I had an unfortunate encounter with a toxin that has reportedly taken down prominent figures, including a Russian whistleblower.
To accommodate a guest with a severe fish allergy, I opted to marinate and cook the fish in my kitchen using a cast iron skillet instead of grilling it outside, where my husband was managing the barbecue. I was quite famished and had already devoured nearly half of one of the generous fillets that my friend, Sarah, had gifted us after her husband’s successful day of fishing. I set aside some smaller portions for my young daughter and the wife of our allergic friend. They each took a tiny bite but soon decided they preferred the hot dogs and burgers instead.
Just fifteen minutes after my husband pulled the meat off the grill, I settled down with the leftover fish and an ear of corn. Suddenly, a wave of heat washed over me. As a redhead, I was no stranger to blushing, but this felt different—like my skin was engulfed in flames.
My heart raced, and I began to feel lightheaded. “Are you alright?” my husband asked, lowering his sunglasses, clearly concerned. “You’re as red as I’ve ever seen you.”
“Actually, no,” I replied, feeling the alarm rising.
I headed to the kitchen, followed closely by my husband and two worried friends. “Is it an allergic reaction?” the friend with the fish allergy asked. “Do you have Benadryl?”
“Right, can’t hurt,” I mumbled, rummaging through the medicine cabinet and swallowing a 25 mg tablet.
“Maybe another one?” my husband suggested, eyeing me warily. “And then to the hospital?”
Our friends nodded in agreement. I reluctantly took another capsule.
“Hospital? Is it that serious?” I questioned, suddenly feeling a bit nervous about the situation.
“Um, your eyes are completely bloodshot,” my husband stated. “And your skin is looking to be purple at this point.”
After our friends left, my husband drove me to the emergency room.
“That’s quite a bad sunburn,” the triage nurse remarked.
“It’s not sunburn,” I insisted. “I’ve barely been outside today, and I always wear sunscreen.”
They took my vitals, revealing rapid pulse and unusually high blood pressure. “One of your medications can increase sun sensitivity,” the nurse practitioner noted.
“I know, I’ve been on and off it for five years and am careful,” I replied.
The emergency room was surprisingly quiet, and I was quickly taken back to a room. Ten minutes later, the doctor entered and listened as I described my symptoms: sudden and severe flushing after eating the fish, a pounding headache, and now—thanks to my time at the hospital—diarrhea.
“You have scombroid poisoning,” he stated matter-of-factly. He explained that he sees cases like mine only once or twice a year, usually in individuals who have consumed fish that wasn’t commercially caught and processed. Scombroid fish poisoning, also known as histamine fish poisoning, occurs when certain fish aren’t properly refrigerated. Bacteria can multiply, breaking down the fish and producing excess histamine, which remains unaffected by cooking. Common culprits include tuna, mackerel, and bonito, among others.
While severe reactions like mine are rare, many milder cases likely go unreported. Neither my daughter nor her friend reacted to the small bites they took—perhaps their portions were unaffected or they were less sensitive for various reasons.
According to poison control, the typical symptoms of scombroid poisoning include rash, diarrhea, facial flushing, sweating, headaches, and vomiting. Some might experience a burning sensation, swelling of the mouth, difficulty swallowing, or stomach cramps. Heart palpitations can also occur.
The doctor administered intravenous medications and monitored me until the flushing subsided and my blood pressure returned to normal. I left with instructions to keep taking Benadryl until I felt better.
Despite this experience, I still enjoy poke and sushi regularly. While I’ll be more cautious about fish caught by friends in the future, this incident has given me a greater appreciation for the hard work of those in the fishing and food industries who ensure the safety of our meals. I look forward to indulging in sushi again soon.
This article was originally published on July 13, 2018.
Summary
In a harrowing experience at a barbecue, I fell victim to scombroid poisoning after consuming improperly handled fish. Following alarming symptoms, I was rushed to the hospital, where I learned about the risks of eating fish that hasn’t been properly refrigerated. Despite the scare, my love for sushi remains undeterred, and I now have a deeper appreciation for food safety practices.