Chest pain may indicate heartburn
Eating raw fish is generally safe but can sometimes lead to stomachache
Autumn, the season of raw fish, is here. There’s something that makes people who enjoy raw fish feel uncomfortable. It’s Anisakis. It’s a parasite that infests most seawater fish like flatfish, rockfish, squid, mackerel, hairtail, yellowtail, and flatfish. If it enters our body alive, it can be so dangerous that it could lead to death. What’s the safe way to eat raw fish? And just how dangerous is Anisakis?
Kim Ji-min, a fish columnist who runs the famous YouTube channel “Memories of Taste,” says in a video titled “The Real Truth about Anisakis” that there’s no need to worry too much about Anisakis. Why is that?
According to Kim, deworming medicine is useless against Anisakis. The deworming tablet Albendazole that we consume is a drug to eradicate parasites like Clonorchis sinensis, roundworms, hookworms, pinworms, and tapeworms from freshwater fish. However, it doesn’t work well against sea parasites. Of course, if taken continuously, it might have some effect, but it doesn’t have the efficacy to directly and fatally harm sea parasites. Therefore, taking parasite medicine doesn’t help much in eradicating Anisakis.
Even so, the probability of Anisakis entering our mouth alive is almost none. Kim says the chance is the same or even lower than the probability of having an accident while using public transportation. More than 90% of the raw fish we eat is farmed. Farmed fish grow by eating feed that has nothing to do with Anisakis.
Kim says, “If you listen to the stories of friends who run sushi restaurants, they’ve been handling 300 farmed fish a day for years, but there are hardly any cases where parasites are found, except for one or two accidental infections.” He adds, “The probability of parasites in farmed fish is very rare.”
There’s no need to worry too much about Anisakis in wild fish. The chance of parasites that infest wild fish entering our mouths is extremely low. First, most Anisakis infest the intestines, which are removed along with the intestines during the fish cleaning process. Therefore, the chance of eating Anisakis when eating fresh sashimi is low.
However, there’s a possibility that Anisakis could be attached to raw fish through a knife or cutting board in unsanitary places where fish are prepared and grapes are picked with the same cutting board. Also, caution is needed when eating sashimi made from dead fish. For example, you can consider cases where mackerel, eel, or ratfish are put in an icebox brought home, and sashimi is made after 3 to 5 hours. Anisakis can move from the intestines to the flesh if the host fish dies.
Even in this case, there’s no need to worry too much. Anisakis dies when cut thinly during the sashimi-making process. Anisakis that enters the mouth alive without being cut because the sashimi is sliced thick also gets cut into small pieces and dies while chewing. Kim says, “I think the probability of Anisakis entering the stomach alive by breaking through this horrible probability is lower than the probability of having an accident when using public transportation.” However, he adds, “The probability is low, but it’s not 0%. If the 0.01% chance happens to me, it becomes 100%. That’s why a few cases of Anisakis disease occur each year, even though the probability is extremely low.”
According to Kim, Anisakis, those that enter the stomach know instinctively that humans are not suitable hosts to live, so they try to escape by piercing the stomach wall. Kim says, “If you feel severe pain like you’re being pricked around the navel about 4 or 5 hours after eating sashimi, you should suspect Anisakis disease.” He adds, “You should go to the emergency room quickly and remove Anisakis through an endoscopy. If you’re unlucky, a perforation could occur.”
One netizen who watched the video containing Kim’s explanation said, “Anisakis broke through that horrible probability and almost caused a perforation by sticking to my dad’s stomach.”
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