One thing many people look forward to when traveling to tropical and beach destinations is the fresh food they’ll be able to indulge in. Even better, most of this fresh fruit, vegetables and fish are delicious and healthy, so there’s no post-meal guilt.
However, while fish tends to be a healthy source of protein and fatty omega-3 acids, it may pose a risk to your health if you’re traveling. That’s because you can actually get sick from fish. Two common types of fish-related food poisoning are ciguatera and scombroid.
Although nearly anyone is susceptible to ciguatera, travelers have a higher risk. This illness is caused by consuming fish that has been contaminated with toxins produced by microorganisms that live around coral reefs. What happens is that small fish eat these microorganisms, larger fish eat the small fish and then you eat the larger fish, where the toxins have become concentrated.
Fish gets shipped around the world for our consumption, which means ciguatera can happen anywhere. But the risk is highest in fish from the Caribbean Sea, Pacific and Indian Oceans. According to the Centers for Disease Control (CDC), as many as 3 percent of people who travel to these areas get ciguatera.
Ciguatera is most commonly caused by eating barracuda, grouper, moray eel, amberjack, sea bass, sturgeon, parrot fish, surgeonfish and red snapper.
If you’ve eaten a contaminated fish, symptoms of ciguatera typically will develop one to three hours after eating the fish. These symptoms can include nausea, vomiting, diarrhea and stomach pain. Some people may even experience neurologic symptoms, like a tingling sensation, tooth pain, feeling as though teeth are loose or even itching, a metallic taste in the mouth or blurred vision.
Currently, there is no treatment for ciguatera and, unfortunately, the toxins that cause ciguatera aren’t destroyed by cooking. So the best way to avoid getting sick is to avoid those fish while traveling, especially barracuda and moray eel. You should also avoid eating the fish’s organs because this is where the highest concentration of the toxins are.
Eating fish may also cause you to become sick with scombroid, which is caused by eating fish that hasn’t been refrigerated or preserved properly. When fish have naturally high levels of the amino acid histidine, bacteria turn that amino acid into histamine when it’s not properly stored. People become sick when the fish contains high levels of histamine.
Scombroid happens around the world, but it’s something to be especially mindful of if you’re traveling somewhere with lower food preparation standards than the U.S. Fish needs to be iced, refrigerated or frozen immediately after it’s caught in order to avoid getting people sick with scombroid. The types of fish are most commonly associated with scombroid include tuna, mackerel, mahi mahi, sardines, anchovies, herring, bluefish, amberjack and marlin.
If you’ve eaten a contaminated fish, the symptoms of scombroid appear within a few minutes to an hour after eating. And these symptoms are far from pleasant – they are similar to an allergic reaction, including a headache, a flush face, itching, heart palpitations, blurred vision, cramps and diarrhea.
This is a tricky illness to avoid – contaminated fish may taste peppery, sharp, metallic or bitter, but it may also look and taste completely normal.
But the good news is that scombroid can be treated with antihistamines, and, even without treatment, people usually get better within 12 hours.
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