Watch Out: Could Sushi Have These Intestinal Parasites?

Even some partly cooked foods may pose a hazard — check out some safety tips for home, the neighborhood, and abroad

by Manny Alvarez, MD | Updated 27 Oct 2017 at 1:36 PM

Here in the U.S., where food is certified and regulated, you don’t expect to come away from a restaurant with an intestinal parasite.

However, just because these infections don’t run rampant does not mean that they don’t happen. In fact, several types of intestinal parasites might just be gaining ground in Western countries.

A Sushi Problem
One type of intestinal parasite that may be increasing is often found in sushi. The fact that more cases are occurring in developed areas doesn't mean that more fish are infected. Instead, it reflects people's increased interest in eating raw fish as a meal.

In one case published in the journal BMJ Case Reports, a healthy man from Portugal made a trip to his doctor after more than a week of severe stomach pain. He was also experiencing vomiting and a low-grade fever.

Upon careful evaluation, the doctors discovered that the man had recently eaten sushi. Suspecting a parasite, the doctor performed an endoscopy, where he viewed the man's digestive tract through a tiny tube with a camera.

Sure enough, the parasite anisakiasis had attached itself to the lining of the man's stomach. His symptoms disappeared immediately once the parasite and its larvae were removed.

"Most of the cases were described in Japan due to food habits; however, it has been increasingly recognized in Western countries," the study's authors noted.

With this increased interest in raw food, especially sushi, people should stay aware of safety habits. Experts recommend eating sushi only at high-grade restaurants where workers are sure to have taken important precautions.

A Summer of Cyclospora
Normally, health experts encourage you to eat plenty of fresh produce, but in the case of cyclosporiasis, fresh produce is likely the culprit.

This intestinal illness happens when a person gets infected by the parasite Cyclospora cayetanensis. Thankfully, you can't spread Cyclospora from person to person, but it does spread through contaminated food or water.

The most common symptom to watch for is watery diarrhea that lasts for several weeks. It may also be the cause of cases with prolonged, intermittent diarrhea.

As for the source, not all fresh produce will have this parasite. Infection happens more often in tropical regions; so most U.S. outbreaks are actually related to imported produce such as basil and raspberries.

In addition, reported cases usually increase in the summer months, possibly due to the higher demand of tropical produce. According to the Centers for Disease Control and Prevention (CDC), reported cases of cyclosporiasis more than doubled this year: 206 cases in 2017 versus 88 cases in 2016.

This increase shows that more food and water sources are being contaminated. The CDC recommends avoiding anything that was possibly contaminated by feces. Also, food growers and producers should follow the guides offered by the Food and Drug Administration (FDA) to ensure proper growing, storage and processing procedures.

The Silent Offender
Last, another offending parasite that has caused problems in Western countries is the tapeworm. Different species of the tapeworm can be found in meats like beef or pork, and one species can cause a dangerous infection called cysticercosis.

In the case of cysticercosis, a person becomes infected by swallowing tapeworm eggs from the Taenia solium species. The larvae then infect various tissues, forming cysts in areas like the brain or muscle. This infection is dangerous because it can lead to harmful swelling and seizures.

Many cases of tapeworm infection go unnoticed and unreported due to mild or nonexistent symptoms. Although the CDC estimates about 1,000 cases in the U.S. each year, the actual number may be much higher or lower.

How are most people infected? Although people can get a tapeworm infection through dogs, this route of infection is not very common. Rather, most people become infected by eating raw or undercooked beef or pork.

Typically, Americans have a higher risk if they live in a concentrated or poor community, especially if the sanitation is poor. Areas with more animals have a greater risk as well.

In addition, people may get the parasite through contact with an infected person who has not practiced good hygiene or by traveling out of the country.

Protecting Yourself from Parasites
Although different types of intestinal parasites infect humans through different routes, you can protect yourself through a few general practices:

  • Cook all meat to the appropriate temperatures recommended by the FDA.
  • Eat only at restaurants with a grade A, especially sushi restaurants.
  • Practice good hygiene: regular hand-washing, bathing, proper cycling of worn clothing.
  • Wash and peel all raw fruits and vegetables.
  • When traveling abroad, only drink bottled or boiled water and stay aware of any food safety concerns at your destinations.
  • Generally, intestinal parasites aren't as common in developed countries as in poorer areas. However, people in the U.S. do get these infections, and many may be unaware of this problem.

Through awareness of food safety practices and proper hygiene, you can protect yourself from many types of intestinal parasites and keep your tummy healthy and happy.

Dr. Manny Alvarez serves as Fox News Channel's senior managing health editor. He also serves as chairman of the department of obstetrics/gynecology and reproductive science at Hackensack University Medical Center in New Jersey. This Fox News piece is used by permission; it also appeared at AskDrManny.com.

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