What is it?
Anisakis worm is a parasite that can cause severe ‘ food poisoning’ infections in humans who eat raw fish and/or who have eaten raw and/or undercooked fish
- It is 2 cm long and is sometimes coughed up after ingesting it in raw or undercooked fish, these parasites invade the oesophagus (food pipe), stomach wall or intestine of humans.
- The parasite is found frequently in cod, haddock, fluke, Pacific salmon, herring including pickled herring, flounder, monkfish and squid, salmon sashimi , mackerel sushi, raw halibut and red snapper.
How It Spreads
- Adult worms are found in the stomach of marine mammals (whales and sea lions), and their eggs are passed in the faeces.
- After the larvae are hatched, they are ingested by shellfish.
- Infected shellfish get eaten by fish and squid, where the larvae make their way into the muscle tissues.
- Ingestion of infected fish or squid by other fish allows the spread of the infection.
- Ingestion by marine mammals (whale and seal lions) is necessary for the larvae to develop into adult worms.
- Accidental human consumption of raw or undercooked marine fish that harbor the infected larvae can result in an allergic reaction, sometimes causing the individual to cough up the worms if swallowed.
- Penetration of the worms into the intestinal tissue causes anisakiasis where our body develops a inflamed mass in the oesophagus, stomach, or intestine.
- The worms are usually eliminated expelled from the intestines within 3 weeks of infection.
- it is not contagious, Anisakiasis cannot be transmitted human to human.
- Other parasites to be aware of especially in sushi is : Diphyllobothrium Nihonkaiense – Sushi Salmon Tapeworm
Diagnosis tests
- Upper gastrointestinal endoscopy
- Blood tests
- Anisakis-specific IgE blood test
- CT scan
- MRI scan of pelvis
- Ultrasound
- Stool test
Cause
- Parasite:
- Anisakis simplex (Roundworm)
- Diphyllobothrium Nihonkaiense – Sushi Salmon Tapeworm
- Eating raw and undercooked fish including cod, haddock, fluke, Pacific salmon, herring including pickled herring, flounder, monkfish and squid, salmon sashimi, mackerel sushi, raw halibut and red snapper.
Symptoms
- High temperature greater than 38°C, 100°F or over greater than 72 hours, chills and sweats?
- Tingling sensation after or while eating raw or undercooked fish or squid in the mouth (worms are moving in the mouth and/or throat)?
- Severe abdominal pain and/or are constant violently vomiting or vomiting longer than two days / one day (if child)?
- Diarrhoea and/or cannot keep liquid down more than a day?
- Increase thirst, heavy sweating and need to urinate frequently?
- Blood and mucus in faeces?
Complications /Information to beware of/General tips:
Do not wait, phone for an ambulance if have or develop:
The FDA recommends the following for seafood preparation or storage to kill parasites.
- Cooking (Seafood in General)
- Cook seafood adequately (to an internal temperature of at least 145° F [~63° C]).
- Freezing (Fish)
- At -4°F (-20°C) or below for 7 days (total time), or
- At -31°F (-35°C) or below until solid, and storing at -31°F (-35°C) or below for 15 hours, or
- At -31°F (-35°C) or below until solid and storing at -4°F (-20°C) or below for 24 hour
FDA
General tips
How to minimize the chances of sushi parasite infection?
- If you still insist on eating sushi despite what you’ve read, then here are a few actions that minimize your chances of a parasite infection.
Chew your sushi extremely well
- If you swallow large chunks of sushi, then your digestive juices can’t penetrate the parasites hidden within. But if you chew your sushi into a pulp, then any parasites present will be exposed to your stomach acid and enzymes. That will decrease your chances of a sushi parasites infecting you.
Make sure you have high levels of stomach acid
- One of the easiest ways to increase your stomach acid is to stay hydrated. Have a full glass of water 15 minutes before you start eating. You also want to minimize your stress around the time you eat sushi. That will make sure your parasympathetic nervous system is dominant (aka the rest and digest branch), which can increase stomach acid.
Use lots of wasabi, horse radish, ginger, lemon and hot sauce
- All of these substances help kill parasites and bacteria present in sushi. That is why those spicy/acidic substances are food staples in every culture across the world.
- If I were to eat sushi, I would add as much wasabi and hot sauce as I could handle.
- These substances all fight parasites when eaten in the same mouthful as the sushi.
- These substances may also increase stomach acid as well.
Stick with saltwater sushi that is high quality
- Freshwater sushi has the nastiest parasites in my opinion. I would strictly stay away from freshwater sushi.
If it doesn’t seem fresh, don’t eat it.
- Older sushi that wasn’t kept frozen is more likely to have live parasites. If it doesn’t seem right, trust your nose – don’t eat the sushi!
Sushi Parasites
This condition may have show similar symptoms to:
Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice
Detailed Information
Please copy and paste any key words from the title: Anisakis (Fish parasites) in the following respective 'Medtick References and/or Sources' to find out more about the disease (this also may include diagnosis tests and generic medical treatments).
- Medical News Today
Medical news and health news headlines posted throughout the day, every day.
- Medscape (Professional level)
Latest medical news and expert commentary in your specialty as well as disease information.
- Healthline
Medical Information and health advice you can trust
- EveryDay Health
Wellness inspired. Wellness enabled.
- Pharmaceutical Journal (Professional level)
The Pharmaceutical Journal covers analysis, features, opinion, learning and careers articles, providing insight and knowledge about drugs, pharmacy practice, medicines use and healthcare policy in the context of the pharmacy profession and pharmaceutical science.
- NHS
Find information and advice on health conditions, symptoms, healthy living, medicines and how to get help (British National Health Service).
- WebMD
Better Information. Better Health.
- Cleveland Clinic
Pushing the Standards of care.
- Mayo Clinic
No.1 Hospital in the Nation (America)
- Drugs.com
Know more. Be sure.
- National Organisation of Rare Diseases
NORD is dedicated to supporting education, elevating care, advancing research, and driving policy for rare diseases.
- Verywell Health
Know more. Fell better.
- Nathnac
Travel health guidance for health professionals advising travellers and for travellers going overseas from the UK.
- DR Axe
Health and fitness news. Recipes, Natural Remedies
- Better health - NHS
Healthy changes start with little changes. Whether you want to lose weight, drink less alcohol, get active or quit smoking, you have access to lots of free tools and support through Better Health. You can also find simple ways to lift your mood with Every Mind Matters.
There has never been a better time to kickstart your health. Let’s do this!
