A Fresno man with an obsessive appetite for raw salmon sushi provided Dr. Kenny Banh, an emergency physician at Community Regional Medical Center, with a great story to share with producers of “This Won’t Hurt A Bit,” a fast-paced podcast for the curious health consumer.
But stop reading now if you are inclined to be queasy.
Banh was working his shift at the downtown Fresno hospital about two months ago when a young man came in complaining of bloody diarrhea – not an unusual complaint treated at the very busy ER, but this patient had another problem that he wanted addressed: “I really want to get treated for worms,” he told Banh.
Skeptical at first, as most ER doctors are of patients self-diagnosing their ailments, the man handed Banh proof in a grocery bag. “I take out a toilet paper roll, and wrapped around it of course is what looks like this giant, long tapeworm,” Banh said on the Jan. 8 podcast.
The really long helminth – the general name for a parasitic worm – unraveled and laid out on paper towels on the emergency department floor, measured 5½ feet long. “Just my height,” Banh said.
The man had discovered the worm as it began wiggling out while he sat on the toilet. He was scared, Banh said. “He thinks he’s dying, ‘oh my guts are coming out of me.’ ” But as he pulls, and the worm continues to come out, it began moving and he felt relieved to realize it was a tapeworm.
The Fresno tapeworm’s length gathered a lot of attention in the ER, but it wasn’t a record-breaker. Dr. Jessica Mason, the CRMC emergency room physician who is a co-host of the podcast, explained a tapeworm can grow to 40 feet in length. The treatment for the patient: a pill that is no different from the single dose given to a dog to kill worms. Although the tapeworm had likely all been pooped out, some of it could have broken off to grow again.
Tapeworms can grow inside for a while without noticeable symptoms. Left untreated, they can cause weight loss and anemia. (Side note from Banh: Some people actually have self-infected themselves with tapeworm eggs to lose weight. But he does not recommend it).
The tapeworm didn’t have that effect on the Fresno patient, who was a little chubby, Banh said.
How he came to have a 5½-foot tapeworm didn’t surprise Banh.
The patient swore that he had not traveled anywhere out of the country, drunk well water or done anything out of the ordinary to become infected – except he confessed that he loves sushi – raw salmon sushi. “He says, ‘I eat raw salmon almost every day,’ ” Banh said on the podcast.
A quick online search found there has been a well-documented outbreak of Japanese tapeworms in Pacific-caught salmon. A mystery solved for the patient, who quickly swore he would not touch the fish again.
Tapeworms can be found in many types of fish that has not been properly flash frozen (the freezing kills the tapeworms).
But the source of the Fresno tapeworm gave Mason momentary pause: Raw salmon sushi is her favorite.
As for Banh, the tapeworm won’t stop him from eating sushi. However, tuna – not salmon – is his choice.