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May 16, 1986

Human Anisakiasis: An Update

Author Affiliations

John A. Burns School of Medicine University of Hawaii, Manoa Honolulu

JAMA. 1986;255(19):2605. doi:10.1001/jama.1986.03370190089026

To the Editor.—  Given the public's continuing fascination with raw seafood delicacies, the editorial by R. E. Fontaine1 on anisakiasis in the United States requires some clarifying comments and an update. Larval anisakid worms frequently do develop beyond the third stage in man. Fourth-stage larvae of Anisakis simplex and Pseudoterranova (-Phocanema) decipiens (Krabbe, 1878, Gibson and Colin, 1982) are frequently found in both the stomach and intestine of man. At least one adult male P decipiens has been recovered from man,2 and I recently identified a partially molted adult male A simplex, which was found in situ attached to the duodenum of a patient suffering acute abdominal pain and vomiting of four days' duration (see below).For those who savor "poisson cru," it is unfortunate but true that not only salmon (Onchorhunchus sp) and herring (Clupea sp) among fish surveyed from US waters regularly have Anisakis larvae in