About 20 people who ate fish included in a home-delivery meal kit have called Auckland's public health unit after becoming sick.
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On Monday, Hello Fresh told customers not to eat trevally included in this week's kit, because it was found to contain elevated levels of histamine.
That can cause diarrhoea, rashes and vomiting.
Auckland Regional Public Health Service has had reports of more than a dozen people who have eaten the fish becoming ill with histamine poisoning, also known as scombroid poisoning.
On Tuesday the Hutt Valley District Health Board confirmed three people sought help at the emergency department after eating the fish, while another person emailed in reporting symptoms.
Medical Officer of Health Dr Jay Harrower said the symptoms are often a combination of an allergic reaction and gastroenteritis.
The most common symptoms of scombroid poisoning are tingling and burning around the mouth, facial flushing, and diarrhoea. Other symptoms may include a skin rash, nausea, abdominal cramps, vomiting, dizziness, palpitations, headaches, and possibly respiratory distress.
"Symptoms may last up to 48 hours, but don't usually result in any long term effects. The illness typically begins within 30 minutes to an hour or two of consuming the fish.
"There are some fish varieties which are more likely to produce histamines at levels that are toxic, often when the fish is not kept chilled," Dr Harrower said.
Fish should be properly iced, refrigerated at temperatures or immediately frozen.
The fish commonly associated with high levels of histamines are:
- trevally
- kahawai
- mackerel
- tuna
- kingfish
- marlin
- bonito
- sardines
- pilchards
- anchovies
- herring.