Primer reporte en Cuba de Anisakis spp. en muestras de pescado en conserva / First report in Cuba of Anisakis spp. in samples of canned fish

Introducción: Las especies de Anisakis representan uno de los grupos parasitarios patógenos transmitidos por alimentos más importantes en relación con sus capacidades zoonóticas y pueden producir una enfermedad emergente llamada anisakiosis. En Cuba, no existen reportes de la enfermedad como tampoco publicaciones sobre la detección del parásito en muestras de productos pesqueros. Objetivo: Identificar larvas de Anisakis spp. en muestras de productos pesqueros. Métodos: Se realizó un estudio para la búsqueda de larvas de Anisakis spp. en muestras de productos pesqueros en conserva recibidos en el Laboratorio de Parasitología de los alimentos del Instituto Nacional de Higiene, Epidemiología y Microbiología de Cuba. Se recibieron 96 muestras de dos marcas diferentes. A cada marca se le asignó las letras A o B para proteger la identidad del fabricante. Las larvas recuperadas fueron previamente aclaradas con lactofenol e identificadas morfológicamente por microscopía. Se utilizaron las claves de identificación para larvas de Anisakis spp. descritas en la literatura. Resultados: El 38,5 por ciento del total de muestras de pescado en conserva analizadas estuvieron parasitadas con larvas de Anisakis spp., con una frecuencia media de 1,2 larvas por cada submuestra. Las larvas fueron clasificadas de tercer estadio y de tipo I. Conclusiones: Por primera vez se identificó en Cuba larvas de Anisakis spp. en muestras de pescado en conserva y se proporcionó datos de interés a las autoridades sanitarias para el fortalecimiento de políticas públicas relacionadas con la calidad e inocuidad de los alimentos(AU)

Introduction: Anisakis species represent one of the most important foodborne pathogenic parasitic groups in relation to their zoonotic capabilities, and can produce an emerging disease called anisakiosis. In Cuba, there are no reports of the disease and there are no publications on the detection of the parasite in samples of fishery products. Objective: To identify Anisakis spp. larvae in samples of fishery products. Methods: A study was conducted to search for Anisakis spp. larvae in samples of canned fish products received at the Laboratory of Food Parasitology of the National Institute of Hygiene, Epidemiology and Microbiology of Cuba. Ninety-six samples of two different brands were received. Each brand was assigned letter A or B to protect the identity of the manufacturer. The larvae recovered were previously rinsed with lactophenol and identified morphologically by microscopy. The identification keys for Anisakis spp. larvae described in the literature were used. Results: 38.5 percent of the total canned fish samples analyzed were parasitized with Anisakis spp. larvae, with a mean frequency of 1.2 larvae per subsample. The larvae were classified as third instar and type I. Conclusions: For the first time in Cuba, Anisakis spp. larvae were identified in canned fish samples and provided data of interest to health authorities to strengthen public policies related to food quality and safety(AU)

Anisakidosis diagnosticada tras la expulsión de vermes en deposiciones: forma poco frecuente de diagnóstico en humanos / Anisakidosis diagnosed after expulsion of worms in stools: a rare form of diagnosis in humans

Resumen La anisakidosis es una zoonosis parasitaria accidental y cosmopolita de los seres humanos, siendo su hospedero definitivo los mamíferos marinos como lobos de mar, focas y delfines, entre otros. El ser humano se infecta por el consumo en estado larvario del nemátodo de la familia Anisakidae presentes en pescados y mariscos crudos como la merluza o el congrio. Los helmintos se ubican preferentemente en el tubo digestivo alto, observándose la regurgitación del parásito a la boca o evidenciándose durante la realización de una endoscopía digestiva alta. En forma infrecuente las larvas pueden migrar al peritoneo o seguir su paso por el intestino delgado y colon, siendo inhabitual la expulsión por las deposiciones. Presentamos el caso de una expulsión dos larvas L3 de la familia Anisakidae en deposiciones.

Abstract Anisakidosis is an accidental and cosmopolitan parasitic zoonosis of human beings, its definitive host being marine mammals such as sea lions, seals and dolphins, among others. Humans are infested by consumption in the larval stage of the nematode of Anisakis present in raw fish and shellfish such as hake or conger eel. The infestation is preferably located in the upper digestive tract, observing the regurgitation of the parasite to the mouth or becoming evident during an upper gastrointestinal endoscopy. In rare cases, the larvae can migrate to the peritoneum or continue their passage through the small intestine and colon, with expulsion in stools being unusual. We present a case of expulsion of two larvae of the Anisakidae family in feces.

Garlic oil as a fight against histological and oxidative stress abnormalities in Wistar rats after oral inoculation of Anisakis spp. Type II (L3) (Nematoda) / [O uso do óleo de alho na luta contra anormalidades histológicas e de estresse oxidativo em ratos Winstar após inoculação oral de Anisakis spp. Tipo II (L3) (Nematoda)]

The consumption of inadequately thermally treated fish is a public health risk due to the possible propagation of Anisakis larvae and their antigenic proteins, the causative agent of the zoonotic disease anisakidosis. The present study demonstrated the physiological and histopathological changes that accompanied an oral inoculation of crude extracts from fresh and thermally treated Anisakis Type II (L3) in Wistar albino rats. Nematode worms were isolated from the marine fish Dicentrarchus labrax. They were examined and taxonomically identified using light and scanning electron microscopy. The study was performed in 6 rat groups: a control group (I), a garlic oil (GO) inoculated group (II), a fresh L3 inoculated group (III), a thermally treated L3 inoculated group (IV), a fresh L3 + GO inoculated group (V), and a thermally treated L3 + GO inoculated group (VI). It was observed that rats inoculated with fresh and thermally treated L3 crude extracts showed abnormal oxidative stress markers associated with the destruction of normal architecture of spleen and thymus. GO produced a protective effect in rat groups inoculated with L3 extracts + GO administration via the amelioration of oxidative stress markers, which was confirmed by the marked normal structure of the organs' histology. Cooking of L3 infected fish induced severe physiological and histopathological alterations compared to uncooked infected fish. The administration of garlic before and after fish eating is recommended to avoid the dangerous effect of anisakids, even if they are cooked.(AU)

O consumo de peixes tratados termicamente de forma inadequada é um risco à saúde pública devido à possível propagação das larvas de Anisakis e suas proteínas antigênicas, o agente causador da doença zoonótica anisakidose. O presente estudo demonstrou as alterações fisiológicas e histopatológicas que acompanharam a inoculação oral de extratos brutos de Anisakis Tipo II (L3) frescos e termicamente tratados em ratos Wistar albinos. Vermes nematoides foram isolados do peixe marinho Dicentrarchus labrax e foram examinados e identificados taxonomicamente usando microscopia óptica e eletrônica de varredura. O estudo foi realizado em 6 grupos de ratos: grupo controle (I), grupo inoculado com óleo de alho (GO) (II), grupo inoculado com L3 fresco (III), grupo inoculado com L3 tratado termicamente (IV), grupo inoculado com L3 + GO fresco (V), e grupo inoculado com L3 + GO tratado termicamente (VI). Observou-se que ratos inoculados com extrato bruto L3 fresco e tratado termicamente mostraram marcadores de estresse oxidativo anormais associados à destruição da estrutura normal do baço e do timo. GO produziu um efeito protetor em grupos de ratos inoculados com extrato L3 + administração de GO através da melhoria dos marcadores de estresse oxidativo, que foi confirmada pela marcante estrutura normal da histologia dos órgãos. O cozimento de peixes infectados com L3 induziu alterações fisiológicas e histopatológicas graves quando comparado com peixes infectados não cozidos. Recomenda-se a administração de alho antes e depois da ingestão do peixe para evitar o efeito perigoso dos anisakídeos, mesmo se cozidos.(AU)

Expansion of T regulatory lymphocytes by murine bone marrow dendritic cells previously stimulated with Anisakis simplex larval antigens

BACKGROUND Anisakis simplex antigens present immunomodulatory properties by the induction of tolerogenic dendritic cells (DCs) in mice. OBJECTIVES To study the capacity of DCs stimulated with A. simplex excretory-secretory (ES) or crude extract (CE) to generate Tregs. To investigate in vitro effects of antigens on the metabolic activity of splenocytes induced by LPS or CpG. METHODS Phenotypic and functional characterization of T cells co-cultured with A. simplex-pulsed DCs was performed by flow cytometry. Lymphocyte mitochondrial respiratory activity was estimated by the Alamar Blue® Assay. FINDINGS In C57BL/6J, CD4+CD25-Foxp3+ and CD8+CD25-Foxp3+ populations increased by CE-stimulated-DCs. In BALB/c, CE-stimulated-DCs caused the expansion of CD4+CD25+Foxp3+IL-10+ and CD8+CD25+Foxp3+IL-10+. IFN-γ expression raised in BALB/c CD4+CD25+ and CD4+CD25- for CE and ES, respectively. ES-stimulated-DCs increased CD4+CD25+ Foxp3+ and CD8+CD25- Foxp3+ expression in T cells. The association of ES or CE with LPS produced the increase in splenocyte activity in C57BL/6J. The association of CE with CpG decreased the proliferation caused by CpG in C57BL/6J. MAIN CONCLUSIONS A. simplex increase the frequency of Tregs, which in turn produce IL-10 and IFN-γ. The host genetic base is essential in the development of anti-Anisakis immune responses (Th2, Th1, Treg).

The oil of garlic, Allium sativum L. (Amaryllidaceae), as a potential protectant against Anisakis spp. Type II (L3) (Nematoda) infection in Wistar rats / O óleo de alho, Allium sativum L. (Amaryllidaceae), como potencial protetor contra Anisakis spp. Infecção tipo II (L3) (Nematoda) em ratos Wistar

Abstract The consumption of inadequately thermally treated fish is a public health risk due to the possible propagation of Anisakis larvae. The present study demonstrated the physiological and histopathological changes that accompanied an oral inoculation of crude extracts from fresh and thermally treated Anisakis Type II (L3) in rats. Worms were isolated from a marine fish and examined and identified using light and scanning electron microscopy. The study was performed in 6 rat groups: control (I), garlic oil (GO) inoculated (II), fresh L3 inoculated (III), thermally treated L3 inoculated (IV), fresh L3 + GO inoculated (V), and a thermally treated L3 + GO inoculated (VI) groups. Rats inoculated with fresh and thermally treated L3 showed abnormal liver and kidney functions associated with the destruction of normal architecture. GO produced a protective effect in rat groups inoculated with L3 extracts + GO via the amelioration of liver and kidney functions, which was confirmed by the marked normal structure on histology. Cooking of L3-infected fish induced severe alterations compared to uncooked fish. The administration of garlic before and after fish eating is recommended to avoid the dangerous effect of anisakids, even if they are cooked.

Resumo O consumo de peixe inadequadamente tratado termicamente representa um risco para a saúde pública, com a possibilidade da propagação de larvas de Anisakis. O presente estudo demonstrou as alterações fisiológicas e histopatológicas acompanhadas de inoculação oral de extractos brutos de Anisakis tipo II (L3) frescos e termicamente tratados em ratos. Os vermes foram isolados de um peixe marinho, examinados e identificados por microscopia de luz e eletrônica de varredura. O estudo foi conduzido em 6 grupos de ratos: controle (I), óleo de alho (GO) inoculado (II), L3 fresco inoculado (III), L3 tratado termicamente inoculado (IV), L3 fresco + GO inoculado (V), e um grupo L3 + GO tratado termicamente inoculado (VI). Observou-se que ratos inoculados com L3 fresco e tratados termicamente mostraram funções hepáticas e renais anormais, associadas à destruição da sua arquitetura normal. GO produziu um efeito protector em grupos de ratos inoculados com extractos L3 + GO através da melhoria das funções do fígado e dos rins, o que foi confirmado pela estrutura normal marcada da sua histologia. A cozedura de peixes infectados com L3 induziu alterações mais graves do que os peixes não cozidos. Recomenda-se a administração de alho antes e depois do consumo de peixe, para evitar o efeito perigoso dos anisakids, mesmo que sejam cozidos.

Anisakis physeteris y Pseudoterranova decipiens en el pez Mugil Curema comercializado en Tumaco, Colombia / Anisakis physeteris and Pseudoterranova decipiens in the Mugil curema fish caught in Tumaco, Colombia

RESUMEN Objetivo. Identificar nematodos de la familia Anisakidae en el pez de consumo Mugil curema. Materiales y métodos. Para este estudio, se recolectaron 16 peces Lisa (M. curema) del puerto de Tumaco, una ciudad en la costa colombiana del Pacífico. La identificación morfológica de las larvas se realizó mediante taxonomía clásica y se calculó el porcentaje de infestación de larvas. Para la identificación molecular, se realizó una PCR múltiple con cebadores para las especies Anisakis physeteris, Pseudoterranova decipiens, Anisakis simplex sensu stricto, Contracaecum osculatum, Hysterothylacium aduncum y Anisakis pegreffii. Resultados. La revisión taxonómica permitió la identificación de larvas de tipo II del género Anisakis y larvas del género Pseudoterranova. Las larvas se aislaron principalmente del intestino, donde se encontró que el 94% de los peces estaban parasitados por nematodos anisakidos. La PCR multiplex permitió la identificación de la especie A. physeteris (Larva tipo II) y P. decipiens. Conclusiones. Este estudio es el primer reporte de nematodo Anisakidae en Tumaco, Colombia. Estos resultados proporcionan una justificación convincente para un estudio adicional sobre la familia Anisakidae en Colombia, como un problema de salud pública.

ABSTRACT Objective: Identification nematodes Anisakidae family in Mugil curema fish. Materials and methods: For this study, 16 Lisa fish (Mugil curema) were obtained from the port of Tumaco, a city on the Colombian Pacific coast. Morphological identification of larvae was made by classical taxonomy and the percentage of larval infestation was calculated. For molecular identification, a multiplex PCR was carried out with primers for six species, Anisakis physeteris, Pseudoterranova decipiens, Anisakis simplex sensu stricto, Contracaecum osculatum, Hysterothylacium aduncum and Anisakis pegreffii. Results: The taxonomic revision enabled the identification of type II larvae of the genus Anisakis and larvae of the genus Pseudoterranova. The larvae were isolated mainly from the intestine, where it was found that 94% of the fish were parasitized by anisakid nematodes. The multiplex PCR enabled the identification of the species A. physeteris (Larva type II), and P. decipiens. Conclusions: This study is the first report of nematode Anisakidae on Tumaco, Colombia. These results provide a compelling justification for further study into the Anisakidae family in Colombia, as a public health problem.

Anisakidae Skrjabin & Karokhin, 1945 and Raphidascarididae Hartwich, 1954 nematodes in lutjanidae (pisces: perciformes) from the Brazilian Northeast Coast / Nematodas Anisakidae Skrjabin & Karokhin, 1945 e Raphidascarididae Hartwich, 1954 em Lutjanidae (Pisces: Perciformes) do litoral nordeste brasileiro

Abstract The present study aimed at describing and evaluating the fauna of Anisakidae and Raphidacarididae nematodes of lutjanid fish (snappers) from the Brazilian northeastern coast unloaded at the city of Aracaju, capital of the State of Sergipe. A total of 186 lutjanids of 5 different species were analyzed including 69 Lutjanus analis, 51 L. vivanus , 29 Ocyurus chrysurus, 23 L. synagris, and 14 L. jocu. Nematode specimens found in the viscera of these fish were clarified with lactophenol. Illustrations of each of these specimens were prepared to help identify these samples and compose their taxonomic description and classification. At necropsy, 3,183 nematodes belonging to two families were collected from fish viscera which included the following: Anisakidae: Anisakis, Terranova , Contracaecum, and Goezia; Raphidascarididae: Raphidascaris (Ichthyascaris) and Hysterothylacium . A total of six genera of nematodes were found at postmortem examination of which adult worms of only three genera (Goezia, Raphidascaris and Hysterothylacium) were detected in the fish examined. Larvae of Terranova sp. were found only in the musculature of O. chrysurus . Most of the nematode larvae were present in the mesentery and organs of the fish necropsied. Therefore, the zoonotic potential of these nematodes cannot be ruled out. There was a significant negative correlation between the intensity of parasitism by anisakids and the total body length of O. chrysurus; the intensity of parasitism was greater in smaller and shortef fish. There was a significant positive correlation between the abundance of these parasites and the length of L. synagris; the presence of these parasites increased according to the fish's body length. To the authors' knowledge, these are the first records of Raphidascaris (Ichthyascaris ) sp. and Hysterothylacium sp. in L. vivanus , of Terranova sp. in O. chrysurus and L. jocu, and of Goezia sp. in L. analis. These novel findings add the Brazilian northeast coast and the State of Sergipe in the geographic distribution of these parasites in the country.

Resumo O objetivo deste trabalho é descrever e avaliar a fauna de Anisakidae e Raphidacarididae de peixes lutjanídeos do litoral nordeste do Brasil desembarcados na cidade de Aracaju, capital do estado de Sergipe. Foram analisados 186 lutjanídeos das espécies Lutjanus analis 69, L. vivanus 51, Ocyurus chrysurus 29, L. synagris 23 e L. jocu 14. Exemplares dos nematodas encontrados nas vísceras foram clarificados em lactofenol e ilustrados para auxiliar na identificação e compor a descrição taxonõmica. Foram coletados 3.183 nematodas das vísceras dos peixes, pertencentes a duas famílias: Anisakidae: Anisakis, Terranova, Contracaecum e Goezia; e Raphidascarididae: Raphidascaris (Ichthyascaris) e Hysterothylacium. Totalizando seis gêneros encontrados, apenas nos três últimos gêneros foram encontrados vermes em estágio adulto. Apenas em O. chrysurus foram encontradas larvas de Terranova sp. na musculatura. A maioria das larvas estava restrita ao mesentério e órgãos dos peixes, e em grande intensidade não podendo se descartar o potencial zoonótico. Observou-se uma correlação significativa negativa entre a intensidade anisakídeos e o comprimento total de O. chrysurus, onde a intensidade dos parasitas é maior em peixes de menor comprimento e uma correlação significativa positiva entre a abundância desses mesmos parasitos com o comprimento de L. synagris, onde a presença dos parasitas aumenta conforme o comprimento do peixe. Esse é o primeiro registro de Raphidascaris ( Ichthyascaris) sp. e Hysterothylacium sp. em L. vivanus ; de Terranova sp. em O. chrysurus e L. jocu e Goezia sp. em L. analis, adicionando o litoral nordeste do Brasil e o estado de Sergipe na distribuição geográfica desses parasitos.

First report of Anisakis sp. (Nematoda: Anisakidae) parasitizing Muscovy duck in Marajó Island, state of Pará, Brazil / Primeiro relato de Anisakis sp. (Nematoda: Anisakidae) parasitando pato doméstico na Ilha de Marajó, estado do Pará, Brasil

Abstract Among the avian used for human consumption, the Muscovy duck is well adapted to various climatic conditions and its breeding is widespread due to its easy handling, and its meat is widely consumed and appreciated, especially in the cuisine of northern Brazil. The present study aimed to report and identify taxonomically the nematodes found in the esophagus of Muscovy ducks reared and marketed in the municipality of Soure, Marajó Island, state of Pará, Brazil, and discuss its zoonotic potential to human. The samples consisted of 30 specimens of Cairina moschata domestica analyzed. A total of 258 nematodes were recovered, which were strongly fixed in the esophageal mucosa of hosts. The morphological and morphometric characteristics were compatible with Anisakis third-stage larvae.

Resumo Entre as aves utilizadas para consumo humano, o pato doméstico está bem adaptado às várias condições climáticas. Sua criação é muito difundida devido ao seu fácil manejo. E sua carne é amplamente consumida e apreciada, principalmente na culinária do norte do Brasil. O presente estudo teve como objetivo relatar e identificar taxonomicamente os nematódeos encontrados no esôfago de patos domésticos, criados e comercializados no município de Soure, Ilha de Marajó, estado do Pará, Brasil. E também discutir o seu potencial zoonótico para o homem. As amostras consistiram em 30 espécimes de Cairina moschata domestica analisados. Um total de 258 nematódeos foram recuperados, fortemente fixados na mucosa esofágica dos hospedeiros. As características morfológicas e morfométricas foram compatíveis com as larvas de terceiro estágio de Anisakis.

Species of Anisakidae nematodes and Clinostomum spp. infecting lisa Mugil curema (Mugilidae) intended for human consumption in Mexico / Espécies de nematoides Anisakidae e Clinostomum spp. infectando tainhas Mugil curema (Mugilidae) destinadas ao consumo humano no México

Abstract Anisakisspp. nematodes are potentially zoonotic parasites; that infects a wide variety of aquatic species worldwide, with marine fish being the paratenic hosts. The aim of study was identify the presence of Anisakidae nematodes, and other parasites in Mugil curema . A total of 96 M . curema obtained from local markets in Tulancingo, Hidalgo, Mexico, were analyzed by necropsy. Only five M . curema present nematode collection in epaxial muscle. The tissues with the highest prevalence of parasites were identified, and samples of epaxial muscle with larval migration analyzed by histopathology. Visible parasites in necropsy tissues were classified according to their morphology. Nematode found in the liver were Contracaecum spp. (41.17%) and Pseudoterranova spp. third stage (7.36%); in the caudal part of the kidney were Anisakis spp. (13.23%), Pseudoterranova spp. third stage (11.77%) and Contracaecum spp. (5.88%); and in epaxial muscle were Anisakis spp. Larva I (5.88%) and Pseudoterranova spp (4.42%). In one fish, Clinostomum spp. was detected in epaxial caudal muscle. The present work reports for the first time the presence of nematodes of the family Anisakidae and Clinostonum spp. metacercariae, with zoonotic potential, in M . curema intended for human consumption in Tulancingo, Hidalgo, Mexico.

Resumo Anisakisspp. são parasitas potencialmente zoonóticos que infectam uma grande variedade de espécies aquáticas em todo o mundo, sendo os peixes marinhos hospedeiros paratênicos. O objetivo deste estudo foi identificar a presença de nematóides da família Anisakidae e de outros parasitas em peixes Mugil curema . Um total de 96 M . curema , obtidos em mercados locais em Tulancingo, Hidalgo, México, foram submetidos a necropsia. Apenas cinco M. curema apresentaram coleção de nematóides no músculo epaxial. Os tecidos com maior prevalência de parasitas foram identificados e amostras do músculo epaxial com migração larval foram analisadas por histopatologia. Os nematóides encontrados no fígado foram Contracaecum spp. (41,17%) e Pseudoterranova spp. terceira etapa (7,36%); na parte caudal do rim Anisakis spp. (13,23%), Pseudoterranova spp. terceira etapa (11,77%) e Contracaecum spp. (5,88%); e no músculo epaxial Anisakis spp. larva I (5,88%) e Pseudoterranova spp. (4,42%). Em um peixe, Clinostomum spp. foi detectado no músculo caudal epaxial. O presente trabalho relata pela primeira vez a presença de nematóides da família Anisakidae e Clinostonum spp. metacercárias, com potencial zoonótico, em M. curema destinado ao consumo humano em Tulancingo, Hidalgo, México.

Anisákidos y anisakidosis: generalidades y su actualidad en Colombia. Revisión bibliográfica / Anisakis and Anisakiasis: General aspects and current situation in Colombia

RESUMEN La anisakidosis es una parasitosis ocasionada por nematodos de la familia Anisakidae, causa-da por el consumo de pescado parasitado con larvas infectivas (L3) de estos nematodos. En Europa y Asia es un problema de salud pública. Sin embargo, en Colombia y en general en los países de América del Sur, es poco conocida. El objetivo de este trabajo es presentar una revisión de las generalidades de los parásitos anisákidos y mostrar la situación actual de esta parasitosis en Colombia. Se realizó una búsqueda estructurada de términos MeSH y DeCS en MEDLINE, Cochrane, Embase, LILACS y Scopus; esta se complementó con otra no estructurada en SciELO y Google Scholar. Se incluye un reporte de caso y seis registros de hospederos. Se describen registros de peces de consumo humano parasitados por Anisakis sp., Anisakis physeteris y Pseudoterranova decipiens para el Océano Pacífico y, los géneros Pseudoterranova y Contracaecum en peces del Océano Atlántico y aguas continentales. Se concluye que la anisakidosis representa un riesgo latente para Colombia, es necesario instaurar legislaciones efectivas para un control eficiente sobre esta parasitosis y educar a la población sobre los cui-dados necesarios para el consumo de pescado.

SUMMARY Anisakidosis is a parasitic disease derived from the consumption of infective larvae from Anisakidae family. In Europe and Asia is a public health problem, however, in Colombia and South American countries is little known. The objective is to review Anikids general aspects and find out about the current situation of this disease in Colombia. Search of MeSH and DeCS terms, through MEDLINE, Cochrane, Embase, and Scopus databases, complemented with grey literature from SciELO and Google Scholar, was made. One case report and six host records were included. Records of fish for human consumption from Pacific Ocean parasitized by Anisakis sp., Anisakis physeteris and Pseudoterranova decipiens are described, as well as for fish from Atlantic Ocean and inland waters with genera Pseudoterranova and Contracaecum. Anisakidosis represents a latent risk for Colombia; it is necessary to establish effective legislations for an efficient control of the emergence of this parasitic disease, as well as to educate people about needed precautions considering fish consumption.

Uma visão atualizada da anafilaxia idiopática: a ausência de evidência não é a evidência de ausência / An updated view of idiopathic anaphylaxis: absence of evidence is not evidence of absence

A anafilaxia idiopática não apresenta etiologia conhecida. A sua prevalência é estimada entre 10-35% de todas as modalidades de anafilaxia. A sintomatologia apresentada é a mesma de qualquer outra anafilaxia: urticária, angioedema, ruborização, prurido, hipotensão arterial, taquicardia, manifestações gastrointestinais (disfagia, náusea, vômitos, cólicas abdominais, diarreia), asma, edema laríngeo, tontura e síncope. A mortalidade é rara. Não há transmissão genética, mas 40% dos pacientes são atópicos. É mais frequente nos adultos do que nas crianças, e principalmente em mulheres. É um diagnóstico de exclusão. Ocorre ativação mastocitária com desgranulação citoplasmática dos mediadores de anafilaxia (triptase, histamina, entre outros). É uma anafilaxia com boa resposta aos corticoides, e, portanto, caso não haja resposta adequada a doses eficazes de prednisona/prednisolona, o seu diagnóstico deve ser revisto. O diagnóstico diferencial da anafilaxia idiopática inclui: a mastocitose sistêmica indolente, síndromes de ativação mastocitária monoclonais, alergia à galactose-alfa-1,3 galactose, anafilaxia induzida por exercícios (com e sem dependência alimentar e medicamentosa), angioedema hereditário (congênito e adquirido), feocromocitoma, síndrome carcinoide, anafilaxia oral acarina, alergia ao Anisakis simplex, disfunção das cordas vocais, síndrome escombroide, alergia ao sêmen, alergia ao látex, manifestações psicossomáticas (síndrome do pânico, globus hystericus e a síndrome de Münchausen), bem como as tradicionais e mais frequentes modalidades de anafilaxia (alergia a alimentos, medicamentos e insetos). O tratamento na crise aguda da anafilaxia idiopática é o mesmo do que nas demais anafilaxias, incluindo a administração intramuscular imediata de epinefrina. Deve haver uma generosa e prolongada prescrição de corticoterapia oral, e também a instituição de medicação preventiva (anti-histamínicos anti- H1 e anti-H2, cetotifeno, albuterol oral, montelucaste, cromoglicato de sódio, e por último o omalizumabe). Os pacientes devem portar epinefrina autoinjetora e ser instruídos sobre como agir em caso de um episódio anafilático. Eles respondem bem à administração de epinefrina. A corticoterapia oral, por 4-6 semanas, pode induzir uma remissão completa.

Idiopathic anaphylaxis is a condition of unknown etiology. Its prevalence ranges from 10 to 35% of all cases of anaphylaxis. Clinical symptoms and signs are those of classic anaphylaxis, including urticaria, angioedema, flushing, itching, hypotension, tachycardia, gastrointestinal manifestations (dysphagia, nausea, vomiting, abdominal cramps, and diarrhea), asthma, laryngeal edema, dizziness, and syncope. Mortality is rare. There is no genetic transmission, but about 40% of patients are atopic. It is more common in adults than in children, affecting mainly women. It is considered a diagnosis of exclusion of other known forms of anaphylaxis. Mast cell activation occurs with cytoplasmatic degranulation of mediators of anaphylaxis (tryptase and histamine, among others). Because idiopathic anaphylaxis is a steroid-responsive condition, if it is not controlled with adequate doses of prednisone/prednisolone, the diagnosis should be challenged. The differential diagnosis of idiopathic anaphylaxis includes indolent systemic mastocytosis, clonal mast cell activation syndromes, galactose-alpha-1,3- galactose allergy, exercise-induced anaphylaxis (both food- and drug-dependent and -independent), hereditary angioedema (congenital and acquired), pheochromocytoma, carcinoid syndrome, oral mite anaphylaxis, Anisakis simplex allergy, vocal cord dysfunction, scombroid poisoning, semen allergy, latex allergy, psychosomatic conditions (panic attacks, globus hystericus, and Münchausen syndrome), and the classic forms of anaphylaxis (food, drug, and insect allergies). Treatment of acute idiopathic anaphylaxis is the same as in the other forms of anaphylaxis, including intramuscular epinephrine, but with prolonged oral corticosteroid therapy. It might also include other oral preventive medications (H1 and H2 antihistamines, ketotifen, oral albuterol, montelukast, sodium cromoglycate, and recently omalizumab). Patients should have an epinephrine auto-injector and be instructed on self-management of anaphylaxis. Good response to epinephrine is observed, and oral corticosteroid therapy for 4-6 weeks can induce complete remission.

El ciclo evolutivo de parásitos de la familia anisakidae. Hacia una prospectiva de medidas sanitarias de control / The evolutionary cycle of parasites of the anisakidae family. towards a prospective of sanitary control measures

Las larvas de nematodos en los peces, generalmente corresponde a especies de la familia Anisakidae, son gusanos redondos, sin segmentación; con hospedadores intermediarios y definitivos y un huésped accidental que es el humano, en quién va producir una enfermedad parasitaria del tacto digestivo, mundialmente conocida como anisakiasis, asociada a reacciones de hipersensibilidad debido a los alérgenos del parásito. La presencia de estos parásitos en los productos de la pesca, deberá ser controlada con medidas preventivas establecidas en la legislación sanitaria de países; estableciendo profilaxis, medidas higiénicas como consumir el pescado cocido, o sometido previamente a congelación a -20°C por 48 a 72 horas, para prevenir la enfermedad. Cuando enfocamos hacia una prospectiva de medidas sanitarias de control preventivo, se plantea el establecimiento de un plan de requerimientos de alimentos seguros, basado en el análisis de riesgos y control de puntos críticos (HACCP), constituido por un paquete de documentos escritos basados en los principios de seguridad de alimentos; que contendrá: el análisis de riesgos; controles preventivos; programas en la cadena de suministros; delineamiento de los procedimientos para ser seguidos por monitoreo, acciones correctivas y verificación. Estará basado en las obligaciones que se puedan establecer bajo jurisdicción regulatoria para el pescado, en cuanto a la pesca o captura, manipulación a bordo o en la orilla y mecanismos de conservación hasta el expendio; que dé lugar a un manual de buenas prácticas de manufactura, análisis de riesgo y controles preventivos de riesgos para la regulación de alimentos de origen marino para consumo humano

The larvae of nematodes in fish generally correspond to species of the Anisakidae family, they are round worms, without segmentation; with intermediate and definitive hosts and an accidental host that is human, in whom it will produce a parasitic disease of the digestive tract, worldwide known as anisakiasis, associated with hypersensitivity reactions due to parasite allergens. The presence of these Parasites in fishery products should be controlled with preventive measures established in the sanitary legislation of countries; establishing prophylaxis, hygienic measures such as consuming the cooked fish, or previously subjected to freezing at -20 ° C for 48 to 72 hours to prevent the disease. When we focus on a prospective of preventive control sanitary measures, the establishment of a plan for safe food requirements based on risk analysis and control of critical points (HACCP), constituted by a package of written documents based on the principles, is considered food safety; which will contain: risk analysis; preventive controls; programs in the supply chain; delineation of the procedures to be followed by monitoring, corrective actions and verification. It will be based on the obligations that can be established under the regulatory jurisdiction for fish, in terms of fishing or capture, handling on board or on the shore and conservation mechanisms up to the sale; that results in a manual of good manufacturing practices, risk analysis and preventive risk controls for the regulation of food of marine origin for human consumption

Anisakiasis gastro-alérgica, primera descripción de un caso en Colombia y revisión bibliográfica / Gastro-allergic anisakiasis: The first case reported in Colombia and a literature review

Resumen La anisakiasis es una enfermedad parasitaria zoonótica causada por el consumo de pescados o mariscos crudos o poco cocidos infectados con nematodos de los géneros Anisakis, Pseudoterranova y Contracaecum. Se describe el primer caso de anisakiasis en Colombia y se resume la literatura médica disponible. Una mujer de 52 años de edad consultó por dolor epigástrico agudo de inicio abrupto, náuseas, vómitos, diarrea y urticaria después de consumir pescado. El examen físico reveló sensibilidad moderada en el epigastrio. El examen de laboratorio evidenció leucocitosis, en tanto que la radiografía simple y el electrocardiograma no reflejaron ninguna anormalidad. El diagnóstico se hizo mediante una endoscopia de vías digestivas altas, la cual reveló engrosamiento de la pared gástrica y un parásito en movimiento. Se encontró una larva de Anisakis y se la extrajo por endoscopia, lo que alivió el dolor de la paciente. Clínicamente, la anisakiasis puede presentarse como una enfermedad gástrica, intestinal, en otros sistemas o alérgica. El diagnóstico se hace con base en la elaboración del historial alimentario del paciente y la visualización directa de las larvas; el único tratamiento efectivo consiste en su extracción endoscópica.

Abstract Anisakiasis is a zoonotic parasitic disease caused by consumption of raw or undercooked fish or seafood infected with nematodes of the Anisakis, Pseudoterranova or Contracaecum genera. Here, we describe the first case of anisakiasis in Colombia and summarize the available literature. A 52-year-old female with a history of abrupt-onset sharp epigastric pain, nausea, vomit, diarrhea, and urticaria following fish consumption consulted the health service. The physical examination revealed moderate tenderness of the epigastric region; the laboratory evaluation showed leukocytosis and a simple X-ray and ECG showed no abnormalities. The diagnosis was made by endoscopic examination, which revealed a thickened gastric wall and a moving larval worm. An Anisakis larva was found and extracted endoscopically, which relieved the pain of the patient. Clinically, anisakiasis may present as a gastric, intestinal, extragastrointestinal or allergic disease. Diagnosis and treatment of anisakiasis are made by a dietary history, direct visualization and endoscopic extraction of possible larvae, which is the only effective therapy.

Anisakid Larvae from Anchovies in the South Coast of Korea

Anisakiasis (anisakidosis) refers to a foodborne zoonosis caused by ingesting raw or undercooked marine fish or cephalopods infected with anisakid larvae. The present study was performed to investigate the prevalence of anisakid larvae in anchovies (Engraulis japonica) purchased from 2 local markets in Gyeongsangnam-do, the Republic of Korea (=Korea), during 2018–2019. Anchovies were transported to our laboratory and examined by pepsin-HCl artificial digestion technique followed by microscopic observations and molecular analyses. The overall prevalence of anisakid larvae was 19.5% (39/200), from which a total of 51 larvae (av. 1.3 larvae/infected anchovy) were recovered. Sequencing of the larvae targeting the ITS region, including ITS1, 5.8S rRNA, and ITS2 genes confirmed the species of larvae as Anisakis pegreffii (54.9%; 28/51), Hysterothylacium sinense (23.5%; 12/51), and Hysterothylacium aduncum (21.5%; 11/51). The results suggested that anchovies could be a potential source of human anisakiasis in Korea.

Anisakidosis

Anisakidosis is a term that collectively refers to a human infection caused by larvae of the family Anisakidae. Because Anisakis simplex was the main cause, it was originally called anisakiasis or anisakiosis, but since other parasites such as Pseudoterranova decipiens also cause similar diseases, the family name is now used as the diagnostic name. Anisakidosis cases have been increasing steadily owing to the propagation of the Japanese raw-fish-eating culture, such as sushi and sashimi, around the world; the traditional raw-fish-eating habits of individual countries; the establishment of marine mammal protection laws; and the development of endoscopic diagnostic techniques. The disease continues to occur in Korea, where most human parasites are believed to have been eradicated and is probably the most common parasitic disease encountered in clinical practice. Anisakidosis is a disease associated with acute abdominal pain. Anisakid larvae can invade the entire digestive tract and abdominal cavity and cause abdominal pain and a variety of digestive system symptoms. Thus, the history of eating raw fish is very important for its differential diagnosis. The lack of a precise understanding of the pathogenesis and clinical course of this disease may lead to unnecessary surgery. Anisakidosis may also manifest as allergic symptoms. Therefore, it is necessary to understand anisakidosis from the perspective of public health, food hygiene, and preventive medicine.

Molecular Identification of Anisakis Larvae Extracted by Gastrointestinal Endoscopy from Health Check-up Patients in Korea

Anisakiasis is a zoonotic disease induced by anisakid nematodes, and endoscopic inspection is used for a diagnosis or remedy for it. Anisakis simplex, Anisakis physeteris, and Pseudoterranova decipiens had been reported to be the major species causing human infections, particularly, in Japan. However, in Korea, recent studies strongly suggested that Anisakis pegreffii is the major species of human infections. To support this suggestion, we collected anisakid larvae (n=20) from 20 human patients who were undergone gastrointestinal endoscopy at a health check-up center in Korea, and molecular identification was performed on the larvae using PCR-RFLP analysis and gene sequencing of rDNA ITS regions and mtDNA cox2. In addition, anisakid larvae (n=53) collected from the sea eel (Astroconger myriaster) were also examined for comparison with those extracted from humans. The results showed that all human samples (100%) were identified as A. pegreffii, whereas 90.7% of the samples from the sea eel were A. pegreffii with the remaining 9.3% being Hysterothylacium aduncum. Our study confirmed that A. pegreffii is the predominant species causing human anisakiasis in Korea, and this seems to be due to the predominance of this larval type in the fish (sea eels) popularly consumed by the Korean people. The possibility of human infection with H. aduncum in Korea is also suggested.

Foodborne parasites in Colombia: [Editorial] / Parásitos transmitidos por alimentos en Colombia: [Editorial]

This number of Infectio includes the first report of Anisakis in edible fish in the Colombian pacific coast. Anisakidiasis has become an increasing threat given the extensive consumption of Sushi and raw fish worldwide as consequence of a global fad food. This report of Anisakis in 42% of the most popular fish specimens consumed in the country, call the attention also about the new health risks present in food, particularly parasites. The Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) established a ranking of the top foodborne parasites for control priority in 2014. This was the first expert meeting that established which were the most important parasites to be included in risk analysis of food. The consequences are important, not only for the health sector, but also for the agriculture export market of developing countries. As free trade agreements have become a rule for the commercial exchange between countries, the only way to limit the entry of food products in the developed world are the sanitary controls. CODEX Alimentarius Commission (CAC) is the international organism that define the sanitary code and rules for quality and risk analysis in food. The economic importance of the rules defined by this commission is evident and discussions about inclusion of new controls for new risks are intense and a particularly though task inside this commission.

Este número de Infectio incluye el primer reporte de Anisakis en pescado comestible en la costa pacífica colombiana. La anisakidiasis se ha convertido en una amenaza creciente dado el amplio consumo de sushi y pescado crudo en el mundo como consecuencia de una moda alimentaria mundial. Este reporte de Anisakis en el 42% de los ejemplares de pescado más consumidos en el país, llama la atención también sobre los nuevos riesgos para la salud presentes en los alimentos, particularmente los parásitos. La Organización de las Naciones Unidas para la Agricultura y la Alimentación (FAO) y la Organización Mundial de la Salud (OMS) establecieron en 2014 una clasificación de los principales parásitos transmitidos por los alimentos para su control prioritario. Esta fue la primera reunión de expertos que estableció cuáles eran los parásitos más importantes a incluir en el análisis de riesgo de los alimentos. Las consecuencias son importantes, no solo para el sector sanitario, sino también para el mercado de exportación agrícola de los países en desarrollo. Como los acuerdos de libre comercio se han convertido en una norma para el intercambio comercial entre países, la única forma de limitar la entrada de productos alimentarios en el mundo desarrollado son los controles sanitarios. La Comisión del CODEX Alimentarius (CAC) es el organismo internacional que define el código sanitario y las normas de calidad y análisis de riesgo en los alimentos. La importancia económica de las normas definidas por esta comisión es evidente y las discusiones sobre la inclusión de nuevos controles para nuevos riesgos son intensas y una tarea especialmente ardua dentro de esta comisión.

First reporting of Anisakis sp. in the Armed Snook fish (Centropomus armatus) caught and commercialized in Buenaventura, Colombia / Primer reporte de Anisakis sp. en el pez Róbalo (Centropomus armatus) capturado y comercializado en Buenaventura, Colombia

Objective: Nematodes of the Anisakidae family are parasites found in aquatic organisms. The lack of studies on anisakidosis and Anisakis in Colombia has meant this type of parasitosis is not widely known by health personnel and underreporting of the disease is highly likely. The objective of this study was to identify anisakid nematodes in the armed snook fish (Centropomus armatus) obtained by artisanal fishing and sold commercially in the coastal port city of Buenaventura. Material and methods: Morphological identification of these worms was performed using taxonomic keys and supplemented with microscopic study using the histochemical Hematoxylin-Eosin technique. Results: Nematodes of the genus Anisakis were found in 42% and the mean abundance was 2.8 in the C. armatus. Conclusions: The findings confirm the presence of Anisakis sp. in fish for human consumption in Buenaventura, the main fishing port in the Colombian Pacific region. This finding in itself warrants further investigation into the possibility of an emerging disease in Colombia.

Objetivos: Los nematodos de la familia Anisakidae son parásitos de organismos acuáticos. La falta de estudios en anisakidosis y anisakidos en Colombia ha resultado en el desconocimiento de esta infección por parte del personal de salud y un posible subregistro de la enfermedad. El objetivo de este estudio fue identificar nematodos anisakidos en el pez róbalo (Centropomus armatus), obtenido por pesca artesanal y comercializado en la localidad de Buenaventura. Materiales y métodos: La identificación morfológica se realizó usando claves taxonómicas para estos gusanos complementada con estudio microscópico mediante técnica histoquímica de Hematoxilina-Eosina. Resultados: Se encontraron nemátodos del género Anisakis en 42% y una abundancia promedio de 2.8 en el hospedero C. armatus. Conclusiones: Los hallazgos confirman la presencia de Anisakis sp. en peces de consumo humano de Buenaventura, principal puerto pesquero en la región Pacífica colombiana, lo cual abre el camino en la investigación de una posible enfermedad emergente en este país.

An Overview of Fish-borne Nematodiases among Returned Travelers for Recent 25 Years– Unexpected Diseases Sometimes Far Away from the Origin

Along with globalization of traveling and trading, fish-borne nematodiases seems to be increasing in number. However, apart from occasional and sporadic case reports or mini-reviews of particular diseases in particular countries, an overview of fish-borne nematodiasis among travelers have never been performed. In this review, we gathered fish-borne nematodiasis among travelers for recent 25 years by an extensive global literature survey using appropriate keywords, e.g. travelers diseases, human infection, anisakiasis, gnathostomiasis, capillariasis, sushi, sashimi, ceviche, Gnathostoma, Pseudoterranova, Anisakis, Capillaria, etc., as well as various combinations of these key words. The Internet search engines PubMed, Medline, Google and Googler Scholar were used as much as possible, and the references of every paper were checked in order to identify useful and reliable publications. The results showed unexpectedly high incidence of gnathostomiasis and low incidence of anisakidosis. The different incidence values of the infection with several fish-borne zoonotic nematode species are discussed, as well as some epidemiological aspects of the infections. The difficulties of differential diagnosis in non-endemic countries are emphasized. It is concluded that travelers must avoid risky behaviors which can lead to infection and that physicians and health authorities must advice travelers on the risks of eating behaviors during travel.

Anisakiasis Involving the Oral Mucosa

Anisakis is a parasite with life cycles involving fish and marine mammals. Human infection, anisakiasis, occurs with the ingestion of raw infected seafood and usually presents with acute or chronic gastrointestinal symptoms from esophageal or gastric invasion. We report a rare caseinvolving the oral cavity. A 39-year-old male presented with oral and sub-sternal pain of one day duration after eating raw cuttlefish. Physical examination revealed areas of erythema and edema with a central white foreign particle on the labial and buccal mucosa. With microscopic field we could remove the foreign material from the lesions. The foreign material was confirmed to be Anisakis. Anisakis was also removed from the esophagus by esophagogastroduodenoscopy. The patient was discharged the following day without complication. Anisakiasis is frequently reported in Korea and Japan, countries where raw seafood ingestion is popular. The symptoms of acute anisakiasis include pain, nausea, and vomiting and usually begin 2–12 hours after ingestion. The differential diagnosis includes food poisoning, acute gastritis, and acute pancreatitis. A history of raw seafood ingestion is important to the diagnosis of anisakiasis. Treatment is complete removal of the Anisakis to relieve acute symptoms and prevent chronic granulomatous inflammation.