Deardorff T L, Kayes S G, Fukumura T
Department of Structural and Cellular Biology, College of Medicine, University of South Alabama, Mobile 36688.
Hawaii Med J. 1991 Jan;50(1):9-16.
Seafood-transmitted parasitic diseases represent an emerging area of interest to the U.S. Food and Drug Administration. Human infections with marine parasites are generally the result of ingesting uncooked seafood products. Over 50 species of helminthic parasites are known to infect humans worldwide. Recently, the number of infections with one of these helminths, the juvenile stage of the marine nematode, Anisakis simplex, has increased in the United States. Raw fish dishes such as lomi lomi salmon and sashimi are known to transmit the parasite to unsuspecting citizens and the most frequently implicated fish in the transmission of this zoonotic disease is the Pacific salmon (Oncorhynchus spp.). The risk of infection from fishes caught in Hawaiian waters is slight; however, a juvenile Anisakis simplex infected one patient from either locally caught aku or ahi. We report 4 new cases, which brings the total number of known cases in Hawaii to 7. Five of the 7 cases were diagnosed and treated by means of an endoscope and biopsy forceps. Serological profiles are presented in several of these cases. One case represents the first known instance of reinfection; the initial infection occurred 2 years prior. The second infection gave an opportunity to compare the human response to a challenge infection and to investigate the validity of the "double hit" theory. Increased awareness by physicians to the clinical features of this disease is warranted. The zoonotic disease, anisakiasis, should be considered in patients presenting with intense abdominal pain, if these patients admit they have recently eaten raw or undercooked seafoods.
食源性寄生虫病是美国食品药品监督管理局关注的一个新领域。人类感染海洋寄生虫通常是由于食用未煮熟的海产品所致。全世界已知有50多种蠕虫寄生虫可感染人类。最近，美国感染其中一种蠕虫——海洋线虫简单异尖线虫幼虫阶段的病例有所增加。生鱼菜肴如鲁米鲁米三文鱼和生鱼片已知会将这种寄生虫传播给毫无防备的民众，而传播这种人畜共患病最常见的鱼类是太平洋鲑鱼（太平洋鲑属）。在夏威夷海域捕获的鱼类感染风险较小；然而，一名简单异尖线虫幼虫感染了一名患者，该患者食用的要么是当地捕获的阿酷鱼，要么是黄鳍金枪鱼。我们报告了4例新病例，使夏威夷已知病例总数达到7例。7例病例中有5例通过内窥镜和活检钳进行了诊断和治疗。其中几例病例还提供了血清学特征。有1例是已知的再感染首例；初次感染发生在2年前。第二次感染为比较人体对再次感染的反应以及研究“双重打击”理论的有效性提供了机会。医生有必要提高对这种疾病临床特征的认识。对于出现剧烈腹痛且承认近期食用过生的或未煮熟海产品的患者，应考虑患有人畜共患病——异尖线虫病的可能性。
