Publisher Summary This chapter reviews the literature on Anisakis, including use of the nematode as a biological tag in applied fishery science. The genetic diagnosis of Anisakis is presented as: three lips, each bearing a bilobed anterior projection, which carries the single dentigerous ridge; interlabia absent; excretory gland with duct opening between ventrolateral lips; oesophagus with anterior muscular portion (preventriculus) and posterior ventriculus, the latter being oblong and sometimes sigmoid or as broad as long; no oesophageal appendix or intestinal caecum; vulva in middle or first third of body; spicules of male unequal; preanal papillae numerous; postanal papillae including a group of three or four pairs set close to the tip of the tail on the ventral side. While euphausiids appear to be important crustacean hosts of Anisakis at least in offshore areas, further is required to show other crustaceans to be significant, possibly in inshore waters. Further investigation may show squid to be of greater significance in the transmission of Anisakis to final hosts than the literature indicates, bearing in mind the importance of squid in the diet of many cetacean species. Several aspects of development remain obscure. In view of the taxonomic importance of the “excretory system” in ascaridoid nematodes, its physiological functions are poorly understood; Anisakis may prove to be a useful experimental model for investigation of these functions. With regard to accidental infection of man with Anisakis, further study might be made of a possible allergic predisposition to severe gastrointestinal reaction.

Anisakis and anisakiasis

This review addresses the biodiversity, biology, distribution, ecology, epidemiology, and consumer health significance of the so far known species of Anisakis, both in their natural hosts and in human accidental host populations, worldwide. These key aspects of the Anisakis species' biology are highlighted, since we consider them as main driving forces behind which most of the research in this field has been carried out over the past decade. From a public health perspective, the human disease caused by Anisakis species (anisakiasis) appears to be considerably underreported and underestimated in many countries or regions around the globe. Indeed, when considering the importance of marine fish species as part of the everyday diet in many coastal communities around the globe, there still exist significant knowledge gaps as to local epidemiological and ecological drivers of the transmission of Anisakis spp. to humans. We further identify some key knowledge gaps related to Anisakis species epidemiology in both natural and accidental hosts, to be filled in light of new 'omic' technologies yet to be fully developed. Moreover, we suggest that future Anisakis research takes a 'holistic' approach by integrating genetic, ecological, immunobiological, and environmental factors, thus allowing proper assessment of the epidemiology of Anisakis spp. in their natural hosts, in human populations, and in the marine ecosystem, in both space and time.

Molecular Epidemiology of Anisakis and Anisakiasis: An Ecological and Evolutionary Road Map.

National surveys on the prevalence of intestinal parasitic infections have been carried out every 5-7 years since 1971 in the Republic of Korea in order to establish control measures. The present nationwide survey was conducted from June to December 2004. The 10% population sampling data of Population and Housing Census by the Korean government in 2000 was used as the survey population. One sample was selected randomly from each of the 22,858 registered subjects, and a total of 20,541 people were ultimately included in this survey. Fecal examinations were performed by the cellophane thick smear and saturated brine flotation techniques. Pinworm infection was examined by cello-tape anal swab method. This survey also included a questionnaire study for a socioeconomic analysis. The total helminth egg positive rate was 3.7%, and the estimated total positive number among nationwide people was 1,780,000. The rates in urban and rural areas were 3.1% and 6.8%, respectively. As the total egg positive rate in the 6th survey in 1997 was 2.4%, the present survey showed that there was a considerable degree of increase in the prevalence rate of intestinal parasitic infections over the 7-year period following the 6th survey. The largest increases occurred in the egg positive rates of Clonorchis sinensis and heterophyids including Metagonimus yokogawai.

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A Nationwide Survey on the Prevalence of Intestinal Parasitic Infections in the Republic of Korea, 2004

Epidemiological surveys concerning cestodes of medical importance in Korea have been sporadically reported by many workers. Among various parasitic infections, cestode infections occur less frequently than other helminthiases, but they often cause serious clinical complications. Cestodes reported so far in Korea belong to the Order Pseudophyllidea or Cyclophyllidea (Subclass Cestoda), i.e., Diphyllobothrium latum, D. yonagoense, Spirometra erinacei, sparganum, Hymenolepis diminuta, H. nana, Mesocestoides lineatus, Taenia saginata, T. solium, metacestode of T. solium (cysticercus), and Echinococcus granulosus. The present paper is a brief review of the literature concerning these cestode infections in Korea. Taeniases by T. saginata or T. solium are prevalent cestode infections in Korea, and cysticercosis by T. solium often reveals serious clinical manifestations. H. nana infection is relatively rare, showing 0.22% egg positive rate in a nationwide survey in 1986. Sparganosis by the plerocercoid larva of Spirometra is not an uncommon cestode infection in man, and 16 kinds of animal hosts including the snakes and frogs have been reported. D. latum infection has been an uncommon intestinal parasitosis, but it tends to increase nowadays. Most of human hydatidosis cases have been recognized as imported ones from outside Korea, but one case was proven indigenous. Other 4 kinds of cestodiases are extremely rare in Korea and only a few cases have been recorded.

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Cestode infections in Korea.

Anisakidae larvae can cause anisakiasis when ingested by humans. Although several groups have reported a gastrointestinal Anisakis allergy among people in Spain and Japan, our report is the first to summarize the clinical features of 10 Anisakis allergy cases in Korea. We enrolled 10 Korean patients (6 men and 4 women) who complained of aggravated allergic symptoms after ingesting raw fish or seafood. Sensitization to Anisakis was confirmed by detecting serum specific IgE to Anisakis simplex. The most common manifestation of anisakiasis was urticaria (100%), followed by abdominal pain (30%) and anaphylaxis (30%). All patients presenting with these symptoms also exhibited high serum specific IgE (0.45 to 100 kU/L) to A. simplex. Nine patients (90%) exhibited atopy and increased total serum IgE levels. The fish species suspected of carrying the Anisakis parasite were flatfish (40%), congers (40%), squid (30%), whelk (10%), and tuna (10%). Anisakis simplex should be considered as a possible causative food allergen in adult patients presenting with urticaria, angioedema, and anaphylaxis following the consumption of raw fish or seafood.

The Clinical Characteristics of Anisakis Allergy in Korea

A survey of intestinal parasites infection among Korean people has been carried out during July 1969 to December 1970. A total of 2,250 stool specimens (male 1,101, female 1,146) was collected from all the provinces and Seoul city in Korea. The specimens were examined routinely by direct fecal smear, zinc sulfate flotation and formalin-ether sedimentation techniques. The results are summarized as follows: 1. Of 2,250 specimens examined, l,803(80.l %) were positive for intestinal parasites. 2. The positive rates of intestinal helminths were 1,644(73.1 %) among 2,250; Ascaris lumbricoides 46.0 %, Trichocephalus trichiurus 46.8 percent, hookworm 6.8 %, Trichostrongylus orientalis 7.0 percent, Clonorchis sinensis 12.1 percent, Enterobius vermicularis 1.6 %, Hymenolepis nana 0.7 percent, Taenia species 0.3 %, Metagonimus yokogawai 0.04 percent, Fasciolidae 0.04 % and one case of lung fluke Paragonimu westermani. 3. The positive rstes of intestinal protozoa were 786(34.9 %); Entamoeba histolytica 6.4 %, Entamoeba coli 20.5 percent, Endolimax nana 10.0 %, Giardia lamblia 5.1 %, Trichomonas hominis 1.1 percent, Chilomastix mesnili 0.5 percent, Iodamoeba butschlii 0.6 percent, Enteromonas hominis 0.7 percent, Dientamoeba fragilis 0.1 % and one case of Isospora hominis. 4. Sexual distribution of helminths and protozoan infections showed higher rate in female than that of male, except C. sinensis, H. nana, Taenia species or G. lamblia. 5. Infections of T. trichiurus, hookworm, T. orientalis, C. sinensis, Taenia species, E. histolytica, E. coli and E. nana increased with age. Conversely, H. nana and G. lamblia infections were more predominent in younger ages.

Prevalence Of Intestinal Parasites In Korea

Authors experienced a case of human infection with Anisakis sp. in left tonsil. The case was 27 year Korean female who visited Department of Otolaryngology, Severance Hospital with the chief complaints of swollowing difficulty, and the sensation of a foreign body in the throat, on November 20th 1968. Physical examination of the oral cavity revealed that both palatin tonsil were chronically enlarged. A larval worm was found in crypt of the upper portion of the left palatin tonsil. Chief complaints of the patient was improved after removal of it by forceps. The greyish white living worm was fixed in lactophenol solution for morphological study. The worm measured 36 mm in length by 0.6 mm in width, 2.4 mm in esophageal length, 1.4 mm in ventricule, 0.1 mm in tail length, and 0.025 mm in caudal spine length, respectively and histological study was carried out from the serial section of the larva which was stained with hematoxylin eosin. Authors identified that the larva was Anisakis species.

A case report on human infection with Anisakis sp. in Korea

A single dose of Tetramisole, 2.5 mg/kg body weight, was given to the infected cases of intestinal parasites. The number of cases were: Ascaris lumbriocides 96, hookworm 16, Trichostrongylus orientalis 10, Trichocephalus trichiurus 114 and Clonorchis sinensis 19. No dietary restriction before and after the administration of Tetramisole was required. 1. In Ascaris infection the egg negative conversion rate and the egg reduction rate were 92.7 per cent and 99.5 per cent, respectively. 2. In Trichostrongylus orientalis infections, 9 out of 10 cases were resulted egg negative after the single dose of Tetramisole, and hookworm, 12 out of 16 administered showed egg negative. However, there were no appreciable effectiveness to the cases of Trichocephalus trichiurus and Clonorchis sinensis. 3. Mild and transient side effects were noted in 75 cases (54.5%) out of 140 cases. The main symptoms were dizziness (25.5%), anorexia (25.5%), abdominal pain (18.6%), diarrhea (16.6%), headache (15.2%), nausea (14.4%) and fever (11.0%). From the above results, it is anticipated that Tetramisole is an effective anthelminthic for elimination of Ascaris, Trichostrongylus and hookworm.

[Anthelminthic Effectiveness Of 2,3,5,6-Tetrahydro 6-Phenyl-Imidazole (2,1-B) Thiazole Hydrochloride (=tetramisole) Upon Intestinal Parasites]

Ultrastructural studies on the integument of digenetic trematodes were investigated by several workers (Senft et al., 1961; Bjorkman and Thorsell, 1964; Burton, l966; Erasmus, l968; Morris and Threadgold, 1967, l968). Clonorchis sinensis is a common parasite of human beings in the Far East. But as far little has been written on ultrastructure of the integument of this parasite. This study was carried out systematically to elucidate the ultrastructure of the integument of adult C. sinensis, and the results are summarized as follows: 1)The integument of C. sinensis was organized in two parts; the epidermis and the muscular layer. 2)The apical surface and basal surface of the epidermis were covered with typical plasma membrane and irregularly invaginated from the surface. Plasma membrane at perisuckers was extremely folded and appeared as if the epidermis might be divided with the layer. 3)The syncytial epidermis contained mitochondria and numerous secretory bodies, and which was connected by cytoplasmic processes to nucleated epidermal cells lying in the parenchyma. 4)The mitochondriae, the secretory bodies, the granular endoplasmic reticulum, the Golgi bodies and the free ribosomes were present in the perinuclear cytoplasm of epidermal cells, but no organelle was observed in processes of epidermal cell except some secretory bodies. 5)The fibrous layer consists of argentophile fiber and collagenous fiber, in which the circular muscle bundles and longitudinal muscle bundles were embedded. Bundles of muscle fiber are well developed at the perisucker, and mitochondriae in this portion contain many cristae as compared with any other parts of C. sinensis.

Ultrastructure of the integument of adult Clonorchis sinensis

In Korea where night soil used as fertilizer for crops and vegetables they may be contaminated simultaneously with infective stage of ascaris, hookworm and other helminthes In this circumstance, the ascaris eggs and hookworm larvae may adhere to certain kinds of leafy vegetables(Chyu, 1957) and may remain viable even after pickling in brine or in other substances (Han and Ko, 1952; Soh, 1960) It has been shown that Heliogen(Thitasut, 1961) will kill the parasite eggs and larvae, and Sodium nitrite (Kozai, 1960; Kim and Soh 1964) and Thiabendazole (Kutsmi, 1964 and 1965; Kim et al, 1966) also had ovicidal action The present study has been planned to study the ovicidal and larvicidal actions of several chemicals in Korean pickle juice(Kimchi) and the results are summarized as follows: 1 Heliogen solution(iodine 100 ppm) did not destroy the ascaris and hookworm eggs within 30 minutes at the temperature of 15-30 degrees C, but the hookworm larvae were killed within 3 minutes under the same conditions Sodium nitrite which was added to pickle juice at the rate of 01 % destroyed more than 90 % of ascaris fresh eggs within 10 days and the embryonated eggs were destroyed within 2 days Hookworm eggs were destroyed within 3 days and larvae were killed within 7 hours 3 Thiabendazole which was added to pickle juice at the rate of 01-0025 % inhibited the infectivity of ascaris embryonated eggs within 24 hours and hookworm eggs were destroyed in the same concentrations of the reagent 4 Hydrogen ion concentration of pickle juice which was mixed with Sodium nitrite (01 %) was not changed for 10 days 5 15 mg of Sodium nitrite or Thiabendazole produced no toxicity in kidney and intestine of mice but slight pathological changes in the liver of the same animal

Chong Hwan Kim

Papers

Prevalence Of Intestinal Parasites In Korea

A case report on human infection with Anisakis sp. in Korea

[Anthelminthic Effectiveness Of 2,3,5,6-Tetrahydro 6-Phenyl-Imidazole (2,1-B) Thiazole Hydrochloride (=tetramisole) Upon Intestinal Parasites]

Ultrastructure of the integument of adult Clonorchis sinensis

Action of several chemicals on the parasites eggs and larvae in Korean Pickle(Kimchi)