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Parasite, lung infection linked to consumption of raw crawfish

The parasites hatch eggs which attach to the lining of the lungs. The parasites hatch eggs which attach to the lining of the lungs.

New Orleans, La. - In south Louisiana, crawfish is a favorite. But new research by a doctor at the LSU Health Sciences Center warns your health could be at risk, depending on how you consume them.

The research published in the July 2013 edition of the Clinical Microbiology Reviews analyzed cases of a parasitic lung infection that is sometimes misdiagnosed because of the symptoms.

"Cough, fever, spitting up blood," said the researcher, James Diaz, M.D. of the LSU Health Sciences Center's School of Public Health. His research focused on the parasite called paragonimus. It causes the lung infection paragonimiasis.

Dr. Diaz said the infection comes from consuming raw crawfish, including domestic crawfish, and eating a tiny imported freshwater Asian crab. Now there are 20 confirmed cases of the infection in the U.S., though none in Louisiana, according to Diaz.

"And all of these cases except one occurred following the consumption of raw or undercooked crawfish in the Mississippi River drainage basin, and we're at the very bottom of that drainage basin," he said.

Diaz said, with so much consumption of crawfish in this area, the general public as well as health care professionals need to beware of the infection, which mimics the symptoms of tuberculosis.

His research said it does not take much raw or undercooked crustacean to make someone very ill. "There have been cases where the patient has reported the consumption of as little as one raw crawfish," said Diaz.

He said some cases in the U.S. have resulted from intoxicated individuals eating raw crawfish during water sports such as canoeing.

Some local fishermen were taken aback by the consumption of raw crawfish.

"I might boil my crawfish for two minutes instead one minute, now," said Mark Morrison after he reeled in a huge catfish. 

He and others said they never consume raw crawfish. "Oh no, never. Always boiled," Morrison said.

John Ferro, who was also out to catch fish, said he once ate a raw shrimp, but never an uncooked crawfish.

"No, crawfish are a different set of circumstances," said Ferro.

Dr. Diaz said the infection is more common in Asia because of the small freshwater crabs that are consumed raw, including in alcoholic drinks. And he said the booze connection is beginning to turn up in the U.S.

"People were going to sushi-type restaurants and they were ordering drinks, specifically martinis, and in the martinis were live freshwater crabs called drunken crabs. And after they finished their martinis they ate the freshwater crabs, which are very small, and they acquired the lung infection," said Dr. Diaz.

Morrison had never heard of such a thing.

"What do you like in your martini?" he was asked.

"An olive, thank you," Morrison replied with a laugh.

Once the parasite enters the body it makes a beeline for the lungs. "It actually gets into the gastrointestinal track and then it penetrates out of the gastrointestinal track and it can either perforate through the diaphragm, or enter the lungs, or it can go right through the liver and enter the lungs," stated Dr. Diaz.

There are other symptoms that can result from the infection, including headaches, seizures, stiff neck, loss of vision and even death, according to the LSUHSC.

Diaz said it was already known before human cases were reported in the U.S. that animals suffered from the infection. "When you see that crawfish escape at the crawfish boil and your cat runs after it and plays with and then eats, that's how cats can acquire the infection and it is an infection that is specific for the lungs," he said.

It is an infection that health professionals say can be avoided by simply cooking crustaceans before consumption. The Centers for Disease Control and Prevention recommends reaching a boiling or cooking temperature of 145 degrees for crustaceans.

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