title: Histamine food poisonings: A systematic review and meta-analysis.
abstract: OBJECTIVE
  The aim of this study was to assess the mean of histamine concentration in food poisoning.
  
  
  METHODS
  Systematic review and meta-analysis of reports published between 1959 and 2013.
  
  
  METHODS
  Main criteria for inclusion of studies were: all report types that present outbreaks of "histamine poisoning' or "scombroid syndrome" from food, including histamine content and type of food. Health status of people involved must be nonpathological.
  
  
  RESULTS
  Fifty-five (55) reports were included, these studies reported 103 incidents. All pooled analyses were based on random effect model; histamine mean concentration in poisoning samples was 1107.21 mg/kg with confidence interval for the meta-mean of 422.62-2900.78 mg/kg; heterogeneity index (I2) was 100% (P < 0.0001); prediction interval was 24.12-50822.78 mg/kg. Fish involved in histamine poisoning was mainly tuna or Istiophoridae species. No clues of association between concomitant conditions (female sex, alcohol consumption, previous medication, and consumption of histamine releasing food) and histamine poisoning, were highlighted.
  
  
  CONCLUSIONS
  This is the first systematic review and meta-analysis that analyzes all the available data on histamine poisoning outbreaks evaluating the histamine concentration in food involved. Histamine mean concentration in poisoning samples was fairly high. Our study suffers from some limitations, which are intrinsic of the studies included, for instance the lack of a complete anamnesis of each poisoning episode. Protocol registration: Methods were specified in advance and have been published as a protocol in PROSPERO database (18/07/2012 -CRD42012002566).
authors: a Dipartimento di Scienze Veterinarie per la Salute , la Produzione Animale e la Sicurezza Alimentare, Università degli Studi di Milano , Milano , Italy.
authors: Fabio M
authors: FM
authors: Colombo
authors: a Dipartimento di Scienze Veterinarie per la Salute , la Produzione Animale e la Sicurezza Alimentare, Università degli Studi di Milano , Milano , Italy.
authors: Patrizia
authors: P
authors: Cattaneo
authors: a Dipartimento di Scienze Veterinarie per la Salute , la Produzione Animale e la Sicurezza Alimentare, Università degli Studi di Milano , Milano , Italy.
authors: Enrica
authors: E
authors: Confalonieri
authors: a Dipartimento di Scienze Veterinarie per la Salute , la Produzione Animale e la Sicurezza Alimentare, Università degli Studi di Milano , Milano , Italy.
authors: Cristian
authors: C
authors: Bernardi
mesh_terms: D000818:Animals; D005399:Fishes; D005506:Food Contamination; D005517:Foodborne Diseases; D006632:Histamine / Q000633:toxicity*; D006801:Humans; D008387:Marine Toxins / Q000032:analysis
chemical_list: D008387:Marine Toxins; D006632:Histamine
keywords: Scombroid syndrome; foodborne illness; histamine intoxication; outbreak; scombrotoxin fish poisoning