I was watching one of the political opinion cable TV programs last night (which I could venture to guess as I was channel surfing) and the topic the host was discussing was the new State Department dump of 7,000 additional Hillary Clinton emails.

Hillary Clinton/photo/ donkey hotey  donkeyhotey.wordpress.com
Hillary Clinton/photo/ donkey hotey donkeyhotey.wordpress.com

One that interests some has in the subject line: Gefilte fish. “Where are we on this?” was in the email body.

Apparently, news accounts says the mysteriously titled email was sent to Richard R. Verma, who was the assistant secretary of state on legislative affairs at the time, and Jake Sullivan, one of Clinton’s high-ranking advisers.

Quite frankly, when I heard the term, Gefilte fish, my thoughts immediately turned to a tapeworm–but I’ll get to that in a moment.

Curiosity forced me to find out more about the Gefilte fish email and I stumbled upon this article in the Jerusalem Post, which stated:

As the confusion gained speed, Yair Rosenberg, a writer for Tablet magazine, was able to help explain the incident, which was mentioned in the recent book by Kulanu MK Michael Oren Ally: My Journey Across the American-Israeli Divide, about his time as the Israel’s ambassador to the US.

It turns out that the incident involved an American shipment of carp, or white fish, that was sent to Israel from Illinois ahead of the Passover holiday. Carp is the central ingredient in gefilte fish, which sees demand jump before Passover and the High Holidays.

Oren wrote that carp was one of the items exempted from the 1985 free trade agreement between the US and Israel, along with oranges, apples and avocados. Out of fears that the American imports would be cheaper than the Israeli versions, the products usually  face a 120 percent import tax

This prompted then-Illinois Rep. Don Manzullo to appeal to Clinton for an exception in 2010.

Talking about his first year as ambassador, Oren wrote that “in view of the possible diplomatic damage, I thought Israel should make this one exception” to allow the American carp import.  Still Manzullo reportedly “ramped up the pressure” on the ambassador and secretary of state.

Oren quoted Clinton as telling reporters during the incident, “You think finding Middle East peace is hard, I’m dealing with carp!”

Back to my nerdish ways. The gefilte fish email made me think of Diphyllobothrium latum, or the fish tapeworm.

The parasite is basically a Scandinavian import to the United States. As the late Robert Desowitz describes in his classic book “New Guinea Tapeworms and Jewish Grandmothers”, many Scandinavian fishermen settled in the cool lake regions of Minnesota and Wisconsin in the nineteenth century and continued to fish for a living but with that brought them the habit of defecating in the water.

This in turn infected the fish of these lakes with the parasite they brought with them.

Gravid proglottids of Diphyllobothrium latum/CDC
Gravid proglottids of Diphyllobothrium latum/CDC

So how did this affect Jewish grandmothers? The fish from the upper Midwest would be imported to New York City. Pike, carp and pickerel would be available to the main customers, Jewish grandmothers who would create balls of minced fish called gefilte fish.

The gefilte fish would be boiled until it was done. This issue for the Jewish grandmothers is they would use their instincts on determining when it was done. They did this by tasting the fish at different stages of cooking and as Dr. Desowitz cleverly states, “they unwittingly get a Scandinavian immigrant in their digestive tract”.

What is the fish tapeworm? It is several species from the genus Diphyllobothrium with D. latum being most common. The adult tapeworm can grow in excess of 50 feet in length.

It occurs in lake regions in the northern hemisphere but cases are seen in the sub-arctic, temperate and tropical zones where eating raw or partly cooked fish is popular.

In the U.S., infections are sporadic and usually come from eating uncooked fish from Alaska or, less commonly, from Midwestern and Canadian lakes.

The disease is frequently asymptomatic, however some people develop vitamin B12 deficiency (pernicious) anemia. Very heavy infections may cause diarrhea, obstruction of the bile duct or intestine and toxic symptoms.

Humans and other animals infected with this tapeworm can disseminate eggs into the environment for many years as long as worms remain in the intestine.

Diagnosis is by identification of the characteristic eggs in feces. Treatment with the antiparasitic drug Praziquantel is the treatment of choice.

Prevention of this disease is by thorough cooking of freshwater fish.

Fortunately for the Jewish grandmothers, the introduction of fish inspection, sanitary practices and thermometers (which was considered high tech back then), this tapeworm is relatively rare in the U.S.

Robert Herriman is a microbiologist and the Editor-in-Chief of Outbreak News Today

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