A patient of Dr. Paul Aijian’s recently came into his office, carrying the remnants of an unwelcome visitor.
The individual was anxious for answers.
Unfolding a tissue, the patient showed the longtime Santa Barbara physician a 10-inch worm — discovered after a trip to the bathroom, Aijian recalled.
After sending the specimen off to the lab for analysis, Aijian got the news.
It was a fish tapeworm, which can live in the intestines of humans and can grow up to 30 feet long.
The patient hadn’t been out of the country, where tapeworms can be more common due to fewer food safety regulations.
Apparently, the patient hadn’t been further than a local grocery store, where salmon had been purchased.
Aijian said the patients admitted the fish hadn’t been cooked properly once it was brought home, and noticed there was “something not quite right” about it, but ate it anyway.
In his 35 years of practice locally, “I’ve never had anybody come in with this,” Aijian told Noozhawk.
Aijian hopes the incident will be a warning to people who may consume raw or undercooked fish or sushi without considering the consequences.
“They just assume the people selling them the sushi know what they’re doing,” he said. “I think most people in civilized Santa Barbara don’t think you’re going to get a tapeworm.”
Fish tapeworms, or Diphyllobothrium, are well-documented in fish like salmon, which are sea fish that spawn in freshwater rivers.
The Food and Drug Administration recommends cooking fish to an internal temperature of at least 145 degrees, or freezing the fish at minus-4 degrees or below for a total of seven days to completely kill parasites.
Aijian said many consumer freezers don’t reach that low of a temperature, so consumers should use caution and make sure their fish suppliers are adequately freezing before sale.
“If you’re eating fish that was not frozen properly, you’re at risk,” he said.
He said he suspects it’s more common than some would like to admit.
Dr. Charity Dean, health officer for the Santa Barbara County Public Health Department, said people may not have any symptoms, other than some belly pain or anemia, before they realize they have a tapeworm.
“I believe these infections are far more common than we realize,” she said.
The county hasn’t recorded any cases of fish tapeworm in the last five years, which Dean suspects is because there’s not a specific reportable category for the condition.
The pork tapeworm is listed among reportable conditions and is “on the list because it’s the No. 1 cause of seizures in the world,” she said.
Pork tapeworms can cause seizures when the worm’s larvae form cysts on the host’s brain.
Nonetheless, the county has only had two cases of pork tapeworm reported during the last five years, a number that Dean said is much higher, based on what she has seen working with patients.
All meat should follow cooking guidelines, which Click here for the guidelines.
By eating undercooked fish or any other meat, “they are putting their own health at risk,” Dean cautioned.
— Noozhawk staff writer Lara Cooper can be reached at lcooper@noozhawk.com. Follow Noozhawk on Twitter: @noozhawk, @NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.
