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Close up of salmon maki.
Sushi can be delicious, but it also carries a health hazard, both for individuals and for society at large.

How safe is your sushi?

Bacteria in raw seafood can make you sick. Seafood can also spread bacteria that are resistant to antibiotics.

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Sushi has become everyday fare in Norway and elsewhere around the globe, and many people opt for sashimi and other raw fish when they want to treat themselves to something tasty.

You don't have to worry too much about getting sick from eating sushi, but it's still good to be aware of the risks.
You don't have to worry too much about getting sick from eating sushi, but it's still good to be aware of the risks.

It is important to emphasise here that, as a general rule, it is completely safe to eat this type of food in Norway. However, despite the fact that sushi can be delicious, it also carries a health hazard, both for individuals and for society at large.

“Bacteria in sushi, sashimi, and cold-smoked fish products can pose a risk to people who eat such foods frequently, especially people with weak immune systems, children, and the elderly,” Hyejeong Lee says.

She recently completed her PhD at the Department of Biotechnology and Food Science at NTNU. In her thesis, she investigated different varieties of Aeromonas bacteria in seafood products that do not undergo extensive processing. 

Without heat treatment or the use of other antibacterial methods, the risk of bacteria levels becoming high increases sharply.

“The goal was to gain more knowledge about Aeromonas in this type of seafood – both the bacteria’s role in the deterioration of the product and in causing disease. Furthermore, we wanted to see if raw seafood can spread antibiotic-resistant bacteria,” Lee says.

Listeria monocytogenes is probably the best-known pathogenic bacteria related to raw or mildly processed seafood. However, the prevalence of Aeromonas in these kinds of products has worried scientists for some time.

Mild processing does not inhibit bacterial growth

Lee started with fish products readily available in the Norwegian market. She checked these products for Aeromonas bacteria.

Hyejeong Lee recently completed her PhD at the Department of Biotechnology and Food Science at NTNU.
Hyejeong Lee recently completed her PhD at the Department of Biotechnology and Food Science at NTNU.

“The results show that the mild processing these fish products receive does not guarantee that the growth of Aeromonas bacteria will be inhibited,” says Lee.

In other words, the processing of sushi, sashimi, and cold-smoked fish is ineffective in preventing bacterial growth. But that’s not all.

“The majority of these Aeromonas variants are possibly pathogenic and there are often several different risk factors associated with them,” she says.

Lee emphasises that the risk of getting sick from Aeromonas is admittedly very small, especially for healthy people.

Aeromonas is often ignored when we talk about food safety. I think my research highlights that the food industry needs to pay more attention to these bacteria,” Lee says.

About Aeromonos bacteria:

  • Aeromonas is a bacterial genus that exists everywhere in nature. In food, the bacteria are primarily associated with seafood. 
  • Aeromonas: Incubation period of 6-48 hours. 
  • Symptoms include stomach pain and diarrhoea, often accompanied by a mild fever, headache, and occasionally vomiting. In severe cases, the illness can resemble dysentery with bloody stools. Duration is usually 1-3 days. 
  • Very few outbreaks have been reported in Norway. In 1994, there was an outbreak in Norway with three cases caused by rakfisk (fermented fish) stored in Aeromonas-contaminated stream water. 

(Source: Infection Control Guidelines, Norwegian Institute of Public Health (link in Norwegian))

Can spread antibiotic resistance

It is, of course, not very nice for the individuals who become sick, but looking at the big picture, another factor is even more important.

Aeromonas bacteria in the sea frequently exchange genetic material with other bacteria. This is especially unfortunate if this genetic material comes from bacteria that are resistant to antibiotics.

“Some strains of Aeromonas can also spread antibiotic resistance from one type of bacteria to another. Eating seafood infected by resistant bacteria is a likely way these bacteria can spread from marine animals and environments to humans,” Lee concludes.

Resistant bacteria are a growing problem around the world. Resistant bacteria do not cause more disease than other bacteria, but they are far more difficult to treat, because not all types of antibiotics work against them. In a worst case scenario, no antibiotics work at all.

How to combat the spread

Anita Nordeng Jakobsen, associate professor at NTNU’s Department of Biotechnology and Food Science.
Anita Nordeng Jakobsen, associate professor at NTNU’s Department of Biotechnology and Food Science.

“To combat the spread of antibiotic-resistant bacteria, it is important that we adopt a broad approach that looks at animal and human health, food production, and the environment together in order to achieve better public health,” Anita Nordeng Jakobsen says. She is an associate professor at NTNU’s Department of Biotechnology and Food Science.

She points out that microorganisms are transferred between animals and humans via food and the environment, so reduced use of antibiotics alone is not enough to prevent bacterial proliferation.

How to safely eat raw seafood:

  • Eat raw or mildly processed seafood products when they are as fresh as possible.
  • Maintain good personal hygiene and kitchen hygiene when preparing food.
  • Maintain adequate refrigeration at all links of the supply chain to inhibit bacterial growth.

Preventative methods include systematically monitoring and taking samples in production environments, finding good monitoring indicators, implementing measures when multidrug-resistant bacteria are detected in groups of animals, vaccination, as well as education and awareness-raising work in food production around the world.

Strict regulation by the authorities is probably the most important means of tackling the problem of antibiotic-resistant bacteria. However, individuals can make a difference by choosing raw produce from countries that only use small amounts of antibiotics in aquaculture, such as Norway.

Norway is among the best in the world when it comes to restrictive use of antibiotics both in the aquaculture industry and in livestock farming. 

However, preventive or growth-promoting use of antibiotics is common in other parts of the world, especially Southeast Asia.

Reference:

Lee et al. Whole genome sequence analysis of Aeromonas spp. isolated from ready-to-eat seafood: antimicrobial resistance and virulence factorsFrontiers in Microbiology, vol. 14, 2023. DOI: 10.3389/fmicb.2023.1175304

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