This question for many lovers of the fish, my patients, one of the main!The fantico fish can be distinguished from other sick people for a reason: it begins to haggle over what kind of fish can be there are still salt. At the reception I always say that any fish, eat only thermally treated. I hear in the answer: opisthorchiasis and the difillobotrioz in salt-water fish, not salt kills the worms, as the alcohol, in the areas of marine delicacies (calamari, mussels and octopus) parasites do not.
The etiology of the
The causal agents anisacidosis human – larval stage of development of helminths of birth: Anisakis, Contracaecum, Pseudoterranova, Hysterothylacium related to the patrol of Ascaridida Skrjabin et Schikhobalova of 1940, the family Anisakidae Skrjabin et Korokhin, 1945. The end the owners of these helminths serve to many marine mammals, fish and fish eating birds, poultry in the gastrointestinal tract of the parasites in males and females. Hence the name of the disease – anisacidosis.
The average length of the females anisacidosis 60-65 mm, of males is 50-55 mm fusiform Body, model-thin at both ends (the smaller the brain the end). At the end of the anisacidosis there are three lips. The fertilized eggs are dispersed in the water, where one of them comes out the larva, which swallow the first intermediate owners – crustaceans, of the composition of krill, often belonging to the family Euphausiidae.
Additional teachers to serve a lot of fish, molluscs, larger crustaceans that feed on small crustaceans. The larvae in the body intermediate owners are found in the body cavity, on the surface or in the inside of the various internal organs and in the muscles of the fish. Are located within a translucent capsule – cyst, or without them. The dimensions of a cyst on an average of 3 to 7 x1-2 mm.
The infection of the late amos Anisacidosis occurs by eating the infected intermediate owners: fish, crustaceans and molluscs. If larger intermediate owners feed on the smaller ones, which are infected with larvae, these larvae will accumulate in the body larger, predatory fish.
Man is infected by ingestion of fish and seafood containing larvae viable. The disinfection of shellfish larvae is possible to freezing and heating. In the salts, and other solutions used for cooking the fish, the larvae can survive for many days, even months. Freezing fish to -18Con leads to the death of all larvae within 14 days; to the -20S die in a period of 4-5 days; the -30S die within 10 minutes In squid larvae die -40S for 40 minutes;- 32Con 1.5 hours; -20ºC at night.
In the united states and the netherlands-sanitary regulations governing the freezing of the fish, which may not be later heat treatment, at-20ºC for 5 days.
The larvae can migrate the increase of the temperature up to +45 ° C. If the temperature is +60 ° C and above them die in 10 minutes therefore, the smoking of fresh fish, in the temperature range of +45 to 60 ° C does not guarantee the disinfection of the larvae. Immunity is not durable.
Anisacidosis the man for the first time has been diagnosed in holland in 1955, in the last two decades this invasion becomes one of the main problems in parasitology medical. To date, cases of infection registered in many countries of europe, north america, south america, and Southeast asia.
The morbidity of the people has a persistent upward trend in relation with the increase of human consumption of the population of fish, shrimp, squid, octopus, and other sea products, as well as the improvement in the diagnosis of this disease. In 1987, in germany there was a serious precedent in connection with the detection of live larvae in the final product of the herring of the atlantic.
Many fish infected with larvae. So, for example, of 25, up to 100% of the populations of halibut, sole, mate, cod, herring and other fish from the sea of okhotsk surprised them. Not least of which is the level of infection and of the fishes of the pacific and the atlantic. Infection of squid pacific reaches 28%. After the capture of fish in the part of the larvae, which are found in the organs of digestion, to quickly and actively migrates from there to other organs (muscle, caviar, fish roe). Therefore, the gutting and cleaning the fish and shellfish, as soon as possible after their capture decreases the likelihood of infection of the edible parts.
The pathogenesis of the
By penetrating in the intestinal tract of man, the larvae are introduced actively the end in the mucosa and the submucosa shell along its throat to the colon. Most frequently detected in the walls of the stomach and the small intestine. In the place of implantation of the larvae develops inflammation, accompanied by eosinophilic infiltration, edema. In the future, it is possible the formation of eosinophilic granulomas, necrosis, and perforation of the intestinal wall. Inflammatory processes and nervous-reflex reaction can cause intestinal obstruction. Sometimes, the larvae migrate to the gallbladder, the ducts of the liver and pancreas, causing these organs, the inflammatory response and the education of the granulomas. In humans, the parasites before puberty do not develop, and the duration of life is of a couple of weeks before 2-3 months. However, the symptoms of the disease, resulting from the toxic-allergic in exposure of the larvae of helminths in the human body, in particular, and as a result of the formation of the granulomas can be observed over several months and even years.
The incubation period is several hours from 7 to 14 days. To a large extent, the clinical picture, the symptoms of the Anisacidosis based on place of location of the parasites. When the search for larvae in the intestinal lumen, the symptoms can be very scarce. When gastric localization (the most common form of the disease) of the patients annoying pain in the the epigastric, nausea, vomiting, sometimes with blood. Observed low-grade or febrile fever, the development of allergic reactions of type immediate (urticaria, angioedema). In the case of retrograde migration of the larvae from the stomach into the esophagus symptoms such as the pain and irritation of throat, cough. When the intestinal infection of the patients complain of pain in the navel area and on the right side of the field, rumbling, abdominal, flatulence. It is possible the onset of symptoms of acute abdomen, characteristic of appendicitis or intestinal obstruction. The course of the disease may be acute, subacute or chronic.
To serious complications of intestinal parasite refers to perforation of the intestinal wall and penetration of intestinal contents into the abdominal cavity with the development of peritonitis.
The larvae can be detected when the contrast radiography and the endoscopy or the study of infected surgical operations of the parcels of the stomach and the intestine. When fibrogastroduodenoscopy, in the field of the implementation of helminths, is detected edema of the mucosa with multiple points erosions. In the study of the blood reveals moderate leukocytosis, and eosinophilia. Serological tests for diagnosis have not been developed. When coproscopy the larvae or the eggs the larvae are not detected. The identification of the parasite before the species and type is possible in the study of the larvae, remote, when the endoscope or the surgical intervention.
Anisacidosis must differentiate gastric ulcer and duodenal ulcer 12, gastritis, pancreatitis, acute cholecystitis, and tumors. When the form is must to rule out appendicitis, diverticulitis, tumors, colitis and enterocolitis.
The treatment of the parasite is very sparsely developed. There is a little work on the effectiveness of the particular drug. But it is not clear schemes. Again, the lack of a clear treatment should alert the lovers of the fish, and limit its use only after heat treatment.