Beyond Salmon

Everything you ever wanted to know about buying and cooking fish (and other musing on all things yummy): by Helen Rennie

Sunday, October 8

Parasites in Fish, Part 2 -- Anisakis and Tapeworm

Now that we know all about cod worms, we are going to venture in the world of the more dangerous parasites: anisakis simplex and tapeworm. If you are cooking fish, you need not worry. According to FDA, you are 100% safe if the fish reached an internal temperature of 140F. Surviving the human intestinal track isn’t easy and requires that anisakis and tapeworm be at full strength. So, if you “only” raise the internal temperature to 120F, a parasite might survive (if he’s positioned in the middle of the fish fillet), but will be so weak that it will most likely die shortly after reaching your stomach.

Anisakis simplex is most common in fresh water and anadromous fish, like wild salmon, which are born in fresh water, migrate to the ocean, then return to fresh water to reproduce. It is also common in certain small salt water fish, such as herrings and sardines. However, anisakis is rare in other salt water fish, such as tuna, swordfish and farm-raised salmon. Just like cod worm, it originates in seals. Tapeworm is mostly found in pacific wild salmon and fresh water fish. It originates in bears and land mammals. They are fascinating organisms and you can read all about the anisakis life cycle and the tapeworm life cycle on wikipedia.

Becoming a host to anisakis worms by eating them live can make you very sick---this disease is known as anisakiasis. According to wikipedia, its symptoms include violent abdominal pain, nausea, and vomiting. "Occasionally the larvae are coughed up. If the larvae pass into the bowel, a severe eosinophilic granulomatous response may also occur 1 to 2 weeks following infection, causing symptoms mimicking Crohn's disease." This isn't a life threatening disease (unless you have a weakened immune system) and is quite common in Japan where consumption of raw fish (that isn't previously frozen) is more wide spread. Unlike anisakis, tapeworms don't always manifest themselves with clear symptoms and can live in humans for decades if untreated, resulting in weight loss, Vitamin B12 deficiency, and potential anemia.

What used to bother me is the possibility of eating the eggs of these worms. Wouldn't they be too small for me to see, and what would happen if I eat them? Dr. Palm, from the Institute for Zoomorphology, Cell Biology and Parasitology in Düsseldorf, Germany, put my worries to rest by explaining the life cycle of these worms. While anisakis and tapeworm are in fish, they are in larvae form (not egg form). They can't reproduce until they find a mammal host (in the case of anisakis and cod worm, it has to be a marine mammal like a seal, so they can't reproduce in a human), and tapeworms rarely make it into humans.

Are you ready to swear of sushi yet? Not so fast. If you are a US resident, keep in mind that you live in a country that just threw away every single bag of spinach because of E.Coli threat. You don't think FDA would allow anything remotely dangerous to be served to the US public, do you? That's why FDA requires all fish with a potential hazard of parasites that is intended for raw consumption to be previously frozen. Freezing fish to -20ºC [-4ºF] or below for 7 days or -35ºC [-31ºF] or below for 15 hours will kill the parasites. Since the restaurants don't want to take any risk and want to avoid supply and demand price fluctuations, most go even further and freeze all fish (not only the ones that could be infected) before serving them raw. So, all that "fresh" sushi you've been eating is previously frozen.

What's counter-intuitive to most cooks is that farm-raised salmon is much safer to eat raw than wild salmon. Farm-raised salmon is served pellet food, which is ground-up, processed fish meat. Any parasites in the fish meat are killed in the processing and grinding stages. Since salmon only obtains dangerous to humans parasites via food, farm-raised salmon simply isn't exposed to them. So, next time you use salmon for gravlax, tartar, or sashimi, go for the farm-raised stuff. When the Food and Agriculture Organization of the United Nations tested various fish for parasites in 2003, no parasites were found in any farm-raised salmon species , whereas parasites were frequently found in wild salmon (section 5.1.4 of Huss et al., 2003).

Does salting fish like for gravlax or curing it in acid like for ceviche kill the parasites? Maybe. The salt or acid used for curing prevents bacteria from growing. It may also weaken or kill parasites. However, it’s not a full-proof method. Opinions in the scientific literature vary as to the degree to which salt/acid harms parasites. Most sources say that salting is more effective than curing in acid. Also, according to Dr. Gardner from Harold W. Manter Laboratory of Parasitology at the University of Nebraska, the acids in your stomach and intestines are at least as strong as lemon/lime juice. So, if you are making ceviche, I would suggest taking the same precautions as you would for eating the fish raw.

To put all this in perspective, the risk you take downhill skiing is an order of magnitude greater than the risk of eating raw, not previously frozen fish. Whether that risk is worth it is up to you. I hate downhill skiing and I love raw fish, so you can guess which risks I choose to take. In fact, the risk of driving or just walking down the street is probably higher than the risk of eating raw fish. I know plenty of people who were in life-threatening car accidents, and I am yet to meat a person who got infected by anisakis simplex or tapeworm. And let me tell you, I get way more pleasure from a bowl of sashimi than my morning commute.

Do parasitologists eat sushi in spite of their intimate familiarity with parasites? Both Dr. Palm and Dr. Gardner said “yes”. In fact, Dr. Palm just got back from Japan where he had really yummy not-previously-frozen sashimi.

What does all this mean to the home cook who wants to make sushi and ceviche? Buy your fish from a reputable source and use it that day if serving raw. Regardless of the parasite issue, fish that was not stored properly, or for too long, will grow bacteria and make you sick. Freezing fish that is not fresh will not help with the bacteria issue, but it will kill parasites. If you are not planning to freeze fish and want to eat it raw, I would limit your purchases to:

Large Tuna (Yellowfin/Ahi, Big-eye, Bluefin)

Farm-raised Altantic salmon
Scallops
Kampachi (farm-raised)

If I find out about other fish that have extremely low occurance of parasites, I'll post them on Beyond Salmon.

What if you want to freeze your fish to eliminate even the slightest chance of getting sick from parasites? What’s the best way to freeze fish? Is all frozen fish equal? Can you buy frozen tuna from Trader Joe's, defrost it, and voila -- $5/Lb sashimi is served? In my next post, I'll answer all these questions and more.

References:

H. H. Huss, L. Ababouch, L. Gram. Assessment and Management of Seafood Safety and Quality. 2003. Food and Agriculture Organization of the United Nations. FAO Fisheries Technical Paper 444.

posted by Helen @ 4:15 PM   8 comments

8 Comments:

At 12:19 PM, Joe said...

What about the Monterey Bay Aquarium's recommendation to avoid farmed salmon?

At 1:53 PM, Jason said...

Hi Joe,

I'm Helen's husband. The trouble with the web page you cite is that it's lacking in details.

"Salmon farmers may use pesticides and antibiotics to control outbreaks of disease among the fish."

Note the use of the word "may." As written, this statement is basically vacuous. If you're worried about pesticides/antibiotics, ask your fishmonger. They should be able to tell you whether such chemicals were used in the raising of Atlantic Salmon that you buy.

"The Environmental Defense has issued a health advisory for Farmed salmon due to high levels of PCBs and dioxins."

Anyone can issue a health advisory. The page that Monterey Bay links to doesn't provide any details. Where are the scientific studies showing that if you eat Atlantic Salmon regularly, something bad will happen to you? I don't see any. If you know of any, please send them along, I'd be very interested to read them.

"Waste from most farms is released directly into the ocean. Parasites and diseases from farmed salmon can spread to wild fish swimming near the farms."

Any fish or mammal that lives in the ocean releases waste into the ocean. This waste can pass along diseases and parasites. A valid concern is that a Salmon farm could create an unnaturally high concentration of waste. But, again, this depends on the farming company. Farmed Salmon are clearly better than wild Salmon in one respect: they don't transmit parasites that are dangerous to humans. Table 5.21 from the Huss/Ababouch/Gram report shows that such parasites are not found in farmed salmon, whereas they are quite prevalent in wild salmon.

Btw, all fish & mammals that live in and around the water have the potential to transmit parasites and diseases. It's misleading to say that farmed Salmon can infect wild fish, since if the Salmon had not been farmed, it would have also had the chance to infect (other) wild fish.

"And feeding farmed salmon actually uses more fish than it produces, which puts more pressure on wild populations."

This is also misleading. The same could be said about wild salmon---they eat more fish than they produce.

"In the market, there is currently no way to tell which salmon are coming from more-sustainable farms..."

I doubt this is true. I know that Whole Foods is quite particular about their farm-raised Salmon. While it's probably true that many fishmongers won't be able to tell you the details of how their fish was raised, that's largely because consumers don't ask.

At 2:19 PM, Helen said...

Hi Joe,

Thanks for your question about farm-raised salmon. It's an issue that comes up over and over, and you've inspired me to do some research on the subject. There are two big questions: 1) does farm-raised salmon pose health risks? and 2) is it bad for the environment?

I have some information about the first issue. Here is an article from Tufts University School of Nutrition Science and Policy about PCBs in farm-raised salmon. At the moment, we have no data that PCBs in such small amounts are dangerous to your health. Here is my previous post on mercury in fish -- another hot button issue.

As far as antibiotics go -- Whole Foods label their fish clearly so that you know what you are buying, and they are starting to carry salmon without antibiotics. But keep in mind that most of the meat that you eat was treated with antibiotics too. Is eating farm-raised salmon every day a good idea? I don't think eating anything in such access is a good idea. But there is no scientific evidence that eating farm-raised salmon is harmful to your health.

From Monterey Bay Aquarium site: "When consumers eat this fish, the residues from the chemicals may affect their health or interfere with medicines they’re taking."

Some people are allergic to seafood all together. Does this mean we should consider it generally dangerous?

I haven't researched environmental issues yet. It's on my to-do list and I'll post about it as soon as I have some information.

Cheers,
-Helen

At 10:59 PM, Anonymous said...

Hi there,

Farmed Salmon have a VERY bad reputation environmentally, and farmed salmon may also possess significant health risks.

Here's some further information and some responses to your posts for further consideration.

Jason stated:
>As written, this statement is
>basically vacuous. If you're >worried about pesticides /
>antibiotics, ask your fishmonger.
>They should be able to tell you
>whether such chemicals were used
>in the raising of Atlantic Salmon
>that you buy.

Remember that the aquarium page is not providing an in-depth analysis of aquaculture. It is attempting to provide a summary of information that is widely available.

As for the antibiotics issue - there is very little chance that the average fishmonger is going to know if their fish is farmed or not. It is primarily specialty stores that spend the time to pay attention to that kind of food issue.

Jason stated:
>"The Environmental Defense has
>issued a health advisory for
>Farmed salmon due to high levels
>of PCBs and dioxins."
>Anyone can issue a health
>advisory. The page that Monterey
>Bay links to doesn't provide any
>details. Where are the scientific
>studies showing that if you eat
>Atlantic Salmon regularly,
>something bad will happen to you?
>I don't see any. If you know of
>any, please send them along, I'd
>be very interested to read them.

Health advisories are usually put out by agencies that have a duty to protect the public, so I think the comment that "anyone" can put out a health advisory is a bit weird. I can put out a health advisory, but no one is going to trust it! I would call the Monterey Bay Aquarium a fairly knowledgeable and trustworthy source!

Their stance is firmly backed up by the science. Here are some studies (out of hundreds available) about dioxins in farmed salmon:
http://www.albany.edu/ihe/salmonstudy/
http://www.newscientist.com/article.ns?id=dn4547
http://www.news.cornell.edu/Chronicle/04/1.15.04/salmon_health_risks.html
http://www.shns.com/shns/g_index2.cfm?action=detail&pk=TOXICSALMON-01-08-04
http://www.medicalnewstoday.com/medicalnews.php?newsid=24012

To summarize the story told in these studies for you, the high levels of dioxins in farmed Salmon are a result of a process similar to bioconcentration resulting from the food that the farmed Salmon are fed. Pellets fed to farmed salmon are impregnated with fish oil made from small fish. The oil comes from the part of the small fish's body where contaminants are concentrated. Because a small amount of oil comes out of each fish, farmed salmon end up with a far greater amount of dioxin than wild salmon - and a disproportionate amount of fish are killed, taxing the environment that these fish come from. But because the small fish are not valuable for human consumption, we feed them to farmed salmon, which ARE valuable for human consumption - ignoring the environmental impacts.

Jason stated:
>"Waste from most farms is
>released directly into the ocean.
>Parasites and diseases from
>farmed salmon can spread to wild
>fish swimming near the farms."
>Any fish or mammal that lives in
>the ocean releases waste into the
>ocean. This waste can pass along
>diseases and parasites. A valid
>concern is that a Salmon farm
>could create an unnaturally high
>concentration of waste. But,
>again, this depends on the
>farming company.

Anti-aquaculture groups object to Salmon farming for many of the same reasons why factory farming is objectionable. In a farm situation, the animals or fish and held in large numbers within a comparatively small area. Because the fish/animals are so concentrated it is very hard to keep the space clean (so the fish/animals may be sitting in their own waste - but this is of less concern in the water) AND because they are so concentrated any parasite/disease will travel very quickly through the population.

Salmon farms put lots of food (overfeed) so that their fish get big. Extra food is also added because the pellets SINK - so there is a lot of wastage.

Remember that Salmon farms are an unnaturally large & dense population, so you get an exponentially higher level of parasites (captive breeding) and, bioconcentration, disease, et cetera.

This concentration of harmful factors would not be a big problem if it was dissipated by an ocean current, but most salmon farms are placed near streams and river mouths where salmon come to spawn. This means that more vulnerable members of the wild stock (like the baby salmon aka Salmon fry) are subjected to an unnaturally high concentration of parasites - so wild stocks become depleted.

This is why in factory farm situations, like Salmon farms, the fish/animals are often given antibiotics AS A MATTER OF COURSE. That is to say, they are given drugs even if they are not sick, as a preventative measure.

Wild salmon don't have access to the antibiotics that farmed salmon are fed, so they are far more vulnerable!

Jason stated:
>Farmed Salmon are clearly better >than wild Salmon in one respect:
>they don't transmit parasites
>that are dangerous to humans.
>Table 5.21 from the >Huss/Ababouch/Gram report shows
>that such parasites are not found
>in farmed salmon, whereas they
>are quite prevalent in wild
>salmon.
>Btw, all fish & mammals that live
>in and around the water have the
>potential to transmit parasites
>and diseases. It's misleading to
>say that farmed Salmon can infect
>wild fish, since if the Salmon
>had not been farmed, it would
>have also had the chance to
>infect (other) wild fish.

Ask yourself this: why don’t the fish have parasites? If wild fish have the parasites, and the parasites occur naturally… this must be because the fish farms give their fish antibiotics. So you are trading parasites for antibiotics in your food. Wild salmon have a lower population density, so they have less exposure to parasites... UNLESS they swim near a salmon farm.

Jason stated:
>"And feeding farmed salmon
>actually uses more fish than it
>produces, which puts more
>pressure on wild populations."
>This is also misleading. The same
>could be said about wild salmon
>- they eat more fish than they
>produce.

This all goes back to the essential problem with all forms of factory farming:
- Farmed animals need to be fed something
- The food that farmed animals are fed must be taken out of the environment, placing an additional stress that is not there naturally

In this particular case, as previously stated, farmed salmon are fed food pellets flavoured with fish oil (they will not eat the pellets without the fish oil). The fish used to make the pellets are not useful to human, but that does not mean they don’t have a role to play in the local environment. Suddenly humans become a new predator, which impacts the balance of the overall ecosystem. If the food for the salmon was farmed as well it would be ISOLATED (somewhat) from the environment – but they are not, so there is a direct impact.

A secondary effect of a fish-farm: highly concentrated levels of decomposing matter in the local environment. Decomposing matter is eaten by bacteria, which use up oxygen. Lack of oxygen kills plants in the local area (not enough air to breathe), and you end up with “dead zones” downstream from fish farms.

Jason stated:
"In the market, there is currently no way to tell which salmon are coming from more-sustainable farms..."
>I doubt this is true. I know that
>Whole Foods is quite particular
>about their farm-raised Salmon.
>While it's probably true that
>many fishmongers won't be able to
>tell you the details of how their
>fish was raised, that's largely
>because consumers don't ask.

Totally true! But that's something people need to be educated about -they need to be told that they should ask. Or they can buy wild salmon and avoid the problem (not there are not problems with salmon fishing, there are environmental concerns there as well).

Helen stated:
>I have some information about the
>first issue. Here is an article
>from Tufts University School of
>Nutrition Science and Policy
>about PCBs in farm-raised salmon.
>At the moment, we have no data
>that PCBs in such small amounts
>are dangerous to your health.
>Here is my previous post on
>mercury in fish – another hot >button issue.

Again, a great point! However, this must be mitigated by the fact that PCBs are bioaccumulative. That is to say, PBCs NEVER leave your body and build up over your lifetime. Anything you can do to avoid PCBs is a good idea! The higher the concentration of contaminants in your body with free-chlorine (as with PCBs) the greater risk of cancer and many other health problems. PCBs are an issue with ALL seafood (and not an insignificant amount of other food), but are 20-30% higher in farmed salmon than in wild salmon. So if you really like to eat fish, you are better off with wild salmon.

Helen stated:
>As far as antibiotics go -- Whole
>Foods label their fish clearly so
>that you know what you are
>buying, and they are starting to
>carry salmon without antibiotics.
>But keep in mind that most of the
>meat that you eat was treated
>with antibiotics too. Is eating
>farm-raised salmon every day a
>good idea? I don't think eating
>anything in such access is a good
>idea. But there is no scientific
>evidence that eating farm-raised
>salmon is harmful to your health.

There is real evidence that farm-raised salmon is harmful to your health (as has been shows above); however, it is a matter of long-term exposure and degree. The overall environmental impacts may also be a moral concern for some.

But you are right, aside from the PCBs, farmed salmon are no worse than any other farmed meat product in terms of antibiotics.

Helen stated:
"When consumers eat this fish, the residues from the chemicals may affect their health or interfere with medicines they’re taking."
>Some people are allergic to
>seafood all together. Does this
>mean we should consider it
>generally dangerous?

No, but if something may contain nuts it has a warning label on it. Food with antibiotics which may interact with medications should have a warning label too, no? Just as products which "may contain fish" should probably have a warning label! :)

In any case, the point of all his is that there are real, significant, and important issues surrounding aquaculture, and suggesting farmed fish over wild fish is a very problematic recommendation. Joe’s criticism is certainly legitimate, as I have attempted to show.

Maybe this subject deserves for a blog post? Give the information to the people and let the people decide for themselves!

Best of luck, your blog is great!

-Steve

At 11:12 PM, Helen said...

Hi Steve,

Ok, you've inspired me. I will research this issue in greater detail and will publish a post on farm-raised salmon. Just give me a few weeks :)

Cheers,
-Helen

At 1:42 PM, Anonymous said...

I shall wait with bated breath!

At 11:46 AM, Jason said...

Hi Steve,

Thanks for the reply and thanks for the link to the Hites et al. study. I can see why you might be concerned---the headlines certainly make it sound like farm raised salmon is dangerous due to levels of toxins which are much higher than the levels found in wild salmon.

"As for the antibiotics issue - there is very little chance that the average fishmonger is going to know if their fish is farmed or not. It is primarily specialty stores that spend the time to pay attention to that kind of food issue."

I could be wrong, but I'm fairly certain that even mainstream grocery stores in the Boston area (where we live) specify farmed/wild. Though, I'd certainly agree with you that few fishmongers would know whether farmed fish they sell was exposed to antibiotics/pesticides/etc.

Concerning the study: it is clear from the study that farmed salmon have much higher levels of PCBs/Dioxins/etc. than wild salmon. What isn't clear is whether these levels are sufficiently high to pose a danger. Also, the wild salmon on average have lower levels of omega-3's, so even if the PCB/Dioxin/etc. levels are high enough to pose a danger, the advantage of lower levels of PCBs/Dioxins/etc. might not be sufficient to offset the disadvantage of lower levels of omega-3's.

Yes, researchers who published the original Jan 9, 2004 Science paper have done later nutritional studies, e.g. J. A. Foran et al. "Quantitiative Analysis of the Benefits and Risks of Consuming Farmed and Wild Salmon". However, they do not provide evidence that wild salmon is better for you than farmed salmon. In particular, they do not study the change in expected lifetime (or other measure of healthfullness) from switching salmon consumption from farmed to wild. Yes, wild salmon provides more omega-3's "per unit risk" (Figure 1). However, consumers don't eat food "per unit risk." The amount of salmon a consumer eats is unlikely to change in switching from farmed to wild. Also, the "unit risk" discussed by the authors seems quite small. They define unit cancerous risk as a 0.001% increase in the risk of death from cancer. If a consumer eats enough farmed salmon (purchased from, say, Eastern US retail locations) to achieve the recommended omega-3 intake (1 g/day), he/she would face merely a 0.0125% increased risk of cancer (due to the PCBs/Dioxins/etc.) according to their calculations. This might be more than offset by the decreased risk of early death from coronary heart disease (versus eating wild salmon instead). They define unit non-cancerous risk as the U.S. EPA Reference Dose (RfD). The U.S. EPA RfD is "a scientific estimate of a daily exposure level that is not expected to cause adverse health effects in humans." I.e. it is a level many times lower than the level at which adverse health effects have ever been observed. Consumption of sufficient (Eastern US retail) farmed salmon to provide 1 g/day of omega-3's does not exceed the RfD.

"Anti-aquaculture groups object to Salmon farming for many of the same reasons why factory farming is objectionable. In a farm situation, the animals or fish and held in large numbers within a comparatively small area. Because the fish/animals are so concentrated it is very hard to keep the space clean (so the fish/animals may be sitting in their own waste - but this is of less concern in the water) AND because they are so concentrated any parasite/disease will travel very quickly through the population."

It sounds like this isn't so much a concern with the general idea of farming, but rather with farms which focus on lowering costs to the detriment of the environment and animal/fish health. Personally, I'd like to see designations for more environmentally-friendly fish farming. It seems that such designations on other products (e.g. "organic") have helped gradually improve the quality of farming in the U.S. via consumer choice.

"Salmon farms put lots of food (overfeed) so that their fish get big. Extra food is also added because the pellets SINK - so there is a lot of wastage."

Do you know what is the typical degree of wastage?

"This is why in factory farm situations, like Salmon farms, the fish/animals are often given antibiotics AS A MATTER OF COURSE. That is to say, they are given drugs even if they are not sick, as a preventative measure."

Are you certain that all salmon farms use antibiotics?

"Ask yourself this: why don't the fish have parasites? If wild fish have the parasites, and the parasites occur naturally... this must be because the fish farms give their fish antibiotics."

I think you missed my point. The main parasites which are dangerous to humans (Table 5.21 from Huss/Ababouch/Gram) are transmitted via food. The grinding process in producing pellets for farmed salmon kills any such parasites (antibiotics have nothing to do with it).

"Decomposing matter is eaten by bacteria, which use up oxygen. Lack of oxygen kills plants in the local area (not enough air to breathe), and you end up with "dead zones" downstream from fish farms."

Don't plants need CO2 to "breathe", not O2?

"That is to say, PBCs NEVER leave your body and build up over your lifetime. Anything you can do to avoid PCBs is a good idea!"

There is nothing you can do to completely eliminate exposure to PCBs. They can be found in most, if not all, foods. The important question isn't "how do I eliminate PCBs from my diet?", but rather "how do I avoid exposure to unsave levels of PCBs?" As far as I can tell, neither the original R. A. Hites (Science, 2004) study, nor follow-up studies indicate that farmed salmon have unsafe levels of PCBs.

"There is real evidence that farm-raised salmon is harmful to your health (as has been shows above); however, it is a matter of long-term exposure and degree."

Why do you think so?

Anyway, I hope my comments were constructive. My goal isn't to push one angle or the other, but rather to understand the real underlying concerns.

Cheers,

Jason

At 3:47 PM, Anonymous said...

One concern that I think has not come up in this discussion is the ecological consequences of farm-fish escapees. In areas where Atlantic salmon are farmed and are native (e.g., east coast of Canada, Maine, Norway) there is concern that farmed fish could escape, interbreed, or out-compete wild populations of Atl salmon. Interbreeding farmed and wild fish can kind of "dumb down" the genetic make-up of wild populations.
However, on the west coast where Atl salmon are farmed (British Columbia and Washington), this is an introduced species. Our inland waters have been devasted by introductions of non-native fish. Many, many, many examples. There are all kinds of concerns when it comes to introduced species-- including passing diseases and parasites, i.e., those normally only found in Atlantic fish, to our native fish.
There was also some talk about wastage/efficiency in food that is fed to farmed fish (with respect to lbs fed to lbs grown). I'm not sure if this was brought up, but one of the problems is that we're already over-fishing wild fish stocks. Catching even more fish to grind up for food only compounds the over-fishing problem.
Oh yeah... and wild fish just taste better. :)
Thanks for this forum.

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