Skip to main content
          Skip to FDA Search
          Skip to in this section menu
          Skip to footer links


U.S. flagAn official website of the United States government

					Here’s how you know
          			Dot gov**The .gov means it’s official.**Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
							      SSL**The site is secure.** The **https://** ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. 
			U.S. Food and Drug Administration
				
        Search
            Menu
							
						Search FDA
									
									Submit search 
		Featured
							Contact FDA
	                FDA Guidance Documents
	                Recalls, Market Withdrawals and Safety Alerts
	                Press Announcements
	                Warning Letters
	                Advisory Committees
	                En Español

					Products
            Food
							Drugs
							Medical Devices
							Radiation-Emitting Products
							Vaccines, Blood, and Biologics
							Animal and Veterinary
							Cosmetics
							Tobacco ProductsTopics
            About FDA
							Combination Products
							Regulatory Information
							Safety
							Emergency Preparedness
							International Programs
							News and Events
							Training and Continuing Education
							Inspections and Compliance
							Science and ResearchInformation For
            Consumers
	            Patients
	            Industry
	            Health Professionals
	            Federal, State and Local Officials 
 In this section:

                Outbreaks of Foodborne Illness

Outbreaks of Foodborne Illness

                        Investigations of Foodborne Illness Outbreaks
          Public Health Advisories from Investigations of Foodborne Illness Outbreaks
          Food Safety Tips for Consumers & Retailers During an Outbreak of Foodborne Illness
          Food Safety Resources for Produce Shippers and Carriers During a Foodborne Illness Outbreak
          Outbreak Investigation Reports
          How to Report Seafood-Related Toxin and Scombrotoxin Fish Poisoning Illnesses
          About the CORE Network
          CORE Annual Reports
          CORE Publications


                        Foodborne Pathogens Home
          Food
          Recalls, Outbreaks & Emergencies
          Outbreaks of Foodborne Illness
          How to Report Seafood-Related Toxin and Scombrotoxin Fish Poisoning IllnessesOutbreaks of Foodborne Illness How to Report Seafood-Related Toxin and Scombrotoxin Fish Poisoning Illnesses
  
  	
    Share
    Post
    Linkedin

    Email
    PrintTo help FDA effectively investigate, remove unsafe seafood products from the market, and develop new prevention strategies, the FDA relies on illness reporting from first responders, physicians, public health officials, healthcare providers, state and local health departments and consumers. FDA works with these stakeholders to investigate illnesses and outbreaks, manage them, and learn how to decrease future occurrences. While most foodborne outbreaks are tracked through the FDA’s Coordinated Outbreak Response and Evaluation (CORE) network, seafood-related illnesses caused by natural toxins and scombrotoxin fish poisoning have a unique reporting mechanism. This web page provides information on commonly occurring seafood-related toxin and scombrotoxin fish poisoning illnesses and identifies the mechanism for reporting them to the FDA. To report an illness from raw bivalve molluscan shellfish, email the FDA at shellfishepi@fda.hhs.gov.

The FDA receives reports of illnesses associated with the consumption of specific types of fish. These illnesses may originate from the activity of certain bacteria, toxins produced by marine algae, or hazards inherent in the fish.

Commonly occurring illnesses are:

Ciguatera Fish Poisoning (CFP)
	Puffer Fish Poisoning (PFP)
	Scombrotoxin Fish Poisoning (SFP)
	Seafood-associated Rhabdomyolysis (sometimes referred to as Haff disease)Illness and reporting information for the commonly occurring illnesses are provided in each section. Contact the FDA with any questions or need for clarification of the illnesses or reporting.

In addition to the illnesses listed above, reporting of other less frequently occurring illnesses resulting from natural toxins may be accomplished by emailing the FDA at Seafood.Illness@fda.hhs.gov.  Refer to Chapter 6 of the Fish and Fishery Products Hazards and Controls Guidance for a comprehensive list of natural toxin illnesses.

**To report illnesses related to miscellaneous natural toxin illnesses from fish other than bivalve molluscan shellfish, please email FDA at**Seafood.Illness@fda.hhs.gov. The reporting email should include at a minimum the following information:

Species of fish;
	Location of illness (e.g., state, country);
	Identify whether a meal remnant* is available and its current condition (i.e., refrigerated, frozen);
	Number of people ill from eating the fish;
	How the fish was obtained such as recreationally captured or commercially purchased; and
	Purchase location (store/restaurant) to include the store’s/restaurant’s name and address.*FDA has defined a meal remnant for the purposes of this program as the edible portion of the fish (leftover), cooked or uncooked, from the exact fish consumed from the illness event associated with the natural toxin or scombrotoxin fish poisoning illnesses. Meal remnants should be frozen immediately and remain so until a representative retrieves them. Additional Information section pertaining to meal remnants may be found below.

Also on this page:

Investigated Illnesses and Outbreaks
	Contact Information
	ResourcesCiguatera Fish Poisoning (CFP)


Ciguatera poisoning is commonly related to the consumption of subtropical and tropical reef fish which can accumulate naturally occurring ciguatoxins through their diet. The highest incidences of ciguatoxins occur between latitudes 35° north to 35° south, and include areas of the Caribbean Sea, Gulf of Mexico, and Atlantic, Pacific, and Indian Oceans. Refer to Chapter 6 of the Fish and Fishery Products Hazards and Controls Guidance for more specific information regarding locations. Many fish species have been associated with CP including but not limited to barracuda; grouper; snapper; jacks and trevally; wrasse; mackerel; tang; moray eels; and parrotfish. Ciguatoxins have also been found in lionfish collected in waters surrounding the U.S. Virgin Islands. In 2023 the FDA investigated a CP illness directly related to the consumption of lionfish by assessing the symptomology; however, FDA was unable to confirm the diagnosis through laboratory analysis since meal remnants were not available. Refer to Table 1 below for additional information.  Additional species of fish associated with this illness may be found in Table 3-2 Potential Vertebrate Species-Related Hazards in the FDA Fish and Fishery Products Hazards and Controls Guidance.

**Note:** FDA has changed the previous acronym from CFP (Ciguatera Fish Poisoning) to CP (Ciguatera Poisoning) to be more inclusive of additional seafood types associated with ciguatera globally. For example, gastropods (*Tectus niloticus*), cone snails (*Conus spp.*), giant clams (*Tridacna maxima*and *Hippopus hippopus*), jellyfish (Cnidaria spp.), and lobster (*Panulirus penicillatus*) have been reported to bioaccumulate ciguatoxins. To date, no cases of CP from the consumption of these additional seafood types have been confirmed in the United States.

The onset of symptoms typically occurs within 6 hours after consuming toxic fish/fishery products and may persist from several days to weeks. In severe cases, some neurological symptoms may persist for months and can recur for years. Fatalities do not usually occur; however, isolated fatalities have been reported. Symptoms of CP fall into three categories and include:

Gastrointestinal:
	Nausea;
		Vomiting; and
		Diarrhea;
	Neurological:
	Numbness and tingling of the lips and extremities;
		Itching of the hands and feet;
		Joint pain;
		Muscle pain;
		Muscle weakness;
		Reversal and sensitivity to temperature;
		Dizziness; and
		Vertigo;
	Cardiovascular:
	Irregular heartbeat; and
		Low blood pressure.For more information on ciguatera poisoning, refer to Chapter 6 of the Fish and Fishery Products Hazards and Controls Guidance and the associated chapter in the FDA Bad Bug Book.

**To report CP related illness(es) please email FDA at**Seafood.Illness@fda.hhs.gov. The reporting email should include at a minimum the following information:

Species of fish/fishery products;
	Location of illness (e.g., state, country);
	Identify whether a meal remnant* is available and its current condition;
	Number of people who became ill from eating the fish/fishery products;
	How the fish/fishery products was obtained such as recreationally captured or commercially purchased; and
	Purchase location (store/restaurant) to include the store’s/restaurant’s name and address.*FDA has defined a meal remnant for the purposes of this program as the edible portion of the fish/fishery products (leftover), cooked or uncooked, from the exact fish/fishery products consumed from the illness event associated with natural toxin or scombrotoxin fish poisoning illnesses. Meal remnants should be frozen immediately and remain so until a representative retrieves them. Additional Information section pertaining to meal remnants may be found below.

Puffer Fish Poisoning (PFP)


Puffer fish poisoning (PFP) typically caused by naturally occurring tetrodotoxin is associated with the consumption of puffer fish from waters of the Indo-Pacific Ocean Regions, Gulf of Mexico, Gulf of California, and specific areas on the Atlantic coast of Florida. In addition, an accumulation of saxitoxins in the puffer fish, introduced through their diet, has also been referred to as puffer fish poisoning and should be reported accordingly.

**Note**: Due to the severity of puffer fish poisoning, puffer fish are a highly regulated product in the United States. See Regulatory Status of Puffer Fish section for additional information. Due to the importation and harvesting restrictions for this product, it is important to determine the source of any fish causing illness for potential regulatory action.

Symptoms usually develop within 3 hours after consumption of contaminated fish and may last from 24 – 48 hours. In extreme cases, death may occur due to muscle paralysis resulting in respiratory failure when ventilatory support is not accessible. Symptoms of PFP include:

Numbness of the lips and tongue;
	Tingling sensation in the face and extremities;
	Headache;
	Abdominal pain;
	Nausea;
	Diarrhea;
	Vomiting;
	Difficulty in walking;
	Paralysis;
	Respiratory distress;
	Difficulty in speech;
	Shortness of breath;
	Blue or purplish discoloration of the lips and skin;
	Lowering of blood pressure;
	Convulsions;
	Mental impairment;
	Irregular heartbeat; and
	Death in extreme cases.For more information on Puffer fish poisoning, refer to Chapter 6 of the Fish and Fishery Products Hazards and Controls Guidance and the associated chapter in the FDA Bad Bug Book.

**To report PFP related illness(es) please email FDA at** Seafood.Illness@fda.hhs.gov. In all PFP cases, determining the source of the suspect fish is critical to assuring that additional unsafe products are not in commerce. The reporting email should include at a minimum the following information:

Species of fish;
	Location of illness (e.g., state, country);
	Identify whether a meal remnant* is available and its current condition;
	Number of people ill from eating the fish;
	How the fish was obtained such as recreationally captured or commercially purchased; and
	Purchase location (store/restaurant) to include the store’s/restaurant’s name and address.*FDA has defined a meal remnant for the purposes of this program as the edible portion of the fish (leftover), cooked or uncooked, from the exact fish consumed from the illness event associated with natural toxin or scombrotoxin fish poisoning illnesses. Meal remnants should be frozen immediately and remain so until a representative retrieves them. Additional Information section pertaining to meal remnants may be found below.

Scombrotoxin Fish Poisoning (SFP)


Scombrotoxin (histamine) formation as a result of time and temperature abuse such as improper storage/refrigeration of certain types of fish can cause consumer illness. SFP is closely linked to the development of histamine in these fish and is primarily associated with the consumption of tuna and mahi-mahi, among other species. Additional species of fish associated with this illness may be found on Table 3-2 Potential Vertebrate Species-Related Hazards in the Fish and Fishery Products Hazards and Controls Guidance.

Symptoms usually occur within a few minutes to a few hours after consumption and last from 12 hours to a few days. Symptoms of SFP include:

Tingling or burning in or around the mouth or throat;
	Rash or hives on the upper body;
	Drop in blood pressure;
	Headache;
	Dizziness;
	Itching of the skin;
	Nausea;
	Vomiting;
	Diarrhea;
	Asthmatic-like constriction of the air passage;
	Heart palpitations; and
	Respiratory distress.For more information on scombrotoxin, refer to Chapter 7 of the Fish and Fishery Products Hazards and Controls Guidance and the associated chapter in the FDA Bad Bug Book.

**To report SFP related illness(es) please email FDA at** Seafood.Illness@fda.hhs.gov. The reporting email should include at a minimum the following information:

Species of fish;
	Location of illness (e.g., state, country);
	Identify whether a meal remnant* is available and its current condition;
	Number of people ill from eating the fish;
	How the fish was obtained such as recreationally captured or commercially purchased; and
	Purchase location (store/restaurant) to include the store’s/restaurant’s name and address.*FDA has defined a meal remnant for the purposes of this program as the edible portion of the fish (leftover), cooked or uncooked, from the exact fish consumed from the illness event associated with natural toxin or scombrotoxin fish poisoning illnesses. Meal remnants should be frozen immediately and remain so until a representative retrieves them. Additional Information section pertaining to meal remnants may be found below.

Seafood-associated Rhabdomyolysis
(sometimes referred to as Haff disease)


Seafood-associated rhabdomyolysis, also known as Haff disease, has primarily been linked to the consumption of buffalo fish in the United States although other fish species such as burbot, crayfish, eel, and pike have been associated with the disease worldwide. The cause(s) of seafood-associated rhabdomyolysis is unknown. Three species of buffalo fish (*Ictiobus*sp.) are commercially harvested in the U.S. Most previous U.S. reports associated this illness with *Ictiobus cyprinellus*(bigmouth buffalo). However, through recent genomic sequencing we were able to associate Haff disease illnesses which have occurred in the U.S. from 2010 – 2020 as being most often associated with commercially harvested *Ictiobus bubalus*(smallmouth buffalo) and *Ictiobus* *niger*(black buffalo).

Seafood-associated rhabdomyolysis results in the breakdown of skeletal muscle (rhabdomyolysis), with a risk of acute kidney failure that develops within 24 hours after consuming certain fish. Initial symptoms include muscle tenderness and weakness, sometimes with tea-colored urine. Blood testing is often used to diagnose seafood-associated rhabdomyolysis/Haff disease with elevated levels of creatine phosphokinase (CPK) being one of the most commonly used indicators.

The FDA is currently collecting meal remnants from patients diagnosed with the disease to confirm the causative species and research the causative agent(s).

For more information on seafood-associated rhabdomyolysis (sometimes referred to as Haff disease), refer to Chapter 6 of the Fish and Fishery Products Hazards and Controls Guidance.

**To report seafood-associated rhabdomyolysis (Haff disease) related illness(es), please email FDA at** Seafood.Illness@fda.hhs.gov. The reporting email should include at a minimum the following information:

Species of fish;
	Location of illness (e.g., state, country);
	Identify whether a meal remnant* is available and its current condition;
	Number of people ill from eating the fish;
	How the fish was obtained such as recreationally captured or commercially purchased; and
	Purchase location (store/restaurant) to include the store’s/restaurant’s name and address.*FDA has defined a meal remnant for the purposes of this program as the edible portion of the fish (leftover), cooked or uncooked, from the exact fish consumed from the illness event associated with natural toxin or scombrotoxin fish poisoning illnesses. Meal remnants should be frozen immediately and remain so until a representative retrieves them. Additional Information section pertaining to meal remnants may be found below.

Additional Information


**Meal Remnants and Disease Related Information**

The FDA collects meal remnants and epidemiological information, whenever available, to expand our knowledge and information database to better understand these illnesses. This data is critical to improving our understanding of the sources of illnesses, and helps the FDA learn more about the epidemiology and science of these illnesses.

Meal remnants:
	FDA defines a meal remnant for the purpose of this program as any remaining edible portion (leftover) of the fish, cooked or uncooked, from the exact fish consumed for the illness incident.
		Any meal remnants should be immediately frozen and should not be eaten by any other individual(s). The meal remnants should be provided to health care providers or state/local public health authorities. The health care providers or state/local authorities will contact their local FDA District Office to coordinate submission of the remnants for analysis as deemed appropriate.
	Epidemiological information: The epidemiological information collected will be used as part of a surveillance effort to confirm the sources of illnesses, characterize the responsible toxins, develop testing methodologies (where appropriate), and determine if development and/or refinement of controls for the toxins are warranted. In addition, a better understanding of long-term effects on the patient may be gained. The information gained from this work may assist the FDA in its partnerships with state and local public health departments to reduce future occurrences.**Regulatory Status of Puffer Fish**

Due to the severity of puffer fish poisoning, it is important to understand the regulatory status of puffer fish.

FDA and the Japanese Ministry of Health reached an agreement regarding the importation of a single species of puffer fish, T*akifugu rubripes*, also known as “Tiger puffer” or “Tora Fugu,” that are prepared under Japanese safety guidelines and tested prior to importation. Any puffer fish not imported pursuant to this agreement is subject to FDA’s Import Alert #16-20, which informs FDA field staff that they may detain the fish without physical examination. Any firms found to be importing puffer fish under false or misleading names to avoid these import restrictions may be placed on the FDA Import Alert #16-04 for species misbranding. Import Alerts can be accessed through Import Alerts by Number (fda.gov).

Puffer fish from domestic sources is sold in the United States and is subject to the seafood HACCP regulation; however, in certain circumstances the FDA will defer to the States for stronger restrictions specifically on harvesting due to toxicity. The southern puffer (*Sphoeroides nephelus*) occurs in Florida and the Gulf of Mexico and was historically harvested and marketed along with the northern puffers (typically harvested in mid-Atlantic waters) in the sea squab fishery. Between 2002 and 2004, 28 cases of PFP occurred along the east coast of the U.S. and were linked to southern puffers from the Indian River lagoon system along the east (Atlantic) coast of Florida. Southern puffers were previously believed to be non-toxic; however, it is now known that southern puffers – specifically from the Indian River Lagoon system – may also contain saxitoxins derived from an algal source and accumulated through the food chain. Furthermore, the toxins in this species, from this location, are contained in the meat, making safe preparation impossible. The state of Florida has banned the commercial and recreational harvesting of all puffer species from the counties of Volusia, Brevard, Indian River, St. Lucie, and Martin, but illnesses still sporadically occur. Commercial harvesting of southern puffers is still allowed on the west coast (Gulf of Mexico) of Florida. Additional tetrodotoxin-containing species of puffer fish occur in Florida and the Gulf of Mexico as well as on the U.S. west coast, but these fish are not typically consumed.

****

Investigated Illnesses and Outbreaks


Below is a list of natural toxin and scombrotoxin fish poisoning illness and outbreak incidents that are no longer active. These incidents have been reported to and managed by the FDA, as well as our state and local partners. The information gathered from these incidents will inform the FDA, as well as refine our policy and guidance for management of the program. Data listed below is from September 2019 to present. As time and resources allow the table will be populated with incidents predating September 2019. This table is updated on a quarterly basis.

**Table 1: Closed Illness and Outbreak Incidents**

Date
			Reported
			FDA Reference
			Number
			Illness
			Type
			Reported
			Fish/
			Fishery
			Product
			Case
			Count
			Reporting
			State
			Analytical
			Results
			Confirmed
			Fish/Fishery
			Products
			Species
			Comments2019.09.20
			19-09-01
			CFP
			Hogfish
			2
			Puerto Rico
			C-CTX
			confirmed
			Hogfish
			(Lachnolaimus maximus)
			N/A2019.10.29
			19-10-01
			CFP
			Hogfish
			1
			Puerto Rico
			C-CTX
			confirmed
			Hogfish
			(Lachnolaimus maximus)
			N/A2019.10.21
			19-10-02
			CFP
			Barracuda
			1
			Florida
			C-CTX
			confirmed
			Great Barracuda
			(Sphyraena
			barracuda)
			N/A2019.10.18
			19-10-03
			CFP
			Barracuda
			3
			Puerto Rico
			C-CTX
			confirmed
			Great Barracuda
			(Sphyraena
			barracuda)
			Great Barracuda (Sphyraena barracuda) ID confirmed visually from intact head2019.10.25
			19-10-04
			CFP
			Barracuda
			2
			Puerto Rico
			C-CTX
			confirmed
			Great Barracuda
			(Sphyraena
			barracuda)
			N/A2019.10.28
			19-10-05
			CFP
			Amberjack
			2
			Florida
			C-CTX
			confirmed
			Wahoo
			(Acanthocybium solandri)
			N/A2019.11.08
			19-10-06
			Haff
			Buffalo
			fish
			3
			Texas
			N/A
			N/A
			No meal remnanats available2019.11.27
			19-11-01
			CFP
			Purplespotted
			Grouper
			4
			Hawaii
			P-CTX
			confirmed
			Purple-spotted Grouper
			(Cephalopholis
			argus)
			N/A2020.01.02
			19-12-01
			CFP
			Barramundi
			1
			Oregon
			N/A
			N/A
			No meal remnants available2020.02.27
			20-02-01
			CFP
			Hogfish
			2
			Puerto Rico
			C-CTX
			confirmed
			Hogfish
			(Lachnolaimus maximus)
			N/A2020.02.27
			20-02-02
			Haff
			Buffalo
			fish
			2
			New Jersey
			N/A
			Smallmouth buffalo
			(Ictiobus bubalus) (2),
			Bigmouth buffalo
			(I. cyprinellus) (1),
			Black buffalo
			 (I. niger) (2)
			Five whole (live) fish collected from same retail tank as suspect fish but no meal remnants available.2020.03.02
			20-03-01
			CFP
			Warsaw
			Grouper
			1
			Florida
			CTX
			not detected/
			CFP
			not confirmed
			Warsaw Grouper
			(Hyporthodus nigritus)
			N/A2020.08.26
			20-08-05
			CFP
			Barracuda
			3
			Maryland
			C-CTX
			confirmed
			Great Barracuda
			(Sphyraena
			barracuda)
			N/A2020.09.02
			20-08-06
			CFP
			Barracuda
			2
			Illinois
			C-CTX
			confirmed
			Great Barracuda
			(Sphyraena
			barracuda)
			C-CTX confirmed in Raw and cooked meal remnants2020.09.11
			20-09-07
			SFP
			Yellowfin
			Tuna
			4
			North Dakota
			N/A
			N/A
			No meal remnants available2020.09.29
			20-09-08
			CFP
			Mackerel
			5
			Puerto Rico
			C-CTX
			confirmed
			King mackerel
			(Scomberomorus cavalla)
			In addition to the human illnesses, 4 dogs ill (3 mortalities)2020.10.26
			20-10-09
			CFP
			Snapper
			2
			Guam
			N/A
			N/A
			N/A2020.12.17
			20-12-10
			Haff
			Buffalo
			fish
			2
			Missouri
			N/A
			Smallmouth buffalo
			(Ictiobus bubalus)
			Meal remnant2021.03.22
			21-03-01
			Unknown
			Lobster
			2
			California
			ASP/DA
			investigated;
			no DA detected
			N/A
			N/A2021.05.24
			21-05-02
			CFP
			Pink
			Salmon
			1
			Indiana
			CTX
			not detected/
			CFP
			not confirmed
			Pink Salmon
			(Oncorhynchus gorbuscha)
			Symptomology aligned with CFP2021.06.09
			21-06-03
			CFP
			Dog
			Snapper
			5
			Puerto Rico
			C-CTX
			confirmed
			Dog Snapper
			(Lutjanus jocu)
			N/A2021.06.15
			21-06-04
			CFP
			Barracuda
			2
			New York
			C-CTX
			confirmed
			Great Barracuda
			(Sphyraena
			barracuda)
			N/A2021.07.01
			21-06-05
			SFP
			Tuna
			3
			Indiana
			N/A
			N/A
			No meal remnants available2021.07.08
			21-07-06
			SFP
			Tuna
			2
			Ohio
			N/A
			N/A
			No meal remnants available2021.07.26
			21-07-07
			SFP
			Tuna
			3
			Massachusetts
			N/A
			N/A
			No meal remnants available2021.07.22
			21-07-08
			SFP
			Tuna
			2
			New Mexico
			Histamine:
			> 3,600 ppm;
			SFP confirmed
			N/A
			Species identification is not typically conducted on SFP samples unless its a non-traditional SFP species2021.09.22
			21-09-09
			CFP
			Grouper
			2
			Kentucky
			N/A
			N/A
			No meal remnants available2021.09.22
			21-09-10
			SFP
			Yellowfin
			Tuna
			1
			Tennessee
			N/A
			N/A
			No meal remnants available2021.10.27
			21-10-12
			SFP
			Tuna
			4
			Wisconsin
			Histamine:
			> 5,700 ppm;
			SFP confirmed
			N/A
			Species identification is not typically conducted on SFP samples unless its a non-traditional SFP species2021.11.15
			21-11-13
			SPF
			Tuna
			2
			California
			Histamine:
			≥ 4,200 ppm;
			SFP confirmed
			N/A
			Species identification is not typically conducted on SFP samples unless its a non-traditional SFP species2022.01.19
			22-01-01
			SFP
			Tuna
			2
			Florida
			N/A
			N/A
			No meal remnants available2022.01.24
			22-01-02
			SFP
			Tuna
			1
			Washington
			N/A
			N/A
			No meal remnants available2022.03.11
			22-02-03
			CFP
			African
			Pompano
			3
			Puerto Rico
			C-CTX
			confirmed
			African pompano
			(Alectis ciliaris)
			N/A2022.03.15
			22-03-04
			CFP
			Red Porgy
			1
			Puerto Rico
			N/A
			N/A
			No meal remnants available2022.04.21
			22-04-05
			CFP
			Hogfish
			6
			Puerto Rico
			C-CTX
			confirmed
			Hogfish
			(Lachnolaimus maximus)
			N/A2022.05.09
			22-05-06
			Unknown
			European
			Sea Bass
			1
			California
			N/A
			Mediterranean sea bass
			(Dicentrarchus
			labrax)
			N/A2022.05.05
			22-05-07
			SFP
			Tuna
			1
			Alabama
			N/A
			N/A
			No meal remnants available2022.06.03
			22-06-08
			SFP
			Tuna
			2
			Michigan
			N/A
			N/A
			No meal remnants available2022.06.16
			22-06-09
			CFP
			Red
			Snapper
			1
			Illinois
			N/A
			N/A
			No meal remnants available2022.07.07
			22-06-10
			CFP
			Unknown
			1
			Illinois
			N/A
			N/A
			No meal remnants available2022.06.28
			22-06-12
			CFP
			King
			Mackerel
			3
			Florida
			C-CTX
			confirmed
			King mackerel
			(Scomberomorus cavalla)
			N/A2022.07.07
			22-07-11
			CFP
			Barracuda
			3
			Florida
			C-CTX
			confirmed
			Great Barracuda
			(Sphyraena
			barracuda)
			N/A2022.07.06
			22-07-13
			SFP
			Tuna
			2
			North Carolina
			N/A
			N/A
			No meal remnants available2022.08.12
			22-08-14
			CFP
			Rock Cod
			3
			California
			N/A
			N/A
			No meal remnants available2022.08.30
			22-08-15
			SFP
			Tuna
			2
			New Jersey
			N/A
			N/A
			No meal remnants available2022.08.28
			22-08-17
			SFP
			Mahi Mahi
			1
			Virginia
			N/A
			N/A
			No meal remnants available2022.09.07
			22-09-16
			CFP
			Barracuda
			1
			Puerto Rico
			C-CTX
			confirmed
			Great Barracuda
			(Sphyraena
			barracuda)
			N/A2022.09.14
			22-09-18
			SFP
			Tuna
			1
			Oregon
			No decomposition
			detected in 2 of 2 subs examined;
			low pass;
			no histamine detected
			N/A
			N/A2022.09.30
			22-09-20
			CFP/SFP
			Red
			Snapper
			2
			South Carolina
			N/A
			N/A
			No meal remnants available2022.10.25
			22-10-21
			Unknown
			Lobster;
			Scallops
			1
			California
			Domoic Acid:
			none detected
			N/A
			Analytical results conducted by the CA Department of Public Health2022.11.23
			22-11-22
			SFP
			Mahi Mahi
			1
			New Hampshire
			N/A
			N/A
			No meal remnants available2022.12.13
			22-12-23
			SFP
			Tuna
			2
			Massachusetts
			N/A
			N/A
			No meal remnants available2023.01.20
			23-01-01
			SFP
			Tuna
			1
			Illinois
			N/A
			N/A
			No meal remnants available2023.02.28
			23-02-02
			CFP
			Whiting
			3
			South Carolina
			N/A
			Pacific Whiting
			(Merluccius
			productus
			Fish associated with the lot consumed was tested for species identification2023.03.01
			23-03-03
			SFP
			Tuna
			1
			California
			N/A
			N/A
			No meal remnants available2023.04.07
			23-04-04
			SFP
			Tuna
			2
			Maryland
			N/A
			N/A
			No meal remnants available2023.05.09
			23-05-05
			SFP
			Tuna
			4
			Nebraska
			N/A
			N/A
			No meal remnants available2023.05.12
			23-05-06
			SFP
			Tuna Ahi
			Poke
			1
			Rhode Island
			N/A
			N/A
			No meal remnants available2023.05.24
			23-05-07
			CFP
			Red
			Snapper
			3
			Puerto Rico
			N/A
			N/A
			No meal remnants available2023.05.25
			23-05-08
			SFP
			Tuna
			2
			Massachusetts
			N/A
			N/A
			No meal remnants available2023.06.23
			23-06-09
			SFP
			Yellowfin
			Tuna
			2
			New York
			N/A
			N/A
			No meal remnants available2023.06.01
			23-06-10
			CFP
			Snapper
			1
			Florida
			N/A
			N/A
			No meal remnants available2023.07.03
			23-07-11
			CFP
			Lionfish
			3
			St. Thomas USVI
			N/A
			N/A
			No meal remnants available2023.06.27
			23-06-12
			SFP
			Tuna
			1
			California
			N/A
			N/A
			No meal remnants available2023.07.02
			23-07-13
			SFP
			Tuna
			2
			California
			N/A
			N/A
			No meal remnants available2023.07.24
			23-07-14
			Unknown
			Unknown
			6
			South Carolina
			N/A
			N/A
			Initially reported as CFP/SFP. Upon investigation was neither illness.2023.07.25
			23-07-15
			SFP
			Sea Bass
			1
			Nevada
			N/A
			N/A
			No meal remnants available2023.08.07
			23-08-16
			SFP
			Yellowfin
			Tuna
			1
			Texas
			N/A
			N/A
			No meal remnants available2023.09.05
			23-09-17
			CP
			Barracuda
			2
			Pennsylvania
			C-CTX
			confirmed
			Great Barracuda
			(Sphyraena
			barracuda)
			N/A2023.09.01
			23-09-18
			SFP
			Tuna
			1
			Maryland
			Below LOQ
			of 2.5 ppm
			N/A
			N/A2023.08.21
			23-08-19
			SFP
			Mahi Mahi
			1
			Texas
			N/A
			N/A
			No meal remnants available2023.09.20
			23-09-20
			SFP
			Sushi
			(Mango
			Crunch Roll)
			1
			California
			N/A
			N/A
			No histamine forming fish identified in the product.2023.10.12
			23-10-21
			SFP
			Tuna
			1
			New York
			Sample 1:
			>800 ppm
			Sample 2:
			~2000 ppm
			N/A
			NYC DOH collected and analyzed samples from the same lot of product.2023.10.07
			23-10-22
			CP
			Amberjack
			5
			Florida
			N/A
			N/A
			No meal remnants available2023.08.15
			23-08-23
			SFP
			Mahi Mahi
			1
			New York
			N/A
			N/A
			No meal remnants available2023.10.24
			23-10-24
			CP
			Jack
			(Caranx
			ignobilis)
			8
			Hawaii
			P-CTX
			not confirmed
			Jack/Trevally
			or
			Giant Trevally
			(Caranx ignobilis)
			The sample portions tested positive for sodium channel activity by the N2a cytotoxicity assay. Pacific ciguatoxin-1 was not confirmed in either portion by LC-MS/MS analysis. However, another unidentified Pacific ciguatoxin congener could be responsible for the sodium channel activity detected.2023.10.23
			23-10-25
			SFP
			Tuna
			1
			Washington
			N/A
			N/A
			No meal remnants available2023.11.01
			23-11-26
			CP
			Grouper
			1
			Puerto Rico
			N/A
			N/A
			No progression due to lack of response by complainant.2023.11.02
			23-11-27
			CP
			Salmon
			4
			Virginia
			C-CTX
			none detected
			Salmon (Salmo salar)
			N/A2023.11.09
			23-11-28
			SFP
			Tuna
			1
			Colorado
			N/A
			N/A
			No meal remnants available2023.11.15
			23-11-29
			SFP
			Ahi Tuna
			1
			New Hampshire
			N/A
			N/A
			No meal remnants available2023.11.17
			23-11-30
			CP
			Greater
			Amberjack
			3
			Florida
			C-CTX
			confirmed
			Greater Amberjack
			(Seriola dumerili)
			N/A2023.11.17
			23-11-31
			CP
			Kingfish
			4
			Puerto Rico
			N/A
			N/A
			No meal remnants available2023.11.27
			23-11-32
			SFP
			Salmon
			1
			Alabama
			N/A
			N/A
			No meal remnants available2023.12.06
			23-12-33
			CP
			Captain
			fish
			(Hogfish)
			3
			Puerto Rico
			N/A
			N/A
			No meal remnants available

Contact

Contact the FDA Division of Seafood Safety at Seafood.Illness@fda.hhs.gov to report a scombrotoxin fish poisoning or natural toxin in fish other than bivalve molluscan shellfish illness, request a specific illness related questionnaire, or if you have any questions regarding the information on this page.

For reporting an illness, please include the following information in the email:

Species of fish;
	Location of illness (e.g., state, country);
	Identify whether a meal remnant* is available and its current condition;
	Number of people ill from eating the fish;
	How the fish was obtained such as recreationally captured or commercially purchased; and
	Purchase location (store/restaurant) to include the store’s/restaurant’s name and address.*FDA has defined a meal remnant for the purposes of this program as the edible portion of the fish (leftover), cooked or uncooked, from the exact fish consumed from the illness event associated with natural toxin or scombrotoxin fish poisoning illnesses. Meal remnants should be frozen immediately and remain so until a representative retrieves them. Additional Information section pertaining to meal remnants may be found above.


Resources

FAO and WHO. 2020. Report of the Expert Meeting on Ciguatera Poisoning. Rome, 19–23 November 2018.Food Safety and Quality No. 9. Rome. https://doi.org/10.4060/ca8817en
	The Seafood List (SFL): The Seafood List (fda.gov)
	Deeds JR, Literman RA, Handy SM, Klontz KC, Swajian KA, Benner RA, Bart HL Jr. Haff disease associated with consumption of buffalofish (*Ictiobus* spp.) in the United States, 2010-2020, with confirmation of the causative species. Clin Toxicol (Phila). 2022 Oct;60(10):1087-1093. doi: 10.1080/15563650.2022.2123815. Epub 2022 Oct 6. PMID: 36200989.
	Center for Disease Control and Prevention: Harmful Algal Bloom (HAB) – Associated Illness: Harmful Algal Bloom-Associated Illnesses | CDC
	Food and Drug Administration: Bad Bug Book, Foodborne Pathogenic Microorganisms and Natural Toxins. Second Edition. 2012. Bad Bug Book (Second Edition) | FDA
	Food and Drug Administration: Fish and Fishery Products Hazards and Controls Guidance. Fourth Edition. June 2022. Fish and Fishery Products Hazards and Controls | FDA
	Food and Drug Administration: Import Alert 16-04. Import Alert 16-04 (fda.gov)
	Food and Drug Administration: Import Alert 16-20. Import Alert 16-20 (fda.gov)
	Food and Drug Administration: 21 CFR Part 123: Fish and Fishery Products Regulation. Electronic Code of Federal Regulations (eCFR)

                                                                                  Content current as of:
      01/23/2024
              
              
Regulated Product(s)
		 Food & Beverages
			  			     			  						              
			
			
			
			
			
						  Seafood/Seafood ProductOutbreaks of Foodborne Illness

          
                        Investigations of Foodborne Illness Outbreaks
          Public Health Advisories from Investigations of Foodborne Illness Outbreaks
          Food Safety Tips for Consumers & Retailers During an Outbreak of Foodborne Illness
          Food Safety Resources for Produce Shippers and Carriers During a Foodborne Illness Outbreak
          Outbreak Investigation Reports
          How to Report Seafood-Related Toxin and Scombrotoxin Fish Poisoning Illnesses
          About the CORE Network
          CORE Annual Reports
          CORE Publications


                        Foodborne Pathogens
 
 Footer Links
    FDA Archive
          About FDA
          Accessibility
      Visitor Information
          Website Policies / Privacy
          No FEAR Act
          Vulnerability Disclosure Policy
      FOIA
          HHS.gov
          USA.gov
    Contact FDA
      Follow FDA on Facebook
      Follow FDA on X
      Follow FDA on Instagram
      Follow FDA on LinkedIn
      View FDA videos on YouTube
      Subscribe to FDA RSS feeds
    FDA Homepage
    Contact Number
      1-888-INFO-FDA (1-888-463-6332) Back toTop