背景:在过去的几十年中,供应生鱼的“日本”餐厅的大规模爆炸在法国普及了新的烹饪习惯。同时,消费者已经养成了在家中自己准备生鱼或腌鱼菜肴的习惯。因此,生鱼肉中活寄生虫幼虫的鉴定很常见,也是专业人士或业余厨师关注的问题。有时候,在吃生鱼后迅速出现严重上腹痛的患者,这些蠕虫在纤维镜检查后被吐出或清除。本文旨在快速回顾法国通过食用生鱼传播给人类的主要寄生虫。
方法:本文基于作者的个人经验,优先参考法国文献和鱼类寄生虫(ANR)研究计划的结果。
结果:从2011年到2014年,鱼类寄生虫(ANR)评估了29种海洋和淡水鱼中寄生虫的患病率。约有57%的海鱼被Anisakidae寄生。在梭鱼中发现了双头鱼幼虫,鲈鱼,和日内瓦湖的Burbot,但没有一条来自Annecy或LeBourget湖的鱼。关于人的象牙病,在2010年至2014年期间,我们对来自法国大学医院的所有医学寄生虫学实验室进行了回顾性调查.已经报告了37例anisakidosis,包括18例变态反应性象牙样病。在同一时期,向国家过敏警戒网络报告了另外6例严重的异株科变态反应。
结论:尽管生鱼的消费量有所增加,与以前的研究相比,anisakidosis的病例正在减少,但是他们的过敏潜力正在增加。二端头虫病的发病率,在大约20年前日内瓦湖沿岸出现了一些趋势之后,目前正在减少,但仍有零星进口病例报告。与专业人员的行动(调查,提供信息)和有关寄生虫风险控制管理的研究计划正在进行中,并已更新了法国食品总局关于控制鱼类寄生虫风险的技术说明。
BACKGROUND: In the past decades, the massive explosion of \"Japanese\" restaurants serving raw fish popularised new culinary habits in France. At the same time, consumers have made a habit of preparing raw or pickled fish dishes themselves at home. As a result, the identification of live parasitic worm larvae in raw fish flesh is common and a source of concern for professionals or amateur cooks. Sometimes, these worms are spit out or removed after fibroscopy in patients developing severe epigastric pain quickly after eating raw fish. This paper is aiming at having a quick review of the main parasites transmitted to humans by eating raw fish in France.
METHODS: This article is based on the personal experience of the authors, on references preferentially from the French literature and on the results of the Fish Parasites (ANR) research program.
RESULTS: From 2011 to 2014, Fish-Parasites (ANR) assessed the prevalence of parasitism in sea and freshwater fish belonging to 29 species. About 57% of sea fish were parasitised by Anisakidae. Larvae of Dibothriocephalus latus were found in pike, perch, and burbot in Lake Geneva but in none of the fish examined from Annecy or Le Bourget lakes. Concerning human anisakidosis, a retrospective survey was carried out in the years 2010 to 2014 among all medical parasitology laboratories from university hospitals in France. Thirty-seven cases of anisakidosis have been reported, including 18 cases of allergic anisakidosis. Six additional cases of severe Anisakidae allergy were reported to the National Allergovigilance Network over the same period.
CONCLUSIONS: Despite the increase in consumption of raw fish, and compared to previous studies, cases of anisakidosis are decreasing, but their allergenic potential is increasing. The incidence of dibothriocephalosis, after some trend of emergence on the shores of Lake Geneva some 20 years ago, is currently decreasing, but sporadic cases of importation are still reported. Actions with professionals (investigation, providing of information) and research programs on management of parasitic risk control are being pursued and have resulted in an update of the technical instruction of the French General Directorate for Food on the control of parasitic risk in fish.