Journal Article

Identification of <i>Kudoa septempunctata</i> as the Causative Agent of Novel Food Poisoning Outbreaks in Japan by Consumption of <i>Paralichthys olivaceus</i> in Raw Fish

Takao Kawai, Tsuyoshi Sekizuka, Yuichiro Yahata, Makoto Kuroda, Yuko Kumeda, Yoshio Iijima, Yoichi Kamata, Yoshiko Sugita-Konishi and Takahiro Ohnishi

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 54, issue 8, pages 1046-1052
Published in print April 2012 | ISSN: 1058-4838
Published online January 2012 | e-ISSN: 1537-6591 | DOI:
Identification of Kudoa septempunctata as the Causative Agent of Novel Food Poisoning Outbreaks in Japan by Consumption of Paralichthys olivaceus in Raw Fish

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Background. Outbreaks of an unidentified food-borne illness associated with the consumption of raw fish have increased in Japan since 2003. Those affected with this illness develop diarrhea and emesis within 2–20 hours after a meal including raw fish. No known causative agents such as bacteria, viruses, bacterial toxins, or toxic chemicals have been detected in the foods that were ingested. Fortunately, this illness is self-limiting with good prognosis in all cases.

Methods. We conducted an epidemiological analysis of outbreaks that occurred during 2008 and 2010 and analysed a fish sample from one outbreak by metagenomic DNA sequencing, real-time polymerase chain reaction, and direct microscopic observations. The pathogenicity of a putative risk factor identified by these techniques was assessed using the suckling-mouse test and a house musk shrew emetic assay.

Results. The epidemiological analysis of outbreaks in 24 municipalities involving >1300 subjects implicated an olive flounder (Paralichthys olivaceus) as the causative food source. The presence of Kudoa septempunctata, a recently-described myxosporean species in P. olivaceus, was prevalent in the causative foods. K. septempunctata induced watery stools and an elevated fluid accumulation ratio in suckling mice, as well as vomiting in house musk shrews.

Conclusions. These results identify K. septempunctata as the etiological agent of this novel food-borne illness outbreak associated with consumption of raw P. olivaceus. This is the first report, to our knowledge, demonstrating the human pathogenicity of Kudoa spores.

Journal Article.  2886 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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