Anisakis sensitization in different population groups and public health impact: A systematic review

Abstract

Anisakis simplex spp. sensitization rates have increased worldwide, with a significant impact on health-care systems. To date, no clear-cut diagnostic criteria and laboratory algorithm have been established, so anisakiasis still represents an under-reported health problem whose clinical manifestations, when present, mimic the much more common allergic and digestive disorders. Aim of the study was to systematically review the available literature on the prevalence of sensitization against Anisakis in the general population and in specific population groups, taking into account the impact of the different available diagnostic techniques on the epidemiological data. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, relevant papers reporting Anisakis sensitization epidemiological data were found covering a period ranging from 1996 to February 2017. Overall, 41 studies comprising 31,701 participants from eleven countries were included in the qualitative synthesis. General asymptomatic population resulted sensitized to Anisakis in 0.4 to 27.4% of cases detected by means of indirect ELISA or ImmunoCAP specific IgE detection, and between 6.6% and 19.6% of the samples by Skin prick test (SPT). Occupationally exposed workers (fishermen, fishmongers and workers of fish-processing industries) documented specific IgE between 11.7% and 50% of cases, whereas SPT positivity ranged between 8% and 46.4%. Symptomatic allergic patients to any kind of allergen were found to be positive to Anisakis specific IgE detection between 0.0% (in children with mastocytosis) to 81.3% (among adults with shellfish allergy). Results highlighted that hypersensitivity prevalence estimates varied widely according to geographical area, characteristics of the population studied, diagnostic criteria and laboratory assays. Further studies are needed to overcome the documented misdiagnosis by improving the diagnostic approach and, consequently, providing more affordable estimates in order to address public health interventions on populations at high risk of exposure to Anisakis and to tailor health services related to specific groups.

Urticaria and silent parasitism by Ascaridoidea: Component-resolved diagnosis reinforces the significance of this association

“…Undoubtedly, the seroprevalence data measured by specific IgE and by specific IgG antibodies are more appropriate and more reflective of the real-world prevalence than data for a single parameter. In the literature, the prevalence of these parasitic infections, have been reported mainly through the use of only one parameter, i.e., specific IgG antibodies against toxocariasis or specific IgE antibodies against anisakiasis [43,48,49].…”

“…Both IgE and IgG antibodies play important roles not only as key parameters in immunological diagnoses but also as factors in several aspects of immunity, including protective strategies [48], and in assessing the clinical status of these parasitoses [43,49,50].…”

“…Unlike Toxocara, the seroprevalence of anisakiasis in Spain is quite high because is one of the European countries with the highest levels of fish consumption [49,[51][52][53][54][55]. In the general asymptomatic population, the prevalence of sensitization to Anisakis antigens ranges from 0.40 to 27.40% [49].…”

Fish Allergy Management: From Component-Resolved Diagnosis to Unmet Diagnostic Needs

“…Anisakis is a parasitic worm infecting fish muscle. Anisakis-spoiled fish, such as in sushi, can induce human illness (anisakiasis) with inflammatory intestinal symptoms [12,13]. Anisakis is also causing IgE-mediated allergy to helminth allergens, mostly excretion/secretion parasite molecules [14].…”

Risk-based scoring and genetic identification for anisakids in frozen fish products from Atlantic FAO areas

“…In humans the ingestion of Anisakidae larvae can result in infection with live larvae, an allergic reaction to Anisakidae allergens or both [9][10][11][12]. The increased consumption of raw or undercooked fish constitutes an underestimated zoonotic potential risk [13][14][15]. In the last decade, Anisakis have been included among the biological hazards reported through the Rapid Alert System for Food and Feed (RASFF) of the European Commission, within the European Union (EU).…”