Scombroid fish poisoning. Underreporting and prevention among noncommercial recreational fishers

Food-borne diseases, including those caused by seafood products, are common and greatly underreported sources of morbidity. In this article we review the epidemiology of scombroid fish poisoning and its possible relationship to the noncommercial and recreational catch and sale of fish. More than 20% of all fish sold in the United States is caught by sport fishers, and outbreaks of scombroid fish poisoning have involved improperly handled fish from private catches. We report an outbreak of scombroid fish poisoning among recreational fishers in California. The unregulated sale of recreationally caught fish for consumption and the prevention of scombrotoxism are discussed from the perspectives of public health agencies, clinicians, and the fishing public. Scientific and policy issues that require further attention are high-lighted.