Tuna and scombrotoxin poisoning in two men
What it found
Two men became ill after eating tuna, one from fresh tuna and one from tinned tuna.
Both had high histamine levels in the fish.
What they found
Studies in people
First case
A 45 year old man had face and throat swelling, flushing, headache and diarrhoea 45 minutes after eating fresh tuna. The fish had histamine levels over 200 mg per 100 g.
Second case
A 31 year old man had a red rash on his face and upper body an hour after eating tinned tuna sandwiches. Six other people who ate the same sandwiches also became ill. The tuna had histamine levels over 250 mg per 100 g.
Symptoms and recovery
Symptoms can start in the mouth with numbness, tingling or burning, then headache, rash, nausea and diarrhoea. Complete recovery within 12 hours is usual.
Other findings
Histamine in fish
Scombrotoxin poisoning happens when certain fish spoil and bacteria produce large amounts of histamine. The fish can look and smell normal but may have a peppery or hot taste.
Tinned tuna risk
Contamination of tinned tuna can happen after opening. In the second case, high histamine levels were reached within seven hours of opening the tin.
What the authors conclude
- They advise that scombrotoxin poisoning should be considered in any patient who suffers the typical symptoms after eating fish.
- They note that many episodes may be ascribed to food sensitivity, and the reported numbers may not reflect the true incidence of this condition.
How it was done
The authors describe this condition because it is relatively rare and can easily be mistaken for an allergic reaction.
They describe two cases. A 45 year old man ate cooked fresh tuna and a 31 year old man ate tuna mayonnaise sandwiches. Samples of the fish were tested for histamine.
What it can’t tell you
- This is a report of two cases, so it cannot show how often this poisoning happens or who is most at risk.
- The exact way histamine reaches the blood in this poisoning is not known.
Who paid
- Authors work at
- Guy's Hospital, United Kingdom
The paper
- Title
- Trouble with tuna: two cases of scombrotoxin poisoning
- Type
- Case report
- Evidence
- Studies in people
- Summarised from
- Full text
- Cite
- Stell IM (1997). Trouble with tuna: two cases of scombrotoxin poisoning. Journal of accident & emergency medicine. doi:10.1136/emj.14.2.110PubMed 9132185DOI
Summary written 30 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error