Category Archives: Scombroid

Hong Kong – Food Focus – Histamine in Fish and Fish Products

CFS

Food Safety Focus (150th Issue, January 2019) – Food Safety Platform

 Histamine in Fish and Fish Products

Reported by Mr. Kenneth Yung, Research Officer,
Risk Assessment Section, Centre for Food Safety

Fish is an important part of many types of cuisine that we savour.  However, the consumption of fish and fish products containing high level of histamine may cause scombrotoxin fish poisoning (SFP), also called histamine poisoning.  In Hong Kong, the Centre for Health Protection of the Department of Health recorded a total of 26 local SFP cases, affecting 45 persons from 2009 to 2018.  In this article, we discuss how histamine is formed and the ways to control level of histamine in fish and fish products..

Examples of fish which contain elevated levels of naturally

Examples of fish which contain elevated levels of naturally occurring histidine: (a) mackerel, (b) sardine, (c) tuna and (d) anchovy.  Some of their respective products have also been found to contain high levels of histamine.

Formation of Histamine in Fish and Fish Products

Histamine is a toxic metabolite produced by histamine-producing bacteria during spoilage and fermentation of fish and fish products.  Many histamine-producing bacteria are part of the natural microflora of the skin, gills and gut of freshly caught fish.  Histidine decarboxylase (HDC) enzymes, synthesized by histamine-producing bacteria when they multiply, convert the amino acid histidine that are naturally present in fish into histamine.

The level of histamine in fish and fish products mainly depends on species of fish and time-temperature control. Certain fishes like mackerel, sardine, tuna and anchovy naturally contain high amount of histidine and have been associated with SFP cases in Hong Kong and/or other places.

Time and temperature control is the most effective method for ensuring food safety for fish species prone to histamine production.  In the absence of proper time-temperature control such as refrigeration and freezing, formation of histamine may occur at any point throughout the supply chain.  Previous study conducted jointly by the Food and Environmental Hygiene Department and the Consumer Council revealed that high levels of histamine (up to 2600 mg/kg) that can cause SFP were detected in opened canned fish samples that were left at room temperature for 24 hours.  However, histamine was not detected in samples that were kept at 2°C for up to 168 hours.

Health Effects of Histamine

SFP is caused by the ingestion of food containing high levels of histamine i.e. consuming a serving size of 250g fish or fish product with histamine level exceeding 200 mg/kg may cause symptoms in healthy individuals.  Symptoms of SFP include tingling and burning sensation around the mouth, facial flushing and sweating, nausea, vomiting, headache, palpitations, dizziness and rash.  Exacerbation of asthma and more serious cardiac manifestations were reported in more severe cases.  The onset of symptoms is within a few hours after consumption and these symptoms will normally disappear in 12 hours without long term effect.

Control of Histamine in Fish and Fish Products

High levels of histamine can build up in fish and fish products before any signs of spoilage (e.g. bad smell or taste) develop.  Therefore, measures for control of histamine should be taken along the food chain from harvest to consumption.

Care should be taken that the cold chain is maintained at or below 4°C along the supply chain, including points of transfer such as offloading of fish from the vessel and processing procedures.  Frozen fish and fish products should be kept at or below -18°C.  Transport vehicles or vessels should be adequately equipped to keep fish cold and pre-chilled before loading fish where applicable.  Adequate heat treatment (e.g. cooking, hot smoking) can kill histamine-producing bacteria and inactivate HDC enzymes, but cannot destroy pre-formed histamine.  Recommendations in the Code of Practice for Fish and Fishery Products (CAC/RCP 52-2003), issued by Codex Alimentarius Commission, should be observed to ensure food safety.

Food chain from harvest to consumption

(a) Cold chain should be maintained throughout the whole supply chain. (b) Refrigerated fish and fish products should be kept at or below 4°C. (c) The time which fish products are kept under ambient temperature should be minimised.

At the consumer level, fish should be chilled rapidly after purchase.  For pre-packaged fish and fish products, store according to the instructions of the manufacturer (e.g. keep refrigerated). If cooked fish and ready-to-eat fish products (e.g. tuna fish sandwiches and opened canned fish) are placed at room temperature all day long, they can be re-contaminated and histamine can form.  Therefore, if these foods are not being eaten immediately, they should be kept under refrigeration and be finished as soon as possible.

Research – What to know about Scombroid Poisoning

Medical News Today

Read the full article at the link above.

Scombroid poisoning is a form of food poisoning. It happens when a person eats fish species containing high amounts of a chemical called histidine.

Histidine is an amino acid that naturally occurs in fish. When people do not keep the fish in a refrigerator, bacteria break down the histidine and turn it into histamine.

Histamine is responsible for the toxicity that causes scombroid poisoning, according to the American Academy of Allergy, Asthma & Immunology (AAAAI).

When a person consumes large quantities of fish with histamine, they experience symptoms that resemble an allergic reaction, such as hives. However, it is not a true allergy to a particular fish, according to the National Capital Poison Center.

The condition usually is not long-term or severe, according to the Food and Drug Administration (FDA)Trusted Source. Mild cases often disappear on their own without treatment, but antihistamine medications may help some people.

A person experiencing severe symptoms, such as chest pain or breathing trouble, should go to an emergency room or call local emergency services.

Luxembourg – SARDINE FILLETS FROM LES NATURELS OCEALLIANCE – Histamine

SAP

Furic Solutions is recalling the following product:

name Sardine fillets
Brand OCEALLIANCE Naturals
Unity 200g
Sales period from 04/29/2022 to 05/03/2022
Use-by date (DLC) 05/03/2022; 04/05/2022
Batch 0622118; 0622119

Danger  : Presence of histamine

Sale in Luxembourg by: Auchan

A sale by other operators cannot be excluded.

Source of information: Auchan recall notification

Communicated by: Government Commission for Quality, Fraud and Food Safety .

RASFF Alerts – Histamine – Tonijnfilet A-Sashimi

RASFF

Histamine in Tonijnfilet A-Sashimi from Sri Lanka in Hong Kong – Belgium, Germany and Netherlands

USA – How to Report Seafood-Related Toxin and Scombrotoxin Fish Poisoning Illnesses

FDA

To help FDA effectively investigate, remove unsafe seafood products from the market, and develop new prevention strategies, the FDA relies on illness reporting from public health officials and healthcare providers. While most foodborne outbreaks are tracked through the FDA’s Coordinated Outbreak Response and Evaluation (CORE) network, seafood-related illnesses caused by natural toxins have a unique reporting mechanism. This web page provides information on commonly occurring seafood-related illnesses and how to report them to the FDA.  To report an illness from raw bivalve molluscan shellfish, email the FDA at shellfishepi@fda.hhs.gov.

The FDA receives reports of illnesses associated with the consumption of specific types of fish. These illnesses may originate from the activity of certain bacteria, toxins produced by marine algae, or hazards inherent in the fish.

Commonly occurring illness:

Illness and reporting information for the commonly occurring illnesses are provided in each section. Contact the FDA with any questions or need for clarification of the illness or reporting.

In addition to the illnesses listed above, reporting of other less frequently occurring illnesses from natural toxins may be accomplished by emailing the FDA at Seafood.Illness@fda.hhs.gov.  Refer to Chapter 6 of the “Fish and Fishery Products Hazards and Controls Guidance” for a comprehensive list of natural toxin illnesses. To report illnesses related to miscellaneous natural toxin illnesses, please email FDA at Seafood.Illness@fda.hhs.gov.

The FDA works with first responders, physicians, and state and local health departments to investigate illnesses and outbreaks, manage them, and learn how to lessen future occurrences.

Research – Two Case Reports of Scombroid in Singapore: A Literature Review

Cureus

Abstract

Scombroid is a foodborne illness that results from eating improperly handled fish. Due to a disruption in the cold chain, these fish have high histamine levels. As a result, scombroid presents with allergy-like symptoms but is not really an allergy per se. Cases have been reported in many countries.

Here, we report two cases of a 48 and 17-year-old father and son in Singapore who developed symptoms suggestive of scombroid after eating tuna imported from Vietnam delivered by an internationally known supply company. The diagnosis was confirmed by elevated histamine levels measured in the culprit fish product. We discuss the pathophysiology, signs, symptoms, and management of scombroid.

Introduction

Scombrotoxin fish poisoning (SFP) also known as scombroid poisoning, scombrotoxicosis, or histamine fish poisoning is a foodborne illness that results from the consumption of fish that has been improperly handled between the time it is caught and the time it is cooked [1]. The word “scombroid” is derived from Scombridae which is a family of dark-fleshed fish consisting of species such as mackerel and tuna. However, non-scombroid fishes such as mahi-mahi, salmon, and sardine have also been implicated in scombroid poisoning [2].

Scombroid poisoning is very common. A 2013 report from the United States estimated over 35,000 cases resulting in 162 hospital admissions between 2000 and 2009 [3]. Scombroid cases have also been reported from countries such as Australia [4], the Netherlands [5], Israel [6], Colombia [7], and many others.

Inappropriate storage, resulting in disruption of the cold chain, of the fish leads to bacterial enzymatic conversion of free histidine into histamine. This is due to the action of bacterial histamine decarboxylase (HDC), usually by mesophilic bacteria such as Clostridium perfringensMorganella morganii, etc. As a result, high levels of histamine are usually found in the culprit seafood item [8]. Whether histamine is the only constituent of “scombrotoxin” is unclear. Nevertheless, the symptomatology is essentially that of histamine toxicity. It is considered an atypical foodborne illness as the main symptoms are not gastrointestinal and also because it is not due to contamination of the product.

While mostly self-limiting and mild, there have been reports of life-threatening scombroid poisoning. A previously healthy young woman developed hypotension needing vasopressors with ST depressions [9] while another scombroid poisoning was complicated by acute pancreatitis [10]. Some cases were severe enough to need ICU admissions. A recent narrative discussed acute coronary syndromes (ACS) associated with scombroid. Of note, there is a potential of hemodynamic failure in the acute stage, even in apparently healthy people [11].

Closer to home, in September 2016, the Agri-Food and Veterinary Authority (AVA) of Singapore issued a recall order on a batch of canned tuna imported from Thailand under a common food brand. This was reported in various newspapers such as The Straits Times and The Independent. In one issue of the Singapore Food Agency’s Food Safety Bulletin in 2018, there was a segment on scombroid. Interestingly, however, a PubMed search was conducted and while we found a case of pufferfish poisoning reported in 2013 [12] and a report of stonefish poisoning in 2009 [13], we found no reports of scombroid poisoning in Singapore. We report two confirmed cases of scombroid poisoning who are from the same household who presented to our hospital after consuming tuna for dinner.

USA – DRAFT: Scombrotoxin (Histamine)-forming Fish and Fishery Products – Decomposition and Histamine (CPG 7108.24)

FDA

Submit Comments by 

Although you can comment on any guidance at any time (see 21 CFR 10.115(g)(5)), to ensure that the FDA considers your comment on a draft guidance before it begins work on the final version of the guidance, submit either online or written comments on the draft guidance before the close date.

If unable to submit comments online, please mail written comments to:

Dockets Management
Food and Drug Administration
5630 Fishers Lane, Rm 1061
Rockville, MD 20852

All written comments should be identified with this document’s docket number: FDA-2021-D-0367


Docket Number:
FDA-2021-D-0367
Issued by:
Office of Regulatory Affairs
Center for Food Safety and Applied Nutrition

The purpose of this compliance policy guide (CPG) is to provide guidance for FDA staff on adulteration associated with decomposition and/or histamine identified during surveillance sampling and testing of fish and fishery products susceptible to histamine formation.

The current CPG Sec. 540.525 is being revised to update FDA regulatory action guidance for sensory analysis and histamine levels in scombrotoxin-forming fish and fishery products.

The  contents of this document do not have the force and effect of law and are not meant to bind the public in any way, unless specifically incorporated into a contract.  This document is intended only to provide clarity to the public regarding existing requirements under the law.  FDA guidance documents, including this CPG, should be viewed only as recommendations, unless specific regulatory or statutory requirements are cited.  The use of the word should in FDA guidances means that something is suggested or recommended, but not required.

Information – How to Report Seafood-Related Toxin and Scombrotoxin Fish Poisoning Illnesses

FDA

To help FDA effectively investigate, remove unsafe seafood products from the market, and develop new prevention strategies, the FDA relies on illness reporting from public health officials and healthcare providers. While most foodborne outbreaks are tracked through the FDA’s Coordinated Outbreak Response and Evaluation (CORE) network, seafood-related illnesses caused by natural toxins have a unique reporting mechanism. This web page provides information on commonly occurring seafood-related illnesses and how to report them to the FDA.  To report an illness from raw bivalve molluscan shellfish, email the FDA at shellfishepi@fda.hhs.gov.

The FDA receives reports of illnesses associated with the consumption of specific types of fish. These illnesses may originate from the activity of certain bacteria, toxins produced by marine algae, or hazards inherent in the fish.

Commonly occurring illness:

Illness and reporting information for the commonly occurring illnesses are provided in each section. Contact the FDA with any questions or need for clarification of the illness or reporting.

In addition to the illnesses listed above, reporting of other less frequently occurring illnesses from natural toxins may be accomplished by emailing the FDA at Seafood.Illness@fda.hhs.gov.  Refer to Chapter 6 of the “Fish and Fishery Products Hazards and Controls Guidance” for a comprehensive list of natural toxin illnesses. To report illnesses related to miscellaneous natural toxin illnesses, please email FDA at Seafood.Illness@fda.hhs.gov.

The FDA works with first responders, physicians, and state and local health departments to investigate illnesses and outbreaks, manage them, and learn how to lessen future occurrences.

RASFF Alerts – Histamine – Tuna – Frozen Sardines

RASFF

Histamine in tuna from Sri Lanka in Sweden

RASFF

Histamine in Frozen Sardines (Sardina pilchardus) from The United Kingdom in France

France – Sliced ​​Tuna Loin – Histamine

Gov france

Identifying information for the recalled product

  • Product category Food
  • Product sub-category Fishery and aquaculture products
  • Product brand name unbranded
  • Names of models or references Sliced ​​tuna loin sold at the traditional stand of the CARREFOUR IVRY SUR SEINE store between 02/10/2021 and 06/10/2021
  • Product identification
    GTIN Lot
    1111111111116 sold between 02/10/2021 and 06/10/2021
  • Packaging by weight, presented sliced
  • Start date / End of marketing From 02/10/2021 to 06/10/2021
  • Storage temperature Product to be stored in the refrigerator
  • Further information Sliced ​​tuna loin sold at the traditional stand of the CARREFOUR IVRY SUR SEINE store between 02/10/2021 and 06/10/2021
  • Geographical sales area CARREFOUR IVRY SUR SEINE ONLY
  • Distributors ONLY CARREFOUR IVRY SUR SEINE

Practical information regarding the recall

  • Reason for recall presence of histamine
  • Risks incurred by the consumer Endogenous toxins: histamine (fish, cheese, alcoholic drinks, cold meats)