Seafood Toxins

Prevalence of seafood allergy in the United States determined by a random telephone survey

“…In 1999, 19 cases of scombroid poisoning were reported in the United States. 5 Presumably, recurrent reactions of scombroid poisoning in 1 person would be unlikely, and documentation of a positive skin test to fish in a person whose only reaction was actually a scombroid poisoning would also be unlikely. Therefore, among reactions to potentially contaminated fish in this study, only 2 adults may have actually had scombroid poisoning, which does not significantly affect the prevalence estimates.…”

“…Essentially all other types of seafood poisoning (eg, toxins such as Ciguatoxin or contamination such as Botulism and others) would not cause symptoms that would be included in our definitions of confirmed or convincing reactions. 5 Exclusion of symptoms that coincide with contamination-related illness may have underestimated allergic reactions, because noneIgEmediated reactions would also be excluded. Although it is was not possible here to verify allergy through directed study (oral challenge, tests for IgE, review of medical records, and so forth, that could result in exclusion of some subjects), we have presented a variety of conservative estimates (Table I, Table IV) that indicate a high rate of seafood allergy even with very strict diagnostic criteria.…”

“…Adverse reactions to seafood include immunologic ones such as IgE antibody-mediated allergy triggered by ingestion 2,3 or inhalation of proteins, 4 and adverse reactions that are not immune-based caused by toxins or infectious contaminants. 5 Allergic reactions to ingestion of seafood may include life-threatening anaphylaxis 2,6-8 and occupational exposure to skin contact and vapors may cause asthma and contact dermatitis. 4 The major allergenic proteins have been identified in fish parvalbumin 9 and in shellfish tropomyosin.…”

Measurement of IgE antibodies to shrimp tropomyosin is superior to skin prick testing with commercial extract and measurement of IgE to shrimp for predicting clinically relevant allergic reactions after shrimp ingestion

“…Adverse reactions by non-immune-mediated mechanisms (eg, toxins or additives in crustaceans) or by IgE-mediated reactivity to the parasite Anisakis species must also be considered. [39][40][41] Furthermore, the development of tolerance can occur in subjects who have seafood allergy. 42,43 One important issue is whether the presence of an IgE response to shrimp or shrimp tropomyosin would be associated with an increased risk to subsequently have shrimp allergy, particularly with severe reactions.…”