Symptoms of fish poisoning, the main causes

Fish is a popular product that happens on our table and on weekdays, and on holidays. The speed of cooking, the straightforwardness of the culinary processing of most fish species, the relative cheapness (with the exception of delicacies), the ease in digestion and the great benefits for the organism make fish a very attractive raw material for different dishes. Many species of fish allow everyone to find a fish for themselves and to taste, and on a pocket. Alas, we are increasingly paying attention to the price of fish, and increasingly less on its quality. But a stale product can cause severe food poisoning by fish, which can even interrupt the person's life.

The benefits and dangers of fish

It should be said that not everyone likes the fish, but many ways to prepare it and the variety of tastes of ready meals help everyone find among them exactly what they like. Since childhood, we are told that the fish is very useful, because it contains a large amount of protein and essential fatty acids, phosphorus and iodine, so necessary for our body. And this is not the whole list of useful substances.

But what is the optimal content of iodine in marine fish species? After all, this element of Mendeleyev's table is not often found in food, and its deficiency adversely affects the work of the thyroid gland. Iodine normalizes cholesterol metabolism and does not allow harmful cholesterol to settle on the walls of blood vessels, disrupting the blood flow. Thus, eating fish can be considered prevention of goiter and arteriosclerosis of blood vessels.

The fish are also appreciated for the high content of animal protein required for building our cells. And here it does not matter where the fish was caught: in sea waters or in a pond. Yes, animal protein is also rich in meat and eggs. But the meat contains more purines than fish, which, deposited in bone tissue, can provoke the development of gout, and eggs have always been considered a rich source of cholesterol, so it is not recommended to use them in large quantities.

But the fish is considered a useful dietary product, because it contains few calories and is easy to digest. It is recommended to eat for adults and children, for whom fish oil and meat are products that promote normal growth and development. Fish is included even in the composition of many therapeutic diets, for the benefit of this variety of ways of cooking. Useful dietary dishes are cooked and baked in a foil fish.

But speaking of the benefits of fish, one should not forget that this product is special because it does not require long heat treatment. Moreover, the preparation of dried, salted and dried fish, as well as the Japanese delicacy called "sushi," more and more popular in our country, generally does not imply exposure to high temperatures. In fact, it is a raw fish cooked with the addition of salt, and in any case it can be dangerous for the organism, if we take into account the conditions under which it lives.

Fish living in freshwater reservoirs quite often become a hotbed of internal parasites, it is not in vain even for animals to recommend river fish fresh because of the danger of helminthiasis. A big role is played by the place where the fish was caught. Well, if it's a clean river or a pond away from industrial areas. After all, the meat of fish caught in the polluted by waste products of the water body or in an ecologically unfavorable region, contains many harmful substances for the body, including salts of heavy metals. And it is good, if at the time of its catching the fish was alive, and not swam up belly, having died from poisoning with toxins, after all these toxins plus the decomposition products subsequently fall into the human body, causing severe food intoxications.

The probability of poisoning by waste products of marine fish is small, except that a tanker with oil will suffer in the sea or there will be some other emergency situation. And helminthiosis does not threaten fish living in salty water, because salt has a harmful effect on bacteria and small parasites. But there is no need to relax, because the fish can accumulate toxic substances from the outside (for example, toxins from some algae). A favorite of many mackerel varieties of fish contain allergen histidine, which during spawning is converted into saurine - a substance that not only causes the strongest allergic reactions, but also provokes disruptions in the work of the gastrointestinal tract and the cardiovascular system. Therefore, poisoning by sea fish is not so rare.

Not less dangerous and the use of sea delicacies from rare fish. Tissues of tropical fish species living near reefs (moray eels, barracuda, sea bass and some others) contain a rather poisonous substance - siguatoxin, which in humans causes severe poisoning and does not break down during short-term heat treatment, much less in its absence. Even more sad is the situation with exotic species of fish (the famous fish fugu, malinka, osman, etc.), in the body and inside which contains an even stronger toxic substance - tetrodotoxin, deactivated even by the correct heat treatment. Even a small dose of tetrodotoxin can be fatal.

Causes of the poisoning with fish

As we have already understood, the use of certain types of fish (reef, exotic, mackerel) is fraught with intoxication of the body and the development of severe allergic reactions. But we also know that toxic substances can be contained in other types of fish that live in salt and freshwater reservoirs if the fish lived in inappropriate conditions. And this is of great concern, because acquiring such a product useful to a person in the market or in a supermarket, the buyer has no idea about the fish's living conditions, so he can not immediately determine the cause of the poisoning, not realizing that it can even be poisoned with freshly caught fish.

But so far we have talked about the peculiarities of some fish and habitats, seeing here a few dangerous moments:

• the content of deadly poison in certain exotic fish species,
• The accumulation of toxic substances in the tissues of fish living in tropical regions,
• A dangerous allergen in the mackerel,
• habitat in ecologically unfavorable regions,
• infection of fish with parasites in freshwater reservoirs,
• emissions into water reservoirs of industrial wastes.

Now it's time to touch on an equally important issue of fish storage, because this product is not only very tasty and useful, but also perishable. At the same time, the spoilage of fish begins before an unpleasant odor appears, and pathological processes in it can be recognized only by individual moments: dull eyes, pale gills, ribs sticking out of the belly, etc.

As for the sanitary norms, it is not so much the duration of storage of fresh fish that is important, as its condition. On hot days, fish, stored without cold and water, can be rotten for several hours. Therefore, inexperienced fishermen often bring home a spoiled product from fishing.

As long as the fish splashes in the water in it, besides helminthes and silt, nothing harmful can and does not happen, especially if it swam in a clean pond. But as soon as it dies, the process of decomposition begins in the tissues with the participation of opportunistic microorganisms (for example, the ubiquitous staphylococci ), accompanied by the accumulation of significant doses of toxic substances, one part of which is the products of microorganisms, and the other is the result of necrotic processes.

Stop the process of decomposition of fish and meat can only be with the help of cold, and the lower the temperature of storage of the product, the longer it can be stored without fear of poisoning by fish. This moment is known also by those who are engaged in fishing, and those who transport it to the place of storage or sale, and the traders themselves. But if in industrial conditions the storage of fish does not present special difficulties, then in the process of its delivery and storage directly in the outlets there may be different shortcomings. Fish is often stored not in frozen, but cooled (on ice), which reduces its shelf life.

There are cases when spoilage occurs on a fishing boat, but cunning businessmen freeze such fish and send them to the outlets. Alas, deep freezing can kill most bacteria, but not toxic substances. Toxins in fish do not disappear even after heat treatment.

Even if the fish was frozen fresh, it is not a fact that it will fall on our table. If in the process of transportation or storage it was defrosted, the repeated freezing will not be able to correct the situation, the process of decomposition in fish begins in a short time.

Bacterial infection in the process of drinking sea and river fish is a more frequent situation than poisoning with delicacies by toxins. First, bacteria are present everywhere, even in the body of fish, but as long as the fish is alive and well, they do not manifest themselves at all, which is typical, for example, of staphylococci. In dead fish, conditionally pathogenic microorganisms are activated and, when ingested, can easily cause food intoxication. And some types of staphylococcus will not wait for the weakening of the human immune system to start multiplying, and they themselves provoke it.

Improper storage conditions for fish near the chicken or eggs can cause it to become infected with salmonella, causing a serious illness in people called salmonellosis. An identical situation can be observed if a person carrying a salmonella cuts the fish with his bare hands, after which it falls on the counters of outlets.

It's terrible to think what a person who, fish with bacteria and toxins, will salt, dry or use for making such Japanese delicacy as sushi, condemns himself or other people. If ko does not know, in real sushi raw fish are used, without subjecting it to heat treatment.

But poisoning can be obtained not only after a delicacy of raw, dried, salted or dried fish (the most dangerous are considered the first 2 species), but also dishes cooked using high temperatures. For example, not all bacteria die within the first 10 to 20 minutes necessary for cooking fish, not to mention the toxins that remain even after prolonged cooking.

The lack of sufficient temperature treatment of fish contaminated with bacteria (and some fish species with a prolonged exposure to high temperatures simply break up into small parts, which looks very unattractive on the table) leads to intestinal infections when bacteria change their residence.

But again, it is important not only to properly prepare fish to reduce the risk of possible poisoning, you need to eat it in time. After all, even if exposed to high temperatures, the fish has a limited shelf life, after which the decomposition processes begin again. Ready fish, which was not eaten immediately after cooking, should be stored only in a refrigerator at low temperatures.

[1], [2]

Pathogenesis

In the pathogenesis of fish poisoning, an important role is played by the penetration of poisons and pathogens into the human body when eating the liver, caviar, milk and even meat. It is believed that the greatest amount of toxic substances accumulates in so-called fish by-products, which provokes poisoning with milk, liver or caviar of fish. But after all, some of the toxic substances are contained in the meat of fish, so eating only meat (and even more so in large quantities) does not exclude intoxication and intestinal infections.

Getting into the body, various pathogenic factors act differently. Bacteria provoke inflammatory and putrefactive processes in the intestine, and poisons and toxins affect not only the gastrointestinal tract, but also other organs (in particular the central nervous system), successively hitting them one by one. Parasites deprive the body of the nutrients it needs, and can also enter into various organs, disrupting their work.

Whatever it was, but penetration into the body of alien aggressive factors, negatively affects human health. Especially it is noticeable on holidays, because many do not imagine a feast without fried, salted or smoked fish, fish pies, casseroles and salads. This, of course, is known to unscrupulous entrepreneurs, for which pre-holiday days are a great opportunity to get rid of products not of the first freshness. It only has to give it a commercial appearance, to use it as a mince in cooking and gastronomy, to make preserves and canned goods, the freshness of raw materials in which one can only guess, and the issue of delay is settled.

According to statistics, the risk of fish poisoning is especially high in the summer, when the shelf life of fish products is reduced due to high ambient temperatures, resulting in even frozen fish that does not last long. A high ambient temperature can lead to spoilage of the product even before it hits the counter.

[3], [4], [5], [6], [7]

Symptoms of the poisoning with fish

Because acute poisoning by fish can be caused by two main factors: bacteria and poisons, it is customary to distinguish between two types (or rather forms) of poisoning. If the cause of the disease is a bacterial factor, it is classified as a type of intestinal infection (cholera-like form) with symptoms characteristic of them. Poisoning by stale fish, regardless of whether the raw meat was meat, salted or thermally processed always occurs with the advent of such a syptomatics:

• Spasmodic pain in the abdomen  and discomfort in the intestines (rumbling, gas leakage, etc.),
• High fever and chills,
• The incessant nausea and attacks of vomiting,
• Severe diarrhea, frequent urge to stool with a stool,
• Deterioration of general condition, weakness.

The first signs of poisoning can be considered spasms in the abdomen and nausea. Almost immediately, they are joined by vomiting and loose stools, which lead to dehydration (dehydration). Temperature is already a sign of a strong intoxication of the body. And already against this background, the state of a person is significantly deteriorating.

If nothing is done, a person begins to experience a constant thirst, sweating is reduced (although at the very beginning it may be elevated), dry mouth appears . All these are signs of dehydration, which can have sad consequences. After all, along with water, the body loses its electrolytes necessary for it.

Poisoning by poisonous species of fish containing potent toxins is classified as paralytic. They are manifested as:

• Razey in the stomach and intestinal colic,
• An excruciating nausea and incessant vomiting,
• The strongest diarrhea,
• A strong desire to drink,
• Decrease in temperature to critical levels,
• Convulsive syndrome and spasms of muscular musculature,
• Panic attacks.

There may also appear a metallic taste in the mouth, photophobia, weakened cardiac activity, muscle weakness, shortness of breath.

Symptoms of a neurological nature arise gradually and depend on the stage of poisoning. At the initial stage, signs of gastrointestinal upset prevail. A little later, signs of dehydration appear, intoxication intensifies, which leads to CNS damage.

Poisoning fugue with fish is a separate conversation, because the toxin contained in it is thousands of times stronger than other poisons known to the world. In order to kill a person, only 1 milligram of poison is enough, and in one fish it is forty times more.

The tender taste of fish, which connoisseurs compare with silk, is not everything. During the use of fugu, a person experiences a strange feeling, which is on the verge between paralysis (death) and a certain euphoria, which gives the meal a certain zest, which acts like a drug. Man again wants to experience this unusual feeling.

But what is he facing? If the fish has been improperly prepared, then in the next quarter of an hour you can expect the appearance of deadly symptoms:

• Severe vertigo with impaired coordination of movements,
• Loss of sensitivity of the tongue and oral cavity, a feeling of tingling in the region of the lips,
• Increased salivation,
• Difficulty with swallowing,
• Paralysis of the extremities,
• Disruption of the cardiovascular system and respiratory apparatus.

In the absence of assistance (and it should be provided by a specialist), a person dies in a short time from a heart failure or respiratory failure. All this is connected with the paralytic action of the poison on the central nervous system, which controls the work of all human organs and systems.

Poisoning by the fish of the Scumbrian family (mackerel, tuna, pelamids, horse mackerel, mackerel, etc.) is not considered food poisoning or poisoning by poison. This is rather a special kind of severe allergic reaction, which occurs with a violation of the digestive system.

For food allergies, which is caused by zaurin, are characterized by:

• Hyperemia of the skin, i.e. Its redness,
• Skin itching, sometimes rashes on the skin,
• Dyspeptic phenomena, nausea,
• Edema syndrome.

These symptoms can be associated with violations of the cardiovascular and respiratory system, which usually do not lead to death.

How long does it take to get poisoned by fish? 

It depends on the cause of the poisoning. If the cause of poisoning lies in the bacterial factor, it takes some time for the infection to acquire a "massive" scale and the amount of toxins produced by the bacteria has caused intoxication of the organism. It can take from 30 minutes to 1 hour before the first symptoms of poisoning appear.

If poisoning has occurred due to the use of poisonous fish, the symptoms appear within half an hour. The stronger the toxin and the larger the portion volume, the faster the person will know about the poisoning. Tetradotoxin fugi the appearance of specific signs is able to cause for a quarter of an hour, and even earlier.

Food allergy with the use of mackerel fish also reminds of itself in the first minutes after a meal. But about the infection with helminths, a person can learn after weeks and months of increased appetite and inexplicable weight loss. Although sometimes parasites are found accidentally in different organs, including the liver and brain, and the patient does not even suspect about their existence inside the body.

Not at once reminds of yourself and chronic intoxication, which is possible if a person for a long time consumes fish caught in the industrial zone. If the toxin dose is low, a person at first can not observe any symptoms. Even later, nausea and weakness may appear, sometimes vomiting is added to them (so the body tries to get rid of the poison, although this is not effective, because the toxins have long been walking by blood).

Poisoning by a fish in a child

All parents want their children to be strong and healthy, and give the fish for lunch or dinner, because it contains very useful substances for growth and development, which are not found in meat or milk. Fish for the baby is very useful, but only if it comes to a freshly prepared product from quality raw materials.

Alas, we can not always trace the entire way of the fish to our table, we do not always know the place of its dwelling, the conditions of storage and transportation. But fish - a delicate product and any violations during storage or preparation are capable of causing severe poisoning, which for children is even more dangerous than for adults. After all, the child's organism is still in the final formation stage for a long time after birth. The body's defenses are still very weak to contain infection or intoxication.

Since few people will think of giving the children exotic fish, then it is useless to talk about poisons. The fish of the Smokbrian family pediatricians are also not advised to give to children, so food allergy can also be ruled out. Usually the cause of the poisoning of the child is the missing fish with a set of bacterial microflora.

And with the dominance of bacteria, the children's body is not yet able to actively fight, so the symptoms of fish poisoning in children may appear earlier than in adults (within half an hour), and their severity is much higher. First, usually vomiting occurs, and the urge is so frequent that it is already exhausting the baby in the first 24 hours. Not every adult can safely withstand 10-15-times vomiting.

A little later the baby starts complaining of abdominal pain, diarrhea begins. The stool becomes watery after a while, but it can also have a greenish shade, which again confirms the bacterial nature of the poisoning.

With mild poisoning, the child feels completely tolerable, but the loss of fluid and increased intoxication are felt by the increase in body temperature and weakness, resulting in the child becoming sluggish, begins to be capricious.

If vomiting is frequent, moreover, and accompanied by severe diarrhea, dehydration occurs at an accelerated rate. The skin of the baby pales, there is a strong thirst, pressure falls, and the pulse on the contrary accelerates, the breathing becomes frequent and heavy, resembling a shortness of breath. The amount of excreted urine decreases, which gets a darker color (becomes more concentrated).

If nothing is done, the child can develop an infectious-toxic shock - a condition that is dangerous for the baby's life, therefore, at the first symptoms of intoxication, all measures should be taken to reduce the toxic effect on the body.

Forms

Consider the main risk factors for fish poisoning, depending on the type of fish or how it is prepared:

• Poisoning raw fish,  although not considered a very common problem (raw fish we have not taken, except in the land), still leads to unpleasant consequences. Even if this is not an exotic marine or oceanic fish, stuffed with its own toxins, and not a resident of polluted water bodies (although it is unlikely that such fish will be used in Japanese restaurants that respect themselves), there is no guarantee that the bacteria in the fish and the parasites .

In fish that lived on fresh water, you can find both small worms (anisakiosis) and tapeworms (opisthorchiasis), sucking from food all useful substances and causing inflammatory processes in the intestine. But unfrozen and improperly stored fish can become a source of staphylococci and salmonella.

• Poisoning with dried fish  is already a more frequent problem, because it is not quite a ready product. Drying is a special way of cooking fish, in which it turns out to be moderately salty and juicy enough, in contrast to dried fish. Undoubtedly, a dried fish is a delicious treat, but often it carries a risk of bacterial contamination.

The fact that as a preservative and antimicrobial component in the fish is salt, and if it is put less than the minimum required amount, the product will still begin to deteriorate quickly, after all the dried fish is cooked at insufficiently high temperatures necessary for the death of microbes. The temperature regime, in which the fish is kept for several days from salting to kneading, also plays a big role, as well as storing the finished product. Dried fish can not be stored for a long time neither warmly nor in the cold, remaining still juicy and safe.

Although the safety of such a product has yet to be argued. For example, where guarantees that fresh raw materials did not initially have parasites, eggs that can be preserved even during salting and drying, or the fish has not been contaminated with pathogens. Although bacteria can appear and as a consequence of non-compliance with the technology of cooking and storing dried fish.

If the fish is bought from a stranger, can you be sure that it was caught in a clean, not polluted waste water industry, and does not contain toxins dangerous to the body. To hope that salt will destroy toxins is at least unreasonable.

• The same can be said about  poisoning with dried fish. Here, of course, salt can be added and more, which will provide a good antibacterial effect, but drying in the heat and prolonged storage in inappropriate conditions can reduce all work to "no."

In addition, it is dangerous to dry fish bought on the market, or to buy already prepared dried or dried products, even in the sense that processing and drying are not known under what conditions, did the manufacturer adhere to hygienic norms or flocks flies around the fish offered to us?

Again, the problem of toxins remains, which is especially important if the internal organs and gills, which accumulate most of the toxic substances, are not extracted from the fish when drying from fish (in the same place, parasites, as well as some bacteria, are hidden most often).

• Salting is another favorite way of cooking a tasty fish, which will have to be the way for any feast, especially with alcohol. But salting is a very delicate matter, which requires a certain concentration of salt solution and sufficient holding of the fish in the brine.

We are forced to upset lovers of salted fish, because the finished product can be obtained in two ways, one of which is very popular, but can cause poisoning by fish. Lightly salted fish can be obtained by keeping it for a long time in a cool place in a not very strong brine, or save time and make brine stronger, and reduce the time of salting. In the latter case, we get a tasty fish salted near the skin and almost moist in the range of the ridge, often even with blood. Leaving the brine, such a fish will quickly deteriorate, not to mention the safety of living parasites inside it, if they existed there.

How can we understand that the fish has salted enough to avoid  poisoning with salted fish? In the eyes. In ready fish, the orbit should be sunk.

It is also important in what conditions the salting of fish was made, because if sanitary and hygienic conditions were not met, infection of fish of various microorganisms could occur at any stage of the cooking process.

Not many people know, but not only high-quality fish is allowed into the salting. For the crooked businessmen it is a good way to get rid of the spoiled goods, after all after salting the unpleasant douche disappears. This is often done with thawed herring or mackerel, which can no longer be stored for long.

• Especially at our festivities we respect the smoked fish, which is considered an exquisite delicacy, especially when it comes to noble species of fish. But smoking can make a fish safe only by observing all the rules: temperature, salt quantity, aging time, otherwise smoked fish  can not be  poisoned.

And smoking can be different. With cold smoking, the emphasis is on the preservative - salt, because only its sufficient amount can destroy harmful microorganisms and parasites. Hot smoking implies the use of less salt, but the fish is additionally subjected to heat treatment. However, this treatment is not enough to prevent the decomposition process for a long time, so the fish of hot smoked fish is not kept for long. As we see, smoking does not make keeping fish eternal and does not cancel the conditions of its storage in refrigerators.

During the treatment of fish with smoke, there is a possibility of the formation of carcinogenic substances harmful to the body. And if you consider that the fish may not even see the smoke, and be lubricated with a special concentrate that gives it the appearance and smell of smoked, the probability of poisoning with chemicals in this case is incredibly high, which again proves to be true statistics. By the way, on the counters of outlets, the percentage of such smeared fish sometimes even exceeds the content of the product prepared according to all standards.

By the way, smoking is another incredibly effective way of using poor-quality raw materials, an overdue and slightly spoiled goods for a pocket, because the smell of smoke helps to hide all these shortcomings. Do entrepreneurs think about those people who can suffer by eating the missing fish with the smell of smoke. And here the cause of poisoning is far from the wrong storage of finished products, the ved goods were spoiled before it was processed.

• The most accessible and popular methods of cooking fish is its frying in oil, baking in foil, or boiling. This fish is present on the table not only on holidays, but also on weekdays. Depending on the possibilities, as a raw material for a delicious lunch or dinner, there is your own catch, a fish bought at a retail outlet or with hands.

It is clear that the safest will be the fish caught by its own forces in a clean pond that said goodbye to life immediately before cooking. But here there is one nuance. If the catch is small, but hungry mouths are enough, then the dish will go at a time. But in the case of successful fishing, all fish are unlikely to be quickly eaten. And if the remains of fresh fish are stored incorrectly (they will not be cleared of the entrails and frozen), they will very quickly become worthless. Even if fried fish fry,  poisoning fried fish is  unlikely to be avoided, because the toxins formed in it with high temperature can not be removed.

The same can be said for boiled or baked fish, which can be considered dietary and safe if quality fresh or frozen fish was used in cooking and the prepared dish was stored under appropriate conditions for a limited time, which did not lead to its spoilage.

It should be understood that  poisoning stale fish, raw or cooked by one of the known methods, is a double danger, because in such a fish there are two life-poisoning factors: bacteria and toxins. And this if you do not take into account possible parasites and toxic substances that could get into the body of fish from the outside.

• Not everyone in his life came across such a miracle of nature as an oiled fish, so named for the fact that its delicate and tasty meat contains an incredible amount of fat. In fact, oily fish is a generalized name for several species of fish with similar taste qualities and very fatty meat. In addition to the Atlantic oil fish, this includes eskolar, seriolella, ruvet, stromatheus, etc. Unknown names? And this is not surprising, because the merchants all this fish has one name.

It can not be said that oily fish are something second-rate, although at one time it was presented to us as animal feed. This species of marine inhabitants has their own admirers, they even cook such fish in expensive restaurants, where they know all the nuances of its preparation.

No, this fish is not poisonous. Just part of the fats contained in it in the human body is digested with difficulty, which leads to problems with digestion, which many accept for food poisoning.

In reality,  poisoning with oily fish  is nothing more than a severe diarrhea caused by the consumption of large amounts of fat at a time. Usually, such a problem is faced by those who do not know how to properly prepare an oily fish. On idea for her any cooking methods are suitable, but to avoid frequent visits to the toilet you need to choose such methods as cooking or grilling. During the boiling of fish, most of the fat is melted into the broth, which is subsequently drained off. But such a fish cooked on the grill will be much more appetizing, and the fat simply drains onto the baking tray during baking.

• A famous delicacy at all times was considered to be red fish. It would seem that such an expensive treat simply can not be unsuitable for food. Alas, episodes of  poisoning by red fish  say the opposite.

The fact is that delicacy varieties of fish with reddish meat are often used to make sushi. It is clear that fresh fish are used, which does not undergo thermal treatment. But in fact red fish are not found in local small reservoirs, it is a resident of the sea, which means that there will be more than one hour or a day before this seafood gets to the store or restaurant. From the fact, in what conditions it will be stored and transported, the safety of the land made from it depends.

On the other hand, sushi can now be bought almost at every corner, but the freshness of the finished product often has to be doubted. If the thawed fish within half an hour in the room conditions becomes a hotbed of bacteria, what can we say about sushi, where the same thawed fish can stay not an hour, or two, until it gets into the stomach of the unlucky buyer.

You can grieve and lovers of salted salmon or salmon. It is not necessary to hope that at the end of the storage period, the fish in the store and, even more so in the market, will be disposed of. Most likely, sellers will do everything to its appearance and smell in no way betrayed the spoilage of the product. You see a good discount on the red fish, think about whether it is caused by critical deadlines and whether such a fish will cause poisoning. After salting the spoiled fish does not make it safe.

And one moment. Red fish, although considered a resident of the salt sea, during the migration of freshwater reservoirs, it may well capture parasites, which will later be given to the person who has eaten such a delicacy. From parasites, only deep freezing or good heat treatment can save. If neither one nor the other was, the parasites can easily migrate to the human body and migrate inside it.

• Fish fugu - not so popular in our region of delicacy. Nevertheless, there are a lot of people who want to get such a risky pleasure from eating fish in unusual, "silk" taste. In Japan, where this fish is trusted to cook only for individual chefs in selected restaurants, and this is not always the case (one should say it is not cheap!) The pleasure ends successfully. Dozens of deaths associated with the consumption of fish from the family of puffers are recorded annually in Japan, but this does not stop the thrill-seekers with large purses.

Poisoning fugu fish is  associated not with damage to the product or contamination with its helminths, but with poisoning the organism of the person who consumed the fish with the most dangerous poison - tetradotoxin, which can only be neutralized by a special method of preparation. In this case, even the cook himself during the manipulation of the fish is exposed to mortal danger. And near the client who wants to taste fugu, in the Japanese restaurants respecting their name there is always a specially trained doctor who is ready to provide first aid at the first signs of poisoning.

A portion of a poisonous fish is always very small, because if a large amount of toxin gets into the body, it is unlikely that a person will be saved.

The use of pufferfish, and especially fugu, is considered one of the most risky activities, capable at any time to result in the death of a person. But  deadly poisoning is  possible not only fish fugu or other types of fish containing poisons. An important role is played by the timeliness of first aid in case of fish poisoning, and for this you need to know the symptoms that indicate intestinal disorders and intoxication of the body.

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Complications and consequences

Whether it is necessary to speak long about the danger posed by poisoning by fish, if it has already been said a lot about the possible consequences of using stale or openly poisonous fish. Probably, a minute of pleasure from eating fish dishes of questionable quality is not worth the torment that may follow.

The only vomiting of what is worth, not to mention diarrhea, which will not allow even to leave the house, not that to go to school, to work or for a walk. During the first day a person is literally tied to the toilet. He can not eat anything, as food intake turns into a new episode of vomiting. And the pain in the abdomen is not conducive to better appetite. The forces of a person are depleted, because there is no supply from outside.

Vomiting, and even in combination with diarrhea, takes the last strength from the victim, causing a complication such as dehydration, which in turn leads to disruption of many organs and systems, beginning with the central nervous system. Blood becomes thicker and blood circulation slows down. The body suffers from hypoxia (oxygen starvation), and the brain first responds with the appearance of preventive symptoms in the form of dizziness, weakness, attention disorder, etc.

In turn, toxins "finish off" the nervous system, causing dangerous neurological symptoms. And the bacteria provoke inflammatory processes in the intestines, which will have to be fought with more than one day. In general, this moment in poisoning is very significant. Sometimes it takes much less time to destroy the causes of foodborne infections, than to fight its consequences, because any malfunctioning of the organs does not pass without a trace, and under suitable conditions they can arise again and again.

The most dangerous consequence of fish poisoning is death from paralysis of the respiratory or cardiovascular system. In the case of fugue fish, the likelihood of such an outcome is too great. But, even after eating a good portion of a non-poisonous, and just foul fish, a person is very at risk and can die if he does not receive the necessary help in time to cleanse the body of bacteria and toxins.

[10], [11]

Diagnostics of the poisoning with fish

When a person consumes obviously spoiled fish, which is indicated by bitter taste and not very appetizing smell, he knows what to prepare for, and when the first symptoms of poisoning appear, he can certainly name its cause. It is clear that lovers of thrill and overseas delicacies should also be aware of the possible consequences.

It's another matter if the victim did not suspect that the product is of poor quality, because salting and smoking are able to hide such small but so inconvenient drawbacks as a change in taste and smell. And the allergy to mackerel fish for many can be a surprise.

The occurrence of vomiting and diarrhea in such cases cause a lot of questions. But the first thing to think about when specific symptoms appear 15-60 minutes after a meal is what kind of food or food poisoning could have been caused. If the menu had fish dishes, then it is likely that the cause of the upset stomach was the fish.

In severe cases, immediately call an ambulance, whose doctor will examine the patient at home and take the victim to the hospital. If the situation is not critical, call a local therapist at the house or go to him for a consultation. In any case, the doctor conducts a physical examination of the victim with palpation of the abdomen, asks about the possible cause of poisoning, studies information about the patient's pathologies. Mandatory measurement of body temperature, blood pressure and pulse.

The patient is prescribed tests: a clinical and biochemical blood test will help assess the degree of dehydration (blood condenses) and the presence of poisonous substances, while the analysis of feces will help determine the causative agent of the disease. Sometimes, for this purpose, the vomiting is carried out.

Urinalysis can also be used to help assess the extent of kidney damage due to intoxication, because kidneys are one of the main body filters, which means they suffer the most.

In the case of minor poisonings, instrumental diagnostics are usually not carried out. The patient may be offered a gastroduodenoscopy or colonoscopy to determine the condition of the stomach and intestinal mucosa, but these studies are not mandatory.

But if a person enters a hospital with severe food intoxication, he may be given an ultrasound examination of the abdominal organs, and sometimes a sigmoidoscopy. In the presence of severe neurologic symptoms, a lumbar puncture is performed.

[12], [13], [14], [15], [16]

Differential diagnosis

The clinical picture of fish poisoning in many ways resembles other food poisoning and in particular botulism is a disease that doctors especially emphasize because of the incredibly high risk of botulinum toxin. The latter is found most often in meat and canned fish.

The task of differential diagnosis in the event of poisoning with fish products is not only to determine the cause of poisoning (eating stale fish or dangerous varieties, the consumption of other low-quality products, medicines), but also in the differentiation of pathogens. In addition, symptoms similar to poisoning can manifest acute gastritis, pancreatitis and other gastrointestinal diseases. When pregnancy with the same symptoms reminds of a toxicosis that is not associated with the use of spoiled or infected foods.

If there is a suspicion of botulism , it is instructive to conduct an electromyography determining the biopotential of the muscles. In addition, botulism will also be indicated by such symptoms as fog before the eyes, a hoarse voice, bifurcation of objects and sharp deterioration of vision, slurred speech. In this case, vomiting and abdominal pain about botuloinfections are infrequent, and the temperature in general remains within normal limits.

[17], [18], [19], [20], [21], [22],

Prevention

The painful symptoms of poisoning and possible dangerous consequences are too expensive for a minute of pleasure. But this does not mean that the use of such a useful dietary product as a fish should be abandoned. It is just more responsible to choose fish and fish products for your table.

In order not to make mistakes in the choice of fish, several simple rules must be followed, which, moreover, must become a habit among those who do not represent their life without fish:

• Do not buy fish from the hands, in dubious markets and in outlets where sanitary and hygienic requirements are not observed, and the conditions for storing fish do not meet the established standards. If in hot weather the fish lies on an open counter, and it is not even tried to lay it on ice, it is definitely safer to pass by without making dangerous purchases.

Preference should be given to proven points. Let it be one or two shops where the products have quality certificates, you can find out when and where the fish is caught, in what conditions is stored, specify the expiration date of the goods.

• Well, if during the purchase the fish was not just in the water, but even was still alive. It's okay if the fish does not feed any signs of life, but it has brightly red or burgundy gills, elastic white or slightly pink meat, glossy smooth adhering scales, clear, transparent eyes, the skin is leveled after pressing down for a couple of seconds. This indicates that the fish is fresh, its death has recently come and the decomposition processes have not yet begun. It is worth paying attention to the smell, which in marine fish is practically absent, while river inhabitants correspond to the smell of water and mud.

What are the signs that will indicate that the fish is stale or even foul:

• an unusual chemical or fetid aroma, the smell of ammonia, which will say that the fish is caught in a dubious place or has already begun to fade,
• scales do not shine, is brittle or absent in several places, covered with muddy mucus,
• The gills are pale and covered with mud,
• The eyes of the raw fish are muddy and sunken,
• meat is not dense, when pressed, it is not leveled or returns to its starting position very slowly,
• the ribs bulge, and when the belly is opened, they fall behind the meat,
• the interior is a shapeless mass, easily torn, which often happens when the fish is repeatedly frozen.

• When buying frozen products it is recommended to always read the certificate for them, which the buyer has the right to see by law. The frozen fish must have documents from which it is easy to know where and when it was caught. The shelf life of such fish should not exceed six months. Suspicious should appear fish with a yellowish coating on the skin or scales, yellow or gray tinge of meat, collapsing after defrosting. Such signs are peculiar to products that have disappeared from old age. By the way, they have a corresponding smell. Frozen fish can also be repeatedly thawed.
• When buying salted and smoked fish, you need to remember that often the raw material for them is just the missing fish. Unusually dark color of meat, white impregnations, not very pleasant smell, too soft meat and skin with damages should alert the buyer. Salted fish and cooked by the method of cold smoking should have a dense structure. With hot smoked is a little more difficult, but rotten fish here often gives off a smell.
• Care must be taken to purchase raw fish without a head. Perhaps it was cut off to hide signs of decay, because everyone knows that the fish is rotting from the head.
• Some doubts are caused by fish in the grocery store food supermarkets. Usually, she goes there after a long time will lie on the side of the fish department. In cooking, most often fish are sent with the appropriate deadlines, and sometimes frankly missing (no one really wants to put their money for delay).
• About discounts in supermarkets in general, the conversation is special. Very rarely, they present a real share for a fresh catch in order to attract customers. Most often under the shares is the possibility of a quick sale of fish, the term of which expires in the near future. This fish can not yet be called missing, but it is not safe to keep it any longer. This fish should be prepared immediately after purchase.

Shares in ordinary stores, where most of the sales are controlled by the sellers themselves (they are also responsible for spoiling the goods), under the guise of a stock, a stale product that poses a health hazard can also be sold. The same can be said about the market points where everyone knows who and how much to pay for the missing goods to remain on the counter and, most importantly, in case of poisoning by the fish it will be practically impossible to prove that the spoiled goods were purchased at this point, because the checks on the market are not issued.

• By the way, a check from a sales outlet that sold a product that is dangerous to health is the only way to bring to justice the unscrupulous traders. Therefore, it must always be demanded, checking that there is a name for the fish and the date of sale.
• With the purchase and use of exotic fish you need to be careful. If you risk yourself, then at least do not endanger the lives of your children. The habitual local fish is not less useful and tasty, if it is properly cooked, but safer than the overseas delicacies, to which our body is unaccustomed, the result is either poisoning or an allergic reaction.
• Fishermen can be advised to adhere to the ban on fishing during spawning, because it is during this period in the body of fish accumulates the greatest amount of hazardous substances.
• Caught by yourself or bought fresh fish in the store is recommended to use during the day. At the same time, it should be stored in water (while still alive) or in the cold. The remaining fish should be frozen, pre-gutted and removed from it the gills. But in the freezer to store fish for months is not recommended. For long-term storage, lower temperatures are required, not provided for in household refrigerators.
• Keep fish in film, having warned her contact with other food. Ideally, a separate knife and cutting board should serve to prepare the fish for cooking or storage.
• If frozen fish was purchased, but while it was reported to the house, it was thawed, it can not be frozen again. Defrosted food should be cooked for a couple of hours.
• It is necessary to pay attention to sufficient thermal processing of fish, especially during roasting and baking. You can not eat fish meat with blood or badly fried, because it is so easy to let in internal parasites into your body.
• You must also salt the fish neatly, without regretting the salt and keeping it in the brine for a sufficient amount of time. When drying fish, the amount of salt is also very important, but do not forget about the sanitary conditions in which the fish will be dried. Raw fish are very fond of flies - the main carriers of infection, and salt is not an obstacle. But the spoilage of the product when laying eggs on it is ensured.

Before you submit a fish to guests or relatives, you must first try it yourself. The presence of an alien suspicious smell and taste indicates the inadequacy of the dish for food. So you can prevent the mass poisoning of fish and not become the culprit of the suffering of other people.

[23], [24], [25], [26], [27],

Forecast

Poisoning by fish is a rather dangerous situation, requiring urgent measures to prevent the spread of toxins in the body and defeat them of the central nervous system. If poisoning with a stale product increases the symptoms of intoxication gradually, and the person has enough time to take appropriate measures, then when poisoning with poisonous fish species, time for first aid is very small.

With timely treatment, poisoning of rotten fish has a generally favorable prognosis, although treatment in severe situations will be quite lengthy. But with exotic species of fish it is better not to joke, because the poison contained in them very quickly gets into the blood, that part leads to the sad consequences - the defeat of vital organs, and sometimes to death.

The worst prognosis for fish poisoning is fugue and botulism. In the first case, even timely assistance does not guarantee saving a person's life. Even in such a situation, the mortality rate exceeds 60%. Poisoning with botulinum toxin requires the rapid introduction of a special serum, and if there is not, the likelihood of a fatal outcome is extremely high. And if such a delicacy as fugu in our region is not popular, but botulinum toxins can be considered ubiquitous, so they can be found in both imported and domestic fish conservation. At the same time, there are facts that say that botulism can get sick even after consuming dried fish, although they used to blame canned food for everything.