Re: PRO> ProMED Digest V2006 #372

From: Liz Brown (bfeab@uaf.edu)
Date: Mon Aug 21 2006 - 09:07:27 PDT

  • Next message: Sridhar Jaganathan: "Differentiation of Cooked & Raw shellfish for Tariff purpose"

    Neither this story nor the linked stories explain what species were
    consumed nor how the live crabs were able to be imported and distributed
    to restaurants without dealing with a parasite hazard in a HACCP plan.
    Can somebody on this list provide that information? Thanks.
    -Liz
    ===============================================

    > Date: Sun, 20 Aug 2006 15:08:19 -0400 (EDT)
    > From: ProMED-mail <promed@promed.isid.harvard.edu>
    > Subject: PRO/AH/EDR> Paragonimus - US (CA)
    >
    > PARAGONIMUS - US (CALIFORNIA)
    > *******************************
    > A ProMED-mail post
    > <http://www.promedmail.org>
    > ProMED-mail is a program of the
    > International Society for Infectious Diseases
    > <http://www.isid.org>
    >
    > Date: Sun 20 Aug 2006
    > From: Brent Barrett <salbrent@sbcglobal.net>
    > Source: County of Orange Health Care Agency Press Release, 11 Aug 2006 [edited]
    > <http://www.ochealthinfo.com/press/2006/08-11.htm>
    >
    >
    > Paragonimiasis from Eating Raw Imported Freshwater Crab
    > - -----------------------------------------------
    > Two cases of this parasitic infection have been identified in persons
    > who consumed live, imported, freshwater crabs in a restaurant in
    > Orange County, Santa Ana, CA, USA.
    >
    > "The Orange County Health Care Agency has received reports of 2 cases
    > of lung fluke infection caused by the parasite Paragonimus. These
    > infections are usually related to eating raw or undercooked
    > freshwater crab that is infected with the parasite," said Dr. Hildy
    > Meyers, Medical Director of Public Health Epidemiology and Assessment.
    >
    > Lung fluke infection can be a serious illness in humans, but it is
    > not transmitted from person-to-person. Symptoms of lung fluke
    > infection can include cough, difficulty breathing, diarrhea,
    > abdominal pain, fever and hives. The parasite, Paragonimus, can
    > migrate from the lungs to other organs, and infection can last for
    > years. Medication is available to treat the infection. "We encourage
    > anyone who has developed any of these symptoms after eating raw or
    > undercooked freshwater crab, even if the symptoms are mild, to
    > contact their physician as soon as possible and provide information
    > about when and where raw crab or crayfish may have been consumed. In
    > many people, onset of symptoms may not occur until 6-10 weeks after
    > ingestion of raw, undercooked, salted or pickled crab. It is also
    > very important that freshwater crab and crayfish are properly cooked
    > and not undercooked before they are eaten," Dr. Meyers stated.
    >
    > A Fact Sheet and information for health care professionals are posted online at
    > <http://www.ochealthinfo.com/epi/paragonimus.htm>.
    >
    > - --
    > Brent Barrett
    > Indianapolis, IN
    > <salbrent@sbcglobal.net>
    >
    > [Paragonimus is a trematode belonging to the same group of helminths
    > as _Schistosoma_ and _Opistrochis_. The most common Paragonimus
    > infection in humans is _Paragonimus wetermani_, which is found
    > worldwide in tropical and subtropical areas. Humans and several other
    > mammals can be infected. When Paragonimus eggs hatch in fresh water,
    > the miracidium enters different snails and develops into cercaria,
    > which infect freshwater crabs and crayfish, where they form cysts in
    > gills and muscles. When freshwater crabs are eaten raw, the parasite
    > penetrates the gut wall, migrates through the abdominal cavity and
    > passes the diaphragm, where it develops into adult worms. The
    > classical symptoms of a fully developed infection is bloody sputum in
    > which Paragonimus eggs can be demonstrated, and Paragonimus is,
    > therefore, an important differential diagnosis to tuberculosis. In
    > the migratory phase, elevated eosinophils and IgE are common.
    > Diagnosis can be aided by detection of specific antibodies. The
    > treatment of choice is praziquantel. - Mod.EP]

    -- 
    Liz Brown
    Assistant Professor
    Alaska Sea Grant Marine Advisory Program
    School of Fisheries and Ocean Sciences
    University of Alaska Fairbanks
    PO Box 1549
    Dillingham, Alaska 99576
    907-842-1265
    fax 907-842-3202
    http://seagrant.uaf.edu/map
    



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