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.

Anisakis pegreffii Larvae in Sea Eels (Astroconger myriaster) from the South Sea, Republic of Korea

Anisakis simplex sensu stricto (s.s.), Anisakis pegreffii, Anisakis berlandi (=A. simplex sp. C), and Anisakis typica are the 4 major species of Anisakis type I larvae. In the Republic of Korea (Korea), A. pegreffii, A. berlandi, and A. typica larvae in fish hosts has seldom been documented. In this study, molecular analysis was performed on Anisakis larvae from the sea eels (Astroconger myriaster), the major source of human anisakiasis in Korea, collected from Tongyeong City, a southern coastal area of Korea. All 20 sea eels examined were infected with Anisakis type I larvae (160 larvae; 8 per fish). Their species were analyzed using PCR-RFLP patterns and nucleotide sequences of internal transcribed spacers (ITS1, 5.8 subunit gene, and ITS2) and mitochondrial cytochrome c oxidase 2 (cox2). Most (86.8%; 112/129) of the Anisakis type I larvae were A. pegreffii, and 7.8% (10/129) were A. typica. The remaining 5.4% (7/129) was not identified. Thus, A. pegreffii is the major species of anisakid larvae in sea eels of the southern coast of Korea.

Molecular Analysis of Anisakis Type I Larvae in Marine Fish from Three Different Sea Areas in Korea

Anisakiasis, a human infection of Anisakis L3 larvae, is one of the common foodborne parasitic diseases in Korea. Studies on the identification of anisakid larvae have been performed in the country, but most of them have been focused on morphological identification of the larvae. In this study, we analyzed the molecular characteristics of 174 Anisakis type I larvae collected from 10 species of fish caught in 3 different sea areas in Korea. PCR-RFLP and sequence analyses of rDNA ITS and mtDNA cox1 revealed that the larvae showed interesting distribution patterns depending on fish species and geographical locations. Anisakis pegreffii was predominant in fish from the Yellow Sea and the South Sea. Meanwhile, both A. pegreffii and A. simplex sensu stricto (A. simplex s.str.) larvae were identified in fish from the East Sea, depending on fish species infected. These results suggested that A. pegreffii was primarily distributed in a diverse species of fish in 3 sea areas around Korea, but A. simplex s.str. was dominantly identified in Oncorhynchus spp. in the East Sea.

Anisakis simplex Larvae: Infection Status in Marine Fish and Cephalopods Purchased from the Cooperative Fish Market in Busan, Korea

The infection status of marine fish and cephalopods with Anisakis simplex third stage larva (L3) was studied over a period of 1 year. A total of 2,537 specimens, which consisted of 40 species of fish and 3 species of cephalopods, were purchased from the Cooperative Fish Market in Busan, Korea, from August 2006 to July 2007. They were examined for A. simplex L3 from the whole body cavity, viscera, and muscles. A. simplex L3 were confirmed by light microscopy. The overall infection rate reached 34.3%, and average 17.1 larvae were parasitized per infected fish. Fish that recorded the highest infection rate was Lophiomus setigerus (100%), followed by Liparis tessellates (90%), Pleurogrammus azonus (90%), and Scomber japonicus (88.7%). The intensity of infection was the highest in Gadus macrocephalus (117.7 larvae per fish), followed by S. japonicus (103.9 larvae) and L. setigerus (54.2 larvae). Although abundance of A. simplex L3 was not seasonal in most of the fish species, 10 of the 16 selected species showed the highest abundance in February and April. A positive correlation between the intensity of L3 infection and the fish length was obvious in S. japonicus and G. macrocephalus. It was likely that A. simplex L3 are more frequently infected during the spring season in some species of fish. Our study revealed that eating raw or undercooked fish or cephalopods could still be a source of human infection with A. simplex L3 in Korea.

Possible influence of the ENSO phenomenon on the pathoecology of diphyllobothriasis and anisakiasis in ancient Chinchorro populations

Current clinical data show a clear relationship between the zoonosis rates of Diphyllobothrium pacificum and Anisakis caused by the El Niño Southern Oscillations (ENSO) phenomenon along the Chilean coast. These parasites are endemic to the region and have a specific habitat distribution. D. pacificum prefers the warmer waters in the northern coast, while Anisakis prefers the colder waters of Southern Chile. The ENSO phenomenon causes a drastic inversion in the seawater temperatures in this region, modifying both the cool nutrient-rich seawater and the local ecology. This causes a latitudinal shift in marine parasite distribution and prevalence, as well as drastic environmental changes. The abundance of human mummies and archaeological coastal sites in the Atacama Desert provides an excellent model to test the ENSO impact on antiquity. We review the clinical and archaeological literature debating to what extent these parasites affected the health of the Chinchorros, the earliest settlers of this region. We hypothesise the Chinchorro and their descendants were affected by this natural and cyclical ENSO phenomenon and should therefore present fluctuating rates of D. pacificum and Anisakis infestations.

Resistência de larvas de Contracaecum sp., a baixas temperaturas / Resistence of Contracaecum sp. larvae under low temperature

Trinta e cinco peixes da espécie Hoplias malabaricus provenientes do rio Cuiabá, estado de Mato Grosso, foram necropsiadospara a coleta de larvas de anisaquídeos, Contracaecum sp., com o objetivo de avaliar a resistência desses nematóides ao frio.As larvas foram coletadas e avaliadas quanto a sua viabilidade, através de movimento espontâneo e integridade morfológica;estas foram acondicionadas entre fatias da massa muscular e mantidas em freezer a -30°C, para avaliação da sobrevivênciados parasitos a cada hora. Após cinco horas de exposição, todas as larvas estavam mortas.

Thirty-five specimens of Hoplias malabaricus collected from Cuiabá River, Mato Grosso state, Brazil, were necropsied forcollecting anisakid larvae, Contracaecum sp., aiming to observe the resistence of these nematode to the cold. The larvae werecollected and considered about as its viability through spontaneous movement and morphologic integrity. It was kept intomuscle masses -30°C, testing its survival on the hour. After five hours of exposition all the larvae were dead.

Pseudoterranovosis y sushi / Pseudoterranovosis and sushi

Se comunica un caso de ingestión accidental de Pseudoterranova decipiens. A raíz de esta paciente se revisan los principales conceptos relativos a esta naciente patología en Chile. El consumo de platos preparados con pescados crudos como el sushi, sashimi, cebiche y mariscal es cada vez más popular. A través de la ingesta de hospederos intermediarios usados en la preparación, se puede adquirir la larva de tercer estadio de Anisakis simplex o P. decipiens. Estos parásitos pueden provocar gastritis aguda que se manifiesta inmediatamente después de consumido el pescado crudo. En ocasiones puede haber compromiso intestinal e invasión del tracto gastrointestinal con manifestaciones en otros órganos. Se asocia a manifestaciones alérgicas como urticaria, angioedema y shock anafiláctico. La larva se elimina en forma espontánea en la mayoría de los casos, pero en otros debe removerse por vía endoscópica. En Chile, es más frecuente la presencia de P. decipiens, que por lo general no migra a la mucosa gástrica, no invade y produce pocos síntomas. Las medidas de prevención son no comer pescados crudos, cocinarlos a temperaturas elevadas o congelación previa a la preparación de los alimentos, para inactivar las larvas.

A case of accidental ingestión of Pseudoterranova decipiens is reported, on account of this patient we review main concepts related to this emerging pathology in Chile. Consumption of raw fish in different preparations such as sushi or sashimi, cebiche and seafood is becoming more and more popular. Through intermediary hosts used in the preparation, one can acquire the third stage larval of Anisakis simplex or P. decipiens. These parasites frequently cause gastritis, acutely after the consumption of raw fish, or more rarely intestinal involvement. It may also cause allergic symptoms such as urticaria, angioedema and anaphylactic shock. The larvae is eliminated spontaneously in most cases; others need to be removed by upper gastrointestinal endoscopio examination. In Chile, the most common species is P. decipiens, which are generally no invasive, rarely migrate beyond the stomach and cause mild or no symptoms. Prevention strategies include avoid eating raw fish or undercooked seafood containing the parasite, to cook food with high temperatures or to freeze raw fish prior to preparation of meals, which inactivates the larvae.

A case of acute gastric anisakiasis provoking severe clinical problems by multiple infection

Acute gastric anisakiasis with multiple anisakid larvae infection is reported. A 68-year-old woman residing in Busan, Korea, had epigastric pain with severe vomiting about 5 hours after eating raw anchovies. Four nematode larvae penetrating the gastric mucosae in the great curvature of the middle body and fundus were found and removed during gasteroendoscopic examination. Another one thread-like moving larva was found in the great curvature of upper body on the following day. On the basis of their morphology, the worms were identified as the 3rd stage larvae of Anisakis simplex. This case is acute gastric anisakiasis provoking severe clinical problems by the multiple infection and the greatest number of anisakid larvae found in a patient in Korea.

A human case of gastric infection by Pseudoterranova decipiens larva

We report a case of gastric pseudoterranoviasis proven by gastrofiberscopy on Dec. 13, 1994. The 34-year-old male patient, residing in Chungju-shi, was admitted to Konkuk University Hospital complaining of prickling epigastric pain. The symptoms suddenly attacked him two days after eating raw marine fish at Chonan-shi. By the gastrofiberscopic examination, a long white-yellowish nematode was found from the fundus region of stomach. The worm was 34.50 x 0.84 mm in size, and was identified as a 3rd stage larva of Pseudoterranova decipiens judging from the position of the intestinal cecum. This is the 12th confirmed case of human pseudoterranoviasis in Korea.

Patogenicidad de las larvas de anisakis physeteris inoculadas experimentalmente en canis familiaris / Pathogenicity of anisakis physeteris larvae experimentally inoculated to canis familiaris

El propósito del presente estudio fue demostrar de manera experimental la patogenicidad de las larvas L3 de Anisakis physeteris en el tracto digestivo de Canis familiaris. Las larvas se colectaron de Scomber japonicus "caballa", capturados en las costas de Pisco, Perú. Macroscópicamente, después de las 36, 42 y 60 horas de la infección se aprecia la mucosa gástrica con engrosamiento de las plicas, edema e hiperemia. Histológicamente se observa severa reacción inflamatoria gástrica mayormente conformada por neutrófilos y eosinófilos asociados a linfocitos, así como monocitos y plasmocitos. La lesión se encuentra rodeada por gran cantidad de tejido conectivo crónico. Estas características patológicas son similares a las descritas en la anisakiosis gástrica humana. Consideramos que A. physeteris es un potencial agente patógeno para el hombre y otros animales que se alimentan con pescado en el Perú

The infection status of anisakid larvae in marine fish and cephalopods from the Bohai Sea, China and their taxonomical consideration

The infection status of anisakid larvae was examined in 290 marine fish of 25 species and in 108 cephalopods of 3 species purchased in Bayuquan region, Yingko city nearby the coast of the Bohai Sea from may to August 1992. A total of 7,327 larvae were collected from 156 fish of 19 species and 8 squids of one species. The 3rd-stage larvae of Anisakis simplex were collected from 121 fish (63.4%) of 15 species (N = 191) and from 8 squids (14.8%) of one species (N = 54), and they were total, 5,992 (81.8%). Out of remaining 1,335 larvae, 154 (2.1%) were classified as Thynnascaris type B from 23 fish of 4 species, 1,013 (13.8%) as Thynnascaris type C from 79 fish of 13 species. 164 (2.2%) as Hysterothylacium China type V from 20 fish of 4 species, 3 (0.04%) as Raphidascaris from 3 fish of 2 species and one was Pseudoterranova decipiens larva.