Fesikh (فسيخ, said roughly “fe-SEEKH”, with the kh as in Scottish “loch”; also written feseekh or faseikh) is whole fish, usually
grey mullet, that has been salted and left to ferment until the flesh turns soft, pungent and very salty. In Egypt it is festival
food: families eat it at Sham el-Nessim, the spring holiday, and at other gatherings. It has also caused repeated outbreaks of type E
botulism, including one of the largest ever recorded, because the fish is salted whole, with its gut still inside. That is why this
page describes fesikh but gives no method for making it.
What Fesikh Is and When It’s Eaten
The usual fish is bouri, the grey mullet (Mugil cephalus); pebbly fish (Alestes baremose) and tiger fish
(Hydrocynus species) are also used. Fesikh is made from shad and sardines too (Walton et al., 2014), and
in Sudan a related salted, fermented fish, fessiekh, is made; in the 1980s about 70 percent of Sudan’s fessiekh was exported to Egypt
(FAO, 1992). Fesikh is eaten as an appetiser and as a main dish at feasts (Chan et al., 2023),
and with the related salted fish moloha and renga it is one of the main dishes at Egyptian social events and festivities
(Farag et al., 2022). Sham el-Nessim (شم النسيم), the Egyptian holiday marking the beginning of spring, is the occasion most closely tied to it: it falls on
the Monday after Easter in the Coptic Orthodox calendar, and fesikh is commonly prepared and eaten for it
(CDC, 2019; AFP, 2023). Fesikh is eaten with flat bread and spring onion
(AFP, 2023), and renga (رنجة, herring) and onion often share the holiday table
(Egypt Independent, 2019). It is as loved as it is divisive: fans prize it, and critics complain about the smell
(AFP, 2023).
How It’s Made Traditionally
Fesikh is made by dry or wet salting, and the finished fish is sealed in containers for storage. Egypt has two kinds: a less salty
fesikh that is ready after maturing for 15 to 20 days, and a heavily salted one that is eaten after 2 to 3 months
(Chan et al., 2023). The defining detail is that the fish is not gutted: the 1991 Cairo investigation described
faseikh simply as “uneviscerated, salted mullet fish” (Weber et al., 1993). The FDA puts moloha (ملوحة), another
Egyptian salt-cured fish, in the same uneviscerated category (FDA).
The Outbreak Record
Botulism from fesikh and similar ungutted salted fish such as moloha is not a rare, theoretical risk. Documented outbreaks span
three decades and three countries, including these:
| Where and when | What happened |
|---|---|
| Cairo, April 1991 | 91 people hospitalised and 18 (20%) died. All five case families in the investigation had bought faseikh from one shop, and very high levels of type E toxin were found in fish from it. The first documented botulism outbreak in Egypt and the largest type E outbreak reported up to then (Weber et al., 1993). |
| New Jersey, 1992 | A man and three family members developed type E botulism after eating moloha, an uneviscerated, salt-cured fish similar to fesikh, bought from a local fish market and eaten without cooking (CDC, 1992; FDA). |
| Ontario, April 2012 | Three people fell ill after a Sham el-Nessim meal of fesikh. Leftover fesikh contained type E toxin and the bacterium, and unsold fesikh mullet pieces in oil tested positive for both (Walton et al., 2014). |
| New Jersey, 2018 | A mother made fesikh at home from two fresh, ungutted mullets, salt-cured and wrapped in plastic, and kept it in the kitchen at room temperature for about 20 days, the way she had made it in Egypt. She and her daughter arrived at hospital in shock two days after eating it; both survived after antitoxin and a week in hospital (CDC, 2019). |
| Alexandria, autumn 2019 | 94 patients were admitted to the Alexandria Poison Center after eating feseekh; 34 were given antitoxin and 2 died (Ghitani et al., 2021). |
The bacterium is in the shop supply too. In samples of fesikh, moloha and renga bought from supermarkets and fish shops in three
governorates in 2022, Clostridium botulinum was found, mostly type E (Hamad et al., 2023). The 2018 note
adds that Egypt’s Ministry of Health has issued warnings about fesikh before the holiday (CDC, 2019).
Why a Whole Salted Fish Is the Problem
C. botulinum spores are common in marine environments, and traditional home preparation might create the airless conditions
that favour toxin production (CDC, 2019). Salt is meant to stop the bacterium, but in an ungutted fish it is difficult to get
enough salt into every part of the fish (FDA). That is the reasoning behind the US rule. The FDA considers
uneviscerated fish that are salt-cured, dried or smoked “a potentially life-threatening health hazard” and applies the same to fillets
and parts cut from them. It will consider regulatory action against such fish longer than five inches, and its policy names faseikh
and moloha. The same policy says the hazard remains whether the fish is kept at room temperature, refrigerated or frozen, and in air
or vacuum packs, and that toxin can be present with no outward sign of spoilage (FDA).
Botulism is not the only concern. Histamine, the amine behind scombroid fish poisoning, was measured at a high level, 521 mg/kg, in feseekh
analysed in an Egyptian study of fermented foods (Rabie et al., 2011).
Why We Don’t Give a Recipe
There is no tested home method for fesikh, and the 2018 case shows what the traditional method can produce in an ordinary kitchen.
Its defining features (a whole ungutted fish, salt, and weeks sealed away from air) are the conditions the outbreaks trace back to.
A home cook also has no way to check whether toxin has formed: “You cannot see, smell, or taste the toxin that causes botulism”
(CDC). So fesikh is a food we describe and don’t prescribe. Other fermented fish carry a type E question too: in Norway, half-fermented
fish was the major cause of the 21 foodborne botulism cases reported from 1975 to 1997, as our rakfisk page explains,
even though rakfisk is gutted. For another strong-smelling fish ferment, see Sweden’s surströmming. Greenland’s kiviaq, whole birds sealed in a skin, has a botulism record too.
If you eat fesikh, know the signs. Botulism causes double or blurred vision, drooping eyelids, slurred speech, difficulty
swallowing or breathing, and muscle weakness, sometimes with vomiting or stomach pain. It is a medical emergency: go to an emergency
department straight away and don’t wait (CDC).
For fish ferments with a documented safety approach, see our guides to burong isda, the Filipino fish-and-rice ferment
and fermented fish sauce, and the world fermented foods table for the rest.