Fish, so foul! Foodborne illness caused by combined fish histamine and wax ester poisoning

Abstract

Nine people who ate a fish curry from a mobile canteen experienced increased heart rate, flushed skin, headache, nausea and diarrhoea shortly afterwards. These symptoms, which lasted for a mean of nine hours, were thought to have been associated with a combination of fish histamine and wax ester poisoning. The incriminated fish used was eventually identified as castor oil fish (Ruvettus pretiosus). Fish histamine poisoning is not confined to any particular species but wax ester intoxication only results from the consumption of two fish species, making identification of the incriminated fish of great importance in ascertaining a cause.