Biomaterial Database

Histamine poisoning associated with eating tuna burgers. 2001

K Becker, and K Southwick, and J Reardon, and R Berg, and J N MacCormack

Office of International and Refugee Health, US Department of Health and Human Services, 5600 Fishers Ln, Parklawn Bldg, Room 18-105, Rockville, MD 20857, USA. kbecker@osophs.dhhs.gov

BACKGROUND Histamine poisoning occurs when persons ingest fish in which bacteria have converted histidine to histamine, a process that usually can be controlled by storage at low temperatures. From 1994 to 1997, North Carolina averaged 2 cases annually; however, from July 1998 to February 1999, a total of 22 cases of histamine fish poisoning were reported. OBJECTIVE To examine the increase in histamine case reports, identify risk factors for poisoning, and develop recommendations for prevention. METHODS Case series evaluated in North Carolina from July 1998 to February 1999. METHODS Reported case-patients with 2 of the following symptoms within 2 hours of eating tuna: rash, facial flushing, vomiting, diarrhea, dyspnea, a tight feeling in the throat, headache, or a metallic or peppery taste in the mouth. RESULTS Twenty cases occurred during 5 outbreaks, and there were 2 single occurrences. Of the 22 persons affected, 19 (86%) sought emergency medical care. All case-patients ate tuna: 18 ate tuna burgers, 2 ate salad containing tuna, and 2 ate filets. Tuna samples (available from 3 outbreaks) had histamine levels above the Food and Drug Administration regulatory level of 50 ppm (levels were between 213 and 3245 ppm). In 19 cases, the tuna used to prepare burgers or salads was frozen and thawed more than once before serving. Violations of recommended temperature controls were identified in 2 of the 5 restaurants, accounting for 14 (64%) cases. CONCLUSIONS Tuna burgers, a relatively new menu item in restaurants, were associated with an increase in histamine poisoning cases in North Carolina. Tuna ground for burgers can be susceptible to both temperature fluctuations and bacterial contamination.

UI	MeSH Term	Description	Entries
D009657	North Carolina	State bounded on the north by Virginia, on the east and Southeast by the Atlantic Ocean, on the south by Georgia and South Carolina, and on the west by Tennessee.
D004196	Disease Outbreaks	Sudden increase in the incidence of a disease. The concept includes EPIDEMICS and PANDEMICS.	Outbreaks,Infectious Disease Outbreaks,Disease Outbreak,Disease Outbreak, Infectious,Disease Outbreaks, Infectious,Infectious Disease Outbreak,Outbreak, Disease,Outbreak, Infectious Disease,Outbreaks, Disease,Outbreaks, Infectious Disease
D005517	Foodborne Diseases	Acute illnesses, usually affecting the GASTROINTESTINAL TRACT, brought on by consuming contaminated food or beverages. Most of these diseases are infectious, caused by a variety of bacteria, viruses, or parasites that can be foodborne. Sometimes the diseases are caused by harmful toxins from the microbes or other chemicals present in the food. Especially in the latter case, the condition is often called food poisoning.	Food Poisoning,Food-borne Disease,Food-borne Illness,Foodborne Disease,Foodborne Illness,Food-borne Diseases,Food-borne Illnesses,Foodborne Illnesses,Poisoning, Food,Disease, Food-borne,Disease, Foodborne,Food Poisonings,Food borne Disease,Food borne Diseases,Food borne Illness,Food borne Illnesses,Illness, Food-borne,Illness, Foodborne,Illnesses, Foodborne
D005519	Food Preservation	Procedures or techniques used to keep food from spoiling.	Preservation, Food
D006632	Histamine	An amine derived by enzymatic decarboxylation of HISTIDINE. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter.	Ceplene,Histamine Dihydrochloride,Histamine Hydrochloride,Peremin
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000818	Animals	Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA.	Animal,Metazoa,Animalia
D012307	Risk Factors	An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent.	Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D014413	Tuna	Common name for various species of large, vigorous ocean fishes in the family Scombridae.	Tunas
D017747	Seafood	Marine fish and shellfish used as food or suitable for food. (Webster, 3d ed) SHELLFISH and FISH PRODUCTS are more specific types of SEAFOOD.	Sea-Food,Sea Food,Sea-Foods,Seafoods