Fishy Business

Last weekend got off to a good start. Unfortunately, it didn’t end as well.

Saturday, Dad drove down from Pittsburgh to spend the weekend with us. He had business meetings in Allentown, PA, the previous week, and he flew to Pittsburgh Friday night, where he had more meetings this week. The visit to Cincinnati was supposed to be a respite in between. Saturday morning, Kevin and I went to Findlay Market and bought fruit, veggies, cheese, fish and flowers, then headed to Matt and Katie’s house for a cookout. We grilled shrimp, burgers and hotdogs (meat and veggie), played cornhole, played Texas Hold ‘Em (thanks for the lesson, Matt), threw darts and had a great day. The weather was beautiful, and Gilmore had a blast playing with his cousins outside all day.

Sunday, we cleaned the house, then Dad and Katie came over (Matt had to work). We sat on the deck and ate cheese, crackers, veggies and dip, drank mojitos and got some input from Dad about repairs we need to do around the house. Then we fixed a simple dinner—grilled corn on the cob, a garden salad and grilled fish. The fish was called Escolar and was thick, meaty and oily, so we needed only to season it with salt and pepper. It was a great summer meal. As usual, Kenzie started begging for fish during dinner and Dad gave him a little bit; he threw it up immediately. That was odd, but Kenzie is often sick, so we didn’t think too much of it.

Near the end of the meal, Katie’s head started hurting and her nose felt stuffy, so she took some Benedryl. Then she started getting hot and feeling nauseated. Soon, her entire upper body—arms, torso, neck, face—turned blood red, her heart started racing, her chest tightened, and she threw up. We were contemplating taking her to Urgent Care since she’s had bad allergic reactions before, when Dad and Kevin both got really hot, started turning red and announced they had pounding headaches too. That was it: We piled into the car and I drove them to Urgent Care. Because Katie was having breathing problems and had developed blisters on her tongue (plus her left arm itched and ached), they gave her an epenephrin shot. Dad and Kevin didn’t officially sign in as patients since all they would have done is give them Bendryl, which they took immediately (along with some Immodium). We were perplexed by the fact that I felt fine, but attributed it to my weekly allergy shots and the fact that I had eaten a smaller piece of fish. Unfortunately, my reaction was just delayed, and it hit me near the end of our Urgent Care visit. The symptoms (including Kenzie’s vomiting) continued for all of us throughout the night. And because the large amount of oil in the fish can’t be absorbed by the human body, we all experienced a very disturbing gastrointestinal side effect that has earned Escolar the dubious title “Ex-Lax Fish.” (interesting article)

None of us went to work Monday, and Dad delayed his return to Pittsburgh. Based on some very reliable web info, we’re 100% sure we had Scombroid (or Histamine) Poisoning, which is caused by toxic levels of histamines developing in certain types of fish. It usually happens on the fishing boat; it it’s not kept cool to the proper temperature, non-harmful histoids in the fish turn into histamines, which trigger an allergic reaction when the fish is eaten, no matter how long it’s cooked. Scombrotoxin can also develop in other types of oily fish like tuna, mackeral and mahi mahi, and it’s the 2nd most common type of seafood poisoning. Unfortunately, it’s rarely diagnosed or reported properly because most people just mistake it as an allergic reaction.

I called the fish market and let the owner know about the illness. He said he had some similar complaints about Escolar in the past and had stopped carrying it, but brought it back this year through a new supplier after overwhelming requests for it. Curiously, his regular supplier was out of the fish last week, so he purchased it from a different vendor. He received the fish whole on Friday and cut it himself Saturday morning. He said he’ll rethink carrying it in the future. I also reported it to the FDA, and they said they’ll investigate it and determine whether they can identify the cause.

Not surprisingly, none of us is eager to eat fish—particularly sushi—any time soon, and we’ll never eat Escolar (or anything else we know little about) again. It was a pretty dreadful way to end the weekend, but it was an interesting adventure.