Gastric Anisakiasis in Japan

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General Survey of Anisakis and Anisakiasis in Japan

  • H. Ishikura

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A major health hazard associated with the eating of raw fish has been attributed to parasitic infections. Anisakiasis has recently become a leading problem in Japan. Anisakiasis is a disease caused by an infection of Anisakinae larvae, which are the visceral larva migrants following an infection by Anisakis larvae or related nematodes. It occurs when the live larvae are taken into the human gastrointestinal tract by eating raw, infected fish, in which the larva is in either stage III or IV. It causes pain, and often the pain is so severe that the patient is treated for acute abdominal pain, although the disease is by no means fatal. Anisakiasis was first reported by van Thiel et al. in 1960 in the Netherlands [1], and it has subsequently been reported in the Netherlands [2–4], Japan [5], England [6, 7], the United States [8], as well as other nations. In Japan, as early as 1957, Otsuru et al., who paid particular attention to a study on visceral larva migrants by Beaver [9], raised the possibility that there might also be many cases of visceral larva migrants in Japan, because Japanese eat a great deal of raw fish [10]. The suspicion of Otsuru et al. was followed by findings of patients with anisakiasis by Nishimura in 1963 [5], Asami et al. in 1964 [11], and then Ishikura and Kikuchi in 1967 [12]. The Special Scientific Research Group of the Ministry of Education, founded in 1964 and led by Otsuru, performed nationwide investigations of the disease, contributing much to the understanding of anisakiasis in Japan. Reports on the disease were continuously published in Japan, while Oshi-ma wrote two papers [13,14], one of which presented detailed Japanese research findings on the disease to the rest of the world [14]. The earlier studies resulted in nationwide recognition of the disease, and there have been more than 1200 papers, in which over 4000 cases of gastric anisakiasis are reported. In the following sections of this chapter, the historical events in the studies of Anisakinae and anisakiasis in Japan will be briefly reviewed. For readers convenience, I put the map of Japan, including occurrence of anisakiasis and representative fish that cause most cases of the disease in the area (Fig. 1).