SCOMBROID FISH POISONING OUTBREAK BY TUNA INGESTION IN CASTELLON, SPAIN

BACKGROUND: To investigate and central of a collective scombroid-fish poisoning (SFP) outbreak, that took place in Castellon, Spain. METHODS : Description of the outbreak and case-control study in order to ident ify risk factors. Active surveillance of SFP cases, and inspection of implicted markets. Histamine determination in urine of cases and foods . RESULTS: During June 1994, 15 cases of SFP were found out, with 12 c ases ocurred on June, 28 and 29. Five families were affected (attack r ate 68.2%). The median incubation period was 45 minutes. Disease sympt oms included facial or general flushing, headache, diarrhea, nausea, a bdominal pain, and peppery taste. Implicated food was fresh tuna, boug ht in a hypermarket of Castellon (adds ratio = 26,4, 95% confidance in tervals: 1.05-666.8), adjusted by age and sex using logistic regressio n analysis. Four samples of urine from cases presented histamine conce ntration above 35 mu g/l. Three samples of tuna consumed by cases and one sample of tuna from the hypermarket had histamine concentration ab ove a 200 ppm. Considering the situation of risk, remaining suspected tuna was confiscated from the hypermarket. Rest unknown if the descomp ositions of tuna occurred in the hypermarket or during capture and dis tribution. CONCLUSIONS: SFP was caused by fresh tuna ingestion with ep idemiologic and analytic confirmation. Determination of histamine in u rine of patients could permit to confirm SFP.