Update on histamine fish poisoning.

Histamine fish poisoning (HFP) is a chemical intoxication that occurs after eating bacterially contaminated fish of particular species. Its incidence has been underestimated because of its frequently mild nature, lack of mandatory reporting, and misdiagnosis (most often as seafood allergy). The fish are non-toxic when caught, but increase in histamine content as bacterial numbers increase. They may look and smell normal, and cooking does not destroy the histamine. Although the condition is caused by histamine intoxication, its pathogenesis is not fully understood, and other toxins or potentiators may be involved.