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Diphyllobothriasis Associated with Salmon Consumption in Pacific Coast States

A. James Ruttenber^*, Bruce G. Weniger^*, Frank Sorvillo, Robert A. Murray AND Sandra L. Ford^*

^* Centers for Disease Control, Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia 30333
Department of Health Services, Los Angeles County, California
State of California Department of Health Services

A review of requests for niclosamide (Niclocide® or Yomesan®) made to the Centers for Disease Control Parasitic Diseases Drug Service indicated that an outbreak of diphyllobothriasis occurred in west coast states in 1980, and in the Los Angeles area in 1981. Our investigation of 52 infections that occurred in 1980 implicates fresh salmon (Oncorhynchus spp.) as the host for the Diphyllobothrium parasite in 82% of the persons interviewed. We describe here common symptoms of the infection, methods of fish preparation employed by infected individuals, and epidemiologic data. We suggest that changes in fish marketing practices and the popularity of uncooked or slightly cooked fresh salmon were responsible for this epidemic. We recommend that salmon be either cooked or frozen before it is eaten.

^* Use of trade names is for identification only and does not imply endorsement of the Public Health Service or the Department of Health and Human Services.