Risk of parasitic worm infection from eating raw fish in Hawai'i: a physician's survey.

Public health concerns have been raised over the risk of parasitic helminth (roundworm, tapeworm and fluke) infections from eating raw fish, an increasing US consumer trend. Hawai'i consumers eat seafood at nearly 3 times the US national average rate, with a long tradition and high level of raw fish consumption. The local fish species commonly eaten raw in Hawai'i include tuna (bigeye, yellowfin, albacore and skipjack), marlin (blue and striped) and deepwater snappers (long-tailedred, pink and blue green). Forty-eight Hawai'i-based physicians (gastroenterologists, internists, general and family practitioners) were surveyed to count known cases of parasitic worm infection linked to raw fish consumption and to explore physicians' perceptions of risk associated with the consumption of fresh, never frozen local fish with an emphasis on raw tuna and skipjack. No single known case of helminth infection due to consumption of raw tuna or skipjack, or other local fish species caught in Hawai'i was reported. The majority of the physicians surveyed reported that they eat raw yellowfin and bigeye tuna, also eat raw skipjack and do not think that these fish present a significant health risk of helminthic parasites. The survey results support the conclusion that the risk of parasitic helminth infection from the consumption of Hawai'i-caught tuna, skipjack, marlin and deepwater snappers is negligible.