Not so long ago in Russia appeared the form of helminthiosis, not typical for this part of the Earth. Anisakidosis is most often found in countries along the sea or ocean coast. In the diet of people living in them, fish predominate. It is in it that the anisakids settle( they are depicted in the photo) - worms from the class of nematodes parasitizing the gastrointestinal tract of the host. The first case of human infection was recorded in 1955 in the Netherlands. The patient ate a lot of slightly salted herring. The consequences were deplorable. The patient could not be cured. Why did a person become infected with such nematodes? Why anisakidy proved to be dangerous for him? What you need to do to prevent the consequences? The answers in this article.
As mentioned above, anisakidosis is an infestation common in coastal countries. Any of us is invaded by these nematodes when eating the infected fish. Until recently, cases of invasion were detected only in the Far East and Kamchatka. Now the invasion has penetrated into the central regions of Russia. And all because of the wide popularity of Japanese cuisine in the world. Sushi and rolls are already firmly in the diet of the modern Russian. At the heart of these dishes is a well-salted, but raw fish, which becomes the main source of the disease. Scientists say that in the Sea of Okhotsk almost all herring and chum( 100%) are struck by the larvae of anisakid. And this is the norm, and not an exception to the rules. Untimely treatment often leads to death of patients. That's why there is a raw fish is very dangerous. Anisakidosis is not transmitted from person to person.
Why does anisakidosis occur?
Anisakids( pictured) - round worms of small size. Their body looks like a spindle, instead of a parasite's head there is a huge mouth consisting of three lips. A sexually mature female lays eggs in the intestines of the final host. Eggs go out together with feces. Invasive, they can become when they get into the pond. There larvae hatch from eggs. They mature, they grow up to four centimeters in length. They are easily swallowed by river, lake or sea fish( herring and chum including).Inside fish, mollusks or crustaceans, the larvae are dangerous to humans. Invasion occurs precisely with the larvae of anisakid. They are very tenacious. They can die only at a temperature of +60 degrees. Not afraid of larvae and cold, only at -30 ° C they can die. That is why salting and smoking, prolonged freezing are not able to protect a person. Anisakids enter the body together with food, they do not spread through all internal systems, like ascarids, settle and parasitize in the intestine. Their livelihoods can be dangerous, and that's why.
Pathogenesis of anisakidosis
What happens when the anisakid larvae that are in the fish get into the human body? They easily overcome the acidic environment of the stomach, and settle in the lower parts of the small intestine, some of them get into the large intestine. In order to gain a foothold, they bore the walls of the mucous membrane of hollow organs and literally bite into it, damaging the integrity of the shell. This leads to the formation of inflammatory processes and edema.
Anisakidosis often causes intestinal obstruction. This pathology is possible because of the formation of granulomatous or eosinophilic infiltrates. Infiltrates often lead to perforation of the intestinal wall. And this is the direct way to the onset of peritonitis. The products of the vital activity of parasites lead to the formation of a large number of toxins. They give impetus to the development of such phenomena as general intoxication of the body and allergy, and it is extremely difficult to treat them.
The main symptoms of anisakidosis
In the first stage, immediately after the lesion, within one two weeks the disease does not manifest itself in any way. Symptoms appear later, when the larvae are firmly fixed within the new host. Manifestations of anizakidosis depend on where the larvae accumulated most.
If anisakids penetrate the stomach, the patient may complain of the following symptoms:
- Pain in the abdomen. They are of an incomprehensible nature: it is difficult to determine exactly where it hurts, what character such feelings are. Pain is not always acute, which is why an ordinary person reacts to a change in state not immediately.
- Frequent vomiting. Sometimes they end in severe vomiting. If there are blood clots in the vomit, this is a true symptom of the presence of anisakid. The main thing is that the clots were in small quantities.
- Skin rashes, similar to hives. An allergic reaction can be localized anywhere. If the rash is accompanied by swelling, this is a true symptom of anisakid.
- Increased body temperature and signs of fever may also indicate anisakidosis.
- Pain in the chest, cough and swelling in the throat.
The presence of two or three symptoms at the same time is an excuse to call a parasitologist or helminthologist and start treatment on time. If there are no polyclinics in the state, a gastroenterologist or therapist can replace them.
In the intestinal form of anisakidosis, the patient has the following complaints:
- Abdominal pain with a clear localization near the navel. They are sharp and intense.
- Constant rumbling in the abdomen, accompanied by flatulence.
- Disturbance of the stool in the direction of diarrhea. In fecal masses, mucus and minor blood clots are present.
When the described symptoms are acute, there is a risk of dangerous complications( intestinal obstruction, peritonitis, inflammation of the peritoneum).The photo shows how the anatomy of the intestine can change during severe forms of invasion. If you ignore such a clinical picture and untimely referral to a doctor, a fatal outcome is possible.
Diagnosis of anisakidosis
As mentioned above, if several of the above symptoms are exposed, you should immediately contact a specialist. To confirm the diagnosis, the doctor will certainly conduct several laboratory tests capable of detecting antibodies to anisakids. The following measures identify the form of the disease and, according to the results, a clear treatment scheme is made:
- Collecting information about whether the patient has eaten fish or seafood delicacies that have not undergone proper heat treatment in the recent past. The doctor should understand where the patient could get infected, what fish he ate, whether he was in countries located in endemic foci.
- A differentiated study of the causes of the appearance of the existing symptoms: whether there is helminthic invasion or into the disease of the gastrointestinal tract.
- Laboratory tests( vomiting, blood and stool tests, revealing the presence of larvae, analysis for antibodies to anisakidosis).The photo shows how the material is checked.
- The patient must be offered to undergo fibrogastroduodenoscopy - a procedure that reveals mucosal edema, the presence of intestinal erosions. Anisakids are seen with gastroscopy.
A summary of the findings is the first step towards effective treatment.
Features of the treatment of anisakidosis
When answering the question how to get rid of anisakidosis, than to treat the described invasion, physicians pay attention to the necessity of drug therapy. At the started stages the operation is also applied. The decision to choose a method is taken after the diagnostic measures listed above.
Antiparasitic drugs of a wide spectrum of action are effective at the initial stages of anisakidosis. Treatment of anizakid Vermox, for example, always shows good results. Macmirror also helps to eliminate the cause of the invasion. For recovery, as a rule, short courses are needed. And this is very encouraging, because any antihelminthic drug is toxic.
Surgical treatment is justified when there is a suspicion that anisakidosis has led to the appearance of the above complications. Today, any such operation is performed in minimally invasive ways, so the patient is recovered very quickly after the operation. Any treatment, if it was undertaken in a timely manner, allows you to give positive predictions.
Prevention of anisacid
Knowing how to treat anisakidosis, you can try to react in time to the emergence of characteristic symptoms and take certain measures. But the described helminthiasis is not difficult to prevent, adhering to certain rules. Prevention of the disease is simple:
- You should not eat lightly salted fish and sea delicacies if they were cooked at a temperature below +60 degrees. You can eat dishes cooked in the oven or on an open fire.
- On fishing, when fishing alone it is important to gut the fish right there at the shore and carefully look at the contents of the intestine.
- For cutting fish it is always necessary to use a separate knife and a separate cutting board. Anisakid larvae are very tenacious. They are able to remain viable for two weeks at a temperature below -18 degrees. The harmful plus temperature should exceed +61, so the usual cleaning of the cutting tools can not protect against invasion.
With more rigorous care, doctors recommend that you follow preventive measures during pregnancy. Since anisakidosis is treated with highly toxic drugs, drug therapy can not be applied to those who expect the baby to be born. Therefore, during pregnancy, you can not eat salted, smoked, frozen and pickled seafood. It is better to completely abandon the use of dishes indicated on the photo, as well as from products made from raw fish( chum including).This is the main and basic rule with which it is best to put up within nine months of bearing the fruit and then, during lactation. If you ate the infected fish, you will have to decide the issue of abortion.
Is it possible to cure anizakidosis by eliminating all its symptoms? From all of the above, it is not difficult to understand that it is easier to get rid of the described disease in the early stages. That's why the material for the article is very relevant for fans of marine delicacies.