Assessment of Food Business Operator Training on Parasitological Risk Management in Sushi Restaurants: A Local Survey in Florence, Italy

By Armani, Andrea; Cianti, Luca et al. | Journal of Environmental Health, September 2017 | Go to article overview

Assessment of Food Business Operator Training on Parasitological Risk Management in Sushi Restaurants: A Local Survey in Florence, Italy


Armani, Andrea, Cianti, Luca, Pistolesi, Marco, Susini, Francesca, Castigliego, Lorenzo, Guarducci, Marcella, Gianfaldoni, Daniela, Journal of Environmental Health


Introduction

Over the last few decades, typical Japanese dishes made of raw fish, such as sushi and sashimi, have become more common in the diet of the Western world (Bestor, 2000). The reason for this success is mainly the growing interest of Western consumers for both exotic tastes and "lightly preserved" seafood products, perceived as more wholesome and genuine than processed ones (Bucci et al., 2013).

It has been estimated that the number of sushi restaurants outside of Japan ranged from 14,000-18,000 (Matsumoto, 2007). In the U.S., Japanese cuisine began to spread in the 1970s and between 1988-1998, the number of sushi restaurants quadrupled. Currently in the U.S. there are about 5,000 sushi restaurants (Hsin-I Feng, 2012; Japan External Trade Organization, 2013). In the European Union (EU), the first Japanese restaurant opened in Dusseldorf (Germany) in 1973, but the sushi boom began in the late 1990s and the first sushi chain opened in London in 1997 (Japan External Trade Organization, 2013). Then, the exponential growth of Japanese restaurants was mostly determined by the conversion of other ethnic food business activities in sushi bars or restaurants (Farrer, 2015; Latham & Wu, 2013; Matsumoto, 2007). In fact, some Chinese restauranteurs began to realize as early as in the 1990s that switching to Japanese food business activities, or including Japanese delicacies in their menus, would give their enterprises a greater mass appeal and financial boost (Cwiertka, 2001).

The preparation of sushi and sashimi has always required qualified personnel because these products need continuous and constant attention during all stages of preparation and serving. In Hong Kong for example, sushi and sashimi are classified as restricted foods (Food Business Regulation, 2010) and both producers and vendors have to obtain a specific endorsement (Hsin-I Feng, 2012).

Beyond the microbiological and chemical issues (Atanassova, Reich, & Klein, 2008; Food and Environmental Hygiene Department of Hong Kong, 2000; Hsin-I Feng, 2012), one of the main risks associated with the consumption of raw fish is the presence of infective parasites such as tapeworms (cestodes), flukes (trematodes), and roundworms (nematodes) (Hsin-I Feng, 2012). Although fish-borne zoonotic trematodes are estimated to infect >18 million persons, those at risk equal more than half a billion worldwide; trematodes are a major public health problem in particular in Southeast Asia, where they are found in mainly freshwater and brackish water fish species (Chai, Murrell, & Lymbery, 2005; World Health Organization, 1995).

In Italy, all the confirmed cases of opisthorchiasis were associated with the consumption of raw fillets of tench (Tinca tinca) (Pozio, Armignacco, Ferri, & Gomez Morales, 2013). In regard to cestodes, the most important fishborne zoonosis is diphyllobothriasis, an intestinal infection caused by the fish tapeworm Diphyllobothrium spp. (Chai et al., 2005). Infective larvae (plerocercoid) of Diphyllobothrium latum, the species most often associated with human infections, reside in the muscles of trout, salmon, pike, and sea bass (Nawa, Hatz, & Blum, 2005). Additionally, D. nihonkaiense, the Asian species, has been identified in Japanese patients who had eaten wild salmon sashimi (Ando et al., 2001); it has also been involved in human cases in Switzerland and in France related to consumption of raw Pacific Chum salmon (Oncorhynchus keta) (Wicht, de Marval, & Peduzzi, 2007). Freshwater fish species, however, are not commonly used for the preparation of sushi and sashimi in Europe (Armani et al., 2017).

Roundworms, such as Anisakidae, represent a very high risk for sushi consumers as they are widely distributed in marine aquatic environments and their very small infectious larvae are difficult to visually detect in muscle (Hsin-I Feng, 2012). In humans, Anisakidae are responsible for a zoonotic disease called anisakidosis (Kassai et al. …

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