Infectious Diseases Associated With Eating Sushi and Sashimi

Sushi is a traditional Japanese food and a favorite for many in the United States. Sashimi, which is thinly sliced raw fish often served with sauces (like wasabi or soy sauce), is another popular delicacy. 

Unlike sashimi, sushi does not necessarily involve raw fish. In fact, sushi simply refers to the small balls or rolls of vinegar-flavored cooked rice. These rice rolls are then wrapped in seaweed and garnished with vegetables, egg, raw fish, cooked fish, or other foods.

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That said, when enjoying sashimi or sushi that contains raw fish, it's important to be aware of the health risks, which include consuming disease-causing bacteria or parasites.


Human infection by Anisakiasis (herring worm) and other nematodes, or roundworms, can be caused by eating certain raw or undercooked fish.

Ingestion of this tiny worm can result in severe abdominal pain, nausea, and vomiting within hours of eating. Even more, if the worms don’t get coughed up or vomited out, they can burrow into the walls of your intestines and cause a localized immune response.

If this does occur, the worms eventually die and are removed by the immune system. However, in severe cases, physical removal of the worms by endoscopy or surgery is needed to reduce the pain.


The bacterial species Vibrio parahaemolyticus is associated with eating raw or undercooked fish and shellfish, particularly oysters. Infection can cause symptoms like diarrhea (including bloody diarrhea), abdominal cramps, nausea, vomiting, headache, fever, and chills. It can become severe in people with weakened immune systems. 

Another Vibrio species, Vibrio vulnificus, has been found in oysters, clams, and crab. In healthy people, ingestion of this microbe may cause nausea, vomiting, watery diarrhea, abdominal cramps, and fever. In people with liver disease or weakened immune systems, the microbe can enter the bloodstream, causing a life-threatening whole-body infection. 

In addition, the Vibrio species can cause wound infections through open sores exposed to water harboring the bacteria. Examples include scrapes when opening oysters or working on boats. Like the gastrointestinal illness, these types of wound infections are most severe in people with impaired immune systems.


Listeriosis is an infection caused by the bacteria Listeria monocytogenes. This bacteria can be found in raw seafood, unpasteurized milk and dairy products, and vegetables such as raw sprouts, among other foods.

The biggest risk for listeriosis is in people who are pregnant, their newborns (the bacteria can pass through the placenta), people aged 65 or older, and those with weakened immune systems.

If listeria spreads to infect the nervous system, it can lead to meningitis and meningoencephalitis. Nervous system infection is most common in the immunocompromised and the elderly.

In people who are not pregnant, listeriosis may cause mild symptoms like fever and diarrhea, or more severe symptoms if the infection has spread to the nervous system (for example, stiff neck and confusion). In pregnant people, listeriosis may lead to a miscarriage, stillbirth, premature delivery, or a serious infection in the newborn.


Salmonella infection causes symptoms of diarrhea, fever, and stomach cramps, often beginning within one to three days of eating the contaminated food. Those most at risk of developing a more severe illness (sometimes requiring hospitalization) are people aged 65 and older or with low immune function, as well as infants.

Bacillus Cereus

Bacillus cereus is another foodborne illness associated with eating sushi, because it's linked to eating contaminated rice along with other foods like fish, vegetables, meats, and milk.

There are two types of Bacillus cereus infections: a diarrheal type, and a vomiting type. The vomiting type is linked to consuming contaminated rice products, such as fried rice that has been sitting at room temperature for long periods.  

Contaminated Food Handlers

If food handlers do not use good hand hygiene, other infections (like norovirus, hepatitis A, and Staphylococcus aureus) can spread. Those who handle food should always wash their hands properly (and stay home from work if ill).

The bottom line is that pregnant women, the elderly, small children or infants, people with liver disorders, and people with weakened immune systems have a greater risk for more severe outcomes from foodborne infections and should more carefully consider what they eat.

A Word From Verywell

Inquiring about the practices and guidelines used to prepare your food is never a bad idea—and if your gut instinct is that something is not right, follow it. Also, talk to your healthcare provider if you are worried about your personal risk or if you think you may have developed an infection from eating sushi or sashimi.

Otherwise, if you are healthy and know your food is coming from a reputable source, please do enjoy this Japanese, nutrient-rich delight.

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6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. Anisakiasis. Updated May 31, 2019.

  2. Centers for Disease Control and Prevention. Vibrio species causing vibriosis: Questions and answers. Updated March 5, 2019.

  3. Centers for Disease Control and Prevention. Listeria: People at risk. Updated December 12, 2016.

  4. Centers for Disease Control and Prevention. Salmonella. Reviewed November 13, 2019.

  5. US Food & Drug Administration. BAM: Bacillus cereus. Updated November 7, 2019.

  6. Centers for Disease Control and Prevention. Key Facts About Food Poisoning. Reviewed October 11, 2019.

Additional Reading
  • Centers for Disease Control and Prevention. (2012). Anisakiasis.
  • Centers for Disease Control and Prevention. (2017). Vibrio Species Causing Vibriosis. Information for Health Professionals & Laboratorians.
  • Centers for Disease Control and Prevention. (2017). Questions and Answers: Listeria (Listeriosis).
  • Food and Drug Administration. Bad Bug Book, Foodborne Pathogenic Microorganisms and Natural Toxins. Second Edition. [Vibrioparahaemolyticus, pp. 26, Bacillus cereus and other Bacillus species. pp. 92 ]. 2012
  • Muscolino D, Giarratana F, Beninati C, Tornambene A, Panebianco A, Ziino G. Hygienic-sanitary evaluation of sushi and sashimi sold in Messina and Catania, Italy. Ital J Food Saf. 2014 Apr 17;3(2):1701.