title: A large outbreak of scombroid fish poisoning associated with eating yellowfin tuna (Thunnus albacares) at a military mass catering in Dakar, Senegal.
abstract: On 26 November 2010, an outbreak of scombroid fish poisoning occurred in the French Armed Forces in Dakar, Senegal. This chemical intoxication, due to high histamine concentration in fish, is often mistaken for an allergic reaction. A case-control study was undertaken including the 71 cases and 78 randomly selected controls among lunch attendees. The usual symptoms for scombroid fish poisoning were observed in cases, i.e. flushing (85.9%), headache (83.1%), rapid/weak pulse (59.1%) and diarrhoea (47.9%). Symptoms occurred from within a few minutes to up to 3 h following the meal. Most patients quickly recovered with antihistamine and/or symptomatic treatment. Tuna was the only food item positively associated with illness (odds ratio 36.3, 95% confidence interval 6.3-210.0), with the risk of illness increasing with the quantity of fish consumed. No bacterial contamination was found in leftover food, but histamine concentration in tuna was found to be 4900 mg/kg, almost 50-fold higher than the concentration allowed by European regulations. This report is unique because of the large size of the case series - to our knowledge, the largest event of scombroid fish poisoning ever reported - and the chemical and bacteriological analyses results obtained on leftover food.
authors.affiliation: Direction Interarmées du Service de Santé, Forces Françaises du Cap-Vert, Sénégal. jp.demoncheaux@voila.fr
authors.forename: J-P
authors.initials: JP
authors.lastname: Demoncheaux
authors.forename: R
authors.initials: R
authors.lastname: Michel
authors.forename: C
authors.initials: C
authors.lastname: Mazenot
authors.forename: G
authors.initials: G
authors.lastname: Duflos
authors.forename: C
authors.initials: C
authors.lastname: Iacini
authors.forename: F
authors.initials: F
authors.lastname: de Laval
authors.forename: F
authors.initials: F
authors.lastname: Delaval
authors.forename: E M
authors.initials: EM
authors.lastname: Saware
authors.forename: J-C
authors.initials: JC
authors.lastname: Renard
mesh_terms: D000328:Adult; D000818:Animals; D004196:Disease Outbreaks; D005260:Female; D005506:Food Contamination / Q000032:analysis*; D005511:Food Handling / Q000592:standards; D005517:Foodborne Diseases / Q000453:epidemiology*; D006632:Histamine / Q000737:chemistry / Q000633:toxicity*; D006801:Humans; D008297:Male; D008460:Meat / Q000009:adverse effects*; D008875:Middle Aged; D008889:Military Personnel; D016017:Odds Ratio; D012307:Risk Factors; D012675:Senegal / Q000453:epidemiology; D014413:Tuna; D055815:Young Adult
chemical_list: D006632:Histamine