One year later, I had another severe pain... Fear of Anisakis allergy and countermeasures June 1 at 6:7
I ate sushi because I wanted to be a little luxurious. That night I woke up with severe pain in my abdomen.
The cause is the parasite "Anisakis".
Moreover, I had no idea that it would become an allergy and the symptoms would repeat. I started interviewing him because of a physical change.
(Good morning Japan Director Yuichiro Okawa)
Anisakis is the number one cause of food poisoning
Last spring, a pleasant holiday.
At a sushi restaurant near my home, I took out nigiri sushi and ate it with my family. There were 9 kinds of squid, flounder, and toro, which are my favorites.
I fell asleep feeling satisfied, but at dawn I woke up with severe abdominal pain. Intermittent pain near the solar plexus. I can't help but squirm.
If you go to the hospital and have an endoscopy of your stomach ... Was! It's Anisakis.
Anisakis larvae parasitize fish and shellfish such as mackerel and horse mackerel, and are about 2 to 3 centimeters long. When it enters the human body, it pierces the stomach and intestines, causing severe abdominal pain and vomiting. This is the "anisakiasis" of food poisoning.
In my case, I was able to remove Anisakis in my stomach with an endoscope. The pain subsided quickly, but the stomach upset continued for about three days. If it enters the intestines, there is a risk of intestinal obstruction.
Anisakis that enters the body dies in about a week.
Last year, 1 cases of Anisakis food poisoning were reported to the Ministry of Health, Labour and Welfare, including mine. This is the highest number since the current tabulation began in 1 and has been on an increasing trend over the past decade. In addition, Anisakis accounts for 566% of the total number of food poisoning cases.
According to Hiroshi Sugiyama, a visiting researcher at the National Institute of Infectious Diseases, only a small percentage of the cases are reported to the Ministry of Health, Labour and Welfare, and based on an analysis of medical fee records, the number of patients per year is estimated to be as high as 2013,10.
Symptoms repeated? Anisakis allergy
I had no idea that the real horror of Anisakis was beyond food poisoning.
This April, I ate sushi again. Then I had a similar abdominal pain as last year.
I felt that the symptoms such as stomach upset appeared earlier than before. When I put up with it, I calmed down, so I didn't go to the hospital right away.
"Anisakis" came to my mind, but as I researched various things on my smartphone, I learned about the existence of "Anisakis allergy".
Anisakis allergies can also be caused by parts of Anisakis' body, secretions, and residues after heating, and symptoms may be repeated.
I was more worried about this one, so I decided to go to the hospital.
We visited Showa University Hospital, which has a department specializing in allergies. Associate Professor Shintaro Suzuki has seen more than 500 patients with Anisakis allergies.
At the medical examination, I was asked about detailed symptoms after eating sushi, family history of allergies, and other unexpected things.
Dr.
Suzuki: Do you have any hobbies such as fishing, marine sports, or scuba diving?
Once a month, to go or not to go."
According to Dr. Suzuki, Anisakis allergy often develops in people who have many opportunities to touch sea fish, such as sushi chefs, people who prefer meals with seafood, and people who fish and do marine sports.
Since I was experiencing my second symptoms, I suspected an Anisakis allergy and had a blood test. It examines the amount of "IgE antibodies" that react to Anisakis and cause allergies.
About a week later, the results were known.
If it were normal, the number would basically be zero, but I had an Anisakis item of "24.8", which was judged to be "Class 4", which was the third from the top of the seven levels.
There were no noticeable figures for the other items.
Dr
. Suzuki: "I wonder if it is okay to identify it as an Anisakis allergy this time, and I will have to live so that the level of this IgE antibody decreases in the future."
Dr.
Suzuki: "If the IgE antibody level is high, we must think that abdominal pain may recur."
Blood test readings are a measure of how likely an allergic reaction is to occur, and symptoms vary from person to person.
There are people like me who have abdominal pain and vomiting, and people who have chronic hives.
Anaphylactic shock can be life-threatening
Anisakis allergy can also lead to life-threatening "anaphylactic shock."
Dr
. Suzuki: "In severe cases, anaphylactic shock is a sudden symptom, and in some cases, blood pressure drops, consciousness is lost, and in some cases, some people are on the verge of dying."
Anaphylactic shock is also known to occur when a bee stings, but it also occurs in Anisakis. Moreover, it has become clear that there may be a surprisingly large number of patients.
Dr. Suzuki and his colleagues examined more than 2020 adult patients who visited Showa University with anaphylaxis (severe allergic reactions) in the 10 years to 500.
About 4 in 1 people, or 23.3%, were caused by Anisakis. This is second only to the 25% of well-known food allergies to wheat and crustaceans. Especially after the age of 40, the proportion of Anisakis is the highest.
Anisakis allergies may not be fully recognized by emergency doctors, and may be overlooked as a cause.
Dr
. Suzuki: "When I looked it up, I found that the number of people who were allergic to Anisakis has been increasing recently. It seems that there are many potential patients who are experiencing symptoms but are unaware of the cause and leave it as it is. How many patients are there and what kind of condition are they? Medical researchers and the government don't have a good grasp of it."
Neither "grilled fish" nor "seafood stock" is good Patient suffering
The pain of Anisakis allergy is also due to the fact that the diet is severely restricted for treatment and prevention of recurrence. Especially once a patient has anaphylactic shock, their lives change completely.
Five years ago, Naoyuki Sato, a 62-year-old company owner living in Tokyo, suddenly experienced nausea and difficulty breathing at home after eating marinated fish at an Italian restaurant.
Naoyuki Sato
: "I felt like my trachea was narrowing and I couldn't breathe, so I rushed to call my family, and when they saw my face, they said, 'What?' By the time I arrived at the hospital, my blood pressure had dropped so much that it was about 60 at the top and 20 at the bottom. It was pretty dangerous."
Diagnosed with anaphylactic shock at the hospital and admitted. Later, I found out that the cause was an Anisakis allergy.
What I was forced to do was strict dietary restrictions. If symptoms reappear, the reaction will become even more violent, which is life-threatening.
Mr. Sato's lunch on the day of the interview consisted of salad, chicken breast, tofu, and brown rice. This is a standard menu. There is no seafood in it.
Even when heated, Anisakis retains some substances that cause allergic reactions. For this reason, Sato was instructed by his doctor to avoid not only raw fish, but also grilled fish, boiled fish, and seafood-based dashi.
Since many seafood may contain Anisakis, it is difficult to choose the type that can be eaten.
In fact, Mr. Sato used to be known as a foodie who published more than 10 books on gourmet food and travel. In particular, I liked seafood so much that I went to sushi classes because I wanted to make it myself.
Naoyuki Sato
: "I was just going to a sushi class, and I loved fish so much that I wanted to enjoy it for the second half of my life while judging and holding fish, so I never thought I would ever go to sushi restaurants, kappo restaurants, and izakayas. I was shocked, I didn't know what it was."
Establishment of a patient group to raise awareness of Anisakis allergy
Mr. Sato was deprived of the joy of food. Wanting to have friends with whom he could share his painful experiences, he established the Anisakis Allergy Association, an organization in which patients and others participate. Currently, there are about 100 members.
Feeling a sense of crisis about the lack of information on Anisakis allergies, he worked with doctors to create a website that summarizes basic information on the web. There are also weekly online meetings.
Naoyuki Sato
: "Japan is a fish-eating country, and I think the problem is that there are surprisingly hidden Anisakis allergy sufferers, but awareness and awareness are not progressing. If things go wrong, they can be life-threatening, so I think it's important to reduce the danger."
To prevent allergies First prevention
According to Dr. Suzuki, the onset of Anisakis allergy may be triggered by Anisakis being stuck in the stomach, but the mechanism has not been elucidated.
At present, as with food poisoning, the countermeasure is to thoroughly remove Anisakis from seafood and kill it.
Here's how to do it:
The way to reliably prevent it is heating. It dies immediately at 70 degrees or more, and in 60 minute at 1 degrees.
▽ In the case of raw food, freeze at -20 degrees Celsius or less for at least 24 hours.
If not frozen, buy fresh fish and remove the internal organs immediately. And look closely. * However, with this method, you may not notice the anisakis that has entered the muscles (body) and may remain.
Be careful with vinegar, wasabi and salt, as normal amounts do not kill you and are not preventive.
Even in Europe, where there is a culture of eating raw fish such as marinades and carpaccio, Anisakis has become a problem. EU = European Union requires that natural fish be frozen when served raw as a countermeasure.
Land-based aquaculture attracting attention
Land-based aquaculture is attracting attention as one of the ways to eat without worrying about getting allergic to Anisakis. In addition to venture companies, the major JR West Japan Group and JGC Corporation, as well as Japan Fisheries and Hitachi Zosen are jointly entering the business or are considering it.
Wild mackerel is said to be parasitic in the sea, so by cultivating it without going through the sea, they are trying to sell that they can be safely eaten raw.
In Kamikawa Town, located in the mountains of Saitama Prefecture, land-based aquaculture has also begun. When you throw food into a large tank, mackerel nearly 30 centimeters in size jumps at you.
Artificially hatched fry are raised in water that has been adjusted to the same components as seawater. The food is made of hardened fish meal, etc., and there is almost no risk of parasites such as Anisakis entering alive.
Aquaculture is carried out at a day-trip hot spring facility right next door. We started the business two years ago because we thought that we could apply hot water circulation technology. Shipments are scheduled to begin on June 2, and will be offered at restaurants at hot spring facilities and some fish shops.
Natsumi Kamata
: "The advantage is that there is less risk of parasites, and I would like to disseminate the raw mackerel culture from this mountainous town of Kamikawa. We want to expand the scale of production and create brand fish that are familiar to people in this area."
However, land-based aquaculture is an issue due to the high cost of equipment and electricity, and the distribution volume is still limited.
Understanding risks to protect food culture
This time, I myself became allergic to Anisakis. The proposed treatment was to avoid seafood as much as possible for six months. If this reduces the amount of antibodies that cause allergic reactions, abdominal pain and hives are less likely to occur.
Still, I love sashimi and grilled fish. I'm scratching my head. I couldn't believe that this could happen with just 2 cm of Anisakis...
In recent years, due to the development of distribution networks in Japan, natural seafood has been distributed throughout the country without freezing.
While there is a benefit of "eating fresh fish," it is difficult to say that consumers have fully understood the risks of eating it raw.
Major conveyor belt sushi chains have taken basic measures such as using frozen seafood, and supermarket fish sections are also taking measures such as displaying any risk of Anisakis.
I felt that the eaters also needed to know a little more about the fish in front of them in order to enjoy them safely and deliciously.
Good morning Japan Director
Yuichiro OkawaJoined
the Aomori Bureau in
2011 and covered the fishing industry as a reporter at the Tokyo Economic Department, loves
squid