Weekend Digest
Name the disease and its pathogen, risk factor, prevention and treatment.
Name the disease and its pathogen, risk factor, prevention and treatment.
2/
Disease: #Anisakiasis
Pathogens (most common):
Anisakis simplex complex
Pseudoterranova decipiens complex
Contracecum osculatum complex
Photo credit: doi.org/10.1016/j.ijid…
Disease: #Anisakiasis
Pathogens (most common):
Anisakis simplex complex
Pseudoterranova decipiens complex
Contracecum osculatum complex
Photo credit: doi.org/10.1016/j.ijid…
3/
Risk factor #Anisakiasis
Consumption of raw / undercooked fish / squid
“Ascaridoid” nematodes (roundworm) of whales, seals (“seal worm”), marine mammals —> eggs excreted in water —> larva in crustaceans —> ingested by fish (“herringworm”, “codworm”) —> consumed by humans
Risk factor #Anisakiasis
Consumption of raw / undercooked fish / squid
“Ascaridoid” nematodes (roundworm) of whales, seals (“seal worm”), marine mammals —> eggs excreted in water —> larva in crustaceans —> ingested by fish (“herringworm”, “codworm”) —> consumed by humans
4/
#Anisakiasis
Clinical: abdominal pain, N/V, abdominal distention, diarrhea (blood and mucus in stool)
Allergic reactions with rash and itching, and infrequently, anaphylaxis.
When larva penetrates through intestinal wall —> peritonitis
#Anisakiasis
Clinical: abdominal pain, N/V, abdominal distention, diarrhea (blood and mucus in stool)
Allergic reactions with rash and itching, and infrequently, anaphylaxis.
When larva penetrates through intestinal wall —> peritonitis
5/
Prevention of #Anisakiasis
Do not eat raw undercooked fish
FDA recommends seafood preparation or storage to kill parasites.
Cooking (internal temp 145°F)
Freezing
At -4°F (-20°C) x7d
At -31°F (-35°C) until solid; store x15h
At -31°F (-35°C) until solid; store at -4°F x24h
Prevention of #Anisakiasis
Do not eat raw undercooked fish
FDA recommends seafood preparation or storage to kill parasites.
Cooking (internal temp 145°F)
Freezing
At -4°F (-20°C) x7d
At -31°F (-35°C) until solid; store x15h
At -31°F (-35°C) until solid; store at -4°F x24h
/6
#Anisakiasis Treatment
Endoscopic or surgical removal
Note that the larva will eventually die
Off label Rx: albendazole
#Anisakiasis Treatment
Endoscopic or surgical removal
Note that the larva will eventually die
Off label Rx: albendazole
Bonus tweet:
Our top DDx as suggested by Dr Wright @wfwrighID is #Enterobius vermicularis (#pinworm)
Araújo R et al. Endoscopy 2010; 42(S02): 155 - 155. doi:10.1055/s-0029-1244153
Our top DDx as suggested by Dr Wright @wfwrighID is #Enterobius vermicularis (#pinworm)
Araújo R et al. Endoscopy 2010; 42(S02): 155 - 155. doi:10.1055/s-0029-1244153
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