Occupational disease due to Anisakis simplex in fish handlers

Abstract

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).