Histamine fish poisoning in Australia, 2001 to 2013

Area of Science:

• Foodborne illness
• Public health surveillance
• Toxicology

Background:

• Histamine fish poisoning (HFP) is caused by consuming fish with high histamine levels, resulting from bacterial spoilage due to improper handling.
• Symptoms often mimic allergic reactions, including flushing, headaches, and rashes, with rapid onset after ingestion.

Purpose of the Study:

• To analyze human illnesses and outbreaks of histamine fish poisoning in Australia from 2001 to 2013.
• To identify common fish species, clinical symptoms, and epidemiological features of HFP outbreaks.

Main Methods:

• Data was collected from the OzFoodNet outbreak register, published case reports, and surveillance data.
• Analysis included outbreak size, food vehicles, incubation periods, symptoms, and hospitalization rates.

Main Results:

• 57 HFP outbreaks affected 187 individuals; 14% required hospitalization, with no reported deaths.
• Tuna (Scombridae family) was the most frequent vehicle; 88% of outbreaks involved fewer than 5 people.
• Short incubation periods (median <1 hour) and symptoms like diarrhea, rash, and flushing were common.

Conclusions:

• HFP outbreaks in Australia are typically small, characterized by rapid onset and common, generally mild symptoms.
• Improved recognition and management are crucial to prevent potential severe health effects.
• Effective temperature control and handling practices post-harvest are essential to mitigate HFP risk.