Scombroid Fish Poisoning: Histamine in Spoiled Fish

Table of Contents

1. Histamine Poisoning, Not an Allergy
2. How Histamine Forms in Fish
3. The Fish Most Often Involved
4. Why Cooking, Canning and Freezing Do Not Remove It
5. How the Fish Looks and Tastes
6. Symptoms and Timing
7. Severe Reactions and Heart Effects
8. Medicines That Make It Worse
9. How It Is Told Apart From Fish Allergy
10. Treatment Reported in Studies
11. How Often It Happens
12. Outbreaks on Record
13. Regulatory Histamine Limits
14. What Is Not Known
15. Key Research Papers
16. Connections
17. Featured Videos

Histamine Poisoning, Not an Allergy

The name comes from the Scombridae, the family of fish that includes tuna and mackerel, because these were the fish first linked to the illness. A 2016 review by Feng, Teuber and Gershwin traces the first description to Britain in 1799 and its return to the medical literature in the 1950s, when outbreaks were reported in Japan. The same illness is also called histamine fish poisoning or scombrotoxin fish poisoning. The US Food and Drug Administration (FDA) prefers “scombrotoxin poisoning”, partly because fish outside the tuna family are now known to cause it.

The key point is that it is a poisoning, not an immune reaction. In a true fish allergy, the immune system makes antibodies called immunoglobulin E (IgE) against fish proteins, and those antibodies make the person's own mast cells burst open and release histamine. In scombroid poisoning, the histamine is already in the fish. Anyone who eats enough of it can get sick, which is why whole tables of diners often fall ill together. A 2023 review by Zhernov and colleagues names the absence of an immunoglobulin E response as the single most important difference between the two conditions.

Hungerford, a scientist at the Food and Drug Administration's Pacific Northwest laboratory, points out in his 2010 review what makes this illness unusual among seafood toxins: it comes from mishandling of the fish after it is caught, not from a toxin the fish picked up from the food chain, as happens with ciguatera or shellfish poisoning.

How Histamine Forms in Fish

Three things have to come together.

1. A fish rich in free histidine. Histidine is an amino acid. Some fish carry large amounts of it loose in their muscle, not locked into protein. Hungerford's 2021 review states that the high levels of free histidine needed for poisoning are found only in certain species of open-ocean (pelagic) fish.
2. Bacteria that make the enzyme histidine decarboxylase. This enzyme removes one small piece from histidine and turns it into histamine in a single step. The Food and Drug Administration's hazards guidance explains that the bacteria responsible live naturally on the gills, skin and gut of live saltwater fish without harming them. When the fish dies, its defences stop and the bacteria start to grow into the muscle. A Japanese review of cases from 1998 to 2020 found that the bacteria isolated most often were Morganella morganii and Photobacterium damselae, with cold-tolerant species also found.
3. Time at a warm temperature. The guidance describes histamine-forming bacteria as growing over a wide temperature range, faster at 70°F (21.1°C) or above than at 45°F (7.2°C), and particularly fast near 90°F (32.2°C). Some large fish such as tuna generate their own body heat, so the inside of the fish can stay warmer than the air around it after death.

The guidance adds several details that explain why the problem is hard to control:

• Once the enzyme is in the fish, it can keep making histamine even after the bacteria themselves stop being active, and it can work at or near refrigerator temperatures.
• The enzyme survives freezing and can become active again very quickly after the fish thaws.
• Cutting and filleting spread the bacteria over the exposed muscle. Finely chopped fish, such as minced tuna for salads, has a large exposed surface; even salads made from canned tuna can be recontaminated during preparation, especially when raw ingredients are mixed in.
• Some histamine-forming bacteria tolerate salt and acid, so histamine can form during brining, salting, smoking, drying, fermenting and pickling until the product is fully shelf-stable.
• Many of these bacteria can grow with little oxygen, so vacuum packing and modified-atmosphere packing do not stop them on their own.

The Centers for Disease Control and Prevention's outbreak reports state the same practical conclusion: the one effective means of prevention they describe is keeping the fish at or below 40°F (4.4°C) at all times from catch to consumption.

The Fish Most Often Involved

The sources read for this page name these fish:

• Tuna of many kinds (including skipjack, albacore and yellowfin). A 2018 systematic review of 103 poisoning incidents reported from 1959 to 2013 found that the fish involved were mainly tuna or marlins and their relatives. In United States outbreak data for 2011–2023, 76% of scombroid outbreaks with a known food source involved tuna. See Tuna.
• Mackerel and bonito, named in the Feng review; mackerel is also one of the three main fish in the Japanese case review, alongside tuna and marlin.
• Mahi-mahi (also called dolphinfish — a fish, not the mammal), marlin and bluefish, which the Food and Drug Administration's guidance lists with tuna as the fish most associated with the illness.
• Sardines. In January 2014, 28 children aged 2 to 5 fell ill after eating canned sardines at a kindergarten in Vojvodina, northern Serbia; seven of nine units tested held more than 300 mg of histamine per kilogram. A survey of canned fish in Tehran markets (tuna, sardine, kilka and mackerel) detected histamine in 46.6% of samples, and 18.3% were above 50 mg per kilogram. See Sardines.
• Anchovies. A study of dried anchovies in the Philippines measured histamine rising along the supply chain, from an average of 8.29 mg per kilogram in raw fish to 54.07 at processing centres and 67.63 at retailers, with salt content and water activity closely linked to the rise.
• Escolar, an unusual cause: in August 2003, 42 of 56 people (75%) who ate escolar at a dinner at a retreat centre in California met the outbreak's case definition, and the fish held 2,000 to 3,800 parts per million of histamine.

The Food and Drug Administration guidance refers to a longer table of other species able to develop high histamine when kept warm; that table was not read for this page, so other species named in popular lists, such as herring and amberjack, are not covered here.

Not only fish. Taylor's 1986 review in Critical Reviews in Toxicology notes that cheese has been implicated in histamine poisoning on occasion, and a 2017 review by Schirone and colleagues adds that fermented foods in general can be involved in outbreaks and single cases.

A note on units. Histamine in food is given as parts per million (ppm), which is the same as milligrams per kilogram (mg/kg). Some papers use milligrams per 100 grams; 50 mg per 100 g equals 500 mg per kilogram.

Why Cooking, Canning and Freezing Do Not Remove It

This is the fact that surprises people most. Histamine is heat-stable. The Food and Drug Administration's guidance states that cooking can kill the bacteria and inactivate the enzyme, but once histamine has been produced, it cannot be eliminated by heat, including the high-pressure heating used for canning, or by freezing. Freezing may kill some of the bacteria, yet the enzyme survives freezing.

That is why canned, smoked, grilled and frozen fish all appear in the outbreak record. The Serbian outbreak came from canned sardines. In the 2017 French outbreak described below, histamine in the cooked tuna (3,720 mg per kilogram) was higher than in the leftover raw tuna (1,720 mg per kilogram). The Centers for Disease Control and Prevention's 2026 surveillance summary describes the marine toxins behind fish poisonings, scombroid toxin among them, as resistant to cooking or freezing.

How the Fish Looks and Tastes

Very often the fish seems perfectly fine. The Zhernov review describes the illness as following fish with “fine organoleptic characteristics” — that is, normal look, smell and taste. The Food and Drug Administration explains why: the rotten odours typical of slow, cold spoilage may be missing when fish has spoiled quickly at a high temperature, which is exactly when histamine builds up fastest. For this reason the guidance calls sensory checking on its own an ineffective control. The 2026 surveillance summary describes these marine toxins as tasteless and odourless.

Some people do notice something. The Centers for Disease Control and Prevention's 2007 outbreak report lists “a burning or peppery taste in the mouth” among the typical symptoms, and the Food and Drug Administration lists tingling or burning in or around the mouth or throat. These sensations come from the histamine acting on the mouth, often while the meal is still being eaten, rather than from any visible sign on the fish.

Symptoms and Timing

The Food and Drug Administration's guidance lists these symptoms:

• tingling or burning in or around the mouth or throat;
• rash or hives on the upper body, and itching of the skin;
• headache and dizziness;
• nausea, vomiting and diarrhoea;
• heart palpitations;
• a drop in blood pressure;
• asthma-like tightening of the airways and breathing difficulty.

The Centers for Disease Control and Prevention's 2007 report adds facial flushing, sweating and abdominal cramps, and a 1996 outbreak report from Taiwan describes blurred vision.

Timing. Onset is fast. The Food and Drug Administration gives a range of a few minutes to a few hours after eating. In a Japanese hospital outbreak, symptoms started between 20 minutes and two hours after the meal; a 2025 case report gives 30 minutes to two hours. Taylor's review describes the illness as having a short incubation period and a short duration.

How long it lasts. Sources differ. The Centers for Disease Control and Prevention's 2007 report states that symptoms usually resolve within several hours without medical treatment. The Food and Drug Administration's guidance gives a duration of 12 hours to a few days. In the 2003 California escolar outbreak, the median duration was 4 hours among those who took medicine and 1.5 hours among those who did not — a comparison that does not show medicine lengthened the illness, since people with worse symptoms are more likely to take medicine.

Severe Reactions and Heart Effects

Most cases are mild, but not all. The Centers for Disease Control and Prevention's 2007 report describes more severe symptoms — respiratory distress, swelling of the tongue and throat, and blurred vision — as needing medical treatment. Low blood pressure, breathing difficulty, throat or tongue swelling, and chest pain are signs hospitals treat as urgent; they are the same signs seen in anaphylaxis.

Heart effects have been reported:

• A 2022 review by de Gregorio and colleagues gathered 19 patients from 13 studies (1997–2020) whose scombroid poisoning came with a heart attack–like picture called acute coronary syndrome. The authors describe the condition as usually benign, except in people with existing coronary artery disease, a previous acute coronary syndrome, or a history of anaphylaxis, and note a potential for circulatory failure in the acute stage even in people who seemed healthy.
• The 2016 Ridolo review notes two reported cases of Kounis syndrome — an allergic-type reaction that triggers spasm of the heart's arteries — following scombroid poisoning.
• The 2025 case report by Gingras and Marois lists bronchospasm and abnormal heart rhythms among severe presentations.
• In a 1999 report on two mass-casualty incidents with 57 patients, one patient needed a heart medication from paramedics at the scene and one was eventually admitted to hospital.

Deaths are rare. A 2013 analysis by the Centers for Disease Control and Prevention estimated zero deaths a year from scombroid poisoning in the United States, against three for ciguatera; the 2011–2023 surveillance summary reported six hospitalizations among 597 scombroid illnesses.

Medicines That Make It Worse

The gut normally breaks down much of the histamine in food before it reaches the blood, using enzymes such as diamine oxidase and monoamine oxidase (explained on the histamine page). Anything that blocks these enzymes lets more histamine through.

Isoniazid, the tuberculosis medicine, is the best-documented example. Taylor's 1986 review lists isoniazid and aminoguanidine as drugs that strengthen histamine's effect by blocking the gut's histamine-breaking enzymes, so more unbroken histamine is absorbed. Two Japanese reports show what this looks like:

• In a tuberculosis ward in 2005, eight patients developed flushing, headache, palpitations, itching, wheezing, breathlessness and diarrhoea 20 minutes to two hours after a dinner that included a ground saury (a small oily fish) paste. All eight were taking isoniazid; the other 378 inpatients had no symptoms. The paste held 32 mg of histamine per 100 g, which the authors described as below the usual toxic level, and the patients' blood levels of monoamine oxidase were reduced.
• An 83-year-old woman taking isoniazid developed a headache, palpitations and itchy skin eruptions while eating raw tuna. When later given fresh raw tuna, she had no reaction, so the authors attributed the episode to spoiled tuna combined with the drug.

A 2020 review by Visciano and colleagues adds alcohol, enzyme deficiency and monoamine oxidase inhibitor antidepressants as conditions that can make dietary histamine dangerous. The picture is not settled, though: the 2018 systematic review of outbreak reports found no clear link between being ill and female sex, alcohol, prior medication, or eating histamine-releasing foods — noting that most reports lacked a full medical history. Decisions about medicines belong with a prescriber or pharmacist.

How It Is Told Apart From Fish Allergy

Several reviews state plainly that scombroid poisoning is often misdiagnosed as fish allergy, and the title of the 2016 Ridolo review sums it up: “it seems to be fish allergy but… it isn't.” Hungerford adds that doctors also have to separate it from reactions to Anisakis, a fish parasite whose proteins can trigger true allergy.

Why it matters. A person wrongly labelled as fish-allergic may be told to give up all fish for life, and may carry an emergency adrenaline injector they do not need. The Feng review notes that misdiagnosis as immunoglobulin E–mediated allergy keeps the disease under-recognised, and the 2022 Japanese review notes that people with histamine poisoning are taken to emergency wards with anaphylactic shock–like symptoms more often than is appreciated. In the 2025 Gingras case, a 30-year-old woman was diagnosed with anaphylaxis after eating salmon before the diagnosis was revised.

Clues that point to scombroid poisoning, drawn from the reviews:

• Several people who ate the same fish fell ill at the same time.
• The person has eaten the same kind of fish before without trouble, and eats fresh fish of the same kind later without trouble (as in the isoniazid case above).
• A peppery or burning taste, and fast onset.
• A normal blood level of tryptase, an enzyme released by mast cells. In a 2010 Italian emergency-department study, all 10 patients with histamine fish poisoning had normal tryptase, while most of 50 patients with true allergic reactions had raised levels (average 24.4 ng/mL, against a normal value below 11). The authors noted that because tryptase disappears quickly, the blood sample needs to be taken one to two hours after symptoms begin.
• Allergy tests for fish antibodies that come back negative, and, where leftovers exist, a high histamine level measured in the fish.

A 2013 review by Banks and Gada describes scombroid poisoning as one of several “masqueraders” — with ciguatera, Anisakis and cross-reactions — that lead doctors to wrong conclusions about seafood allergy. More on true allergy is on the Food Allergy page.

Treatment Reported in Studies

Because histamine causes the symptoms, the treatment reported throughout the literature is antihistamines.

• Hungerford's 2010 review states that people with scombroid poisoning respond well to antihistamines, which is part of the evidence that histamine is the cause.
• Taylor's 1986 review lists the success of antihistamine treatment, the allergy-like symptoms and the high histamine in the implicated fish as the three findings that point strongly to histamine.
• In the 1996 Taiwan outbreaks, most patients received antihistamines and had a rapid and complete recovery.
• The 2025 Gingras case report describes management with antihistamines and supportive care, with adrenaline (epinephrine) and corticosteroids reserved for severe reactions.

Mild cases often settle without treatment, as the Centers for Disease Control and Prevention's 2007 report describes. The 1999 report on two mass-casualty incidents found that recognising the cause early let paramedics treat many patients on the spot and release some from the scene.

How Often It Happens

Reported cases are a small fraction of real ones, because the illness is short, often mild, and often mistaken for allergy.

• United States, 2000–2009. For outbreaks reported in 2000–2007 and poison-centre calls in 2005–2009, a 2013 analysis led by Centers for Disease Control and Prevention researchers found an average of 28 reported scombroid outbreaks a year (108 ill people) and about 200 calls a year to poison centres. After adjusting for underreporting and underdiagnosis, it estimated about 35,142 illnesses a year (90% credible interval 10,496 to 78,128), 162 hospitalizations and no deaths.
• United States, 2011–2023. The 2026 Centers for Disease Control and Prevention surveillance summary counted 192 scombroid outbreaks, 597 illnesses and six hospitalizations. New York (43), Florida (38), California (23) and Hawaii (18) reported the most. Where importation status was known, 53% involved imported fish; where a single preparation place was known, 57% were sit-down restaurants.
• Share of food poisoning. The 2022 de Gregorio review and the 2025 Gingras report both put scombroid at about 5% of food poisonings in the United States.
• Japan, 1998–2020. The national review counted a mean of 9.7 incidents and 195.3 cases a year, about 70% of incidents in restaurants and school or workplace lunch facilities.
• The global trade. The Feng review notes that more than 80% of fish eaten in the United States was imported at the time it was written, which ties the illness closely to the handling of fish far from where it is eaten.

Outbreaks on Record

• Paris region, France, April 2017. On 20 April, 40 people in a military unit near Paris fell ill (attack rate 16.6%). A case-control study pointed to cooked yellowfin tuna fillet from Reunion Island, supplied vacuum-sealed and packed with ice; no break in the cold chain could be established. Histamine reached 1,720 mg per kilogram in leftover raw tuna and 3,720 in cooked tuna. Two bacteria known to make histamine, Klebsiella variicola and Pantoea agglomerans, were found in the raw fish.
• United States, autumn 2019. The Food and Drug Administration was notified of 51 cases, including two hospitalizations, in 11 states, all linked to tuna imported from Vietnam. Of 34 samples collected along the supply chain, 29 were decomposed or had high histamine. The exporting firms were placed on an import alert and recalls followed.
• Louisiana and Tennessee, 2006. Two outbreaks were traced to tuna steaks from Indonesia and Vietnam respectively.
• Vojvodina, Serbia, January 2014. Twenty-eight kindergarten children aged 2 to 5 fell ill after canned sardines. Border checks over the next two years found 9 of 273 imported fish lots (3.29%) unsafe.
• Taiwan, 1996. Two outbreaks: four women after marlin with 84.13 mg histamine per 100 g, and 55 employees at one cafeteria after a tuna-family fish with up to 271.9 mg per 100 g.
• California, August 2003. The escolar outbreak at a retreat centre described above — 42 of 56 diners who ate the fish.

Across 103 incidents, the 2018 systematic review found an average histamine level in implicated foods of 1,107 mg per kilogram, but the range of plausible values ran from 24 to over 50,000, showing how widely the levels vary from one outbreak to another.

Regulatory Histamine Limits

Histamine is the one biogenic amine with legal limits in fish in the European Union, according to the Schirone review, because it can be fatal.

• United States. The Food and Drug Administration's Fish and Fishery Products Hazards and Controls Guidance, Chapter 7, sets a guidance level of 50 ppm histamine in the edible portion of fish. It explains that histamine is spread unevenly, so if 50 ppm is found in one section of a fish or lot, other sections may exceed 500 ppm. The same chapter notes that in most cases histamine in fish that made people ill has been above 200 ppm, often above 500 ppm. When samples are pooled, it uses 17 ppm in a three-sample pool in place of 50 ppm for a single sample.
• European Union. The 2019 report on the French outbreak describes the threshold limit defined by European regulations as 200 mg per kilogram. The full text of the EU microbiological criteria regulation (Regulation (EC) No 2073/2005) could not be opened for this page, so its sampling plan and its separate limits for fish products matured in brine are not described here.

The Hungerford reviews describe how these limits are policed: by keeping a cold chain from boat to plate, by histamine testing with laboratory methods and newer rapid test kits, and, for canned tuna, by checking cooked loins for “honeycombing” — small holes in the flesh that the Food and Drug Administration describes as a sign of past temperature abuse.

What Is Not Known

• Why spoiled fish is more toxic than pure histamine. Taylor's 1986 review notes that histamine eaten in spoiled fish appears much more toxic than the same histamine swallowed in water. Other amines formed during spoilage, such as putrescine and cadaverine, may help by blocking the gut's histamine-breaking enzymes. Hungerford's 2010 review states that various mechanisms have been put forward and none has been proven; the 2023 Zhernov review adds cis-urocanic acid and other histamine releasers as candidates and describes “many blank spots” in current understanding.
• The safe dose. Because histamine levels vary so much from one outbreak to another, and some people react at low levels (such as the isoniazid patients), no single level separates safe from unsafe fish for everyone.
• Who is most susceptible. Individual sensitivity and detoxification differ, as the Schirone review notes, but the 2018 meta-analysis could not confirm any single risk factor from outbreak data.
• The true number of cases. United States estimates rest on statistical multipliers for underreporting, with a wide uncertainty range.

Key Research Papers

1. Feng C, Teuber S, Gershwin ME. Histamine (Scombroid) Fish Poisoning: a Comprehensive Review. Clinical Reviews in Allergy & Immunology. 2016;50(1):64-9. PubMed PMID: 25876709
2. Hungerford JM. Scombroid poisoning: a review. Toxicon. 2010;56(2):231-43. PubMed PMID: 20152850
3. Hungerford JM. Histamine and Scombrotoxins. Toxicon. 2021;201:115-126. PubMed PMID: 34419509
4. Taylor SL. Histamine food poisoning: toxicology and clinical aspects. Critical Reviews in Toxicology. 1986;17(2):91-128. PubMed PMID: 3530640
5. Colombo FM, Cattaneo P, Confalonieri E, Bernardi C. Histamine food poisonings: A systematic review and meta-analysis. Critical Reviews in Food Science and Nutrition. 2018;58(7):1131-1151. PubMed PMID: 27791395
6. Ridolo E, Martignago I, Senna G, Ricci G. Scombroid syndrome: it seems to be fish allergy but... it isn't. Current Opinion in Allergy and Clinical Immunology. 2016;16(5):516-21. PubMed PMID: 27466827
7. Zhernov YV, Simanduyev MY, Zaostrovtseva OK, Semeniako EE, Kolykhalova KI, Fadeeva IA, et al. Molecular Mechanisms of Scombroid Food Poisoning. International Journal of Molecular Sciences. 2023;24(1):809. PubMed PMID: 36614252
8. Gingras V, Marois L. Case of scombroid syndrome mimicking an anaphylactic fish allergy. International Journal of Emergency Medicine. 2025;18(1):122. PubMed PMID: 40610892
9. Ricci G, Zannoni M, Cigolini D, Caroselli C, Codogni R, Caruso B, et al. Tryptase serum level as a possible indicator of scombroid syndrome. Clinical Toxicology. 2010;48(3):203-6. PubMed PMID: 20230333
10. Banks TA, Gada SM. Cross-reactivity and masqueraders in seafood reactions. Allergy and Asthma Proceedings. 2013;34(6):497-503. PubMed PMID: 24169056
11. de Gregorio C, Ferrazzo G, Koniari I, Kounis NG. Acute coronary syndrome from scombroid poisoning: a narrative review of case reports. Clinical Toxicology. 2022;60(1):1-9. PubMed PMID: 34396875
12. Eckstein M, Serna M, DelaCruz P, Mallon WK. Out-of-hospital and emergency department management of epidemic scombroid poisoning. Academic Emergency Medicine. 1999;6(9):916-20. PubMed PMID: 10490254
13. Miki M, Ishikawa T, Okayama H. An outbreak of histamine poisoning after ingestion of the ground saury paste in eight patients taking isoniazid in tuberculous ward. Internal Medicine. 2005;44(11):1133-6. PubMed PMID: 16357449
14. Morinaga S, Kawasaki A, Hirata H, Suzuki S, Mizushima Y. Histamine poisoning after ingestion of spoiled raw tuna in a patient taking isoniazid. Internal Medicine. 1997;36(3):198-200. PubMed PMID: 9144013
15. Visciano P, Schirone M, Paparella A. An Overview of Histamine and Other Biogenic Amines in Fish and Fish Products. Foods. 2020;9(12):1795. PubMed PMID: 33287193
16. Schirone M, Visciano P, Tofalo R, Suzzi G. Histamine Food Poisoning. Handbook of Experimental Pharmacology. 2017;241:217-235. PubMed PMID: 27752845
17. Pennotti R, Scallan E, Backer L, Thomas J, Angulo FJ. Ciguatera and scombroid fish poisoning in the United States. Foodborne Pathogens and Disease. 2013;10(12):1059-66. PubMed PMID: 24093307
18. Hartley CM, Hoang ST, Roberts VA, Chard AN. Foodborne Disease Outbreaks Associated with Marine Toxins - Foodborne Disease Outbreak Surveillance System, United States, 2011-2023. MMWR Surveillance Summaries. 2026;75(3):1-13. PubMed PMID: 42301912
19. Centers for Disease Control and Prevention (CDC). Scombroid fish poisoning associated with tuna steaks--Louisiana and Tennessee, 2006. MMWR Morbidity and Mortality Weekly Report. 2007;56(32):817-9. PubMed PMID: 17703171
20. Velut G, Delon F, Mérigaud JP, Tong C, Duflos G, Boissan F, et al. Histamine food poisoning: a sudden, large outbreak linked to fresh yellowfin tuna from Reunion Island, France, April 2017. Euro Surveillance. 2019;24(22):1800405. PubMed PMID: 31164189
21. Pereira E, Elliot EL, Singleton LS, Otto M, Tesfai A, Doyle M, et al. An Outbreak Investigation of Scombrotoxin Fish Poisoning Illnesses in the United States Linked to Yellowfin Tuna Imported from Vietnam-2019. Journal of Food Protection. 2021;84(6):962-972. PubMed PMID: 33428741
22. Petrovic J, Babić J, Jaksic S, Kartalovic B, Ljubojevic D, Cirkovic M. Fish Product-Borne Histamine Intoxication Outbreak and Survey of Imported Fish and Fish Products in Serbia. Journal of Food Protection. 2016;79(1):90-4. PubMed PMID: 26735034
23. Peivasteh-Roudsari L, Rahmani A, Shariatifar N, Tajdar-Oranj B, Mazaheri M, Sadighara P, et al. Occurrence of Histamine in Canned Fish Samples (Tuna, Sardine, Kilka, and Mackerel) from Markets in Tehran. Journal of Food Protection. 2020;83(1):136-141. PubMed PMID: 31855616
24. Amascual RH, Panganoron H, Gamba A, Irene E. Physicochemical and microbiological attributes of dried anchovies (Stolephorus commersonnii) in the formation of histamine along the supply chain. Italian Journal of Food Safety. 2023;12(3):11319. PubMed PMID: 37753205
25. Feldman KA, Werner SB, Cronan S, Hernandez M, Horvath AR, Lea CS, et al. A large outbreak of scombroid fish poisoning associated with eating escolar fish (Lepidocybium flavobrunneum). Epidemiology and Infection. 2005;133(1):29-33. PubMed PMID: 15724707
26. Wu ML, Yang CC, Yang GY, Ger J, Deng JF. Scombroid fish poisoning: an overlooked marine food poisoning. Veterinary and Human Toxicology. 1997;39(4):236-41. PubMed PMID: 9251176
27. Tomaru A, Toda M, Hara-Kudo Y. [Literature Review on the Type of Fish and Histamine-producing Bacteria Associated with Histamine Poisonings in Japan]. Shokuhin Eiseigaku Zasshi. 2022;63(3):109-116. PubMed PMID: 35858795

PubMed Topic Searches

1. PubMed: scombroid poisoning
2. PubMed: histamine fish poisoning outbreaks
3. PubMed: histamine poisoning and isoniazid
4. PubMed: scombroid poisoning misdiagnosed as allergy

Other Sources

1. US Food and Drug Administration. Fish and Fishery Products Hazards and Controls Guidance, Chapter 7: Scombrotoxin (Histamine) Formation. fda.gov/media/80248

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Connections

• Food and Diet Toxins — the category this page belongs to
• Tuna — the fish most often involved
• Sardines — involved in canned-fish outbreaks
• Herring — another small oily fish
• Histidine, Histamine, and Allergy — the chemistry behind the poisoning
• Low-Histamine Diet — histamine in everyday foods
• Histamine and Allergy Animation — how histamine acts in the body
• Food Allergy — the condition it is mistaken for
• Hives and Flushing — the leading skin signs
• Anisakis — the fish parasite in the differential diagnosis

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