Popularity of sushi has brought rise in parasitic infections, warn d... https://www.theguardian.com/world/2017/may/12/popularity-of-s...

Popularity of sushi has brought rise in

parasitic infections, warn doctors
Doctors have highlighted the need for awareness of anisakiasis, caused by the larvae of a
worm found in contaminated undercooked or raw fish or seafood

Under European food hygiene legislation sh that is to be eaten raw should be frozen before it is sold to consumers to ensure
any parasites have been killed. Photograph: Alamy

Nicola Davis
Friday 12 May 2017 12.29BST

From nigiri to temaki, sushi has boomed in popularity in the west, but now doctors are
warning of a less appetising trend: a rise in parasitic infections.

A team of doctors from Portugal raised concerns after a 32-year old man was admitted to
hospital complaining of pain in his abdomen just below his ribs, vomiting and had a
slight fever, all of which had lasted for a week.

An endoscopy soon revealed the culprit: the larvae of a type of parasitic worm from the
genus Anisakis. The doctors note that the condition, known as anisakiasis, is caused by
eating undercooked or raw sh or seafood that has been contaminated: indeed,
questioning of the patient revealed that he had recently eaten sushi.

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After the larva was removed the man rapidly recovered, say the medics.

Two views of the parasite, seen here rmly attached to an area

of the patients upper gastrointestinal tract. Photograph:
Carmo et al/BMJ case reports

Writing in the journal BMJ Case reports, the team warn that with sushi in vogue in the
west, awareness of anisakiasis is growing.

Most of the cases were described in Japan due to food habits; however, it has been
increasingly recognised in western countries, the authors write, pointing to a Spanish
study that reported 25 cases of the condition over a three year period from 1999 to 2002,
with all patients having eating raw anchovies, as well as Italian research which agged
both anchovies and sushi as routes by which individuals could become infected.

The Italian study added that medical professionals should suspect the condition should
patients complain of severe abdominal pain after eating raw sh, pointing out that no
eective pharmacological treatment is able to kill the larvae once eaten.

Indeed, as the US Center for Disease Control and Prevention notes, The treatment for
anisakiasis may require removal of the worm from the body by endoscopy or surgery.

The authors of the latest report add that besides the symptoms shown in the Portuguese
case, the condition can also trigger a host of other symptoms including severe allergic
reaction, as well as complications such as digestive bleeding, bowel obstruction and
peritonitis.

The Food Standards Agency noted that raw sh occasionally contain parasitic larvae, but
said that under European food hygiene legislation sh that is to be eaten raw should be
frozen before it is sold to consumers to ensure any parasites have been killed.

The FSA added that sh and meat should always be cooked properly according to the
producers instructions, but oered a few tips to those planning to make their own sushi.

If you do choose to make your own sushi from sh at home, ensure you follow a
reputable recipe, the FSA advised. If wild sh are to be eaten raw or lightly cooked,
ensure that all parts, especially the thickest part, have been frozen for at least four days
in a domestic freezer at -15C or colder. This will ensure that any undetected Anisakis
larvae are killed.

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