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Scombroid poisoning

Scombroid poisoning is a disease caused by the ingestion of contaminated food /mainly fish/. In this type of poisoning, the bacteria multiply in improper storage of the dark meat of the fish and begin to release scombroid.

This type of toxin or poison is a combination of histamine and histamine-like chemicals. They do not cause clinical symptoms in anyone who ingests them.

There are no 100% reliable tests for the presence of this toxin in fish. Heat treatment kills the bacteria, but toxins remain in the fish tissues and can be absorbed after ingestion.

The highest risk of the formation of scombroid toxin exists in the meat of the following types of fish:

• Tuna fish, anchovy, Australian salmon, halibut;
• Bonito, pike, herring, mackerel;

Other fish are likely to be added to the list if testing systems for the toxin improve. Flesh of affected fish may have a metallic or pungent taste.

What are the symptoms?

Clinical manifestations of this type of poisoning usually begin rapidly about 30 minutes to 1 hour after ingestion of the toxin and are expressed in:

• Nausea and vomiting;
• Flushing of the face;
• Abdominal cramps;
• Diarrhea;
• Headache;

Other possible symptoms are:

• Itching;
• Urticaria;
• Burning sensation in the mouth;
• Fever;
• Sensation of abnormal heartbeat;

Possible more severe reactions to poisoning are:

• Decrease in blood pressure;
• Palpitations;
• Difficulty breathing;

Symptoms usually last about 3 hours but some people experience discomfort for several days.

Treatment of scombroid poisoning

Most doctors suggest that inducing vomiting can help flush the toxin out of the body if the poisoned person is awake and has eaten fish in the last 3 hours. strong>

Orally activated charcoal can be used in patients suspected of having ingested large amounts of food possibly containing a significant amount of scombroid toxin. Some doctors recommend doing a gastric lavage before administering activated charcoal. In addition, patients are given intravenous fluids as they may become dehydrated from vomiting.

Scombroid toxin poisoning can be treated with diphenhydramine 25-50 mg. oral or initially IV every 6 hours and one ranitidine tablet twice daily for symptom relief.

Antihistamines can also be used to suppress symptoms; such as histamine 1 (H1) and histamine 2, H2-blockers can be used.

When should we seek medical attention?

An unusually severe or prolonged reaction to the toxin, manifested by shortness of breath, hypotension, swelling of the tongue and throat, requires the initiation of medical treatment , as soon as possible.

If the symptoms are milder, the affected person can also consult the doctor over the phone regarding treatment with over-the-counter medications.

Prevention

Scombroid toxin can reach levels /about 10-100 mg. histamines per 100 grams of fish meat/ to cause clinical manifestations in humans, about 6 hours after the fish meat has been out of the refrigerator.

It is recommended that food, especially freshly caught fish, be immediately refrigerated and kept at 5 degrees Celsius or below until it is prepared and eaten. Fish that are out of the refrigerator, have an unusual or bad smell or have a strange appearance should not be bought and consumed.

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