{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:54:58Z","timestamp":1787849698566,"version":"build-2784847793"},"reference-count":23,"publisher":"Korean Society of Epidemiology","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018688","name":"Korea Disease Control and Prevention Agency","doi-asserted-by":"crossref","award":["2019-P4402-00"],"award-info":[{"award-number":["2019-P4402-00"]}],"id":[{"id":"10.13039\/100018688","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100018688","name":"Korea Disease Control and Prevention Agency","doi-asserted-by":"crossref","award":["2021-07-002"],"award-info":[{"award-number":["2021-07-002"]}],"id":[{"id":"10.13039\/100018688","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["e-epih.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol Health"],"abstract":"<jats:p>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\u2013infected 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\u2013infected 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\u2013infected P. olivaceus ranged from 71.2 (95% confidence interval [CI], 27.0 to 178.6) to 124.5 (95% CI, 43.5 to 355.0) across the 2 case definitions. A strong and statistically significant association was observed between exposure to K. septempunctata\u2013infected 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\u2013infected farmed P. olivaceus and the onset of gastrointestinal symptoms.<\/jats:p>","DOI":"10.4178\/epih.e2026003","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T08:26:57Z","timestamp":1768984017000},"page":"e2026003","update-policy":"https:\/\/doi.org\/10.4178\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The association between the consumption of raw Kudoa septempunctata\u2013infected farmed Paralichthys olivaceus and gastrointestinal symptoms"],"prefix":"10.4178","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9517-2908","authenticated-orcid":true,"given":"Jihye","family":"An","sequence":"first","affiliation":[{"name":"Department of Epidemic Intelligence Service, Incheon Communicable Diseases Center, Incheon, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0757-6032","authenticated-orcid":true,"given":"En-Joo","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Public Healthcare Center, Seoul National University Hospital, Seoul, Korea"},{"name":"Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1774-056X","authenticated-orcid":true,"given":"Soon-Ok","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medical Research Center for Bioreaction to Reactive Oxygen Species, Biomedical Science Institute, School of Medicine, Graduate School, Kyung Hee University, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2708-2671","authenticated-orcid":true,"given":"Jong-Hoon","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Vectors and Parasitic Diseases, Korea Disease Control and Prevention Agency, Cheongju, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8231-4252","authenticated-orcid":true,"given":"JungHee","family":"Kim","sequence":"additional","affiliation":[{"name":"Incheon Metropolitan City Institute of Public Health and Environment, Incheon, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8677-4714","authenticated-orcid":true,"given":"Sung-Jong","family":"Hong","sequence":"additional","affiliation":[{"name":"Chung-Ang University, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5253-7254","authenticated-orcid":true,"given":"Sung-Hee","family":"Hong","sequence":"additional","affiliation":[{"name":"Division of Vectors and Parasitic Diseases, Korea Disease Control and Prevention Agency, Cheongju, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5248-6995","authenticated-orcid":true,"given":"Jung-Won","family":"Ju","sequence":"additional","affiliation":[{"name":"Division of Vectors and Parasitic Diseases, Korea Disease Control and Prevention Agency, Cheongju, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0254-965X","authenticated-orcid":true,"given":"Hyungjun","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease Control, Korea Disease Control and Prevention Agency, Cheongju, 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Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2679","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1111\/jfd.12395"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir1040"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.7847\/jfp.2013.26.3.129"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.14252\/foodsafetyfscj.2014026"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.5668\/JEHS.2020.46.2.184"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.3390\/fishes5030021"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.4178\/epih.e2017014"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.4178\/epih.e2017037r"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.4178\/epih.e2017004"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.5657\/KFAS.2014.0611"},{"key":"ref11","first-page":"85","volume-title":"Economic impact effect analysis of 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