Clinical diagnosis of anisakiosis is rarely done before surgery has been performed for suspicion of appendicitis, gastric tumour, etc. Often a biopsy is taken and the correct diagnosis made when the larvae are identified in histological sections. Skin tests, indirect immunofluorescence (IFL) and the enzyme linked immunosorbent assay (ELISA) have been tried with limited success due to cross-antigenicity with other helminths and failure to detect light infections (Ruitenberg 1970). An assay using monoclonal antibody specific for Anisakis larvae antigen seems, however, promising (Yagihashi et al. 1990). Several methods have been developed for diagnosis of Anisakis simplex allergy, these include IgE immunoblotting (Garcia et al. 1997) and capture ELISA (Lorenzo et al. 1999).

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