Product or Activity Name

Cured Fish

Rating

Inconclusive

Description

Rating

Avoid unless cooked until steaming hot — current UK guidance from the NHS and the Food Standards Agency advises pregnant women not to eat ready-to-eat cold-smoked or cured fish (such as smoked salmon, smoked trout and gravlax) unless they are cooked through first.

(The previous rating of “Inconclusive” has been revised. UK guidance was updated in 2022 following a listeria outbreak, and the position is now clear.)

Description

“Cured fish” is a broad category — and crucially, the safety advice depends on how the fish has been processed, not just whether it has been “cured.” The key question for any cured fish product is: was it cooked at a high enough temperature to kill listeria?

The main risk is listeriosis, caused by Listeria monocytogenes. Listeria infection is rare overall, but pregnant women are around 20 times more likely than other healthy adults to develop a serious case, and the consequences can be severe — miscarriage, stillbirth, premature birth, or serious illness in a newborn baby.

Cold-smoked and cured (not heat-treated): avoid unless cooked

These products are cured with salt and/or smoked at low temperatures that flavour and preserve the fish but do not kill listeria. They should be avoided in pregnancy unless cooked until steaming hot:

Smoked salmon (the thin-sliced kind sold in supermarket packs)
Smoked trout
Gravlax / gravadlax (salmon cured with salt, sugar and dill)
Cold-smoked mackerel (less common)
Smoked salmon in sushi — same risk as the sliced product

Refrigeration does not kill listeria. Neither does the cold-smoking process itself. The only way to make these products safe is to cook them through — for example, stirring smoked salmon into scrambled eggs on the hob until the whole dish is piping hot, or baking it into a quiche. Simply warming it briefly in a pan won’t reach a high enough temperature.

Hot-smoked and heat-treated: generally safe

These have been cooked during processing to a temperature that kills listeria, so they can be eaten cold straight from the packet:

Hot-smoked salmon (sold as firm, flaky fillets rather than thin slices)
Hot-smoked mackerel (peppered mackerel fillets, smoked mackerel pâté made commercially from heat-treated fish — though pâté itself is a separate issue, see below)
Tinned smoked fish (kippers, tinned mackerel, tinned salmon)

If a label says “hot-smoked” you’re fine to eat it cold. If it just says “smoked,” it’s likely cold-smoked and should be treated as cold-cured.

A note on pâté: even when made from heat-treated fish, all pâtés (including fish pâté) should be avoided in pregnancy because they have their own listeria risk.

Salt-cured fish and roe

Salted herring (rollmops, matjes, pickled herring): the curing is mainly salt and sometimes vinegar — not heat. Treat as cold-cured and avoid unless cooked.
Anchovies (the salt-cured tinned or jarred kind): salt levels are very high and the fish is not cooked. Most pregnancy guidance suggests limiting them due to sodium and treating them like other cold-cured fish. Cooked into a hot dish (e.g. melted into a pasta sauce or roast lamb) they’re fine.
Bottarga (salt-cured, pressed fish roe): not cooked. Treat as cold-cured.
Caviar / fish roe: pasteurised caviar is generally considered safe; unpasteurised is not. Always check the label.

Mercury — a separate consideration

Listeria is the main concern, but mercury matters too:

Salmon, trout, mackerel, herring, sardines and anchovies are oily fish. Current UK guidance is to eat no more than two portions of oily fish per week during pregnancy, because they can contain pollutants like dioxins and PCBs.
Tinned tuna is not classed as oily fish for this purpose, but fresh tuna is limited.
Avoid shark, swordfish and marlin entirely — high mercury.

So even if a cured fish product is “safe” from a listeria standpoint (e.g. hot-smoked salmon), it still counts towards your weekly oily fish limit.

If you’ve already eaten some

A single serving of cold-smoked salmon at a brunch is not cause for panic — listeriosis from these products is rare. But watch for symptoms in the following weeks: fever (38°C or above), aches, chills, nausea, vomiting or diarrhoea. If any of these appear, contact your GP, midwife or NHS 111 and mention what you ate.

Bottom line

Cold-smoked salmon, gravlax, smoked trout: avoid unless cooked until steaming hot.
Hot-smoked fish and tinned smoked fish: safe to eat cold.
Salted herring, anchovies, bottarga: treat as cold-cured — fine if cooked into hot dishes.
Smoked salmon in sushi: same risk as the sliced product — avoid.
All fish pâté: avoid, even if heat-treated.
Keep total oily fish to no more than two portions a week.
Always check with your midwife or GP for advice tailored to you.