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Chapter: Modern Medical Toxicology: Food Poisons: Food Poisoning

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Parasites - Food Poisoning

Japanese Restaurant Syndrome.

Parasites

While a number of intestinal parasites are responsible for producing periodic diarrhoea and malabsorption states in humans, only those responsible for a specialised condition referred to as “Japanese restaurant syndrome” will be discussed here.

Japanese Restaurant Syndrome.

Source

Raw fish (popular culinary delicacy in Japanese cuisine).

Aetiological Agents

·      Roundworm (Eustrongylidis anisakis)

·      Fish tapeworm (Diphyllobothrium species)

Clinical Features

Anisakiasis or Eustrongylidiasis—After an interval of 1 to 2 hours following consumption of fish, the following symptoms occur: nausea, vomiting, and crampy abdominal pain. Perforation of intestinal wall is possible due to inva-sion of larvae, resulting in severe localised abdominal pain mimicking appendicitis. Diagnosis can be established by visual inspection of larvae on endoscopy, laparotomy, or pathological examination.

Diphyllobothriasis or Fish tapeworm disease—After an interval of 1 to 2 weeks following consumption of fish, the following symptoms occur: nausea, vomiting, abdominal cramps, flatulence, diarrhoea, and megaloblastic anaemia.

Diagnosis can be made by identification of tapeworm proglottids in stool.

Treatment

Niclosamide, praziquantel, or paromomycin may be effective.


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