This increased incidence was assessed by EFSA and linked to four grouped and connected multistate events. HFP reached its highest incidence in 2017, with 117 HFP outbreaks involving 572 cases, mainly reported by France and Spain. According to the European Food Safety Authority (EFSA) and European Centre for Disease Prevention and Control (ECDC), 599 HFP outbreaks were notified in the European Union (EU) during the period 2010–17. The proportion of HFP among food poisoning outbreaks can vary according to the dietary habits of countries. Once formed, histamine-and to some extent other biogenic amines-are not destroyed by cooking, smoking or freezing. Histamine production is most commonly due to inadequate refrigeration of the fish, and can occur at any stage of the food chain. The production of biogenic amines depends mainly on time-temperature abuse (deviation from the optimal storage temperature for a time period), but also on fish product pH, salinity, oxygen availability and competition with other spoilage microorganisms. Other biogenic amines might be produced during bacterial growth and potentiate the histamine effect by inhibiting intestinal histamine metabolising enzymes. These bacteria can come from normal fish flora (in particular, fish gut Enterobacterales), from the marine environment and from secondary contamination of the food (improper handling, cross-contamination from catering equipment and facilities, and/or raw foods). Through this enzyme, certain bacteria can form histamine from histidine. Their muscles contain a high level of free amino acid histidine, which is preserved as a substrate for bacterial histidine decarboxylase. mahi-mahi, sardines, pilchards, herring) are commonly implicated in HFP. tuna, mackerel) and some non-scombroid fish (e.g. The clinical picture is usually characterised by rapid onset (within 1 hour) of symptoms such as flushing, cutaneous rash or headache mild severity short duration and self-limitation. Histamine food poisoning (HFP) is an allergy-like reaction caused by consumption of fish or fermented foods containing a high concentration of histamine. We describe the outbreak to highlight the specific key points of this type of investigation. This type of food poisoning is rarely recognised and confirmed. The presence of Klebsiella variicola and Pantoea agglomerans, microorganisms of the Enterobacterales order that have been reported to produce histamine, was confirmed in the leftover raw tuna. Histamine concentration was found to be 1,720 mg/kg in leftover raw tuna, and 3,720 mg/kg in control cooked tuna, well above the threshold limit values defined by European regulations (200 mg/kg). No cold chain issues could be established in the upstream and downstream supply chains. The fresh yellowfin tuna was from Reunion Island and was supplied vacuum-sealed and packed with ice at the principal food market of Paris. Multivariate analysis pointed to cooked yellowfin tuna fillet as the very likely source of food poisoning (odds ratio = 156.8 95% confidence interval: 18.4–1,338.4). We conducted a case–control study on 31 cases and 63 controls. A total of 40 cases were identified (attack rate: 16.6%). On 20 April 2017, an outbreak of histamine food poisoning occurred in a French military unit located near Paris.
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