Occupational disease due to Anisakis simplex in fish handlers.

BACKGROUND: Anisakis is a marine nematode. Its larvae can be found encysted in several species, both in the abdominal cavity and in the adjacent musculature. The most commonly affected commercial species are hake, whiting, cod, and mackerel. The prevalence in fish varies according to the fishing area and the size of the host. MATERIALS AND METHODS: Until now only three species have been confirmed to be involved in human anisakiasis, the most common ones being A. simplex sensu stricto (s.s.) and A. pegreffii, and anecdotally, A. physeteris. Infestation in humans occurs when they eat raw or undercooked parasitized fish or cephalopods (pickled, cold-smoked, salted, semi-preserved, prepared in certain Asian styles like sushi or sashimi, ceviche). RESULTS: The majority of anisakiasis cases have been described by Japanese authors. However, over the last few years there has been an increase in the number of cases reported in other countries including Italy and Spain. It is estimated that its incidence in the European Union is 0.32/100,000, and in the Basque Country (Spain), this parasite is responsible for 10% of anaphylaxis cases and 32% of urticaria cases in adults aged 40-60 years, around 300 cases/year. Anisakis-related disease in the work environment (occupational disease) is less common. CONCLUSIONS: We present three cases of the occupational disease in Spain due to a type I hypersensitivity to Anisakis simplex in individuals who handle fish (one fishmonger, one supermarket employee, and one chef).

Occupational contact allergy to omeprazole and ranitidine.

Omeprazole is a proton pump inhibition and ranitidine is an H2 histamine receptor antagonist widely used in the treatment of gastroesophageal reflex disease, peptic ulcer disease, Zollinger-Ellison syndrome and as a protector of the gastric mucosae. We report a case of occupational contact allergy to omeprazole and ranitidine. A 48-year-old man, with no pre-existing history of atopy or lifestyle factors. He neither had any medical history of consumption of drugs such as ranitidine and omeprazole. He worked for 19 months in the pharmaceutical company that manufactured ranitidine base. He presented rash in the face and eczema on the dorsum of the hands with itching. The study by prick tests with ranitidine gave negative response. Patch testing with ranitidine base and ranitidine hydrochloride gave positive response. A month later, when the patient was asymptomatic he returned to the pharmaceutical company, being switched from this previous job to the reactor manufacturing omeprazole. A few days after that, he presented erythematous eruptions involving face and neck with itching. Prick tests, path tests and in vitro laboratories studies with omeprazole gave positives. In this case the patient presented hypersensitivity type I at omeprazole and hypersensitivity type IV at omeprazole and ranitidine. Our aportation indicates the importance of careful analysis of the occupational exposure histories of patients with the suspected type I or type IV hypersensitivity to allergens, to determine whether work exposure is the cause. Med Pr 2017;68(3):433-435.

Description of a novel panallergen of cross-reactivity between moulds and foods.

The present investigation is undertaken to demonstrate a novel cross-reactivity between aeroallergens (moulds fungi imperfecti) and allergens from foods (spinach and mushroom Agaricus bisporus). We have performed a dual study in vivo and in vitro, in a population of atopic patients. Data from in vivo tests performed with spinach and mushroom have been statistically analysed. To the in vitro assays, mushroom and spinach extracts have been obtained, and sera from moulds allergic patients analysed by means of IgE-immunoblott assays. Inhibition experiments have been also performed to study a possible relation between proteins. Statistical analysis of data showed a relation between allergenicity to moulds (Alternaria alternata, Cladosporium herbarum and/or Aspergillus fumigatus), and positive skin prick tests with mushroom and/or spinach. The immunoblotts performed showed that seven moulds allergic patients had a strong recognition of a protein with a molecular weight of about 30 kD present both in spinach and mushroom extracts, and by means of inhibition assays we could determine that these two proteins were related. This study demonstrates the existence of a new allergen responsible for cross reactivity between moulds and two frequently consumed foods, mushroom and spinach. We conclude that a novel cross-reactive allergen between aeroallergens and foods has been identified.