This week's (rather disturbing) case was generously donated by Dr. Niels Olson. This is a parasite found in salmon throughout the world - sorry sushi lovers - no slight is meant against any commercial provider of salmon. Parasitism is a fact of life. What is the likely identification of this parasite? What would happen if it was ingested without cooking or freezing?
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Anisakiasis
That is why need to froze the salmon.
EGD removal is the treatment.
FDA recommend cook or froze the salmon to kill the parasite. However, some people never eat sushi or poke bowel because they think they will have Anisakiasis, which could happened only if the salmon is not frozen prior serving.
So as a Costco shopper and sashimi eater of their salmon (mostly the farmed Atlantic) how did this happen as I thought all commercial salmon was supposed to have been frozen?
As a follow on if we find something like this what is our responsibility about reporting and is anyone interested? In a GI heavy practice in San Francisco we see probably once a year.
Awesome video! Anisakine infestation.
BW in VT
👍👍👍👍
The "sushi" worm
Roundworm larva embedded in gastric sometimes intestinal mucosa acquired by eating raw fish: herring, salmon, mackerel, cod, squid; other species increasingly implicated with aquaculture.
Worldwide distribution in colder waters, mostly Japan, North Atlantic, Pacific
Anisakis worm ingestion can cause penetration into intestine
Wow, that’s many Anisakid worms. They live in the fish which is cold blooded. Once accidentally ingested for sure they will feel the human body heat and compelled to wiggle their way around. Just the gastro discomfort will make the patient throw it out or cough it up. Most cases end upon the good riddance ( besides the heat, the gastric acids will make the worm dance). Hopefully there may be no further medical intervention I.e gastroscopic removal, allergic treatment or intestinal perforation.
Florida Fan
It is frozen, then thawed for sale. Usually these worms die from the freeze but doesn’t seem to the case on this one. Cook properly!
Anasakid nematodes
If you're eating the farm raised stuff, you'll be safe. Their food supply is heavily monitored and controlled. In the wild, anything goes! That's why the wild caught stuff has to be frozen too a certain temp for a specific duration.
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