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  5. How to Report Seafood-Related Toxin and Scombrotoxin Fish Poisoning Illnesses
  1. Outbreaks of Foodborne Illness

How to Report Seafood-Related Toxin and Scombrotoxin Fish Poisoning Illnesses

To help FDA effectively investigate, remove unsafe seafood products from the market, and develop new prevention strategies, the FDA relies on illness reporting from first responders, physicians, public health officials, healthcare providers, state and local health departments and consumers. FDA works with these stakeholders to investigate illnesses and outbreaks, manage them, and learn how to decrease future occurrences. While most foodborne outbreaks are tracked through the FDA’s Coordinated Outbreak Response and Evaluation (CORE) network, seafood-related illnesses caused by natural toxins and scombrotoxin fish poisoning have a unique reporting mechanism. This web page provides information on commonly occurring seafood-related toxin and scombrotoxin fish poisoning illnesses and identifies the mechanism for reporting them to the FDA. To report an illness from raw bivalve molluscan shellfish, email the FDA at shellfishepi@fda.hhs.gov.

The FDA receives reports of illnesses associated with the consumption of specific types of fish. These illnesses may originate from the activity of certain bacteria, toxins produced by marine algae, or hazards inherent in the fish.

Commonly occurring illnesses are:

Illness and reporting information for the commonly occurring illnesses are provided in each section. Contact the FDA with any questions or need for clarification of the illnesses or reporting.

In addition to the illnesses listed above, reporting of other less frequently occurring illnesses resulting from natural toxins may be accomplished by emailing the FDA at Seafood.Illness@fda.hhs.gov.  Refer to Chapter 6 of the Fish and Fishery Products Hazards and Controls Guidance for a comprehensive list of natural toxin illnesses.

To report illnesses related to miscellaneous natural toxin illnesses from fish other than bivalve molluscan shellfish, please email FDA at Seafood.Illness@fda.hhs.gov. The reporting email should include at a minimum the following information:

  • Species of fish;
  • Location of illness (e.g., state, country);
  • Identify whether a meal remnant* is available and its current condition (i.e., refrigerated, frozen);
  • Number of people ill from eating the fish;
  • How the fish was obtained such as recreationally captured or commercially purchased; and
  • Purchase location (store/restaurant) to include the store’s/restaurant’s name and address. 

*FDA has defined a meal remnant for the purposes of this program as the edible portion of the fish (leftover), cooked or uncooked, from the exact fish consumed from the illness event associated with the natural toxin or scombrotoxin fish poisoning illnesses. Meal remnants should be frozen immediately and remain so until a representative retrieves them. Additional Information section pertaining to meal remnants may be found below.

Also on this page: 

Ciguatera Poisoning (CP)

Ciguatera poisoning is commonly related to the consumption of subtropical and tropical reef fish which can accumulate naturally occurring ciguatoxins through their diet. The highest incidences of ciguatoxins occur between latitudes 35° north to 35° south, and include areas of the Caribbean Sea, Gulf of Mexico, and Atlantic, Pacific, and Indian Oceans. Refer to Chapter 6 of the Fish and Fishery Products Hazards and Controls Guidance for more specific information regarding locations. Many fish species have been associated with CP including but not limited to barracuda; grouper; snapper; jacks and trevally; wrasse; mackerel; tang; moray eels; and parrotfish. Ciguatoxins have also been found in lionfish collected in waters surrounding the U.S. Virgin Islands. In 2023 the FDA investigated a CP illness directly related to the consumption of lionfish by assessing the symptomology; however, FDA was unable to confirm the diagnosis through laboratory analysis since meal remnants were not available. Refer to Table 1 below for additional information.  Additional species of fish associated with this illness may be found in Table 3-2 Potential Vertebrate Species-Related Hazards in the FDA Fish and Fishery Products Hazards and Controls Guidance.

Note: FDA has changed the previous acronym from CFP (Ciguatera Fish Poisoning) to CP (Ciguatera Poisoning) to be more inclusive of additional seafood types associated with ciguatera globally. For example, gastropods (Tectus niloticus), cone snails (Conus spp.), giant clams (Tridacna maxima and Hippopus hippopus), jellyfish (Cnidaria spp.), and lobster (Panulirus penicillatus) have been reported to bioaccumulate ciguatoxins. To date, no cases of CP from the consumption of these additional seafood types have been confirmed in the United States.

The onset of symptoms typically occurs within 6 hours after consuming toxic fish/fishery products and may persist from several days to weeks. In severe cases, some neurological symptoms may persist for months and can recur for years. Fatalities do not usually occur; however, isolated fatalities have been reported. Symptoms of CP fall into three categories and include:

  • Gastrointestinal:
    • Nausea;
    • Vomiting; and
    • Diarrhea;
  • Neurological:
    • Numbness and tingling of the lips and extremities;
    • Itching of the hands and feet;
    • Joint pain;
    • Muscle pain;
    • Muscle weakness;
    • Reversal and sensitivity to temperature;
    • Dizziness; and
    • Vertigo;
  • Cardiovascular:
    • Irregular heartbeat; and
    • Low blood pressure.

For more information on ciguatera poisoning, refer to Chapter 6 of the Fish and Fishery Products Hazards and Controls Guidance and the associated chapter in the FDA Bad Bug Book.

To report CP related illness(es) please email FDA at Seafood.Illness@fda.hhs.gov. The reporting email should include at a minimum the following information:

  • Species of fish/fishery products;
  • Location of illness (e.g., state, country);
  • Identify whether a meal remnant* is available and its current condition;
  • Number of people who became ill from eating the fish/fishery products;
  • How the fish/fishery products was obtained such as recreationally captured or commercially purchased; and
  • Purchase location (store/restaurant) to include the store’s/restaurant’s name and address. 

*FDA has defined a meal remnant for the purposes of this program as the edible portion of the fish/fishery products (leftover), cooked or uncooked, from the exact fish/fishery products consumed from the illness event associated with natural toxin or scombrotoxin fish poisoning illnesses. Meal remnants should be frozen immediately and remain so until a representative retrieves them. Additional Information section pertaining to meal remnants may be found below.

Puffer Fish Poisoning (PFP)

Puffer fish poisoning (PFP) typically caused by naturally occurring tetrodotoxin is associated with the consumption of puffer fish from waters of the Indo-Pacific Ocean Regions, Gulf of Mexico, Gulf of California, and specific areas on the Atlantic coast of Florida. In addition, an accumulation of saxitoxins in the puffer fish, introduced through their diet, has also been referred to as puffer fish poisoning and should be reported accordingly.

Note: Due to the severity of puffer fish poisoning, puffer fish are a highly regulated product in the United States. See Regulatory Status of Puffer Fish section for additional information. Due to the importation and harvesting restrictions for this product, it is important to determine the source of any fish causing illness for potential regulatory action.  

Symptoms usually develop within 3 hours after consumption of contaminated fish and may last from 24 – 48 hours. In extreme cases, death may occur due to muscle paralysis resulting in respiratory failure when ventilatory support is not accessible. Symptoms of PFP include:

  • Numbness of the lips and tongue;
  • Tingling sensation in the face and extremities;
  • Headache;
  • Abdominal pain;
  • Nausea;
  • Diarrhea;
  • Vomiting;
  • Difficulty in walking;
  • Paralysis;
  • Respiratory distress;
  • Difficulty in speech;
  • Shortness of breath;
  • Blue or purplish discoloration of the lips and skin;
  • Lowering of blood pressure;
  • Convulsions;
  • Mental impairment;
  • Irregular heartbeat; and
  • Death in extreme cases.

For more information on Puffer fish poisoning, refer to Chapter 6 of the Fish and Fishery Products Hazards and Controls Guidance and the associated chapter in the FDA Bad Bug Book.

To report PFP related illness(es) please email FDA at Seafood.Illness@fda.hhs.gov. In all PFP cases, determining the source of the suspect fish is critical to assuring that additional unsafe products are not in commerce. The reporting email should include at a minimum the following information:

  • Species of fish;
  • Location of illness (e.g., state, country);
  • Identify whether a meal remnant* is available and its current condition;
  • Number of people ill from eating the fish;
  • How the fish was obtained such as recreationally captured or commercially purchased; and
  • Purchase location (store/restaurant) to include the store’s/restaurant’s name and address. 

*FDA has defined a meal remnant for the purposes of this program as the edible portion of the fish (leftover), cooked or uncooked, from the exact fish consumed from the illness event associated with natural toxin or scombrotoxin fish poisoning illnesses. Meal remnants should be frozen immediately and remain so until a representative retrieves them. Additional Information section pertaining to meal remnants may be found below.

Scombrotoxin Fish Poisoning (SFP)

Scombrotoxin (histamine) formation as a result of time and temperature abuse such as improper storage/refrigeration of certain types of fish can cause consumer illness. SFP is closely linked to the development of histamine in these fish and is primarily associated with the consumption of tuna and mahi-mahi, among other species. Additional species of fish associated with this illness may be found on Table 3-2 Potential Vertebrate Species-Related Hazards in the Fish and Fishery Products Hazards and Controls Guidance.

Symptoms usually occur within a few minutes to a few hours after consumption and last from 12 hours to a few days. Symptoms of SFP include:

  • Tingling or burning in or around the mouth or throat;
  • Rash or hives on the upper body;
  • Drop in blood pressure;
  • Headache;
  • Dizziness;
  • Itching of the skin;
  • Nausea;
  • Vomiting;
  • Diarrhea;
  • Asthmatic-like constriction of the air passage;
  • Heart palpitations; and
  • Respiratory distress.

For more information on scombrotoxin, refer to Chapter 7 of the Fish and Fishery Products Hazards and Controls Guidance and the associated chapter in the FDA Bad Bug Book.

To report SFP related illness(es) please email FDA at Seafood.Illness@fda.hhs.gov. The reporting email should include at a minimum the following information:

  • Species of fish;
  • Location of illness (e.g., state, country);
  • Identify whether a meal remnant* is available and its current condition;
  • Number of people ill from eating the fish;
  • How the fish was obtained such as recreationally captured or commercially purchased; and
  • Purchase location (store/restaurant) to include the store’s/restaurant’s name and address. 

*FDA has defined a meal remnant for the purposes of this program as the edible portion of the fish (leftover), cooked or uncooked, from the exact fish consumed from the illness event associated with natural toxin or scombrotoxin fish poisoning illnesses. Meal remnants should be frozen immediately and remain so until a representative retrieves them. Additional Information section pertaining to meal remnants may be found below.

Seafood-associated Rhabdomyolysis
(sometimes referred to as Haff disease)

Seafood-associated rhabdomyolysis, also known as Haff disease, has primarily been linked to the consumption of buffalo fish in the United States although other fish species such as burbot, crayfish, eel, and pike have been associated with the disease worldwide. The cause(s) of seafood-associated rhabdomyolysis is unknown. Three species of buffalo fish (Ictiobus sp.) are commercially harvested in the U.S. Most previous U.S. reports associated this illness with Ictiobus cyprinellus (bigmouth buffalo). However, through recent genomic sequencing we were able to associate Haff disease illnesses which have occurred in the U.S. from 2010 – 2020 as being most often associated with commercially harvested Ictiobus bubalus (smallmouth buffalo) and Ictiobus niger (black buffalo).

Seafood-associated rhabdomyolysis results in the breakdown of skeletal muscle (rhabdomyolysis), with a risk of acute kidney failure that develops within 24 hours after consuming certain fish. Initial symptoms include muscle tenderness and weakness, sometimes with tea-colored urine. Blood testing is often used to diagnose seafood-associated rhabdomyolysis/Haff disease with elevated levels of creatine phosphokinase (CPK) being one of the most commonly used indicators.

The FDA is currently collecting meal remnants from patients diagnosed with the disease to confirm the causative species and research the causative agent(s).

For more information on seafood-associated rhabdomyolysis (sometimes referred to as Haff disease), refer to Chapter 6 of the Fish and Fishery Products Hazards and Controls Guidance.

To report seafood-associated rhabdomyolysis (Haff disease) related illness(es), please email FDA at Seafood.Illness@fda.hhs.gov. The reporting email should include at a minimum the following information:

  • Species of fish;
  • Location of illness (e.g., state, country);
  • Identify whether a meal remnant* is available and its current condition;
  • Number of people ill from eating the fish;
  • How the fish was obtained such as recreationally captured or commercially purchased; and
  • Purchase location (store/restaurant) to include the store’s/restaurant’s name and address. 

*FDA has defined a meal remnant for the purposes of this program as the edible portion of the fish (leftover), cooked or uncooked, from the exact fish consumed from the illness event associated with natural toxin or scombrotoxin fish poisoning illnesses. Meal remnants should be frozen immediately and remain so until a representative retrieves them. Additional Information section pertaining to meal remnants may be found below.

Additional Information

Meal Remnants and Disease Related Information

The FDA collects meal remnants and epidemiological information, whenever available, to expand our knowledge and information database to better understand these illnesses. This data is critical to improving our understanding of the sources of illnesses, and helps the FDA learn more about the epidemiology and science of these illnesses.

  • Meal remnants:
    • FDA defines a meal remnant for the purpose of this program as any remaining edible portion (leftover) of the fish, cooked or uncooked, from the exact fish consumed for the illness incident.
    • Any meal remnants should be immediately frozen and should not be eaten by any other individual(s). The meal remnants should be provided to health care providers or state/local public health authorities. The health care providers or state/local authorities will contact their local FDA District Office to coordinate submission of the remnants for analysis as deemed appropriate.
  • Epidemiological information: The epidemiological information collected will be used as part of a surveillance effort to confirm the sources of illnesses, characterize the responsible toxins, develop testing methodologies (where appropriate), and determine if development and/or refinement of controls for the toxins are warranted. In addition, a better understanding of long-term effects on the patient may be gained. The information gained from this work may assist the FDA in its partnerships with state and local public health departments to reduce future occurrences.

Regulatory Status of Puffer Fish

Due to the severity of puffer fish poisoning, it is important to understand the regulatory status of puffer fish.

FDA and the Japanese Ministry of Health reached an agreement regarding the importation of a single species of puffer fish, Takifugu rubripes, also known as “Tiger puffer” or “Tora Fugu,” that are prepared under Japanese safety guidelines and tested prior to importation. Any puffer fish not imported pursuant to this agreement is subject to FDA’s Import Alert #16-20, which informs FDA field staff that they may detain the fish without physical examination. Any firms found to be importing puffer fish under false or misleading names to avoid these import restrictions may be placed on the FDA Import Alert #16-04 for species misbranding. Import Alerts can be accessed through Import Alerts by Number (fda.gov).

Puffer fish from domestic sources is sold in the United States and is subject to the seafood HACCP regulation; however, in certain circumstances the FDA will defer to the States for stronger restrictions specifically on harvesting due to toxicity. The southern puffer (Sphoeroides nephelus) occurs in Florida and the Gulf of Mexico and was historically harvested and marketed along with the northern puffers (typically harvested in mid-Atlantic waters) in the sea squab fishery. Between 2002 and 2004, 28 cases of PFP occurred along the east coast of the U.S. and were linked to southern puffers from the Indian River lagoon system along the east (Atlantic) coast of Florida. Southern puffers were previously believed to be non-toxic; however, it is now known that southern puffers – specifically from the Indian River Lagoon system – may also contain saxitoxins derived from an algal source and accumulated through the food chain. Furthermore, the toxins in this species, from this location, are contained in the meat, making safe preparation impossible. The state of Florida has banned the commercial and recreational harvesting of all puffer species from the counties of Volusia, Brevard, Indian River, St. Lucie, and Martin, but illnesses still sporadically occur. Commercial harvesting of southern puffers is still allowed on the west coast (Gulf of Mexico) of Florida. Additional tetrodotoxin-containing species of puffer fish occur in Florida and the Gulf of Mexico as well as on the U.S. west coast, but these fish are not typically consumed.

Investigated Illnesses and Outbreaks

Below is a list of natural toxin and scombrotoxin fish poisoning illness and outbreak incidents that are no longer active. These incidents have been reported to and managed by the FDA, as well as our state and local partners. The information gathered from these incidents will inform the FDA, as well as refine our policy and guidance for management of the program. Data listed below is from September 2019 to present. As time and resources allow the table will be populated with incidents predating September 2019. This table is updated on a quarterly basis.

Table 1: Closed Illness and Outbreak Incidents

Date
Reported		 FDA Reference
Number		 Illness
Type		 Reported
Fish/
Fishery
Product		 Case
Count		 Reporting
State		 Analytical
Results		 Confirmed
Fish/Fishery
Products
Species		 Comments 
2019.09.20 19-09-01 CP Hogfish 2 Puerto Rico C-CTX: Confirmed Hogfish
(Lachnolaimus maximus)		 N/A
2019.10.29 19-10-01 CP Hogfish 1 Puerto Rico C-CTX: Confirmed Hogfish
(Lachnolaimus maximus)		 N/A
2019.10.21 19-10-02 CP Barracuda 1 Florida C-CTX: Confirmed Great Barracuda
(Sphyraena barracuda)		 N/A
2019.10.18 19-10-03 CP Barracuda 3 Puerto Rico C-CTX: Confirmed Great Barracuda
(Sphyraena barracuda)		 Great Barracuda (Sphyraena barracuda) ID confirmed visually from intact head
2019.10.25 19-10-04 CP Barracuda 2 Puerto Rico C-CTX: Confirmed Great Barracuda
(Sphyraena barracuda)		 N/A
2019.10.28 19-10-05 CP Amberjack 2 Florida C-CTX: Confirmed Wahoo
(Acanthocybium solandri)		 N/A
2019.11.08 19-10-06 Haff Buffalo fish 3 Texas N/A N/A No meal remnants available
2019.11.27 19-11-01 CP Purplespotted Grouper 4 Hawaii C-CTX: Confirmed Purple-spotted Grouper
(Cephalopholis argus)		 N/A
2020.01.02 19-12-01 CP Barramundi 1 Oregon N/A  N/A No meal remnants available
2020.02.27 20-02-01 CP Hogfish 2 Puerto Rico C-CTX: Confirmed Hogfish
(Lachnolaimus maximus)		 N/A
2020.02.27 20-02-02 Haff Buffalo fish 2 New Jersey N/A Smallmouth buffalo
(Ictiobus bubalus) (2),
Bigmouth buffalo
(Ictiobus cyprinellus) (1),
Black buffalo
 (Ictiobus niger) (2)		 Five whole (live) fish collected from same retail tank as suspect fish but no meal remnants available. 
2020.03.02 20-03-01 CP Warsaw Grouper 1 Florida CTX: Not detected |
CP: Not confirmed 		 Warsaw Grouper
(Hyporthodus nigritus)		 N/A
2020.08.26 20-08-05 CP Barracuda 3 Maryland C-CTX: Confirmed Great Barracuda
(Sphyraena barracuda)		 N/A
2020.09.02 20-08-06 CP Barracuda 2 Illinois C-CTX: Confirmed Great Barracuda
(Sphyraena barracuda)		 C-CTX confirmed in Raw and cooked meal remnants 
2020.09.11 20-09-07 SFP Yellowfin Tuna 4 North Dakota N/A N/A No meal remnants available
2020.09.29 20-09-08 CP Mackerel 5 Puerto Rico C-CTX: Confirmed King mackerel
(Scomberomorus cavalla)		 In addition to the human illnesses, 4 dogs ill (3 mortalities)
2020.10.26 20-10-09 CP Snapper 2 Guam N/A N/A N/A
2020.12.17 20-12-10 Haff Buffalo fish 2 Missouri N/A Smallmouth buffalo
(Ictiobus bubalus)		 N/A
2021.03.22 21-03-01 Unknown Lobster 2 California ASP/DA investigated;
no DA detected 		 N/A N/A
2021.05.24 21-05-02 CP Pink Salmon 1 Indiana CTX: Not detected |
CP: Not confirmed 		 Pink Salmon
(Oncorhynchus gorbuscha)		 Symptomology aligned with CFP 
2021.06.09 21-06-03 CP Dog Snapper 5 Puerto Rico C-CTX: Confirmed Dog Snapper
(Lutjanus jocu)		 N/A
2021.06.15 21-06-04 CP Barracuda 2 New York C-CTX: Confirmed Great Barracuda
(Sphyraena barracuda)		 N/A
2021.07.01 21-06-05 SFP Tuna 3 Indiana N/A N/A No meal remnants available 
2021.07.08 21-07-06 SFP Tuna 2 Ohio N/A N/A No meal remnants available
2021.07.26 21-07-07 SFP Tuna 3 Massachusetts N/A N/A No meal remnants available
2021.07.22 21-07-08 SFP Tuna 2 New Mexico Histamine: > 3,600 ppm |
SFP: Confirmed		 N/A Species identification is not typically conducted on SFP samples unless its a non-traditional SFP species
2021.09.22 21-09-09 CP Grouper 2 Kentucky N/A N/A No meal remnants available
2021.09.22 21-09-10 SFP Yellowfin Tuna 1 Tennessee N/A N/A No meal remnants available
2021.10.27 21-10-12 SFP Tuna 4 Wisconsin Histamine: > 5,700 ppm |
SFP: Confirmed		 N/A Species identification is not typically conducted on SFP samples unless its a non-traditional SFP species
2021.11.15 21-11-13 SPF Tuna 2 California Histamine: ≥ 4,200 ppm |
SFP: Confirmed		 N/A Species identification is not typically conducted on SFP samples unless its a non-traditional SFP species
2022.01.19 22-01-01 SFP Tuna 2 Florida N/A N/A No meal remnants available
2022.01.24 22-01-02 SFP Tuna  1 Washington N/A N/A No meal remnants available
2022.03.11 22-02-03 CP African Pompano 3 Puerto Rico C-CTX: Confirmed African pompano
(Alectis ciliaris)		 N/A
2022.03.15 22-03-04 CP Red Porgy 1 Puerto Rico N/A N/A No meal remnants available
2022.04.21 22-04-05 CP Hogfish 6 Puerto Rico C-CTX: Confirmed Hogfish
(Lachnolaimus maximus)		 N/A
2022.05.09 22-05-06 Unknown European Sea Bass 1 California N/A Mediterranean sea bass
(Dicentrarchus labrax)		 N/A
2022.05.05 22-05-07 SFP Tuna 1 Alabama N/A N/A No meal remnants available
2022.06.03 22-06-08 SFP Tuna 2 Michigan N/A N/A No meal remnants available
2022.06.16 22-06-09 CP Red Snapper 1 Illinois N/A N/A No meal remnants available
2022.07.07 22-06-10 CP Unknown   1 Illinois N/A N/A No meal remnants available
2022.06.28 22-06-12 CP King Mackerel 3 Florida C-CTX: Confirmed King mackerel
(Scomberomorus cavalla)		 N/A
2022.07.07 22-07-11 CP Barracuda 3 Florida C-CTX: Confirmed Great Barracuda
(Sphyraena barracuda)		 N/A
2022.07.06 22-07-13 SFP Tuna 2 North Carolina N/A N/A No meal remnants available
2022.08.12 22-08-14 CP Rock Cod 3 California N/A N/A No meal remnants available
2022.08.30 22-08-15 SFP Tuna 2 New Jersey N/A N/A No meal remnants available
2022.08.28 22-08-17 SFP Mahi Mahi 1 Virginia N/A N/A No meal remnants available
2022.09.07 22-09-16 CP Barracuda 1 Puerto Rico C-CTX: Confirmed Great Barracuda
(Sphyraena barracuda)		 N/A
2022.09.14 22-09-18 SFP Tuna 1 Oregon No decomposition detected in 2 of 2 subs examined; low pass; no histamine detected N/A N/A
2022.09.30 22-09-20 CP/SFP Red Snapper 2 South Carolina N/A N/A No meal remnants available
2022.10.25 22-10-21 Unknown Lobster;
Scallops		 1 California Domoic Acid: None detected N/A Analytical results conducted by the CA Department of Public Health
2022.11.23 22-11-22 SFP Mahi Mahi 1 New Hampshire N/A N/A No meal remnants available
2022.12.13 22-12-23 SFP Tuna 2 Massachusetts N/A N/A No meal remnants available
2023.01.20 23-01-01 SFP Tuna 1 Illinois N/A N/A No meal remnants available
2023.02.28 23-02-02 CP Whiting 3 South Carolina N/A Pacific Whiting
(Merluccius productus)		 Fish associated with the lot consumed was tested for species identification
2023.03.01 23-03-03 SFP Tuna 1 California N/A N/A No meal remnants available
2023.04.07 23-04-04 SFP Tuna 2 Maryland N/A N/A No meal remnants available
2023.05.09 23-05-05 SFP Tuna 4 Nebraska N/A N/A No meal remnants available
2023.05.12 23-05-06 SFP Tuna Ahi Poke 1 Rhode Island N/A N/A No meal remnants available
2023.05.24 23-05-07 CP Red Snapper 3 Puerto Rico N/A N/A No meal remnants available
2023.05.25 23-05-08 SFP Tuna 2 Massachusetts N/A N/A No meal remnants available
2023.06.23 23-06-09 SFP Yellowfin Tuna 2 New York N/A N/A No meal remnants available 
2023.06.01 23-06-10 CP Snapper 1 Florida N/A N/A No meal remnants available
2023.06.27 23-06-12 SFP Tuna 1 California N/A N/A No meal remnants available 
2023.07.03 23-07-11 CP Lionfish 3 St. Thomas USVI N/A N/A No meal remnants available 
2023.07.02 23-07-13 SFP Tuna 2 California N/A N/A No meal remnants available 
2023.07.24 23-07-14 Unknown Unknown   6 South Carolina N/A N/A Initially reported as CFP/SFP. Upon investigation was neither illness. 
2023.07.25 23-07-15 SFP Sea Bass 1 Nevada N/A N/A No meal remnants available
2023.08.07 23-08-16 SFP Yellowfin Tuna 1 Texas N/A N/A No meal remnants available
2023.08.21 23-08-19 SFP Mahi Mahi 1 Texas N/A N/A No meal remnants available
2023.08.15 23-08-23 SFP Mahi Mahi 1 New York N/A N/A No meal remnants available 
2023.09.05 23-09-17 CP Barracuda 2 Pennsylvania C-CTX: Confirmed Great Barracuda
(Sphyraena barracuda)		 N/A
2023.09.01 23-09-18 SFP Tuna 1 Maryland Below LOQ of 2.5 ppm N/A N/A
2023.09.20 23-09-20 SFP Sushi (Mango Crunch Roll) 1 California N/A N/A No histamine forming fish identified in the product.
2023.10.12 23-10-21 SFP Tuna 1 New York Sample 1: >800 ppm
Sample 2: ~2000 ppm		 N/A NYC DOH collected and analyzed samples from the same lot of product. 
2023.10.07 23-10-22 CP Amberjack 5 Florida N/A N/A No meal remnants available
2023.10.24 23-10-24 CP Jack
(Caranx ignobilis)		 8 Hawaii P-CTX: Not confirmed Jack/Trevally or Giant Trevally
(Caranx ignobilis)		 The sample portions tested positive for sodium channel activity by the N2a cytotoxicity assay. Pacific ciguatoxin-1 was not confirmed in either portion by LC-MS/MS analysis. However, another unidentified Pacific ciguatoxin congener could be responsible for the sodium channel activity detected. 
2023.10.23 23-10-25 SFP Tuna 1 Washington N/A N/A No meal remnants available 
2023.11.01 23-11-26 CP Grouper 1 Puerto Rico N/A N/A No progression due to lack of response by complainant. 
2023.11.02 23-11-27 CP Salmon 4 Virginia CTX: Not detected |
CP: Not confirmed 		 Salmon
(Salmo salar) 		 N/A
2023.11.09 23-11-28 SFP Tuna 1 Colorado N/A N/A No meal remnants available
2023.11.15 23-11-29 SFP Ahi Tuna 1 New Hampshire N/A N/A No meal remnants available
2023.11.17 23-11-30 CP Greater Amberjack 3 Florida C-CTX: Confirmed Greater Amberjack
(Seriola dumerili)		 N/A
2023.11.17 23-11-31 CP Kingfish 4 Puerto Rico N/A N/A No meal remnants available
2023.11.27 23-11-32 SFP Salmon 1 Alabama N/A N/A No meal remnants available
2023.12.06 23-12-33 CP Captain fish (Hogfish) 3 Puerto Rico N/A N/A No meal remnants available 
2023.12.14 23-12-34 CP Hogfish 2 Puerto Rico C-CTX: Confirmed Hogfish
(Lachnolaimus maximus)		 N/A
2023.12.26 23-12-35 SFP Herring 1 Washington No decomposition or histamine detected N/A N/A
2023.12.22 23-12-36 SFP Tuna 3 Tennessee No decomposition detected in Poke bowls due to excessive spices. Decomposition detected in 2 of 11 subsamples of raw CO treated ground tuna. Histamine Range: 48.4 – 4186 ppm:
SFP Confirmed		 N/A Species identification is not typically conducted on SFP samples unless its a non-traditional SFP species
2024.01.24 24-01-01 CP Red Snapper 2 Puerto Rico N/A N/A No meal remnants available
2024.01.26 24-01-02 CP Hogfish 3 Puerto Rico C-CTX: Confirmed Hogfish
(Lachnolaimus maximus)		 N/A
2024.02.02 24-02-03 CP African Pompano 3 Puerto Rico C-CTX: Confirmed African Pompano
(Alectis ciliaris)		 N/A
2024.03.27 24-03-04 SFP Wahoo 2 Indiana N/A N/A No meal remnants available
2024.04.05 24-04-05 SFP Tuna (canned) 1 Michigan N/A N/A No meal remnants available
2024.04.12 24-04-06 CP Snapper 2 Puerto Rico C-CTX: Confirmed Cubera Snapper
(Lutjanus cyanopterus) 		 N/A
2024.04.18 24-04-07 SFP Tuna 2 Tennessee 4,660 ppm (4.66 g/kg) N/A - insufficient amount to conduct  
2024.04.30 24-04-08 SFP Tuna 4 Rhode Island N/A N/A No meal remnants available
2024.05.09 24-05-09 SFP Tuna 1 California N/A N/A No meal remnants available
2024.05.13 24-05-10 SFP Yellowtail & Salmon 1 Washington No histamine detected;
No decomposition detected		 N/A N/A
2024.05.15 24-05-11 CP Peacock Grouper 3 Hawaii P-CTX: Confirmed  Purplespotted Grouper
(Cephalopholus argus)		 N/A
2024.05.22 24-05-12 CP Sea Bass 7 Puerto Rico C-CTX: Not detected Snook
(Centropomus undecimalis)		 N/A
2024.05.28 24-05-13 Haff Buffalo fish 1 Illinois N/A N/A No meal remnants available 
2024.05.28 24-05-14 SFP Sardines in olive oil 2 California 1,100 ppm (1.1 g/kg) N/A N/A
2024.06.10 24-06-15 PFP Blowfish 1 New Jersey STX/TTX: Not confirmed Northern Puffer or Southern Puffer
(Sphoeroides maculatus or Sphoeroides nephelus)		 N/A
2024.06.11 24-06-16 CP Sierra (Mackerel) 2 Puerto Rico N/A N/A No meal remnants available 
2024.06.11 24-06-17 CP Barracuda
(Fresh)		 3 Puerto Rico C-CTX: Confirmed Barracuda
(Sphyraena barracuda)		 N/A
2024.06.13 24-06-18 SFP Yellowfin Tuna
(Fresh)		 2 California Raw: 3,900 ppm (3.9 g/kg)
Cooked: 1,800 ppm (1.8 g/kg)		 N/A N/A
2024.06.11 24-06-19 SFP Ahi Tuna
(Grilled)		 1 New York 3,412 ppm N/A N/A
2024.06.02 24-06-20 SFP Tuna Tacos 2 Pennsylvania N/A N/A No meal remnants available 
2024.06.20 24-06-21 CP Barracuda 1 Florida N/A N/A No meal remnants available 
2024.05.29 24-05-22 SFP Yellowtail
(Fish Tacos)		 1 California N/A N/A No meal remnants available 
2024.06.24 24-06-23 SFP Yellowtail
(Raw Sushi)		 1 Maryland N/A N/A No meal remnants available 
2024.07.02 24-07-24 CP Trevally
(Fried)		 1 Hawaii P-CTX: Not confirmed  Jack | Trevally
(Caranx ingobilis)		 The sample tested positive for sodium channel activity by the N2a cytotoxicity assay. Pacific-ciguatoxin-1 was not confirmed by LC-MS/MS analysis. However, another unidentified Pacific ciguatoxin congener could be responsible for the sodium channel activity detected.
2024.06.30 24-06-25 SFP Tuna
 (Grilled)		 2 Florida N/A N/A No meal remnants available
2024.07.12 24-07-26 SFP Ahi Tuna
(Nachos)		 1 Washington N/A N/A No meal remnants available 
2024.08.05 24-08-27 SFP Yellowfin Tuna
(Fresh)		 2 New York N/A N/A No meal remnants available 
2024.08.02 24-08-28 CP-Like Salmon
(Raw Sushi)		 1 Utah N/A N/A No meal remnants available 

Contact

Contact the FDA Division of Seafood Safety at Seafood.Illness@fda.hhs.gov to report a scombrotoxin fish poisoning or natural toxin in fish other than bivalve molluscan shellfish illness, request a specific illness related questionnaire, or if you have any questions regarding the information on this page.

For reporting an illness, please include the following information in the email:

  • Species of fish;
  • Location of illness (e.g., state, country);
  • Identify whether a meal remnant* is available and its current condition;
  • Number of people ill from eating the fish;
  • How the fish was obtained such as recreationally captured or commercially purchased; and
  • Purchase location (store/restaurant) to include the store’s/restaurant’s name and address. 

*FDA has defined a meal remnant for the purposes of this program as the edible portion of the fish (leftover), cooked or uncooked, from the exact fish consumed from the illness event associated with natural toxin or scombrotoxin fish poisoning illnesses. Meal remnants should be frozen immediately and remain so until a representative retrieves them. Additional Information section pertaining to meal remnants may be found above.

Program Evaluations

Natural Toxin and Scombrotoxin Fish Poisoning Illness in Fish Other Than Bivalve Molluscan Shellfish Annual Report for Calendar Years 2020 – 2023 (PDF 409KB)

 

Resources

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