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A large outbreak of scombroid fish poisoning associated with eating escolar fish (Lepidocybium flavobrunneum)

Published online by Cambridge University Press:  17 November 2004

K. A. FELDMAN ,
S. B. WERNER ,
S. CRONAN ,
M. HERNANDEZ ,
A. R. HORVATH ,
C. S. LEA ,
A. M. AU  and
D. J. VUGIA
K. A. FELDMAN
Affiliation:
California Emerging Infections Program, Oakland, CA, USA
S. B. WERNER
Affiliation:
California Department of Health Services, Infectious Diseases Branch, Berkeley, CA, USA
S. CRONAN
Affiliation:
Marin County Department of Health and Human Services, San Rafael, CA, USA
M. HERNANDEZ
Affiliation:
California Department of Health Services, Food and Drug Branch, Sacramento, CA, USA
A. R. HORVATH
Affiliation:
Marin County Department of Health and Human Services, San Rafael, CA, USA
C. S. LEA
Affiliation:
Marin County Department of Health and Human Services, San Rafael, CA, USA
A. M. AU
Affiliation:
California Department of Health Services, Food and Drug Laboratory Branch, Richmond, CA, USA
D. J. VUGIA
Affiliation:
California Department of Health Services, Infectious Diseases Branch, Berkeley, CA, USA
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Abstract

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In August 2003, an outbreak of scombroid fish poisoning occurred at a retreat centre in California, USA. In a retrospective cohort study, 42 (75%) of the 56 dinner attendees who ate escolar fish (Lepidocybium flavobrunneum) met the case definition. Individuals who ate at least 2 oz of fish were 1·5 times more likely to develop symptoms than those who ate less (relative risk 1·5, 95% confidence interval 0·9–2·6), and to develop more symptoms (median 7 vs. 3 symptoms, P=0·03). Patients who took medicine had a longer duration of symptoms than those who did not (median 4 vs. 1·5 h, P=0·05), and experienced a greater number of symptoms (median 8 vs. 3 symptoms, P=0·0002). Samples of fish contained markedly elevated histamine levels (from 2000 to 3800 ppm). This is one of the largest reported outbreaks of scombroid fish poisoning in the United States and was associated with a rare vehicle for scombroid fish poisoning, escolar.

Type
Research Article
Information
Epidemiology & Infection , Volume 133 , Issue 1 , February 2005 , pp. 29 - 33
Copyright
2004 Cambridge University Press