This outbreak is an example of scombroid poisoning. Scombroid enterotoxin is actually a heat stable bi-product of histamine, and results when dark-fleshed fish begin to decompose. Its one of the few illnesses through food that have a correlation directly to spoilage although there may be others (certain strains of C botulinum). Because the symptoms occur rapidly and are easily recognized by the victim as food related, few outbreaks go unreported and uninvestigated. This illness is an example of how reporting artifacts confound epidemiological statistics. A recent study by the Centers for Science in the Public Interest reported that fish and seafood are the vehicles most often identified in foodborne illness outbreaks. Failure to understand the effect of reporting bias in the data related to fish, makes that work and its conclusions flawed. In addition, that study also relied upon data on shellfish infections and intoxications, and ciguatera intoxication. These data also suffer from the same type of reporting bias issues.

However, tuna and other species of Scromboid fishes (jacks, mahi) have a very high risk of this hazard. Its occurrence is quite an important issue as HACCP has been in place in fisheries in the US for many years. Without rigorous supplier controls controlling risks all the way to harvesting, HACCP as an intervention in this illness is weak.

There is a corollary between Scomboid poisoning and other hazards such as those found in fresh produce, that lack a kill step.

UK: Tuna ‘link’ in sickness outbreak
BBC News
A tuna meal may have been to blame for an illness outbreak at Aberdeen Exhibition and Conference Centre, NHS Grampian has said.
Twelve people needed hospital treatment after the emergency services were called out on Thursday afternoon.
The health board said the common link between the patients was a tuna dish for lunch. Samples are being tested.
One man who fell ill, who did not want to be named, said the symptoms were rashes, headaches and palpitations.