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The research is being done to investigate long-term consume sushi will cause Anisakidosis. It had been concluded that most of the Malaysian like sushi. It had been said that eat too much raw food are putting risk on many disease. The research is carried out to investigate the bad effect of consume in sushi, which are the favorite of mostly Malaysian. It had proved by journal that eating too much sushi will cause Anisakidosis in most of the Malaysian who consume their favorite sushi. The journal used is published by Oxford Universities Press on the behalf of the department of Epidemiology and International Health, Boston University School of Public Health, Section of infection disease, Department of Medicine, Boston which entitled 'Anisakidosis: Perils of the Deep'. The authors in this journal include Natasha S.Hochberg and Davidson H. Hamer. The authors do the research about Anisakidosis, which is also known as whale worm, herring worm, sealworm, and codworm disease. It is the result of accidental human infection with the larval stage of several nematodes found in raw or undercooked marine fish or squid. The first case of a young child vomiting an "ascarid" wans described in1876, but it was not until 1960 that the Netherlands who had consumed raw herring. It had been know that anisakidosis has been increasingly identified as the cause of gastric, intestinal and allergic in human recently who have consume uncooked seafood. Anisakis simplex and Pseudoterranova decipiens are causing most human. The term anisakidosis refers to disease caused by members of the genus Anisakis and Pseudoterranovosis by the genus Pseudoterranova. Anisakidosis, infectio with seafood-associated parasites occurs most commonly where people consume raw or inadequately cooked saltwater fish or squid. 190% occur in Japan from approximately 20,000 reported cases worldwide. It happens primarily among adult men in coastal regions. Coastal areas of Europe such as Netherland, Germany, France and Spain are the most other cases happened. Approximately 60 cases of anisakidosis have been described in United States although it is underdiagnosed and underreported. During the past 2 decade, there have also been increasing reports from New Zealand, Canada, Brazil, Chile, and Egypt. The rising incidence can be attributed to larger populations of the definitive hosts, increased consumption of the raw or lightly cooked food, and improved endoscopic diagnostic techniques.
Anisakid-infected marine life has been reported to exist in all major oceans and seas. One study found out that 98% of the markerel and 94% of the cod from a wholesale fish market in Japan carried the parasite. In a fish market in Spain, 39.4% of fish were found to have anisakid infection. High rates also occur in fish of the coast of Scotland, Italy and France. In the United States, there is a high prevalence of infection in wild salmon. Pseudoterranovosis rarely occurs in Japan and Europe. By contrast, it occurs more frequently in the United States and Canada, where P.decipiens is mainly transmitted by the Atlantic or Pacific cod, Pacific halibut and red snapper. Some country like Atlantic and Pacific Oceans, a substantial proportion of cod harvested infected with P.decipiens (Figure 1)
Figure 1.Pseudoterranova species larvae embedded in the flesh of cod. Photograph courtesy of the Centers for Disease Control and Prevention-DPDx
The particular source of human infection varies according to the fish-eating culture of the country. In Japan, although sushi and sashimi are potentially high risk, fish commonly served in sushi bars tend to be less contaminated or even free of Anisakid nematodes, and sushi chefs are experts in identifying of larvae infestation. The risk of infection is greater with less expensive marine fish, for example, cod, herring and mackerel and squid that are more frequently consumed in local restaurants and at home and not in sushi bars. In United States, one study found that there was a 1 in 13 chance of consuming an anisakid larva in salmon sushi. Other than sushi, high-risk dishes include salted and smoked herring in the Netherlands, Scandinavian gravlax, Hawaiian lomi-lomi (raw salmon), South American ceviche, and pickled anchovies and raw sardines in Spain.
Figure 2 Pseudoterranova species larva extracted from cod. Photograph courtesy of the Centers for Disease Control and Prevention-DPDx
The authors carried out and investigated their research which entitled "Anisakidosis: the perils of the deeps". A series of method is being used by the authors. A history of recent consumption of raw or incompletely cooked fish or squid followed by the acute onset of epigastric or right lower quadrant abdominal pain provide important clues for the diagnosis of anisakidosis. Gastroscopic or surgical removal and examination of the larva provides a definitive diagnosis. Anisakid larvae are characterized by the presence of 3 bilobed lips, a ventral boring tooth and large anterior excretory glands. Most commonly, A.simplex larvae are white and milky colored, 19-36 mm in length, and 0.3-0.6 mm in width and have a blunt tail, long stomach, Y-shaped laterial cords, and no cecum. Compared with A. simplex, the larvae of P.decipiens are yellow-brown in color, longer (length, 25-50 mm), and wider (width, 0.3-1.2 mm); they have an anterioly directed cecum.
Besides directly visualizing the worms embedded in the gastric mucosa, endoscopy may reveal erthema, edema, severe erosive gastritis, a tumor-like nodule, or ulcerations. The burrowing or dead larva precipitates an intense Th2 immune response, and biopsy can show an early inflammatory infiltrate of eosinophils and lymphocytes in the mucosa and submucoasa as well as phlegmon formation. Although larvae may be found up to at least 6 days after consumption of seafood, if endoscopy is delayed, the worm may degenerate, be eliminated, or pass through mucosa and no longer be visualized; the only signs may be thickened gastric folds and inflammation. Chronic infection can be result in abscess and granuloma formation in response to degenerating larvae. Radiographic findings depend on the site of infection. Thread-like filling defects and mucosal edema can be seen on barium studies in gastric infection. Intestinal infection can cause nonspecific, irregular bowel-wall thickening with a disappearance of Kerckring folds, mucosal edema, and luminal narrowing. Computed, tomography findings include lymphadenopathy, focal masses and ascites. Ascitic fluid obtained by paracentesis may demonstrate an eosinophilic predominance. Gastric infection is frequently accompanied by leukocytosis; eosinophilia is seen more commonly in gastric than intestinal infection-particularly if the worm remains in place. Although extraction of the larvae is the most direct method of diagnosis, serologic evaluation can be useful intestinal detection can be performend by enzyme-linked immunosorbent assay (ELISA). Persons with allegic anisakidosis often have high levels of anti-A.simplex. The results of such assays may be difficult to interpret, however, given that some crude assys are cross-reactive with other parasites, fincluding Ascaris species, Toxocara canis, and nonrelated animals, such as insects or crustaceans. Furthermore, asymptomatic persons who frequently consume raw fish may also have elevated anti A,simplex levels, as can those with intestinal anisakid infection. More specific tests are under investigation. In light of the existing limitations with the assays, it has been suggested that the diagnosis of allergy to A.simplex should be based on the following criteria: a compatible history of allergic reaction after consumption or exposure to fish, a positive immediate-type hypersensitivity skin-prick test result, elevetaed specific anti-Asimplex levels, and a lack of reaction to fish proteins on skin testing. Multiples polymerase chain reaction methods have been developed for identification of specific marine nematodes species in fish, but these are not available for human use.
(C) Methods of gathering data
To find out more detail about sushi, such as the ways of preparing, the ingredients used to make sushi, the effect cause by long-term consuming sushi, methods that people consume sushi , the compound of sushi that cause Anisakidosis to human and many more. Therefore, a series of method is carried out by us to complete the data and the dissertation. The methods been used are as following:
It is an archival methods that using all the sources from library. We go for library Tunku Abdul Rahman College for searching all the information about sushi. But, we found out that the information that we can get about sushi from library is too little for done our dissertation. This problem had been solved by using other methods.
Worldwide website and internet
In the 20th century, internet is the best way to get to information that we want just with one click. Internet is the useful tools to find information as it will become the references materials. Through this method, we are able to know the way people prepared sushi and the method they used to prepare sushi. This method is also enables us to know why long-term consuming sushi will cause Anisakidosis. Besides, we also find out our journal by using internet.
Our questionnaires had been covered to 60 citizen from Malaysia with different age range and gender. The question is all related to our title. The format of our question is more about the personal opinion such as duration when consume sushi, how you think about sushi to our health concern and more. We also set the questions in multiple choices. Through this method, we know most Malaysian like to eat sushi. Besides, we also know about the effect that long-term consume raw food in sushi will cause Anisakidosis.
We also use journal to proof the effect of long-term consuming sushi. Form the journal, we found out that Anisakidosis is caused by eating raw or undercooked food in sushi. The journal we refer to is emerging infection invited article that published by Oxford University press on behalf of the department of Epidemiology and International Health, Boston University School of Public Health, Section of infection disease, Department of Medicine, Boston which entitled 'Anisakidosis: Perils of the Deep'. The authors in this journal include Natasha S.Hochberg and Davidson H. Hamer.
(D) Personal reactions and biases
Our title said about the sushi had been become a favorite to most of the Malaysian. So our group decided to make this to our dissertation title. But some problem had had been face when making dissertation. At first, we are facing about the problem choosing a topic for our dissertation. This is because we need to make a selection of interesting and challenging topic that can have many topics to write. The problem is solved when we review for various researches in the past and deriving ideas out of the topic for those researches.
We also found out that writing a research proposal for dissertation in high level English also problem they need to be solve and we had to learn more about it by learning excellent writing skills. We also found out that it is difficult to present the aims and objective clearly and concisely in the research proposal for dissertation and we solved it by doing many writing and rewriting the objectives of research and doing many reviewing about the research. We also face the problems in designing, formulating and writing an effective research, the problems is being solved by study carefully various research methods and techniques.
Besides, we also having difficult to submit the dissertation within a specific time period. Time management is important, so we help each other to solve the problem and end up with a final dissertation. We also plan ahead and carefully reviewing the sections of the proposal which have been completed.
It is also hard to find the information in the website. To carry out an in-depth research, we try many ways to complete our dissertation. We access to both offline and online resources that will enable us to collect as many as want material for the dissertation. We had go through all kinds of resources such as online libraries, online journal, online dissertation archives, local libraries and school library. We also talk to our classmate about the assignment and stay in touch with our lecturer. We also talk to friends who completed their dissertation.
In additions, we also find out some problems when doing questionnaire. Mostly, people will feel incentive to take the survey. For example, if the survey takes more than a few minutes, they will not feel to complete it and even start it. We also never sure that are the answer on the survey forms is given truthfully or the answer is write by the takers that think the answer we want to hear. So, some of them may not give a real data.
Data that obtained from other researcher
Table 1: the type of fishborne and foodborne parasite that found in the marine fish
Sushi is not only beneficial to human body health, but it is also has a lot of side effect if take sushi not regularly or over eating. Sushi is traditional Japanese meals. Sushi is prepared from marine fish such as tuna, salmon, red snapper, yellow tail and flatfish.
However, according to the Dr.Yukifumi Nawa in Clinical Infectious Disease Journal, he stated that different types of parasites may transmitted into the human body if consumed too much of raw fish, for example salmon fish. Salmon fish is the most common raw fish sushi, it is the intermediate host for the fish tapeworm Diphyllobothrium latum. These parasites may reduce blood serum level of vitamin B12 if human ingested this type of fish parasites.
Researcher also found that majority of marine fish species has contaminated with Anisakis larvae. These marine fishes are mainly consumed at home or restaurant. These foodborne parasites usually penetrate the gastric wall causing acute abdominal cramping, vomiting, nausea within few minutes to several hours. Immediate diagnosis is required to confirm by direct detection and expiration of the parasite by upper gastrointestinal endoscopic examination. Besides that, this Anisakis larvae sometimes diffuses into the peritoneal cavity or other visceral organ to cause eosinophilic granuloma.
As a result, people should take fishborne and other foodborne parasites into consideration. It is because zoonotic parasites will cause an unacceptable burden of mortality and lead to serious damage in aquaculture, which is valuable source of food and employment in developing countries.
Impact of the data obtained
Pie chart1.1: The percentage on sushi is good for brain development
Pie chart 1.2: The percentage on sushi can improve blood cholesterol
Pie chart 1.3: The percentage on sushi can reduce the risk of heart disease
Based on the pie chart 1.1, 13% of people are totally agree the sushi is good for brain development, 23% of people are disagree the sushi is good for brain development and the rest of people are neutral, means that they do not even know about it. In fact, sushi is good source of Omega-3 fatty acids. It is because raw fish sushi contain high amount of Omega-3 fatty acid, which act as a "good fat" and it is very effective to our brain development, especially children. Studies have also shown eat sushi can reduce the risk of developing Alzheimer's disease by 60%.
Based on the pie chart 1.2, 23% of people are totally agree eat sushi can improve the blood cholesterol level, 25% people are disagree the eat sushi can improve the blood cholesterol level, while 52% of people are neutral. Sushi is a type of food that has a high amount of Omega-3 fatty acids, which is polyunsaturated fat. Well, eat sushi can provide more HDL (high density lipoprotein) cholesterol to our body. At the same time, it reduces bad cholesterol-LDL (low density lipoprotein) cholesterol in our body.
Based on the pie chart 1.3, 13% of people are agree eat sushi can reduce the risk of heart disease, 28% of people are disagree eat sushi are reduce the risk of heart disease, while the rest, which is 59% of people are neutral. Studies also shown that sushi can reduce the risk of heart disease especially salmon sushi. Salmon is a type of fish that has high amount of Omega-3 and high in protein and it is very healthful to heart. It also lowers the risk of abnormal heart rhythm if consume sushi regularly. Therefore, we can conclude that more than 50% of Malaysian citizen are really not understand or realize about the benefit of eating sushi.
Pie chart 2: The percentage on eating too much sushi will cause tapeworm production in the body.
Based on the pie chart 2, 45% of people are strongly agree sushi will cause tapeworm or parasites production in our body if consume over. 20% of people are disagree eat sushi will cause tapeworm production in the body while 35% of people are stand as neutral. According to Elisa Zied, R.D, she stated eat sushi can cause variety of foodborne illness if consume too much of raw fish sushi. Foodborne illness is caused by bacteria and parasites, which can lead to diarrhea, vomit, cramping, as well as viruses such as Hepatitis A and Norwalk-like viruses. However, freezing the raw fish would not be able to 100% kill the bacteria, it will only stop or slow down the growth rate of parasites or bacteria.
Pie chart 3: The percentage on eating too much sushi will cause abdominal cramping
Based on the pie chart 3, 40% of people are strongly agree eat sushi too much will cause abdominal cramping or stomachache, 17% of people are strongly disagree eat sushi will cause abdominal cramping if consume large amount, while 43% of people are stand as neutral. Raw fish sushi not only contain high amount of Omega-3 fatty acids, it also contain high level of mercury. Studies had shown that too much of mercury inside the body, it not only can lead to abdominal cramping, it also can affect your body health such as damage the nervous system, memory loss and vision problems as well. According to the Food and Drug Administration, one week's consumption doesn't affect the change of level of mercury inside the body. However, eat a lot sushi will produce food toxins in the body.
Graph 1: The number of respondent on the reason eat sushi
According to the graph 1 above, it very obvious show that Malaysia citizens are eating sushi is not for the healthy and for keep fit. Majority of citizens are influence by others, means that they are influence either family or friends. Some of the citizens eat the sushi because sushi is a type of Japanese fast food, quite convenience and quickly compared to other fast food. The graph also shows that some of citizens are follow the trend to eat the sushi.
Graph 2: The number of respondent on choosing the type of sushi
Based on the graph 2, Based to the result, we also found out that the most favorable and popular sushi is salmon sushi. According to the research, salmon fish is contain a lot of high omega-3 fatty acids, low saturated and also high in protein which is very good for heart and brain development. People like to eat salmon because salmon is contains a lot of good nutrient and also very low calories. Besides that, the second types of sushi that are Malaysian citizen prefer are Tamago-yaki. Tamago-yaki is a type of sushi that rolled up the egg serve with the rice. As it is made from egg, therefore, it contain high amount of protein in this type sushi and it is also very suitable for vegetarian to consume.
Pie chart 4: The percentage on sushi is affordable
According to the pie chart 4 above, there are 62% of Malaysia citizen think that sushi is affordable among 60 Malaysia citizens, while 38% Malaysia citizen think that sushi is very expensive. This is due to economic status are quite stable in Malaysia. There are also many of sushi restaurant available in Malaysia such as Sushi King, Sakae Sushi and Sushi Zanmai. So that, majority Malaysia citizens think that sushi is affordable and also is a very famous food in Malaysia.
By doing the dissertation, it had been found out that majority of Malaysian like to eat sushi. They had been influences by the Japan cuisine from the drama, songs and friends. There is high amount of Malaysian like to eat sushi because of other people are eating too. They also think that it is such a fast and convenience food in the busy lifestyle. They also think that the price of the sushi is affordable.
Unfortunately, Malaysian not really understand or realized the benefits of eating sushi. Actually, sushi is a healthy food choice to our country. This is because Malaysian like to eat a lot of fast food and oily food, sushi is a very good choice, because it is low in cholesterol and fat content. Sushi can help to develop the brain because it mostly made up with fish that contain high omega-3.
From the overall result from doing the dissertation, we also found that a lot of Malaysian know about if eat sushi too much will cause body unhealthy. They have a lot of knowledge about eating too much sushi will cause parasites or tapeworm disease to human body. Many of them also know that it will cause abdominal cramps when consume too much of sushi. This is because sushi is mostly made with raw or uncooked seafood.
The popularity of sushi in Malaysia is very good since a lot of citizen think that the price of sushi is quite affordable. There are also a lot of shops being open in our country to fulfill the taste of Malaysian. We hope that sushi will become more popular in Malaysia society because it is a more healthy food choice that is really beneficial to human body.