In August 2022, I woke up with severe heartburn and a needle-like burning sensation in my upper abdomen. The previous night, I had eaten salmon sashimi at a South Mumbai restaurant. Unable to fall asleep for nights on end, I went from one general physician to another, and each of them pinned it down to stress, anxiety, and acid reflux. Until nearly three weeks later, a colonoscopy revealed bacteria had eaten into the lining of my small intestine, carving multiple ulcers, which led to internal bleeding. “Avoid raw fish, especially in the monsoon,” my gastroenterologist said. The procedure was followed by a six-month-long recovery process that involved a cocktail of medications and bland food.
I am not alone. In April this year, nearly 100 people reported food poisoning in Sweden after eating at a sushi restaurant. Back home, a group of eleven people dined at a cafe in Navi Mumbai, and each person who ate the smoked salmon suffered from food poisoning. “My son and husband were hospitalised, and my son spent four days in the hospital due to high fever, vomiting, diarrhoea, and dehydration,” wrote diner Prithi Venkatram on Google Reviews.
Is it safe to eat raw fish in India?
“Raw fish can harbour bacteria such as non typhoidal Salmonella, Vibrio species, pathogenic E. coli, and Staphylococcus, all of which thrive if fish is not kept consistently cold or handled hygienically,” says Dr Aashik Y S, associate consultant—Medical Gastroenterology, Manipal Hospital, Bengaluru.
While these bacteria can exist in other countries as well, India poses its own challenges when it comes to raw fish. “High ambient temperatures, combined with humidity and heavy monsoon rains, make it easier for bacteria to multiply on fish during transport, storage, and preparation if the cold chain is not perfect. In summer and monsoon, even a short break in refrigeration or exposure to contaminated water and surfaces can turn otherwise safe fish into a high risk ingredient when served raw,” the doctor adds.
To kill parasites, the Food and Drug Administration in the United States mandates that restaurants need to freeze raw fish at -20°C for seven days or blast freeze it at –35°C for a shorter duration. The European Union, too, mandates that raw fish be frozen for 24 hours at certain temperatures to kill parasites before serving. In India, the Food Safety and Standards Authority of India (FSSAI) mandates that raw fish must be quick-frozen using appropriate equipment until the temperature reaches -18o C or colder at its thermal centre, but there are no guidelines on freezing temperatures for parasite destruction at restaurants.
Japanese restaurants are opening in spades in India, but not all restaurants are equipped to handle raw fish, say doctors, chefs and restaurateurs. “Problems usually arise when there are lapses in cold chain, cross contamination in the kitchen, or inadequate staff training—these are often behind cluster episodes of food poisoning,” says Aashik.
Lakhan Jethani, head chef and co-founder of Mumbai’s Mizu Izakaya, follows the internationally recognised multi-step food safety management system, Hazard Analysis and Critical Control Points (HACCP). “It starts with working with trusted suppliers who import fish from Japan or Norway. At Mizu, 150 kg of fish is flown in from Japan every week,” he says. “The second step is a surface temperature check. Fresh fish needs to be stored at less than 4°C, the fish will then measure less than 8°C. If it’s over, the fish is rejected.” Then comes the inspection of body markers. “We check the belly. The fish needs to be gutted, otherwise it could carry infections. We check if the fish looks fresh and smells fresh. It should not be over slimy, the eyes should look fresh, and the gills should be bright red in colour,” Jethani adds.
The fish then goes for an initial wash; it’s quickly filleted and then put into a freezer or lightly cured. “This is all done in an air-conditioned room. We have to follow the two-to-four-hour rule, where all ingredients have to be stored below 4°C within two to four hours,” he says. The fish, especially tuna, is frozen at -35°C to kill bacteria in a medical-grade freezer. “99% of restaurants are not equipped to freeze fish at that temperature. Tuna is a very fatty fish, and it resides in waters that are below -30°C; if it’s not stored properly, it will start harbouring bacteria,” says Jethani.
Izumi in Mumbai and Goa follows a similar process. The salmon is frozen at -40°C, while tuna at -50°C, says Nooresha Kably, co-founder and chef at Izumi. “We work with very small portions, and even before the fish completely thaws, we put it back into the freezer. It’s never left out for too long,” she adds. While Kably was not particularly a fan of delivering sushi and didn’t do it initially, she now sends ice packs along with it to ensure it doesn’t start to spoil.
How to be smart sushi consumers?
In the United States, menus come with a disclaimer: “Consuming raw or undercooked meats, poultry, seafood, shellfish, or eggs may increase your risk of foodborne illness.” In India, no such warning exists on menus. The FSSAI conducted nearly 4 lakh inspections across food establishments in 2025-26, and as many as 23,580 adjudication cases were decided, as per reports.
So, diners must choose their restaurant wisely. “Since there is no standardisation in the industry, consumers need to keep in mind that handling raw fish is a more demanding task than handling cooked fish,” says Dr Subrata Das, lead consultant and HOD—Internal Medicine, Aster Whitefield Hospitals, Bengaluru.
“Restaurants that specialise in sushi and ceviche tend to be careful. They audit their suppliers, store fish at appropriate temperatures, use separate cutting boards and knives for raw items, and train staff in hygiene,” he adds.
“A busy restaurant is a good sign. High turnover of guests means fresher fish,” adds restaurateur Gauri Devidayal. Aashik advises besides picking places with visible hygiene standards, diners should avoid sushi and ceviche that has been sitting out at room temperature, especially in hot or very humid weather. “People who are pregnant, immunocompromised, have advanced liver disease, or have had recent GI surgery should avoid raw fish altogether.”
Kably also suggests that customers can look out for body markers too. “It should look and smell fresh at all times. Raw fish is also paired with wasabi, pickled ginger, soy, and vinegar for a reason. They have anti-bacterial properties.”
If all fails and you do experience fever, vomiting, or diarrhea after consuming raw fish, seek medical advice immediately, both doctors advise.
Shradha Shahani is a Mumbai-based lifestyle journalist.