Spain is the second country with highest number of intoxications by Anisakis after Japan.

-Occur in the world every year 20,000 cases of poisoning Anisakis enrolled with digestive or intestinal disorders and allergy

-Spanish cuisine with dishes like fish in marinades, vinaigrettes or oil facilitates the spread of the infection

-extreme temperatures are the only measure of effective prevention according to the Spanish Foundation of the appliance (digestive)FEAD) recommends cooking the fish to 60 degrees or freezing at-20 ºc for 48 h

Spain, March of 2013– the Anisakis is a parasite of about 20-30 mm of the intestine of many marine species and which is transmitted to humans through the ingestion of fish or contaminated cephalopodscausing gastrointestinal and allergic disorders. In the past 30 years the number of cases has increased due to culinary fashions and new methods of conservation or manufacturing of the fish. The Spanish Foundation of the digestive apparatus (FEAD) calls attention to this phenomenon and highlights the need to observe basic prevention measures.

Given that the Anisakis parasite is widespread in all the seas of the planet the only solution is prevention and self responsibility in the consumption of fish ”, explains Dr. Alfredo Lucendo, expert of the Spanish Foundation of digestive apparatus (FEAD), and designates three prevention tips: cooking fish at a temperature of 60 °, freezing it at least 48 hours at – 20 º if you were to consume raw or semi raw and make sure that the fish has been processed correctly when consumed away from home. Finally, he warns that microwave cooking is not safe since it does not guarantee a homogeneous temperature higher than 60 °.

The incidence of anisakiasis in our country depends on the culinary customs of each zone and the conservation of the fish and not the variety of species consumed ”, says Dr. Lucendo. According to a study published in 2012, there are fewer fish infected with Anisakis in Galicia (0.43%) to Madrid (13.4%), for instance which implies that the mode of preservation and transportation of fish is as important as your treatment or cooking ”, indicates the specialist.

Increase of anisakiasis

The anisakiasis is relatively modern; the first reported cases occurred in the North of Europe, in Scandinavia in the 1960s, related to the consumption of smoked salmon and cod liver. However, in the last 30 years infections and intestinal and allergic disorders caused by this parasite have increased considerably. According to the Fundación Española of the digestive (FEAD) three are the causes of this increase: certain preference for eating raw fish or raw semi, the best technique for the conservation of the fish, provided that it is consumed fresh in places further away from the coast and the modern fishing practices that the fish is cleaned in high seas and infected casings are pulled to the Sea serving food to other fish.
In 2012 reported 20,000 cases of anisakiasis in all the world. the Anisakis is even present in the farm that has been fed with infected food fish, and the most affected countries are Japan and secondly Spain , says Dr. Alfredo Lucendo.

The causes can be found in that Spain is the second country in the world in terms of intake of fish per capita per year and there is a high degree of parasitation in most species of regular consumption ”, explains Dr. Lucendo. Although the percentage of affected samples is very variable according to the area of origin and the time of year, more frequently parasitized fish are hake and tuna (almost 100% of hake from the Cantabrian greater than 65 cm, and up to 81% of the beautiful). However, those who produce more episodes of anisakiasis are other fish, which are eaten with less preparation (raw, marinated…), like anchovy, anchovy and sardine. Contrary to what tend to think, Spanish cuisine offers a wide variety of traditional dishes with high risk of Anisakis ”, explains Dr. Lucendo, are fish dishes prepared in oils, vinegar, salted, smoked or pickled ”. Highlights, this specialist, that extreme temperatures tend to destroy the parasite, while the salt, oil, pickled or smoked are procedures that do not show any efficiency on larvae.

There are other marine species infected as crustaceans (lobster, shrimp, crab…) or cephalopods (Octopus, cuttlefish or squid), but which produce fewer infections for its mode of consumption. A species that is saved from infection are Bivalves (oysters, mussels, cockles…) since their mode of feeding (by filtration) prevents the larva to nest in them.

Symptoms and treatment of the anisakiasis

Anisakis infection presents a picture of intestinal disorders by 10% and of these cases 1% leads to allergic manifestations. The most common digestive or intestinal symptoms caused by the presence of the parasite in the stomach or the intestine are nausea, vomiting and abdominal pain, different location according to the point in which the parasite penetrates. Most often is a pain in the pit of the stomach (epigastric) a few hours after ingestion, but pictures obstructive if the parasite reaches the intestine, forcing sometimes surgery of the abdomen may appear. When the infection triggers allergic reactions, these are similar to those produced by the seafood, ranging from mild Urticaria (itching and skin lesions) to more severe anaphylaxis which can cause shock and vital danger.

Only occasionally produced extreme reaction to Anisakis cases as two cases developed in the clinical note published in the Spanish journal of digestive diseases (REED Vol. 104. No. 11, pp. 607-610, 2012).

One corresponds to a woman 55 years old with acute gastrointestinal symptoms and the other a young man of 28 years who presented a strong reaction with abdominal pain a month after ingestion of raw fish. As a curiosity, on the other hand, can be mentioned some cases of occupational allergy to anisakis in fishmongers, in which awareness occurs by contact through hands.
Treatment, once produced the infection, is symptomatic. In cases of digestive clinic primarily used drugs “gastric protectors”, clinic and may disappear if you perform an endoscopy that detect and remove the parasite. But must be fast, the more it takes more difficult is observed in the digestive tract parasite. In case of obstructive clinic, corticoids reduce local inflammation facilitating transit and avoiding surgical intervention. In case of allergic reactions, other than corticosteroids, antihistamines reduce symptoms.

Fundación Española of the digestive (FEAD)

The Spanish Foundation of the digestive apparatus (FEAD) is a private non-profit, created and promoted by the Spanish society of digestive pathology (EDPS), and subjected to the protectorate of the Ministry of education and science. Its main objectives include promoting the digestive health of the Spanish population, campaigns of prevention of digestive diseases through health education of the population, supporting research in Gastroenterology and promote the formation of quality of healthcare professionals in this specialty. This entity also works in international cooperation programmes to the third world.