Table 3. Prevalence of Anisakis sensitization according to different study samples and diagnostic tests.
| Author, year, (reference) | Sample characteristics | Sample size (n) age range (mean, SD) |
Skin Prick Tests % (n), >3 mm threshold |
ELISA/ImmunoCAP % (n), threshold |
Other tests / criteria |
|---|---|---|---|---|---|
| General asymptomatic population (15 studies) | |||||
| Abattouy, 2013 | Random samples | 333 | - | 5.1% | - |
| Del Rey Moreno, 2006 | Healthy blood donors | 77 | - |
22.1% (n = 17) |
Immunoblot 67.5% recognized antigens of A. simplex |
| Figueiredo, 2013 | Healthy military | 67 | - |
20.9% (n = 14) |
- |
| Frezzolini, 2010 | Healthy subjects | 20 | 10.0% | 10.0% | 0.0% CD63 BAT |
| Garcia, 1997 | Healthy blood donors | 51 |
19.6% (n = 10) |
27.4% | Immunoblot 1 75.0% type 4 1.9% (n = 1) type 1 15.0% type 3 |
| García-Palacios, 1996 | Random sera | 1,008 | - |
6.0% (n = 61) |
- |
| Garcia-Perez, 2015 | Healthy controls | 47 | - | 6.4% IgA1, rAni s 1; 10.6% IgA1, rAni s 5 | - |
| Guillén-Bueno, 1999 | Asymptomatic adults | 251 | - | 18.3% | Immunoblot E17, 50-70-250 kDa eosinophilia, leukocytosis |
| Lin, 2012 | Blood donors | 100 | - | 2.0% ImmunoCAP > 0.35 kU/L | - |
| Lin, 2014 | Blood donors | 993 | - |
0.4% ImmunoCAP (0.0% ELISA with rAni s 1 and rAni s 7) |
Immunoblot 40–100 kDa (weaker bands) |
| Mladineo, 2014 | Random healthy | 500 | - |
2.0% indirect ELISA Ani s 1 s 7 |
- |
| Puente, 2008 | Healthy residents | 264 (18–65 years) | - | 11.7% UA3 Ani s 7 | - |
| Purello-D’Ambrosio, 2000 | Healthy donors not occupationally exposed | 15 | 6.6% (n = 1) | 0.0% (n = 0) RAST | - |
| Valinas, 2001 | Healthy blood donors | 2,801 | - | 0.4% UA3 | - |
| Ventura, 2013 | Healthy controls | 187 | 16.0% | - | - |
| Occupationally exposed population, symptomatic and asymptomatic (3 studies) | |||||
| Mazzucco, 2012 | 94 workers in fisheries sector: fishmongers (n = 21), fish industry emplooyees (n = 35), Fishermen/sailors (n = 38) | 94 | - |
11.7% (n = 11) UniCAP-100 |
- |
| Nieuwenhuizen, 2006 | workers employed in 2 large fish-processing workplaces in the Western Cape province of South Africa | 578 |
8.0% (n = 46) |
- | - |
| Purello-D’Ambrosio, 2000 | Fishermen/fishmongers occupationally exposed group | 28 |
46.4% (n = 13) |
RAST 50.0% (n = 14) |
- |
| Symptomatic population with allergies to any kind of allergen (24 studies) | |||||
| Anadon, 2010 | Food allergic; controls non food-related allergic |
493 food allergic; 25 controls non food-related allergic. |
- | CAP-FEIA: 52.7% (n = 195 true positive + 65 false positive) 3 false negative; ELISA rAni s 1 s 7: 40.2% (n = 198) 0 false positive 0 false negative |
- |
| Añíbarro, 2007 | Food allergic | 436 | 12.4% 2 | 12.4% 2 | - |
| Asero, 2009 | Food allergic | 1,110 (12–79 years) | - | - | 0.3% prevalence of systemic reactions/ anaphylaxis |
| Bernardini, 2000 | Suspect allergy | 805 (0.5–17.6 years) | 6.1% (n = 49) | - | - |
| Caballero, 2012 | Sample A: suspect allergy other than fish related; sample B: Anisakis allergic patients (anaphylaxis, angioedema, urticaria or gastrointestinal symptoms few hours after eating undercooked fish) | Sample A: 99; sample B: 35 | Sample A: 18.0%; sample B: 100% | ImmunoCAP: sample A: 17.0%; sample B: 100% | Immunoblot rAni s 1,3,5,9,10: sample A: 15.0%; sample B: 100% |
| Consortium AAITO-IFIACI Anisakis, 2011 |
Suspect allergy | 10,570 | 4.5% (n = 474) | - | Anamnesis + exclusion fish allergy: 0.6% overall; 14.0% of sensitized |
| Daschner, 2005 | Chronic urticaria | 135 | 48.1% (combined SPT+ and IgE+) |
52.6% (only IgE+) 31.8% (only IgG4) |
- |
| Del Pozo, 1997 | Urticaria/angioedema (AE) or anaphylaxis | 100 | 14.0% | 22.0% (>0.7 kU/L) | + symptoms < 6 h after fish ingestion + exclusion other causes: 8.0% real allergy to Anisakis |
| Estrada Rodriguez, 1997 | Asthmatic/urticaria | 66 | - | 19.7% (n = 13) | - |
| Falcao, 2008 | Relapsing acute urticaria | 200 | 16.5% | 6.0% (>0.7 kU/L IgE); 9.0% (>0.35 kU/L IgE) | Combinations SPT IgE: 2.5%
(SPT and >0.7 IgE); 3.0% (SPT and >0.35 IgE); 20.0% (SPT or> 0.7 IgE); 22.5% (SPT or >0.35 IgE) |
| Frezzolini, 2010 | Chronic urticarial, atopic patients |
57 chronic urticarial; 22 atopic patients | 63.0% chronic urticarial; 14.0% atopic patients |
61.0%
(> 0.35 kU/L) chronic urticarial; 18.0% atopic patients |
CD63 BAT 67.0% combined 75% chronic urticarial; 0.0% atopic patients |
| Garcia, 1997 | Subjects with IgE against Anisakis divided into: allergic (anamnesis, the time interval <4 hours between the ingestion of fish and the onset of the reaction, and the exclusion of other causes of allergy); non allergic (had not eaten any fish 12 hours before the onset of the symptoms); doubtful (who did not remember the previous ingestion of fish or for whom the interval between ingestion and onset of symptoms was between 4 and 12 hours) |
61 overall (25 allergic; 16 non allergic; 20 doubtful) |
92.0% allergic; 50.0% non allergic; 70.0% doubtful |
CAP-radioimmunoassay 100% 3 overall; 100% 3 allergic; 100% 3 non allergic; 100% 3 doubtful |
Immunoblot 1: allergic: 80.0% type 1 pattern, 8.0% type 3; non allergic: 12.5% (n = 2) type 1, 56.3% (n = 9) type 4, 19.0% type 3; doubtful: 40.0% type 1, 35.0% type 3 |
| Gomez, 1998 | Suspected allergy | 147 | 10.0% 2 | 10.0% 2 | - |
| González de Olano, 2007 | Mastocytosis: adults (18–65 years); children (7 months-14 years) |
163 adults; 47 children | - | 26.9% (n = 44) adults; 0.0% (n = 0) children | symptoms referred 13.6% (n = 6) adults; 0.0% (n = 0) children |
| Gonzalez Munoz, 2005 | Suspect allergy subdivided into: Anisakis allergy; chronic urticaria or abdominal pain unrelated to fish ingestion; healthy controls |
88 overall; 37
Anisakis allergy; 51 chronic urticaria or abdominal pain unrelated to fish ingestion; 12 healthy controls |
- |
42.0% (n = 37) had a clinical history of A. simplex allergy confirmed by IgE+ |
CD63 BAT Anisakis+ vs Anisakis- and Anisakis + vs healthy controls, the cutoff for a positive basophil activation test was 21% (specificity = 96%, sensitivity = 100%), and 16% (sensitivity and specificity of 100%) respectively |
| Heffler, 2016 | Allergic clinic outpatients | 3,419 | 15.0% | - | 0.8% + allergic symptoms after raw fish |
| Kimura, 1999 | Urticaria or food allergy | 2,108 | - | 29.8% (n = 629) (>0.7 kU/L IgE) | - |
| Lin, 2012 | Serum samples from Allergy laboratory: sample A without any additional information on analytical results; sample B Phadiatop+ subjects |
600 sample A; 198 sample B | - | ImmunoCAP (> 0.35 kU/L); 2.2% sample A; 6.6% sample B | - |
| Lin, 2014 | Subjects with total IgE levels ≥1000 kU/L | 414 | - | 16.2% (0.2% ELISA with rAni s 1 and rAni s 7) | Immunoblot five bands ranging between 40 and 100 kDa to A. simplex CE |
| Montoro, 1997 | Patients with acute recidivous urticaria who usually eat fish or other seafood. | 25 | 64.0% (n = 16) | 76.0% (n = 19) | Immunoblot 56.0% (14 of the 25) tested sera showed the characteristic band at 49.8–80 kDa compared to the E17 reference serum. Most of the sera showed a common immunorecognition pattern with a group of bands at 200–80 kDa |
| Pascual, 1996 | Patients with increased levels of serum total IgE divided into: shellfish allergy; fish allergy; probable parasitic disease; respiratory allergy |
73 overall; 16 shellfish allergy; 20 fish allergy; 17 probable parasitic disease; 20 respiratory allergy |
- |
56.2% (n = 41) overall; 81.3% shellfish allergy; 40.0% fish allergy; 58.8% probable parasitic disease; 50.0% respiratory allergy |
- |
| Puente, 2008 | Allergic residents with negative skin prick test to Anisakis | 86 | 0.0% 3 | 3.5% UA3 Ani s 7 | - |
| Rodriguez, 2000 | Drug allergic patients | 53 | 54.7% (n = 29) | - | - |
| Ventura, 2013 | Chronic urticaria | 213 | 49.7% | - | - |
| Hospital presenting patients for any reason (5 studies) | |||||
| Andreu-Ballester, 2008 | Non appendectomized controls presenting at emergency department | 80 | - |
1.3% IgG+; 7.5% IgM+; 3.8% IgA+; 5.0% IgE+ |
- |
| Falcao, 2008 | Controls selected for programmed orthopaedic, maxillofacial, or general surgery |
200 (6–18 years) | 5.5% | 1.5% (>0.7 kU/L IgE); 3.0% (>0.35 kU/L IgE) | Combinations SPT ± IgE: 0.5% (SPT+ and >0.7 kU/L IgE); 1.5% (SPT+ and >0.35 kU/L IgE); 6.5% (SPT+ or > 0.7 kU/L IgE); 7.0% (SPT or >0.35 kU/L IgE) |
| Kim 2011 | Subjects presenting at hospital for routine controls | 498 | - |
5.0% larval Anisakis crude extract; 6.6% excretory-secretory proteins |
Immunoblot A specific protein band of 130 kDa was detected from 10 patients with western blot analysis against crude extract and excretory-secretory proteins among those who showed positive results by ELISA |
| Puente, 2008 | Non-digestive nonallergic pathologies unrelated to anisakiosis |
50 | - | 16.0% UA3 Ani s 7 | - |
| Uga, 1996 | Diarrhea /routine check-up without symptoms | 244 | - | 11.0% | - |
| Patients with digestive system disorders (6 studies) | |||||
| Andreu-Ballester,2008 | Cases appendectomized | 80 | - |
2.5% IgG+; 2.5% IgM+; 1.3% IgA+; 2.5% IgE+; |
- |
| Garcia-Perez, 2015 | Cases gastrointestinal cancer | 47 | - | 38.3% IgA1+, rAni s 1, 42.6% IgA1+, rAni s 5 | - |
| Gomez, 1998 | Sample A: eosinophilic gastroenteritis; sample B: digestive disorder different from eosinophilic gastroenteritis | Sample A: 10; Sample B: 10 | Sample A: 80.0%3 Sample B: 10.0%3 | Sample A: 80.0%3; Sample B: 10.0%3 | - |
| Guillen Bueno, 1999 | Crohn disease | 73 | - |
29.0% specific total Ig (G+M+A) 44.0% IgG+; 18.0% IgM+; 53.0% IgA+ |
Immunoblot: human anisakidosis reference serum (E17); 50 and 250 kDa, with a band of about 70 kDa |
| Gutierrez, 2002 | 19 digestive Haemorrhaging; 30 Crohn’s disease; 4 digestive cancer; 5 appendicitis |
57 (42.38 ± 17.60 years) | - |
Crude Extract: Igs-CE 89.4%; IgG-CE 75.4%; IgM- CE 26.3%; IgA- CE 63.1%; IgE- CE 14.0%; Excretory- Secretory antigens: Igs- ES 49.1%; IgG- ES 57.8%; IgM- ES 22.8%; IgA- ES 57.8% |
Immunoblot 24.0% and 48.0% of sera from patients with symptoms of Crohn’s disease and digestive haemorrhaging, respectively, showed a positive immunorecognition pattern of CE antigen. |
| Toro, 2004 | Dyspeptic symptoms | 174 | - |
13.8% (n = 24) IgE anti Ani s 1 |
- |
| Post-partum women (1 study) | |||||
| Figueiredo, 2015 | 170 from high-risk birth unit and 139 from a low-risk birth unit | 309 | - | 19.4% (n = 60) IgG+ | - |
1 Pattern types: type 1: group of several bands of medium molecular weight (MW) (30 to 50 kd) and others of low MW (14 to 30 kd); type 2: two or more bands of medium MW; type 3: only one band of medium MW (about 40 kd); type 4: negative blot without any band.
2 It is not specified whether each subject was tested with both IgE detection and SPT or only one diagnostic technique.
3 The prevalence rate is the result of an inclusion criterion of the study.