Information Officer, Consulate General of Japan, 280 Park Avenue, New York, NY 10017
To the information officer:
I would like to encourage members of our firm to take our customers out to eat at sushi restaurants. However, I've been reading many reports lately that suggest that raw fish may be dangerous.
Item: In Racine, Wis., a man developed severe loss of motor function, headaches and muscle cramps when an uncooked 12-pound flounder fell from a seventh floor window and landed on his head.
Item: In Rubrick, Ill., three women lunching on sushi were killed when a runaway school bus plowed into their restaurant. The people at the next table were unhurt -- they'd ordered the yakatori.
Although I've always enjoyed sushi, I can't, in good conscience, urge our customers to join me for what might be a fatal dining experience. We are a small company, and we can't afford to lose many clients. I would very much appreciate hearing from you about the dangers -- real or imagined -- from this, your delightful regional favorite. I look forward to your thoughts on sushi safety. Yours, Randy Cohen, Manhattan Applied Research Center Mr. Randy Cohen, Manhattan Applied Research Division, 245 West 13 Street, New York, New York 10011
Dear Mr. Cohen:
Re your letter of Sept. 21, 1981, you have our official approval of the consumption of sushi.
However, it is fate's and each individual's responsibility to see that that individual consumes sanitary sushi at safe places.
Just as it would be improper to assault the Italian government for every occasion one digests sickening pasta, so it would be pointless to complain to us about second-rate sushi served at a pseudo-Japanese restaurant. Turn, rather, to the U.S.'s legal machine. It would be only too happy to drag sushi through the courts.
We can offer no sushi guarantee, just sushi encouragement.
Success with sushi! Roger A. Van Damme, Information Officer, Consulate General of Japan
SUSHI EATERS can stop worrying -- so much. The sushi scare, which seemed so alarming a few months ago, looks much less substantial than initial reports indicated. The possible danger in eating raw fresh fish, if you haven't heard, is infection from two sinewy creatures, a tapeworm, diphyllobothrium, and a parasitic roundworm, called anisakis.
There was a flurry of concern this summer when the Los Angeles County Department of Health reported tapeworm infections in four people who ate Japanese sushi at a party in September 1980. The tapeworm was attributed to fresh salmon (follow-up studies also showed samples of salmon in the area heavily contaminated with the anisakis roundworm), which came as a big surprise because saltwater fish don't ordinarily carry the tapeworm. To find it in salmon on the West Coast was rare. Experts believe the tapeworm was picked up by the salmon during their freshwater cycle. From there, what scientists regarded as an intriguing incident worthy of further investigation somehow grew to a potential epidemic in press reports. The alarms seemed justified because more Americans are now eating sushi and sashimi -- raw fish.
But, if you are a sushi lovers, consider these comforting facts from the experts. The 1980 summer flare-up of fish tapeworm did not repeat itself this past summer, and some scientists now believe the episode was a fluke.
During 1980, there were 204 reported cases nationwide of fish tapeworm, and fewer are anticipated for 1981. Sandy Ford of the Center for Disease Control (CDC) in Atlanta says there has not been an increase of fish tapeworm in the Washington metropolitan area since 1967. "There are usually two to three cases a year," she says.
Furthermore, in the entire medical literature there are only "about a dozen" published cases of infection from anisakis roundworm in this country, according to Dr. George J. Jackson, the Food and Drug Administration's top authority on parasites in fish. However, he and other experts suspect the figure is somewhat higher, because this rare disease is undoubtedly often overlooked or mis-diagnosed by physicians.
Nevertheless, Dr. Jackson notes that the small risk of infection is shaved even smaller if you eat your raw fish in Japanese restaurants, as most Washingtonians do. Dr. Jackson says: "I do not know of one case of anisakis infection associated with a restaurant." The reason: Sushi chefs are well acquainted with the possibility of contamination, are experts at detecting worms and removing them, and know exactly which fish to choose to avoid the danger. As a fail-safe procedure, they may also freeze the fish to kill the parasites. At least that's what some authorities suspect, although sushi chefs may deny it because freezing can change the texture and taste of the fish. The manager of the Mikado restaurant here does say that all its squid are frozen.
Gus Stathopoulos at Zoltrow's Live Fish Store, which sells to local Japanese restaurants, including the Mikado, also notes that sushi chefs use deepwater fish, less apt to be contaminated. Dr. Jackson agrees such fish would probably be safer.
If you do become sick from eating raw fish, the consequences can be unpleasant but hardly ever life-threatening. The small roundworm, anisakis, doesn't like the human habitat, and usually dies within hours or weeks. In the meantime, it can cause nausea or severe abdominal pain, and in rare cases, enough stomach and intestinal irritation to be mistaken for an ulcer. The anisakis parasites have also burrowed into the stomach tissues, leading to the mis-diagnosis of a tumor.
The tapeworm can cause diarrhea and painful cramping, but it often passes through the digestive tract on its own, or is easily killed by the drug niclosamide. "It's a fairly benign infection," according to Dr. Jim Ruttenber, officer of epidemic intelligence service at the CDC.
Even though raw fish are contaminated with the organisms, they may not cause illness; rather, whether you are affected depends on the amount present and your resistance to them. And don't jump to the conclusion that worms you see in fish are necessarily tapeworms or anisakis. "They could be maggots, or any other kind of worm," says Dr. Ruttenber. The anisakis looks like a "small, visible hair," says Dr. Jackson, resembling a nerve or blood vessel, although it sometimes is curled up. The tapeworm, at the time of ingestion, is in larva form.
Some advice from the experts for sushi lovers: For maximum safety, stick to sushi made in restaurants by expert chefs. If you make it at home, buy fish that's been frozen. Or, both the FDA and CDC recommend freezing the fish yourself for three days at 20 degrees centigrade. If you believe freezing ruins the taste, Dr. Jackson suggests slicing the fish very thin, to reveal any parasites, and inspecting the fish with a magnifying glass. Dr. Jackson says he "tends not to eat raw fish," but admits he did eat it when he was in Japan, "found it delicious" and "did not come down with anisakiasis."
Dr. Ruttenber believes the raw-fish scare is "more a potential problem, than a real one. It's very rare. I never even ate raw fish until I started investigating it for tapeworm. Now I eat it and I like it. I see no reason to stop eating sushi. We're just not seeing a lot of clinical illness from raw fish." In Dr. Ruttenber's view the only real danger is if you notice an upset stomach and forget to tell your doctor that you've been eating raw fish.