Several studies have helped put seafood safety issues into perspective. A 1991 study by the National Academy of Sciences concluded that "most seafood available to the U.S. public are wholesome and unlikely to cause illness." The study did, however, identify areas of risk and priority needs for research and education, and it recommended improvements in the seafood surveillance system.

The FDA also recently reviewed seafood safety issues and concluded that "the vast majority of seafood in the marketplace is safe to eat, and overall, American shoppers can be confident that the fish they buy will provide a healthful meal." A recent FDA study estimated that the risk of illness from seafood was 1 illness from seafood in 250,000 servings. The same study estimated a risk of about 1 illness in every 25,000 servings for chicken.

While scientists agree that the seafood supply generally meets acceptable safety standards, potential health risks can be associated with bacterial or viral contamination, naturally occurring toxins, and chemical contaminants.
The following information is provided to help you understand specific seafood safety issues and avoid potential risks.

Improperly Handled Seafood
Most food safety experts believe that improper food handling is the most important safety concern and the leading cause of food-borne illness in the United States. Seafood is one of the most perishable foods, and proper handling, and preparation are essential to maintain quality and ensure safety. All raw foods contain bacteria, which can grow and multiply rapidly if food is left for several hours at room temperature. Observe the following handling tips to maintain seafood quality and avoid illness:

Keep seafood cold at all times. Always keep seafood at a temperature as close to 32*F as possible. Get seafood home as quickly as possible. Store fresh seafood in the coldest part of the refrigerator (meat or vegetable compartment or on open shelves close to the back) and frozen seafood in the freezer, and keep it there until it's needed.

Avoid cross-contamination. Don't transfer bacteria from one food or food contact surface (your hands, utensils, knives, cutting boards) to another when handling, storing, or preparing seafood. Thoroughly wash your hands, utensils, containers, and any food preparation surfaces after touching or preparing raw seafood, meat, or poultry.

Store raw seafood in leakproof containers or bags when possible. Prevent seafood from dripping or splashing onto other foods and prevent seafood from being contaminated by other foods.

Handle and store raw and cooked seafood separately. It's especially important to prevent raw foods from touching, dripping, or splashing onto foods that won't be cooked again before being eaten.

Cook seafood properly to ensure safety. Most experts suggest cooking seafood to an internal temperature of at least 145*F. A temperature of 160*F or higher is recommended to kill bacteria, but excessive exposure to high temperatures can easily cause seafood to be overcooked and become dry and tough. Properly cooked fish should be opaque, moist, and flake easily.

Cool cooked seafood as rapidly as possible. When preparing large amounts of cooked seafood (such as a large pot of clam chowder), put the cooked product into small, shallow containers, which will cool faster in the refrigerator.

Thaw seafood properly. Frozen seafood should be thawed in the refrigerator or under cold continuously running and draining water. Never thaw seafood in warm or standing water or at room temperature - environments that allow bacteria to grow.

Eating Raw Seafood
Some seafood is traditionally eaten raw, even though eating raw foods is considerably riskier than eating cooked foods. Cooking seafood properly is necessary to destroy disease-causing organisms that occur naturally or that can be introduced during handling, storage, or preparation. When seafood or any other food is eaten raw or partially cooked, the risk of illness is significantly increased. Some raw products that have been implicated in human infection are: ceviche (fish and spices marinated in lime juice); lomi lomi (salmon marinated in lemon juice, onions and tomato); poisson cru (fish marinated in citrus juice, onions, tomatoes and coconut milk); salmon roe; sashimi (chunks of raw fish); sushi (pieces of raw fish with rice and other ingredients); green herring (lightly brined herring); drunken crabs (crabs marinated in wine and peppers); cold-smoked fish; and, undercooked grilled fish.

Bivalve Molluscan Shellfish
Bivalve molluscan shellfish, like clams and oysters, are commonly eaten raw or partially cooked. Because of where they live, how they feed, and how they're eaten, they could contain bacteria or viruses that can cause illness.

Bivalves live in coastal areas close to the shore. Bacteria and viruses from human and land animal sources can be carried into coastal waters with runoff from the land, in sewage discharges, or from other sources. These shellfish, which obtain food by pumping water through their digestive system and filtering out small organisms, may collect bacteria and viruses from the water in which they live. People can ingest these organisms when they eat these products raw. For these reasons, potential health risks associated with eating raw bivalve shellfish are usually directly related to the quality of the waters from which they were harvested.

The FDA and coastal state governments oversee the National Shellfish Sanitation Program, which sets standards for waters in which shellfish are grown and requires those waters be tested regularly. The program is designed to ensure that shellfish are harvested from certified waters and meet safety standards. Because of this program, large amounts of raw clams and oysters are eaten each year without incident.

Some shellfish-related illnesses, however, still occur. Many of the reported illnesses are believed to be the result of "bootlegging" or the illegal harvesting of shellfish from uncertified waters. Coastal states have greatly increased penalties for bootleggers, and the FDA has made the elimination of bootlegging a priority. Other illnesses result from bacteria which are natural summertime inhabitants of clean (unpolluted) coastal waters. When present in shellfish waters, these bacteria, which include Vibrio cholera, Vibrio parahaemolyticus, and Vibrio vulnificus, can accumulate in molluscan bivalves. Although the bacteria do not affect the health of the shellfish, they can cause illness in humans consuming raw or undercooked bivalves. Individuals whose physical health is weakened by certain preexisting medical conditions are considered "at risk" for contracting Vibrio vulnificus infections. Vulnificus infections are serious, causing death in 46% of people who contract them. Therefore, some states like Louisiana and California require warnings on raw bivalve packages and on menus of restaurants serving raw bivalve shellfish. Raw or partially cooked bivalves should not be eaten by anyone with one or more of the "at risk" conditions. At risk conditions include compromised immune systems, AIDS, cancer (especially during chemotherapy), liver disease, diabetes, hemochromatosis, chronic kidney disease, inflammatory bowel disease, steroid dependency, achlorhydria, and other stomach problems. Additional high-risk individuals include alcoholics, infants, pregnant women, the elderly, and people on antacid therapy.

The following tips can help healthy individuals who choose to eat raw bivalve molluscan shellfish reduce potential risks:

Always buy clams, oysters, and mussels from a licensed, reputable dealer.
If you harvest clams, oysters, or mussels yourself, obey all posted warnings and verifY with local authorities that the waters are certified for shellfish harvesting.
Don't use dead shellfish, whose shells don't close tightly when tapped or agitated. (Soft-shell clams can't completely close their shell, but should move when touched.)
Handle and store shellfish properly. Keep shellfish cool and damp. Rinse when necessary to remove dirt or debris, but avoid prolonged contact with freshwater, drastic temperature changes, and airtight containers. Don't allow other foods to drip on shellfish during storage, and prevent contamination by using clean containers and utensils for storage, preparation, and serving. Food handlers should wash their hands with warm, soapy water before and after preparing and serving shellfish.
Consider cooking shellfish properly to reduce potential risks further. The FDA recommends that live oysters, clams, and mussels be steamed for 4 to 9 minutes or that they be placed in boiling water and cooked for 3 to 5 minutes after the shells have opened. Shellfish should be cooked in small batches to ensure thorough cooking. Shucked shellfish should be boiled or simmered for at least 3 minutes or until edges curl, fried in 375oF oil for at least 3 minutes, broiled 3" from heat for 3 minutes, or baked for 10 minutes at 450oF.
Raw Fish

Raw fish dishes such a sushi and sashimi and uncooked marinated dishes like ceviche have become popular in the United States. Disease causing bacteria and viruses don't normally occur in the muscle of a whole fish, or the part that is usually eaten. However, fish fillets and steaks can be contaminated by improper handling. Because raw fish dishes aren't heated to a temperature that would normally kill bacteria, only high quality or sushi grade products should be used. If you choose to eat raw or uncooked fish, purchase the fish from reputable establishments that have high standards for quality and sanitation.

Parasites, (e.g. tapeworms, flatworms, and roundworms), which occur naturally in some fish, are another potential safety concern when raw fish are eaten. The National Academy of Sciences found that human parasitic infections from seafood are rare in the United States, and as yet there is no evidence of a significant increase due to the growing popularity of raw fish dishes. While sushi chefs are trained to detect and remove parasites, home chefs can eliminate potential health risks from parasites only by proper cooking or freezing.

Cooking fish to an internal temperature of at least 145oF for at least 1 minute will kill parasites. Dead parasites are not harmful when ingested but may be aesthetically unappealing. Even though preparing raw fish dishes at home is not encouraged, if you choose to do so use frozen fish. The FDA recommends that fish intended for raw consumption be frozen to an internal temperature of -4oF for 7 days or at -3oF internal temperature for 15 hours to kill parasites. The Food Code recommends these freezing conditions to retailers who provide fish intended for raw consumption.

The seafood industry inspects fish and removes parasites using a procedure called candling. Even the most diligent operations, however, may not find all parasites. Always conduct a quick visual check of your food before you cook it to avoid unpleasant surprises. Most retailers will replace products if parasites are found.

Seafood Toxins
Toxins can be produced by naturally occurring marine algae and can accumulate in fish and shellfish that inhabit the same marine environment. Unlike bacteria and parasites, toxins are not destroyed by cooking. There are five recognized fish poisoning syndromes in the United States caused by marine species consuming toxic algae: ciguatera fish poisoning (CFP), paralytic shellfish poisoning (PSP), neurotoxic shellfish poisoning (NSP), diarrhetic shellfish poisoning (DSP), and amnesic shellfish poisoning (ASP). To reduce potential health risks, purchase seafood from reputable sources, handle it properly, and exercise caution when eating fish and shellfish that you've caught in unfamiliar waters.

Ciguatoxin is a marine toxin that can accumulate in some tropical saltwater reef fish, and poisoning can occur when those fish are eaten. Commercial fishers are generally able to avoid areas that contain ciguatoxic fish. Recreational anglers who aren't familiar with local fishing areas are more likely to catch toxic fish unknowingly. More than 90 percent of the reported cases of ciguatoxin poisoning in the United States from 1978 to 1987 occurred in Puerto Rico, Guam, the Virgin Islands, and Hawaii. Visitors to tropical areas should patronize only reputable dealers and restaurants and should be prudent about the recreationally caught reef fish they eat.

The four types of shellfish toxins are produced by marine algae during periods of excessive growth, or "blooms." A common algae bloom is the "red tide." Waters in which shellfish are harvested are monitored and tested, and waters are closed to shellfish harvesting when toxins that can cause illness are likely to be present. To minimize the risk of illness further, individuals who harvest their own shellfish should check with local authorities and heed all warnings regarding shellfish harvesting restrictions.

Escolar, puffer fish, and whelk may contain naturally occurring toxins that do not involve marine algae. Escolar (Lepidocybium flavobrunneum and Ruvettus pretiosus) contains a strong purgative oil, called gempylotoxin. FDA advises against importation.

Puffer fish, or fugu, which may contain tetrodotoxin, may not be imported except under strict certification requirements and specific authorization from FDA. Poisonings from tetrodotoxin have usually been associated with the consumption of puffer fish from waters of the Indo Pacific ocean regions. However, several reported cases of poisonings, including fatalities, involved puffer fish from the Atlantic Ocean, Gulf of Mexico, and Gulf of California. There have been no confirmed cases of poisonings from Spheroides maculatus but there is still reason for concern.

Tetramine is a toxin that is found in the salivary glands of Neptunia spp., a type of whelk. The hazard can be controlled by removing the glands.

Histamine or scombrotoxin is caused by improper fish handling rather than by naturally occurring marine algae. Histamine or scombrotoxin is produced when fish such as tuna, mackerel, bluefish, mahi-mahi, and amberjack begin to spoil. When these fish are exposed to temperatures that allow rapid bacterial growth, histamine is formed, which can cause an allergic-like reaction when the fish is eaten. This illness, called histamine or scombroid poisoning, isn't severe for most people, but it can be uncomfortable. Because histamine is not destroyed by cooking, this illness must be prevented by handling and cooling fish properly. Histamine can be rapidly produced when fish are allowed to remain on the deck of a fishing boat or a dock for long periods in warm weather. Recreational anglers should plan ahead and have plenty of ice available to keep their catch cold. When purchasing fish, avoid products that are not adequately chilled. Store fish at temperatures as close to 32oF as possible, and avoid exposing it to warmer temperatures for a long time.

Chemical Contaminants
Potential health risks from chemical contaminants in fish have been more difficult to quantify. The long-term health effects of PCBs, mercury, and pesticides have not been clearly demonstrated in humans, but there is evidence that exposure to these chemicals over time may affect reproduction, growth and development in children, and lifetime cancer risk. Recreational and subsistence anglers, pregnant women, and children who eat large amounts of sport fish caught from contaminated waters are at greatest risk.

The FDA sets action and tolerance levels for chemicals that are suspected to pose a potential health threat. These levels are intended to protect consumers from food-borne chemical hazards. Federal and state government agencies monitor contaminant levels in fish and shellfish. When levels exceed tolerance or action levels, contaminated bodies of water are closed to commercial fishing or an individual species of fish is banned from the commercial marketplace.

Contaminant levels in most commercial species that have been tested are well below established limits. Ocean species that spend their entire life far from the shore are less likely to have contaminants than those that stay in near-shore areas. Large predatory fish that live for a long time, like swordfish, can accumulate higher levels of contaminants such as mercury. These species are tested more frequently to ensure that the commercial supply meets government standards. Since 1994 the FDA has advised women who may become pregnant and those already pregnant to limit consumption of shark and swordfish to no more than once per month. Other consumers are advised to limit consumption of these species to no more than once per week. The current FDA action level of 1.0 ppm in the edible portion of fish is under review.

Twenty percent of the fish and shellfish eaten in the United States are harvested by individuals for their personal consumption. Recreational and subsistence anglers may catch fish from waters that are known to contain elevated levels of chemical contaminants, even though commercial fishing in those waters is banned. Those individuals who consistently consume fish from contaminated waters are at greatest risk.

When contaminant levels in recreational fish exceed the tolerance or action limits, health authorities issue fish consumption advisories, which advise anglers, and higher-risk individuals to limit their consumption of certain types and sizes of fish or from specific bodies of water. In Georgia, advisories are produced by the state Department of Natural Resources (DNR) and published in their Guidelines for Eating Fish from Georgia Waters (see "Catching Your Own Seafood" chapter).

The following guidelines can help individuals concerned about chemical contaminants in fish and shellfish manage potential health risks:

Eat a variety of different fish and shellfish.
Avoid eating excessive amounts of any single type of fish or shellfish.
Avoid eating the internal organs of fish, the tomalley of lobsters, and the mustard of crabs. They can contain significantly higher amounts of contaminants than the flesh.

When catching your own fish, check and follow all applicable health advisories. Advisories are available from local and state health departments, and state fisheries agencies like the Georgia Department of Natural Resources (DNR).
High-risk individuals, including pregnant women, nursing mothers, women of child-bearing age, and children under age 15, should limit their consumption of species known to have elevated levels of contaminants.
If you choose to eat sport fish that may contain elevated levels of contaminants, remove skin and trim away fatty areas. Use cooking methods like grilling or broiling, which allow fats and juices to drain away.

Seafood Allergies
True food allergies are not very common, occurring in only about 2% of the general population. Seafood allergies have been estimated at less than one tenth of one percent. True food allergies are abnormal responses of the body's immune system to certain foods or food ingredients. Specifically, a protein in the offending food "fools" the immune system into recognizing it as a foreign invader. The immune system produces antibodies to help fight the "invasion." Antibodies bind with other cells and this complex releases histamines. Histamines are responsible for allergy symptoms which can range from mild to severe. Symptoms can affect the gastrointestinal tract (nausea, stomach cramps, vomiting, diarrhea), skin (localized itching, hives or rashes, swelling of the lips), and/or respiratory system (breathing problems). People who already have asthma may be more likely to have food allergies. Although allergic reactions are usually mild, some individuals can experience severe symptoms, like anaphylactic shock, which can cause death.

Allergies to seafood don't usually go away or diminish with age. In fact, allergic reactions may become more severe with each subsequent exposure to the offending food. That's why it's important to recognize an allergy or have it diagnosed by a medical doctor. The allergy is managed by avoiding the offending food. There is no cure for food allergies.

Most allergies are specific to a certain specie or type of seafood. For instance, someone who is allergic to finfish, may not be allergic to shellfish and vice versa. However, if you know for certain you are allergic to a certain type or specie of seafood, read ingredient listings on food labels and question restaurant staff carefully before eating food you suspect contains a potential allergen. Sometimes very small amounts of the allergen can trigger a reaction. People who have a history of anaphylactic reactions should carry medication like epinephrine and know how to self-administer it.

Seafood Inspection
Despite the public perception that seafood is not inspected, seafood, like all other food, is subject to federal, state, and local government regulations and inspections.

At the federal level, the FDA is primarily responsible for the regulation of seafood. The FDA inspects seafood processing plants and imported seafood, oversees the National Shellfish Sanitation Program, samples and tests seafood products, and enforces labeling requirements. The FDA works with the individual states to implement these regulatory programs.

Recently, the FDA has expanded its regulatory program and implemented a new system for seafood safety control called HACCP (pronounced hassup), which stands for Hazard Analysis Critical Control Point. Designed to control potential hazards in food production, HACCP based systems are already being used by the space program to produce food for astronauts and the canned food industry. Effective December 18, 1997, all seafood processors must have HACCP plans in place and be able to demonstrate it's effectiveness to FDA inspectors. The U.S. Department of Agriculture is switching to HACCP regulations in phases for meat and poultry processors as follows: January 25, 1998 for plants with more than 500 employees; January 25, 1999 for plants with more than 10 employees; and January 25, 2000 for plants with less than 10 employees.

State agencies also conduct regular inspections. In our state,for example, the Georgia Department of Agriculture inspects and licenses seafood processing plants, shellfish processors, and distributors, and regularly inspects retail stores. The Coastal Resources Division of the DNR monitors molluscan shellfish-growing waters, licenses and monitors shellfish harvesters, and tests shellfish for chemical contaminants. The Environmental Protection and Wildlife Resources divisions of the DNR collect and interpret information about chemical contaminants in sport fish and other safety concerns, evaluate health risks, and issue advisories when necessary. Local health departments also regularly inspect restaurants.

In addition to mandatory federal and state programs, another federal agency, the National Marine Fisheries Service, coordinates a voluntary inspection program.

Changes in the regulatory system are likely to occur as the public debate on food safety continues, and both consumers and the seafood industry are likely to benefit from programs that provide additional cost effective and practical safety controls.