Human anisakiasis: an update.

To the Editor.— Given the public's continuing fascination with raw seafood delicacies, the editorial by R. E. Fontaine 1 on 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 of Anisakis 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 male P decipiens has been recovered from man, 2 and I recently identified a partially molted adult male A 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 ( Onchorhunchus sp) and herring ( Clupea sp) among fish surveyed from US waters regularly have Anisakis larvae in