What is histamine food poisoning?
Umanga Yasas
Assistant Manager - Manufacturing Excellence | Coca-Cola Beverages Sri Lanka specializing in Supply Chain Management | Data Analyst | Supply Chain Expert
Introduction
What is histamine?
Histamine is a biogenic amine which is a naturally occurring substance in the human body. Histamine is derived from the breakdown (decarboxylation) of the amino acid histidine. It has important physiological functions related to local immune responses, gastric acid secretion and neuromodulation. Histamine is involved in the body’s inflammation response and, if elevated levels are ingested, it can produce symptoms similar to that of an allergic reaction.
Histamine is a biogenic amine produced in fish tissue through the decarboxylation of free histidine by exogenous decarboxylases released by microorganisms. Histamine is rarely found in fresh fish but its level increases with the progress of fish decomposition. The microorganisms naturally present on the gills and in the gut of live fish start to grow upon death because the defense mechanisms are inactive.
In particular histamine forming bacteria are able to grow more rapidly at high abuse than at moderate abuse temperatures. However once the enzyme histidine decarboxylase has been formed, it can continue to produce histamine also at or near refrigeration temperature, it remains stable in frozen fish and can be reactivated after thawing. Frozen temperature (-18°C or below) can stop the growth of bacteria and prevent any preformed histidine decarboxylase from producing histamine.
Conversely histamine production is greater at high abusive temperatures (21.1°C or higher) particularly at temperatures near 32.2°C. Cooking can inactivate both the enzyme and the microorganisms, but histamine which has been formed cannot be eliminated because it is heat stable.
Histamine poisoning is a food-borne disease characterized by a variety of symptoms similar to allergic reactions. The toxic effects of histamine are related to its normal physiological actions in the body. In particular the dilatation of the peripheral blood vessels results in hypotension, flushing, and headache, while the increased capillary permeability causes urticaria, hemoconcentration, and eyelids edema; the symptoms affecting the gastrointestinal system are due to the contraction of smooth muscles leading to abdominal cramps, diarrhea, nausea, and vomiting.
Histamine exerts also a stimulatory action on the heart by increasing its contractility and exhibiting palpitations and tachycardia, while it is a potent stimulant of sensory and motor neurons producing pain and itching associated with the rash. The variability of symptoms can be linked both to the amount of histamine ingested and individual sensitivity.
The ingestion of food containing small amounts of histamine has little effect in healthy individuals, but it can result in histamine intolerance in persons characterized by impairment of diamine oxidase (DAO) activity, either due to genetic predisposition, gastrointestinal diseases, or medication with monoamine oxidase (MAO) inhibitors, whereas histamine intoxication can appear in everyone as a result of its high amounts in foods like fish and fishery products or ripened cheese. The symptoms of histamine poisoning can appear for few hours or a day but in rare case they can persist for some days.
However, statistical data about its incidence are not available because the poisoning incidents are often underestimated due to mild or not recognized nature of illness and to inadequate systems to attribute food-borne diagnosis.
The histamine intoxication outbreaks between 2005 and 2010 using Rapid Alert System for Food and Feed (RASFF) were above 100 cases. The measures used to estimate the dose/exposure level causing histamine intoxication are generally based on the detection of the biogenic amine in the suspected food or on the patients reports. Moreover, the toxic effects of histamine are enhanced by the presence of other biogenic amines such as putrescine and cadaverine.
?
What is histamine food poisoning??
?
Histamine is formed in foods by certain bacteria that are able to decarboxylate the amino acid, histidine. However, foods containing unusually high levels of histamine may not appear to be outwardly spoiled. Foods with histamine concentrations exceeding 50 mg per 100 g of food are generally considered to be hazardous. Histamine formation in fish can be prevented by proper handling and refrigerated storage while the control of histamine formation in cheese seems dependent on insuring that histamine-producing bacteria are not present in significant numbers in the raw milk.
Histamine or “Scombroid fish” poisoning is a foodborne illness most commonly caused by consuming certain species of marine fish (e.g. tuna, herring, mackerel) that have naturally high levels of histamine and possibly other biogenic amines in their tissues. After fish, cheeses are the foods most commonly associated with histamine poisoning. However, histamine production can occur in other foods such as fermented foods, e.g. wine, dry sausage, sauerkraut, miso, and soy sauce. Histamine toxicity, also known as scombroid poisoning, is a form of food poisoning. Histamine toxicity is sometimes confused with an allergic reaction to fish.
Here is why:
Some kinds of fish contain naturally high levels of the chemical histidine. This chemical can be converted to histamine by bacteria. In an allergic reaction, mast cells release histamine which triggers allergy symptoms. So, if a person eats fish that has a high level of histamine, the response may resemble an allergic reaction to that food. Certain kinds of fish are more prone to cause histamine toxicity. These include tuna, mackerel, mahi mahi, anchovy, herring, bluefish, amberjack and marlin.The most common cause of acute histamine toxicity is the result of inadequate refrigeration or spoiled fish.
This causes an overgrowth of bacteria which converts histidine to high levels of histamine.Individuals who have unusually low levels of the enzyme diamine oxidase may be more susceptible to histamine toxicity.
What are the symptoms of illness??
Onset of symptoms of histamine food poisoning can range from several minutes to several hours following ingestion of toxin. Typically, the average incubation period before onset of illness is approximately one hour. Severity of illness varies, depending on factors such as the level of exposure and the susceptibility of the affected individual. Typically observed symptoms are:
§?Nausea
§?Malaise
§?Vomiting
§?Diarrhoea
§?Abdominal cramps
§?Headaches
§?Skin rash
§?Flushing
§?Burning sensation of the mouth and lips
§?A peppery taste sensation
§?Hives
§?Itching
§?Hypotension
Histamine formation
Histamine is produced when bacteria that naturally occur in the skin, gills and gut of fish break down histidine, an amino acid found in the muscles of certain fish species that contain naturally high levels of this amino acid (mackerel/herring/sardines/tuna). The production of histamine is directly related to the mishandling of food as a result of storage at incorrect temperatures.
Histidine decarboxylase, the enzyme responsible for breaking down histidine into histamine, can remain active even after the bacteria responsible for producing it have been inactivated or killed.
The enzyme continues histamine production slowly at refrigeration temperatures and remains stable if frozen, thus allowing it to rapidly recommence activity after thawing. Although the enzyme that produces histamine can be inactivated by cooking, once histamine has been produced, it cannot be eliminated by normal cooking or freezing temperatures, and its toxicity remains intact.
?
Many of these fish species have significant amounts of histidine in their muscle tissues that serves as a substrate for bacterial histidine decarboxylase. Free histidine is generally found in large amounts in the muscle of fatty, red-meat active and migratory species as compared to its amount in the white meat of slower species. Most studies have investigated histidine decarboxylation into histamine, whereas fewer reports exists on production of other biogenic amines.
The potential for histamine and biogenic amines formation was evaluated by measuring the decarboxylase activity. This is not always appropriate as it ignores the role of histaminase for example, which has been found in some bacterial species.
In general, the amino acid decarboxylase enzymes, especially histidine decarboxylase, can be found in species of Enterobacteriaceae,?Clostridium, Lactobacillus, Vibrio, Pseudomonas and Photobacterium.?Vibrio, Pseudomonas?and?Photobacterium?species are indigenous bacteria found naturally in the marine environment and on fish whereas the mesophilic Enterobacteriaceae and?C. perfringens?typically occur as a result of post-harvest contamination. The enteric bacteria (especially?Morganella morganii) tend to prevail during the summer season, whereas the indigenous bacteria may predominate during the winter.
Can processing technologies prevent histamine production??
Bacteria associated with histamine production are readily found in salt water. As such, many of these bacteria are halotolerant (salt resistant) or halophilic (salt loving) and some are capable of producing histamine under acidic conditions (low pH). Therefore, histamine production is possible even during processes such as smoking, brining, salting, fermenting and drying. Histamine already produced can also survive these processes. In addition, vacuum packaging is not an effective method of preventing the production of histamine.
What histamine levels are harmful in foods??
Levels of above 200 mg/kg (ppm) have been associated with human illness. However, levels as low as 50 mg/kg have known to cause illness, but this is uncommon. Most cases of illness caused by histamine in fish have been above 200 mg/kg, and often above 500 mg/kg.
The human tolerance limit for histamine is 10 mg per 100 g. In general, there is no risk of histamine poisoning in well-iced fish.
Which bacteria are involved??
A wide range of bacteria are capable of producing histamine. Examples include?Morganella morganii,?Klebsiella?spp.,?Pseudomonas,?Clostridium,?Citrobacter freundii?and more. Many of these bacteria are found naturally in fish environments.
What are the signs of food spoilage that can result in high levels of histamine??
Harmful levels of histamine can build up in fish before any signs of spoilage develop, such as a bad smell or taste. For these reasons, control strategies focus on prevention through the use of strict temperature control throughout the food chain.
How is histamine controlled???
Strict control of the cold chain is essential to prevent the formation of histamine. Fish must be chilled immediately after catching, as this is the highest risk period for bacterial growth and histamine production.
The integrity of the cold chain must be protected throughout all processing stages (catching/transport/delivery/sale) in order to control histamine production and ensure maximum product shelf life. Records of cold chain integrity should be kept at all stages of the food chain.
A food business operator should:
§?Store fish frozen or at 0 °C (on ice) as per the requirements in?Regulation 853/2004?(as amended)
§?Examine supplier temperature records to ensure fish was rapidly chilled after catching
§?Examine supplier records to ensure that a temperature approaching that of melting ice were maintained throughout storage and transport
§?Ensure that fish is stored immediately on receipt and that temperatures of 0 °C (on ice) are maintained at all times
§?Keep records of all temperatures throughout the food chain to ensure compliance?
§?Take account of relevant information accompanying incoming product such as date of minimum durability, date of freezing or first freezing (unprocessed fishery products), date of production and date of freezing if different from date of production (frozen products of animal origin)?
§?Assign an appropriate shelf life.
?
High levels of histamine can build up in fish and fish products before any signs of spoilage (e.g. bad smell or taste) develop.?Therefore, measures for control of histamine should be taken along the food chain from harvest to consumption.
?
a) Cold chain should be maintained throughout the whole supply chain.
(b) Refrigerated fish and fish products should be kept at or below 4°C.
(c) The time which fish products are kept under ambient temperature should be minimised.
How does the histamine affect the human body?
领英推荐
In humans histamine is found in nearly all?tissues?of the body, where it is stored primarily in the granules of tissue?mast cells. The blood cells called?basophils?also harbour histamine-containing granules. Once released from its granules, histamine produces many varied effects within the body, including the contraction of?smooth muscle?tissues of the lungs, uterus, and stomach; the dilation of?blood vessels, which increases permeability and lowers?blood pressure; the stimulation of gastric acid?secretion?in the stomach; and the acceleration of heart rate.
Histamine also serves as a?neurotransmitter, carrying chemical messages between nerve cells. The effect histamine has on?blood vessels?is crucial to its role in the immune response, which is most clearly observed in?inflammation i.e., the local reaction of bodily tissues to injury caused by physical damage, infection, or?allergic reaction. Injured tissue?mast cells?release histamine, causing the surrounding blood vessels to dilate and increase in permeability.
This allows fluid and cells of the?immune system, such as leukocytes (white blood cells) and blood?plasma?proteins, to leak from the bloodstream through the vessel walls and migrate to the site of tissue injury or infection, where they begin to fight the infection and nourish and heal the injured tissues. In an?allergic?reaction the immune system’s?hypersensitivity?reaction to usually harmless foreign substances (called?antigens?in this context) that enter the body mast cells release histamine in inordinate amounts. Immune system proteins called?antibodies, which are bound to mast cells, bind to the antigens to remove them, but in the process the mast cells are stimulated to release their histamines.
This causes the visible symptoms of a localized allergic reaction, including runny nose, watery eyes, constriction of bronchi, and tissue swelling. Histamine also contributes to generalized allergic conditions such as?anaphylaxis, a severe, immediate, and often fatal response to exposure to a previously encountered?antigen. Anaphylaxis is especially common in susceptible individuals following insect stings.
Role of Histamine
Histamine plays a central role in the pathogenesis of several allergic diseases, such as atopic dermatitis, allergic rhinitis, and allergic asthma through differential regulation of T helper lymphocytes. Thereby, histamine regulates the effective balance between Th1 and Th2 cells by assisting a shift toward Th2. Histamine-mediated mast cell activation plays a critical role in various allergic diseases. Histamine may induce the release of leukotrienes, cytokines, and chemokines via H4R in CD34+ cord blood-derived human mast cells.
In mouse mast cells, both histamine and 4-methylhistamine can induce IL-6 production individually, an effect that is potentiated by LPS stimulation. This effect can be blocked by H4R antagonists and does not occur in H4R-deficient allergic mice.
Histamine Receptors
Histamine and its receptors (H1R–H4R) play a crucial and significant role in the development of various allergic diseases. Mast cells are multifunctional bone marrow-derived tissue-dwelling cells that are the major producer of histamine in the body. H1R are expressed in many cells, including mast cells, and are involved in Type 1 hypersensitivity reactions. H2R are involved in Th1 lymphocyte cytokine production. H3R are mainly involved in blood brain barrier function. H4R are highly expressed on mast cells where their stimulation exacerbates histamine and cytokine generation.
Both H1R and H4R have important roles in the progression and modulation of histamine-mediated allergic diseases. Antihistamines that target H1R alone are not entirely effective in the treatment of acute pruritus, atopic dermatitis, allergic asthma, and other allergic diseases. However, antagonists that target H4R have shown promising effects in preclinical and clinical studies in the treatment of several allergic diseases. In the present review, we examine the accumulating evidence suggesting novel therapeutic approaches that explore both H1R and H4R as therapeutic targets for histamine-mediated allergic diseases.
Mast cells are the major producer of histamine and express a vast array of receptors on their surface such as FcεR1, FcγRI, and receptors for complement components (C3aR and C5aR), nerve growth factor (NGF) (Trk A), substance P, vasoactive intestinal peptide (MrgX2), adenosine phosphate, etc. Activation through these receptors by their respective stimulants, such as allergens, complement peptides C3a, C5a ,NGF ,neuropeptides, adenosine mono-phosphate activate human cord blood-derived mast cells to release various inflammatory mediators including histamine.
Histamine can also be produced by basophils and other immune cells but much higher concentrations of histamine may be found in intestinal mucosa, skin, and bronchial tissues. Histamine regulates a plethora of pathophysiological and physiological processes, such as secretion of gastric acid, inflammation, and the regulation of vasodilatation and bronchoconstriction. In addition, it can also serve as a neurotransmitter.
Histamine Receptors and Their Role in Allergic Inflammation
Histamine receptors (H1R–H4R) are characterized by their function, structure, distribution, and their affinity to histamine. Histamine has diverse effects, both pro-inflammatory and anti-inflammatory, which are determined by both the histamine receptor subtype and the cells stimulated types. The H1-receptor drives cellular migration, nociception, vasodilatation, and bronchoconstriction, whereas the H2-receptor modifies gastric acid secretion, airway mucus production, and vascular permeability. The H3-receptor plays an important role in neuro-inflammatory diseases. The H4-receptor has also been shown to be involved in allergy and inflammation. H4R-mediated mast cell activation can regulate a powerful inflammatory cascade by releasing several inflammatory mediators; these mediators may stimulate the migration of different inflammatory cells into the inflammatory site. Likewise, the activation of H1R also regulates allergic responses by enhancing the migration of Th2 cells toward the allergen during lung inflammation.
Preventive and hygienic measures
The risk of histamine poisoning could be controlled by applying basic Good Manufacturing and Hygiene Practices associated to an appropriate Hazard Analysis Critical Control Point (HACCP) system.
According to European Legislation fish must be maintained at a temperature approaching that of melting ice as soon possible after harvest, in order to comply with freshness criteria and to avoid the growth of spoilage and histamine producing bacteria. All operations (heading, gutting, filleting, or cutting, etc.) should be carried out hygienically on board vessels. Moreover fresh fishery products must be kept at the above mentioned temperature during storage and transport in such a way as not adversely to affect food safety.
Fishery products can be involved in foodborne outbreaks by histamine when the application of Good Hygiene Practices and proper temperatures of storage failed to comply during the food chain. The regulatory systems have developed control strategies and monitoring procedures, such as sampling plan for fish species with a high amount of histidine, in order to assuring seafood safety.
?
The risk of histamine poisoning could be controlled by applying basic Good Manufacturing and Hygiene Practices associated to an appropriate Hazard Analysis Critical Control Point (HACCP) system.
According to European Legislation fish must be maintained at a temperature approaching that of melting ice as soon possible after harvest, in order to comply with freshness criteria and to avoid the growth of spoilage and histamine producing bacteria. All operations (heading, gutting, filleting, or cutting, etc.) should be carried out hygienically on board vessels. Moreover fresh fishery products must be kept at the above mentioned temperature during storage and transport in such a way as not adversely to affect food safety.
The treatments for the products concerned by our study are sterilization for canned fish, salting for semi-preserved, freezing for frozen fish, and refrigeration for fresh fish.
For Semi-Preserved Fish
Semi-preserved fish are products that have undergone a maturation treatment and has led to several physico-chemical and biochemical changes. Semi-preserved are products characterized by a pH of 5.3 to 5.7, a water activity (Aw) of less than 0.76, a moisture level of less than 50% and a chloride rate (NaCl) of more than 15%. These parameters associated with storage at a temperature of 15 °C create conditions that allow a better protection against possible bacterial growth . Hence, if this treatment is well conducted, the production of high levels of histamine can be limited.
?
How safety and handling can be applied to avoid histamine formation?
Avoid fishing in warm waters
Warm water holds less oxygen than cold water. When the temperature of the water rises, the lower oxygen levels increase stress on fish (optimum temperature for many trout species is 15 C). Fish that are experiencing elevated stress often do not survive the additional stress of being caught, handled, and released.
Anglers should:
Consider water depths when fishing for walleye or perch
Walleye and yellow perch have a reduced chance of survival if they are caught in water deeper than seven metres, brought to the surface, and then released. When walleye or perch are caught in deep water, their swim bladders can’t adapt quickly enough to the change in water pressure. This causes the fish the equivalent of ‘the bends’. The internal damage that results will kill the fish.
If you are fishing deep water, and catch a prohibited fish, it must be put back, even if it dies. The sportfishing regulations state that you must release every fish that cannot be legally kept because of species, catch limit, size limit, or other regulations, without exception, even if the fish is injured or dead.
Walleye and perch should be fished in relatively shallow water, where there are great angling opportunities too.
Do not "fizz" fish
A fish with a ‘swollen’ swim bladder from decompression will have sides that are hard where they should be fleshy, or will have the swim bladder protruding from its mouth. When you release a fish with a swollen swim bladder, do not ‘fizz’ it (poke a hole in the swim bladder so the fish sinks). Fizzing does not increase survival, but causes injury, stress, and most certainly death.
Fish with swollen swim bladders should be released gently into the water. With enough time, a swollen swim bladder can correct itself. The fish may float belly up on the water, but it has a better chance of survival if left on its own.
Measuring the fish
When fishing where there is a size limit, carry a measuring stick. Leave the fish in the water and hold the stick beside it to determine if it’s legal length. If it is legal length and you are keeping it, hold the fish in a rubber mesh net or a holding cradle and measure the side of the fishing that is lying flat to ensure it is legal. If it’s not legal length, gently remove the hook with needle-nose pliers and release the fish.
Although studies show that overall fish mortality rates are the same regardless of whether they are caught with barbed or barbless hooks, some anglers prefer to use barbless hooks in order to reduce fish handling times. The use of barbless hooks is not a requirement in Alberta.
?
Tools for safe fish-handling
·????????Fish-holding cradle
·????????
Hemostats or needle nose pliers
·????????Measuring board or stick
·????????Mesh rubber landing net
·????????Wool or cotton gloves
?
?
?
Conclusion
Fishery products can be involved in foodborne outbreaks by histamine when the application of Good Hygiene Practices and proper temperatures of storage failed to comply during the food chain. The regulatory systems have developed control strategies and monitoring procedures, such as sampling plan for fish species with a high amount of histidine, in order to assuring seafood safety
The results of this study will be a basis for helping risk managers prioritise management actions and decide on which first interventions to make. The risk of histamine poisoning of Moroccan consumers following the consumption of canned, frozen and semi-preserved fish products is lower, compared to that which may occur following the consumption of fresh sardine or other fresh pelagic fish.
With respect to the cold chain, the application of good hygiene practices are the key to reducing the number of people intoxicated by histamine per year.
Recommendations have been sent to risk managers. A good control of histamine must take its starting point in the upstream of the food chain and exactly at the moment of catching. The best ways to prevent histamine formation is the rapid cooling of fish immediately after catching, and the application of good hygiene practices along the food chain from the boat to the consumer’s table.
?
?
References ………….
?
?
?
?