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- Original article The association between the consumption of raw Kudoa septempunctata–infected farmed Paralichthys olivaceus and gastrointestinal symptoms
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Jihye An1
, En-Joo Jung2,3
, Soon-Ok Lee4
, Jong-Hoon Choi5
, Jung Hee Kim6
, Sung-Jong Hong7,8
, Sung-Hee Hong5
, Jung-Wong Ju5
, Hyungjun Kim9
, Kwang-Pil Ko3,10
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Epidemiol Health 2026;e2026003
DOI: https://doi.org/10.4178/epih.e2026003 [Accepted]
Published online: January 19, 2026
2Department of Public Healthcare Center, Seoul National University Hospital, Seoul, Korea
3Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Korea
4Department of Medical Research Center for Bioreaction to Reactive Oxygen Species, Biomedical Science Institute, School of Medicine, Graduate School, Kyung Hee University, Seoul, Korea
5Division of Vectors and Parasitic Diseases, Korea Disease Control and Prevention Agency, Cheongju, Korea
6Department Diseases Research, Incheon Metropolitan City Institute of Public Health and Environment, Incheon, Korea
7Convergence Research Center for Insect Vectors Incheon National University, Incheon, Korea
8Chung-Ang University 84 Heukseok-ro, Dongjak-gu, Seoul, Korea
9Korea Disease Control and Prevention Agency Division of Infectious Disease Control, Cheongju, Korea
10Republic of Korea Clinical Preventive Medicine Center, Seoul National University Bundang Hospital, Seongnam, Korea
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Corresponding author:
Kwang-Pil Ko,
Email: kpkono1@gmail.com
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Abstract
OBJECTIVES
Kudoa septempunctata has been identified as the causative agent of food poisoning following the consumption of raw farmed Paralichthys olivaceus. However, cohort studies providing robust evidence for an association between K. septempunctata and gastrointestinal symptoms remain limited. This prospective cohort study investigated the association between the consumption of K. septempunctata–infected farmed P. olivaceus and the occurrence of gastrointestinal symptoms.
METHODS
Individuals who purchased raw farmed P. olivaceus between 2020 and 2021 were selected as the study population. Study data included 2 rounds of questionnaire surveys administered before and after consumption, 2 muscle specimens obtained from each purchased fish, and human biological specimens collected from individuals who developed gastrointestinal symptoms within 24 hours after consumption. Data were analyzed using the chi-square test and t-test, and the association between consumption of K. septempunctata–infected farmed P. olivaceus and gastrointestinal symptoms was evaluated using relative risk estimates between exposure groups.
RESULTS
The relative risk of gastrointestinal symptoms associated with exposure to K. septempunctata–infected P. olivaceus ranged from 71.2 (95% CI, 27.0–178.6) to 124.5 (95% CI, 43.5–355) across the 2 case definitions. A strong and statistically significant association was observed between exposure to K. septempunctata–infected P. olivaceus and the development of acute gastrointestinal symptoms.
CONCLUSIONS
These findings indicate both an association and a causal relationship between consumption of K. septempunctata–infected farmed P. olivaceus and the onset of gastrointestinal symptoms.
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