Cases of puffer fish poisoning should be treated by maintaining adequate
respiration, circulation and renal functions. There is some evidence that
recovery of muscle power is accelerated by administration of an
anticholinesterase (Torda et al., 1973 as cited in Kantha, 1987).
From 1972 to 1974, there was one outbreak, involving two cases, of puffer fish poisoning reported to the CDC (Horwitz, 1977). According to USFDA reports there are an average of 19 fatalities from puffer fish poisoning in Japan each year (Anonymous, 1989). Other sources report that puffer fish toxicity is the number 1 cause of fatal food poisoning in Japan and is responsible for approximately 100 fatalities/year (Anonymous, 1989).
Detection & Prevention
In Japan, chefs are required to have at least three years experience before they are allowed to handle fugu. According to Japanese reports, no cases of poisoning have been attributed to puffers prepared by certified chefs. Problems only occur when inexperienced individuals try to prepare fugu (Anonymous, 1989).
The USFDA has recently lifted an import ban on one type of puffer fish, the
tiger fish. Unlike some species of puffer, which may have toxins in the
entrails, liver, ovaries, skin and muscle; tetrodotoxin is only found in the
liver of the tiger fish (Anonymous, 1989). Before importation to the U.S., the
FDA requires that all tiger fish are cleaned, toxic tissues are removed and fish
are laboratory certified to be tetrodotoxin-free. Japanese chefs preparing the
fish for export to the U.S. are required to have at least 13 years of experience
in handling fugu.
Anisakis Simplex or Herring Worm
Anisakis simplex, commonly called herring worm, is a parasitic nematode whose final hosts are dolphins, porpoises and sperm whales (Oshima, 1972, as cited in Pinkus et al., 1975). In the larval stage, the stage which infects fish, the parasite is usually 18-36 mm in length, 0.24-0.69 mm in width and whitish in color (Pinkus et al., 1975). Anisakis larvae are more prevalent in the Pacific than the Atlantic since the Pacific has a large population of whales, one of the final hosts of Anisakis (Myers, 1979; Schantz, 1989).
Humans are accidental hosts of Anisakis larvae. Anisakiasis, the illness caused by Anisakis simplex, is associated with the presence of a marine mammal population and eating raw or undercooked fish (sushi, sashimi, lomi lomi, ceviche, sunomono, Dutch green herring, marinated and cold smoked fish).
Generally, both prevalence and intensity of Anisakis infection increase with size and age of fish (Smith and Wootten, 1978; McGladdery and Burt, 1985 as cited in McGladdery, 1986). Those species which feed primarily on benthic organisms have a lower incidence of Anisakis contamination, while fish that predominantly feed on other fish generally have a high incidence of contamination (Myers, 1979). The types of fish commonly infected with Anisakis larvae include: herring (Hauck, 1977; Smith, 1984; Schantz, 1989); Atlantic and Pacific cod, (Myers, 1979; Rodrick and Cheng, 1989; Schantz, 1989); Pacific salmon (Deardorff et al., 1986; McKerrow et al., 1988); sole (Myers, 1979; and Cheng, 1976 as cited in Roderick and Cheng, 1989); mackerel (Schantz, 1989; Smith, 1984); pollock (Smith, 1984); whiting (Smith, 1984); bonito (Pinkus et al., 1975); squid (Pinkus et al., 1975; Olson, 1986; Oshima, 1987); and Pacific rockfish (Schantz, 1989; McKerrow et al., 1988).
The Icons below will guide you to the other Seafood Safety Pages