Gnathostomiasis is an infection caused by the roundworm gnathostoma spinigerum and manifests with abdominal pain or painful migrating skin lesions. It is contracted from eating raw or undercooked fish, chicken, frog, snake or pig.

Where does it occur?

It occurs mainly in South East Asia and South America. Thailand and Japan account for the vast majority of cases.

How is it transmitted?

It is transmitted primarily by eating raw or undercooked fish, chicken, frog, snake or pig. Usual suspects are sashimi, sushi and ‘ceviche.’ It can also be present in contaminated water.

Is it contagious from person to person?

It is not contagious from person to person.

What is the risk for travelers?

Generally the risk is very low, but increased in travelers to developing nations who eat raw fish and meat.

How soon after exposure will one develop symptoms?

Symptoms of abdominal pain can be seen 2-4 days after ingestion, however it takes 3-4 weeks or perhaps months for the larvae to migrate through the liver to skin and muscles and cause areas of swelling that migrate; these can be painful and itchy or painless.

What are the signs and symptoms?

Symptoms include abdominal pain, nausea and vomiting and subsequently one will notice areas of swelling of skin; usually of the abdomen which can be painful and itchy. These skin swellings can last in one area from 1-4 weeks and then migrate to another area.

If the larvae migrate to the central nervous system one experiences headaches, weakness of the muscles of the face or limbs, decreased level of consciousness etc.

Are there any lab tests to diagnose the illness?

Blood eosinophil count is elevated and specific antibody tests (ELISA) against gnathostoma spinigerum is available.

Is there any treatment?

Antibiotics like albendazole and ivermectin are effective

What preventive measures can be taken?

Avoid raw or undercooked fish and meats.

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