 EP - 92 JF - The Israel Medical Association journal : IMAJ JO - Isr. Med. Assoc. J. VL - 10 IS - 11 N2 - BACKGROUND: Scombroid fish poisoning is an acute illness caused by consumption of fish containing high concentrations of histamine. Improper handling of fish leads to bacterial contamination. Bacterial enzymes convert histidine to histamine. Symptoms develop quickly and resemble an immunoglobulin E-mediated allergic reaction. The diagnosis is often missed. Serious complications (e.g., bronchospasm, hypotension) are infrequent. OBJECTIVES: To evaluate the prevalence and characteristics of scombroid fish poisoning in Israel as reported to the national poison information center. METHODS: We conducted a retrospective poison center chart review from January 2005 to December 2007. RESULTS: During the study period, 21 events of scombroid poisoning involving 46 patients were recorded. Tuna was the commonest fish consumed (84.7%). Clinical manifestations developed within 20 minutes in 65.2% of the patients. The main clinical manifestations included rash (41%), flushing (37%), gastrointestinal complaints (37%) and headache (30.4%). About 25% had abnormal vital signs; two patients developed hypotension. Treatment was supportive and included mainly H1-antagonists (65.2%) and fluids (13%). Five patients were initially misdiagnosed as having an allergic reaction and were treated with corticosteroids (four patients) and epinephrine (one patient). CONCLUSIONS: Scombroid fish poisoning should be suspected in patients with histamine-like manifestations that are temporally related to fish (mainly tuna) consumption, especially in outbreaks. Although scombroid poisoning is often self-limited and responds well to antihistamines, prolonged observation may be required as severe toxicity can supervene. Proper handling of fish and urgent notification of the Ministry of Health are mandatory in order to prevent this potentially serious public heath problem. SN - 1565-1088 UR - https://www.unboundmedicine.com/medline/citation/19070288/Scombroid_fish_poisoning_in_Israel_2005_2007_ L2 - http://www.ima.org.il/IMAJ/ViewArticle.aspx?year=2008&month=11&page=789 DB - PRIME DP - Unbound Medicine ER -