Confirmed Case

Probable Case

• Clinical illness [1] within 1 hour of consumption of at risk fish [2].
  

Notes

1. Clinical illness defined as: facial flushing, sweating, peppery taste in the mouth, abdominal discomfort, diarrhea, headache, numbness/tingling and/or palpitations. Clinical features may also include generalized flushing, nausea, vomiting, urticaria, dry mouth, dizziness, wheezing, blurry vision and/or hypotension. Symptoms usually last up to 12 hours; full recovery is expected. Allergic reaction and anaphylaxis should be ruled-out.
2. At risk fish include: mackerel, tuna, skipjack tuna, saury, bonito, mahi-mahi, sardines, pilchards, anchovies, herring, marlin, bluefish. Cases have also been reported with exposure to Western Australian Salmon, sockeye salmon, amberjack and cape yellowtail. Fish need to have experienced temperature abuse (this is most often associated with commercially-caught or processed fish). Fermented fish sauces can also be at risk products.