Claire joins the TWiP team to discuss her training and experience as an infectious disease physician, and her transition to science communication, then we solve the case of the Honduran Male with Seizures.
Hosts: Vincent Racaniello, Dickson Despommier, Daniel Griffin, and Christina Naula
Guest: Claire Panosian
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Download TWiP #207 (56 MB .mp3, 93 minutes)
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Links for this episode
- Claire’s website
- Claire’s videos (Vimeo)
- Letters read on TWiP 207
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Case Study for TWiP 207
Woman in 20s, spent time in Kenya 6 months prior, vomited up a worm. 0.5 cm in length. Sent to lab. Was moving. Earlier that day she went out with friends to sushi place, ate fish. Developed horrible abdominal pain, then vomited.
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Music by Ronald Jenkees
Dear Drs. Naula, Racaniello, Despommier and Griffin.
I discovered This Week in Parasitism over a year ago, as a spinoff from TWIV, and now I am hooked to both programs. This is the first time I am writing to you, in response to the case study about a woman in her twenties who vomits a small worm after eating sushi.
I was almost led into confusion by the little tricky piece of information provided by Dr. Griffin when he added the woman traveled to Kenya six months before the worm incident.
However, when examining all the pieces of information, I believe the patient did not get infected in Kenya but the United States.
After I searched for information in the CDC website, and consulted the Parasitic Diseases book in PDF which is available on the Doctors Without Borders website, my best guess is that the patient ate sushi infected with Anisakis worms. These worms are present in raw or undercooked fish or squid, and therefore, can be found in sushi.
I could not tell, or imagine, whether she ingested only one worm, and I could not find any references in the literature about how likely is it to ingest only one worm when eating raw fish infected with Anisakis worms. In any case, I hope she was lucky enough to expel all the worms she ate when she vomited. This is because, when worms are not vomited, they can invade the gastrointestinal tract, die there and produce inflammation, gastric pain, nausea, and possibly, diarrhea.
According to the Merck manual and your book, the treatment consists of the physical removal of the worms. Albendazole 400 mg administered orally twice a day for 3 to 21 days is another option.
Thank you for all you do to educate the public.
Y’all, along with the TWIV team, are my favorite YouTubers in the entire world :).
Student at CUNY School of Public Health (Ph.D. in Epidemiology)