title: High prevalence of Anisakis simplex hypersensitivity and allergy in Sicily, Italy.
abstract: BACKGROUND
  Anisakis simplex can elicit allergic reactions when ingested in raw or marinated fish. The prevalence of A simplex hypersensitivity and allergy in Sicily (Italy), an area where the consumption of raw or marinated fish is very common, has not been investigated thus far.
  
  
  OBJECTIVE
  To investigate the prevalence of A simplex sensitization and its clinical relevance in a large group of unselected patients.
  
  
  METHODS
  All consecutive patients referred to the authors' allergy clinic during a 22 month-period were included in the study, evaluated for sensitization to A simplex and other allergens depending on their clinical history, and investigated for allergic symptoms after the ingestion of raw or marinated fish.
  
  
  RESULTS
  Of 3,419 patients screened, 527 (15.4%) were sensitized to A simplex and 29 of these (5.5% of sensitized patients) had a history of A simplex allergy. Approximately 30% of patients had mono-sensitization to A simplex. Co-sensitization to house dust mites or molds yielded an odds ratio of 1.98 or 3.18, respectively, for allergy to A simplex.
  
  
  CONCLUSIONS
  A high prevalence of A simplex sensitization in a large proportion of patients with mono-sensitization was found, confirming that eating habits influence sensitization to this nematode. Allergic symptoms from A simplex ingestion in raw or marinated fish were quite frequent, with symptoms ranging from oral allergy syndrome to anaphylaxis. Patients sensitized to A simplex were more prone to have allergic symptoms when they had co-sensitization to house dust mites or molds, suggesting possible cross-reactive but clinically relevant allergens between these allergenic sources.
authors.affiliation: Respiratory Medicine and Allergology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy. Electronic address: heffler.enrico@gmail.com.
authors.forename: Enrico
authors.initials: E
authors.lastname: Heffler
authors.affiliation: Respiratory Medicine and Allergology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: Maria Eva
authors.initials: ME
authors.lastname: Sberna
authors.affiliation: Respiratory Medicine and Allergology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Sichili
authors.affiliation: Respiratory Medicine and Allergology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Intravaia
authors.affiliation: Respiratory Medicine and Allergology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: Giuliana
authors.initials: G
authors.lastname: Nicolosi
authors.affiliation: Respiratory Medicine and Allergology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: Morena
authors.initials: M
authors.lastname: Porto
authors.affiliation: Respiratory Medicine and Allergology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Liuzzo
authors.affiliation: Respiratory Medicine and Allergology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Picardi
authors.affiliation: Respiratory Medicine and Allergology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Fichera
authors.affiliation: Respiratory Medicine and Allergology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
authors.forename: Nunzio
authors.initials: N
authors.lastname: Crimi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000276:immunology; D000818:Animals; D017163:Anisakis / Q000276:immunology*; D000947:Antigens, Helminth / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D017747:Seafood / Q000009:adverse effects*; D012802:Sicily / Q000453:epidemiology; D012882:Skin Tests; D055815:Young Adult
chemical_list: D000485:Allergens; D000947:Antigens, Helminth