Case Study: A 71-year-old man in South Korea had developed an infection after eating raw seafood, and the resulting complications required amputation of his forearm, according to a report published in the New England Journal of Medicine last month.
The man had a history of type 2 diabetes and high blood pressure and was dialyzed because of end stage renal and renal disease. The disease developed within 12 hours of eating, causing fever and excruciating pain in the left hand.
After two days of suffering, he visited the emergency room at Chonbuk National University Hospital in Jeonju, South Korea.
By the time he reached the hospital, on the palm of his left hand, a 3.5-by-4.5 centimeter blood-filled cave had developed, while he had a swollen cavity beneath his upper and lower hands of the skin.
When his physicians performed urgent surgery, they isolated Vibrio vulnificus, a bacteria commonly found in coastal ocean waters, as the cause of his infection.
The United States Centers for Disease Control and Prevention estimate that these bacteria cause 205 infections nationwide each year. Some cases require amputations, and 1
5% to 30% of cases are fatal, according to the Agency.
After the operation, the man received two strong antibiotics intravenously. The medication, however, prevented his skin lesions from deteriorating, and doctors performed amputation of his left forearm 25 days after his arrival at the emergency room.
"The patient was healthy after the operation and was discharged home," conclude the authors of his case report.
Vibrio vulnificus – sometimes falsely referred to as "carnivorous bacteria" – belongs to a family of 12 bacterial species responsible for human disease. Symptoms of these infections can be watery diarrhea, abdominal cramps, nausea, vomiting, fever, and chills. In general, these infections are not in need of treatment and, according to CDC, a serious illness is rare.
About 80% of infections occur between May and October, when coastal waters are the warmest Consumption of infected shellfish, with oysters being a frequent culprit. However, you can also become infected when bacteria enter the water in an open wound or incision, the CDC says.
Although amputation of a South Korean patient is certainly one of the hairiest ways that can occur after eating raw fish, other dangers lurk in raw or poorly cooked meals.
The growing popularity of sushi and other raw or uncooked fish and seafood dishes in Western countries has led to an increase in diseases caused by anisakide nematodes (worms) in BMJ case reports, according to a study published last year
Anisakiasis results from the consumption of fish or seafood contaminated with this parasite.
When the worms enter the stomach wall or intestines, The result is gastrointestinal pain, nausea and vomiting, according to the CDC. Some people develop complications, including bleeding in the digestive tract, intestinal obstruction and peritonitis (an inflammation of the inner wall of the abdomen). Other people may experience an allergic reaction, including swelling, rash or even anaphylaxis, which can cause breathing difficulties and loss of consciousness.
Anisakiasis can not be transferred from one person to another and is most common in Japan, where sushi is king. According to the authors of the case study, Japan sees about 3,000 cases a year.
In recent years, however, other parts of the globe have seen an increase in anisakiasis disease, according to the CDC, although the agency estimates that only one case or two of them are reported each year in the US.
Raw or uncooked fish can also harbor the most common foodborne bacteria, salmonella, which causes about 1.2 million illnesses, 23,000 hospitalizations and 450 deaths US every year, according to the CDC. Foods are the source of most of these diseases. Although raw or uncooked fish are less likely to cause Salmonella infection than other foods, including chicken and beef, they still carry these bacteria.
The symptoms of diarrhea, fever, and abdominal cramping usually develop within 72 hours of infection, and the disease generally lasts four to seven days. Although most people recover from salmonella infection without treatment, some patients experience such severe diarrhea that they need to go to hospital.
To reduce the risk of disease from fish consumption, the CDC recommends that you do not eat raw or uncooked fish or squid. When roasting, cooking or cooking seafood, an interior temperature of at least 145 degrees Fahrenheit (about 63 degrees Celsius) must be reached to kill all dangerous lurking under the skin.