Microbiology
A helminth (worm) (Review). Not to be worn when riding a motorcycle. Anisakis simplex, Contracaecum comples, and Pseudoterranova decipiens complex.
Also called herring worm disease.
Epidemiologic Risks
Eating undercooked fish or squid.
A. simplex complex: Japan, Spain (second-highest reported incidence from marinated anchovies) (Pubmed) the Netherlands, northern Europe, United States, Korea.
Pacific salmon, herring, anchovies, scad, hake, mackerel sushi, sashimi, salted or smoked herring, gravlax, boquerones, Hawaiian lomi-lomi, ceviche.
P. decipiens complex: United States, Canada Japan, Korea, Chile, Atlantic and Pacific cod, Ceviche, Pacific halibut, red snapper, hake.
Syndromes
Eosinophilic gastroenteritis after eating undercooked fish with abdominal pain, nausea & vomiting, abdominal distention, diarrhea, bloody and mucousy stool, with mild fever.
4 major clinical syndromes: gastric, intestinal, ectopic (or extra-gastrointestinal), and allergic disease. Patients can have anaphylaxis if they make IgE against the worm and subsequently eat it.
Per the (CDC): "Some people experience a tingling sensation after or while eating raw or undercooked fish or squid. This is actually the worm moving in the mouth or throat. These people can often extract the worm manually from their mouth or cough up the worm and prevent infection." Ew.
Treatment
Self-limited in about two weeks, plucking out the worms endoscopically can (?) hasten healing; occasionally it is chronic.
Maybe albendazole 400 bid for 6–21 days.
Notes
Cooking and freezing will kill it. Me? I love sushi.
Last update: 12/29/19