[Scombroid poisoning at an Icelandic restaurant]

We report four cases of scombroid poisoning. During a lunch meeting three males had the same dish: a club sandwich with raw tuna. All developed erythema over the face and neck within two hours of eating the tuna. The severity of symptoms varied. Other symptoms were profuse sweating, a feeling of intense thirst and palpitations. The symptoms disappeared after few hours. Samples obtained from the tuna revealed histamine levels above the recommended FDA levels. We also report a case with similar symptoms after eating canned tuna in a mixed salad. Scombroid poisoning has been associated with the consumption of dark-flesh fish with high levels of histidine, which can be converted to histamine by decarboxylase from Gram-negative bacteria in the fish. The fish most often implicated is tuna. It is of great importance to increase the awareness of this type of poisoning for correct diagnosis and to prevent other cases by improving storage.