Toxins #3 – Scromboid Poisoning

Scromboid Poisoning:

We went to a local restaurant on the beach last night, known for their fresh mackerel caught that day.  It was delicious.  But, several hours later we all had nausea, vomiting, diarrhea, a red rash, sweating, and a strong metallic taste in our mouths.  We must have had too much of the cheap local beer. 

Scromboid:
 
Scromboid poisoning occurs when tuna, mackerel, or bonito are caught, but not properly refrigerated before cooking and eating. 

If the fish is not kept alive or refrigerated bacterial spoilage of the fish will occur. 

The bacteria will multiply in the fish flesh and convert the histidines, naturally occurring chemicals in the flesh of the fish, to histamines. 

When the fish is later eaten, the individual will essentially get an overdose of histamines. 

Like the biotoxins, the histamines are heat-stable, so cooking does not offer protection.

Symptoms:

Onset occurs in 2 minutes to 2 hours
Rash
Flushing
Diarrhea
Vomiting
Abdominal pain
Sweating
Headache
Burning or swelling of the mouth
Metallic taste

Treatment:

Antihistamines.
May need epinephrine, i.e. treat like anaphylaxis.

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