Sushi's growing popularity could be a cause for a rise in parasitic infections, doctors have warned.
"When humans eat raw or undercooked infected fish or squid, they ingest nematode larvae", said a statement on the Centers of Disease Control and Prevention website.
Freezing or cooking doesn't make for palatable sushi, but to give an example of what damage the parasite can inflict, the study, published yesterday in the journal BMJ Case Reports, talks about a "previously healthy" 32-year-old who became violently ill after he ate raw fish.
The physicians are advising medical professionals to keep the condition in mind when attempting to treat patients who have recently eaten raw or undercooked fish and are experiencing pain, nausea, vomiting, bowel obstruction or bleeding.
A blood test indicated mild inflammation, and the area below his ribs was tender.
Experts say anisakis dies in three or four days even if left untreated, but recommend people to visit doctors and have the parasite removed using endoscopes as the infection is very painful. An endoscopy procedure involving the insertion of a long tube with a camera at one end down the gullet and into the stomach has found that the larva of a filiform parasite was firmly attached to an area of swollen and inflamed gut lining.
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"Owing to changes in food habits, anisakiasis is a growing disease in Western countries, which should be suspected in patients with a history of ingestion of raw or uncooked fish", Dr Carmo explained.
In the report, doctors in Portugal describe getting to the bottom of the man's stomach pains.
Hiromu Sugiyama, an official at the National Institute of Infectious Diseases, said more seafood being transported across Japan raw rather than frozen may be the cause of the sharp increase in the number of infection reports. He was also vomiting and had a fever. The larva was removed, and the patient's symptoms improved immediately, according to the BMJ report.
Until recently cases in Western countries were rare because most dietary fish is cooked, which kills the worms.
The NHS warns that eating fish that is not fresh or that has not been stored and prepared hygienically can lead to food poisoning.
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