Libro de las enfermedades alérgicas de la Fundación BBVA

Abstract

Background: Anisakis simplex is a world wide distributed fish and cephalopod helminth parasite. It produces anisakiasis or human parasitation by living larva and hypersensitivity allergic reactions against parasite proteins. This report revises this parasite existing estudies, biological cycle, clinical manifestations, diagnosis methods and preventive measures to adopt. The biological cycle includes an adult form and three larvae stages, being human an accidental host. There are three groups of antigenic molecules: somatic, excretory and surface antigen. We suspect diagnosis when we can relate symptoms with fish ingestion and there was good tolerance before this time. We have two types of diagnosis tests: skin prick test and specific serum IgE determination (CAP, PAST), with less sensitivity than skin tests. Oral provocation with dead larva confirms clinical allergy diagnosis. Frequently there is cross-reactivity between Anisakis and other parasites, making difficult diagnosis. This can produce high prevalence of sensitization in Spain. Conclusions: Fish infestation by Anisakis represents a health public problem. We must suspect allergy when there were compatible reactions after ingest several types of fish. The best way of prevention is to cook or to freeze fish. In Spain fulfilment of fish conservation and manipulation legislation is incomplete.