Definition
The term "anisakiasis" or "anisakidosis" is intended to indicate a particular type of parasitosis caused by nematode worms belonging to the genus Anisakis or related genres.
Indeed, "man is an accidental guest for the"Anisakisin fact, the life cycle of these parasites normally takes place in fish and marine mammals.
Causes
As mentioned, anisakiasis is caused by the accidental ingestion of nematode larvae belonging to the genus Anisakis or similar. In particular, the species most involved in the "onset of" anisakiasis is the "Anisakis simplex.
The larvae are found in the intestine of various species of sea fish (herring, tuna, mackerel, hake, cod, swordfish, anchovies, etc.) and are transmitted to humans through the ingestion of raw fish or undercooked and not subjected to a preventive freezing before its consumption.
Symptoms
Once ingested, the larvae reach the stomach and sometimes the intestine of the host, causing symptoms such as abdominal pain, nausea and vomiting. If the larvae make it to the intestines, the host's immune system may react to the infestation with a granulomatous response, causing enteric symptoms similar to those caused by Crohn's disease.
In some cases, moreover, the larvae of Anisakis they can also cause perforation of the gastrointestinal wall.
Other symptoms that may arise in individuals affected by the infestation are diarrhea, anorexia, pain and / or a feeling of heaviness in the stomach.
Finally, the larvae of Anisakis they can be responsible for the onset of allergic reactions in sensitive individuals.These reactions can manifest themselves in the form of urticaria, angioedema, conjunctivitis, asthmatic attacks, contact dermatitis and anaphylactic reactions.
The information on Anisakis - Drugs and Treatment of Anisakiasis is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Anisakis - Drugs and Treatment of Anisakiasis.
Medicines
In some cases, anisakiasis tends to self-resolve and the host individual heals on his own within a few days, possibly taking palliative drugs to help counteract the symptoms caused by the parasitosis.
In other cases, however, it is necessary to remove the parasite from the patient's gastrointestinal tract, even more so if the larvae have caused a serious obstruction in the small intestine.
Removal of the larvae of Anisakis it can take place either through surgery or endoscopically. Where possible, it is generally preferred to remove the parasites through this last method of removal.
In some patients, however, it is possible to eliminate the nematodes through a therapy based on albendazole (an antiparasitic drug), thus avoiding the need for surgery.
However, pharmacological treatment is not always effective and the only solution for anisakiasis remains endoscopic removal or surgical removal of the larvae.
Anisakis in keta salmon meat (above) and in a laboratory slide.
Images taken from: http://fishparasite.fs.a.u-tokyo.ac.jp/
The drug most used in the therapy against anisakiasis and some examples of pharmacological specialties is briefly described below; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient. patient and his response to treatment.
Albendazole
Albendazole (Zentel ®) is an antiparasitic drug - more precisely an anthelmintic - which can be used for the treatment of nematode infestations, such as anisakiasis.
It is a drug available for oral administration in the form of tablets. The dose of albendazole usually used in adults and children over two years of age is 400 mg, to be taken once or twice a day, according to the doctor's opinion.
It should be remembered that elderly patients and patients with hepatic and / or renal insufficiency should be carefully monitored, both before and during treatment with the drug.
In addition, the drug should not be used during pregnancy and breastfeeding, as there are suspicions about its possible teratogenic and mutagenic effect.
Prevention of anisakiasis
However, the best way to defeat anisakiasis remains prevention.
In this regard, it is recommended to freeze the fish for a rather long period (from 15 hours to 7 days, depending on the temperature used) immediately after having caught it, and proper cooking at high temperatures before its consumption.
If the fish is to be eaten raw, however, it should be gutted very quickly after having caught it, in order to prevent the larvae of Anisakis they migrate from the intestine to the muscular masses of the same fish. It should be remembered that the larvae resist the process of smoking, salting and even the preservation of fish in brine.
