Human Anisakiasis: An Update

To the Editor.— Given the public's continuing fascination with raw seafood delicacies, the editorial by R. E. Fontaine¹on anisakiasis in the United States requires some clarifying comments and an update. Larval anisakid worms frequently do develop beyond the third stage in man. Fourth-stage larvae ofAnisakis simplex and Pseudoterranova (-Phocanema) decipiens(Krabbe, 1878, Gibson and Colin, 1982) are frequently found in both the stomach and intestine of man. At least one adult maleP decipienshas been recovered from man,²and I recently identified a partially molted adult maleA simplex, which was found in situ attached to the duodenum of a patient suffering acute abdominal pain and vomiting of four days' duration (see below). For those who savor "poisson cru," it is unfortunate but true that not only salmon (Onchorhunchussp) and herring (Clupeasp) among fish surveyed from US waters regularly haveAnisakislarvae in