Impacts of globalisation on foodborne parasites

Human diphyllobothriasis in Argentina: assessing the epidemiological significance from historical records and reports of new cases

Between 1898 and 1940, eight human cases of diphyllobothriasis were reported in Argentina, always in recently arrived European immigrants. In 1982, the first autochthonous case was detected, and since then, 33 other autochthonous cases have been reported, totaling 42 cases of human diphyllobothriasis in Argentina before the present study. Our aim is to update the information on diphyllobothriasis in Argentina by identifying specimens from new cases using morphometrical and/or molecular methods. We also aim to assess the epidemiological relevance of this food-borne disease in the country. Anamnestic data were obtained from patients or professionals, along with 26 worms identified using morphometrical (21 samples) and molecular techniques (5 samples). All the patients acquired the infection by consuming freshwater salmonids caught in Andean lakes in Northern Patagonia. Morphometrics and DNA markers of worms were compatible with Dibothriocephalus latus. In total, 68 human cases have been detected in Argentina, 60 of which were autochthonous. The human population living North-western Patagonia, whose lakes are inhabited by salmonids, is increasing. Similarly, the number of other definitive hosts for Dibothriocephalus dendriticus (gulls) and for D. latus (dogs) is also increasing. In addition, salmonid fishing and the habit of consuming home-prepared raw fish dishes are becoming widespread. Therefore, it is to be expected that diphyllobothriasis in Argentina will increase further.

The Occurrence of Freshwater Fish-Borne Zoonotic Helminths in Italy and Neighbouring Countries: A Systematic Review

In recent years, the consumption of fish products has surged in European countries, being an essential part of a healthy diet. Despite representing a small part of EU production, freshwater fisheries hold considerable significance for lake-dwelling populations and tourists seeking traditional dishes. This increased fish consumption has brought to light potential health risks associated with fish-borne zoonotic helminths (FBZHs), now acknowledged as global food-borne parasites. Fish-borne zoonotic helminths belong to various taxonomic groups, including nematodes (Anisakidae), trematodes (Opisthorchiidae and Heterophyidae), and cestodes (Diphyllobothriidae). More than 50 species of FBZH are known to cause human infections, derived from eating raw or undercooked aquatic foods containing viable parasites. Despite increased attention, FBZHs remain relatively neglected compared to other food-borne pathogens due to factors like chronic disease progression and under-diagnosis. This systematic review concentrates on the prevalence of six freshwater FBZHs (Clinostomum complanatum, Contracaecum rudolphii, Dibothriocephalus latus, Eustrongylides excisus, Opisthorchis felineus, and Pseudamphistomum truncatum) in Italy and neighbouring countries. The study explores the expansion of these parasites, analysing their biological and epidemiological aspects, and the factors that influence their proliferation, such as the increased cormorant population and the lake eutrophication phenomena. In summary, this research highlights the necessity for further research, the development of spatial databases, and the establishment of a unified European policy to effectively manage these multifaceted health concerns. It strongly advocates adopting a One-Health approach to address the growing incidence of parasitic zoonoses within the context of food safety in EU countries.

Surrogates of foodborne and waterborne protozoan parasites: A review

The protozoan parasites Cryptosporidium parvum, Cyclospora cayetanensis, and Toxoplasma gondii are major causes of waterborne and foodborne diseases worldwide. The assessment of their removal or inactivation during water treatment and food processing remains challenging, partly because research on these parasites is hindered by various economical, ethical, methodological, and biological constraints. To address public health concerns and gain new knowledge, researchers are increasingly seeking alternatives to the use of such pathogenic parasites. Over the past few decades, several non-pathogenic microorganisms and manufactured microparticles have been evaluated as potential surrogates of waterborne and foodborne protozoan parasites. Here, we review the surrogates that have been reported for C. parvum, C. cayetanensis, and T. gondii oocysts, and discuss their use and relevance to assess the transport, removal, and inactivation of these parasites in food and water matrices. Biological surrogates including non-human pathogenic Eimeria parasites, microorganisms found in water sources (anaerobic and aerobic spore-forming bacteria, algae), and non-biological surrogates (i.e. manufactured microparticles) have been identified. We emphasize that such surrogates have to be carefully selected and implemented depending on the parasite and the targeted application. Eimeria oocysts appear as promising surrogates to investigate in the future the pathogenic coccidian parasites C. cayetanensis and T. gondii that are the most challenging to work with.

Human diphyllobothriosis in Taiwan: A review of cases and molecular evidence of Dibothriocephalus nihonkaiensis

Diphyllobothriosis is an infectious disease caused by the consumption of raw freshwater or marine fish containing larvae of broad tapeworms (Diphyllobothriidae). In the present study, we critically reviewed all cases of human diphyllobothriosis reported from Taiwan, including unpublished reports from hospitals in Taipei. Genotyping based on mitochondrial DNA marker (cox1) confirmed that two of the recent cases were caused by Dibothriocephalus nihonkaiensis, which is not native to Taiwan and was probably imported with Pacific salmon infected with larvae of D. nihonkaiensis. The causative species previously reported in Taiwan could not be definitively confirmed. However, considering the distribution of Dibothriocephalus latus, which is not endemic in Taiwan, past cases diagnosed as D. latus are questionable.

Investigating the Occurrence of Soil-Transmitted Parasites Contaminating Soil, Vegetables, and Green Fodder in the East of Nile Delta, Egypt

Background

Food-borne parasites are major sources of human and animal illness, posing severe health risks in places with contaminated soil, poor water quality, cleanliness, and poor sanitation. The usage of untreated organic fertilizers arising from the excreta of the parasites' definitive hosts either man or animal pollutes the agricultural soil and is reflected in its products of vegetables and green fodders causing serious health problems. Therefore, to the best of our knowledge, this will be the first study that investigated the combination of parasitic contamination of the agricultural soil and its products of raw eaten vegetables and green fodder in East Nile Delta, Egypt.

Aim

The purpose of this study was to investigate the type and degree of contamination caused by parasites in regularly used raw vegetables, green fodder, and soil samples collected from open fields in Egypt's East Nile Delta. Study Procedures. A cross-sectional study comprised a simple random collection of 400 soil samples, 180 green fodder samples, and as well as 400 vegetable samples, including lettuce, radish, coriander, parsley, dill, watercress, tomatoes, green pepper, cucumber, and carrot, that were gathered throughout one year period from January to December 2021 to represent all seasons (winter, spring, summer, and autumn). The research locations were chosen from various open green fields and farming regions in Egypt's East Nile Delta producing ready-to-eat vegetables for human consumptions and planting green fodder for animal feeding. Concentrations, including sedimentation, and flotation, and staining techniques were used to recover the greatest number of parasitic life forms. The parasitic structures discovered were identified using biometric and imaging data and compared with known parasite morphology. Statistical analysis was performed with the SPSS software version 22 (IBM, Chicago, IL, USA). Data were presented in numbers and percentages. P-values equal to or less than 0.05 were considered to be statistically significant. The difference in parasitic contamination among the different categories was compared using the chi-square test.

Results

In this investigation, 243 out of 400 soil samples (60.7%) confirmed positive for parasitic contamination (P < 0.05). Various parasitic life forms were significantly found in 249 out of 400 (62.25%) of the vegetable samples, with (65.1%) of them harboring one parasite species, whereas 9.2% significantly contained up to three parasites. Ascaris eggs, Trichuris eggs, and Giardia cysts were the most prevalent parasites, which were predominantly isolated from vegetables with uneven surfaces. 109 of 180 (60.0%) green fodder samples confirmed insignificantly positive for parasitic pollution. The proportion of parasite contamination in vegetable samples was insignificant although the highest was in spring (29.3%), followed by summer (27.7%), whereas it is significant in autumn (24.5%). The prevalence rate was the lowest in winter (20.1%). Conclusion and Recommendations. Our findings demonstrated a significant load of parasites notably the soil-transmitted parasitic infection in raw vegetables and green fodder cultivated in open fields as well as in their mother soil in the east of the Nile Delta, Egypt. These results confirm the urgent need to deploy strict control measures to the soil, especially during the pre-harvest period of raw eaten vegetables and green fodder, a critical step in reducing food-borne transmission of soil-transmitted parasites to man and animals.

The Presence of Potentially Pathogenic Protozoa in Lettuce (Lactuca sativa) Sold in Markets in the Central Peruvian Andes

Peru is currently one of the world’s leading culinary destinations, whose world-renowned cuisine uses vegetables, mainly lettuce, as frequent ingredients. Vegetable consumption is promoted worldwide as a part of a healthy diet. However, vegetables, more frequently lettuce, have been implicated as a vehicle of infection for several foodborne parasites. This study aimed to determine the presence of potentially pathogenic parasites in lettuce marketed in the Central Andes of Peru. A total of 75 lettuce samples were collected from the two largest wholesale markets and the main open-air market in Jauja province, in the central Peruvian Andes. The province of provenance (coast vs. highlands), lettuce variety (“curly-leaf”, “iceberg”, and “butter”), and type of market were recorded. The samples were microscopically examined for detection of parasitic life forms using standard parasitological methods including direct slide smear, Lugol’s iodine staining, and Modified Ziehl−Neelsen staining. The overall positivity of parasitic contamination in lettuces was 45.3% (CI 95%: 34−56.6%). Cryptosporidium spp., Isospora belli, Giardia lamblia, Balantidium coli, and Entamoeba spp. were detected in twenty-six (34.7%), six (8%), four (5.3%), two (2.7%), and two (2.7%) lettuces, respectively. I. belli was found in a significantly (p < 0.01) lower proportion in the “butter” variety, and significantly (p < 0.05) higher contamination with G. lamblia was found in lettuce sold at the open-air market. B. coli, G. lamblia, and E. histolytica/E. dispar/E. moshkovskii were detected only in lettuce from the highlands (Tarma province). This study provides important data for health authorities to develop food safety programs. This information is also of interest to the international community because of the increased visibility that Peru has gained as a tourist destination.

Knowledge and practices on consumption of free-range chickens in selected rural communities of KwaZulu-Natal, South Africa, with focus on zoonotic transmission of Toxoplasma gondii and Toxocara spp

Chickens are a host to a variety of pathogens of zoonotic importance and this depends more on the husbandry system practiced. Toxoplasma gondii and Toxocara spp which are more prevalent in free-range chickens (FRC) can be acquired by humans via the ingestion of raw or undercooked meat (muscle) and/or viscera contaminated with infective stages of T. gondii and Toxocara spp. This study aimed to assess knowledge and practices on the household consumption of FRC meat and viscera by rural communities in KwaZulu-Natal (KZN) province, South Africa, as a risk factor in the transmission of zoonotic pathogens with special emphasis on T. gondii and Toxocara spp. A cross-sectional study was conducted on twenty (20) randomly selected households in four selected communities located on the northern coast (Gingindlovu and Ozwathini) and southern coast (uMzinto and Shongweni) of KZN province using a semi-structured questionnaire. To determine the presence of selected zoonotic pathogens in FRC, birds were purchased from randomly selected households in the study localities for sacrifice. Brain tissues were collected and subjected to molecular detection of T. gondii using TOX4 and TOX5 primers while other tissues and organs that were collected were subjected to molecular detection of Toxocara spp using Nem 18S primers. Questionnaire data were analyzed using the statistical package for social sciences (SPSS) version 25.0. Descriptive and chi-square statistics were used to assess knowledge and practices related to FRC consumption and zoonosis transmission. Molecular results showed four positive samples for T. canis from Gingindlovu (n = 1), uMzinto (n = 1), and Shongweni (n = 2). The role of FRC consumption in zoonosis transmission is discussed.

A Review on Alaria alata, Toxoplasma gondii and Sarcocystis spp. in Mammalian Game Meat Consumed in Europe: Epidemiology, Risk Management and Future Directions

Simple Summary

In many European countries, game meat consumption is related to the traditional hunting culture. Its demand and consumption are increasing, also due to the growing populations of wild ungulates. However, specific public health issues exist and should be taken into account. This review focuses on the causal agents, epidemiology, potential risk for human health and its management along the supply chain, including parasite detection at slaughtering and inactivation in meat, of three parasites (Alaria alata, Toxoplasma gondii and Sarcocystis spp.), which can be transmitted by the main mammalian game meat species in the EU: wild boar (Sus scrofa), red deer (Cervus elaphus), roe deer (Capreolus capreolus), fallow deer (Dama dama), Alpine chamois (Rupicapra rupicapra), moose (Alces alces), hare (Lepus europaeus) and wild rabbit (Oryctolagus cuniculus). By presenting the main issues and knowledge gaps, this study aims to contribute to an improved control supporting the risk analysis process.

Abstract

Game meat is increasingly appreciated and consumed in Europe, also due to the growing population of wild ungulates. In addition to interesting nutritional properties and market opportunities, game meat is characterized by some specific public health issues. This review focuses on the etiology, epidemiology, public health aspects and risk management along the supply chain, including parasite detection at slaughtering and inactivation in meat, of three selected foodborne parasitic hazards (Alaria alata, Toxoplasma gondii and Sarcocystis spp.) in the main mammalian game meat species in the EU: wild boar (Sus scrofa), red deer (Cervus elaphus), roe deer (Capreolus capreolus), fallow deer (Dama dama), Alpine chamois (Rupicapra rupicapra), moose (Alces alces), hare (Lepus europaeus) and wild rabbit (Oryctolagus cuniculus). The presented data point out the main issues, and knowledge gaps as well as the potential for improved control in order to contribute to the risk analysis process. To pursue an effective management of these parasitic zoonoses, awareness raising should involve all figures in the supply chain, including hunters, restaurateurs and consumers. Human behaviour and the lack of knowledge regarding meat borne parasitic zoonoses and the health risks they pose seem to be the most important factors responsible for human infections. However, detection methods, starting from the sampling procedure, should be further developed and standardized in order to improve the collection of accurate and up-to-date epidemiological data.

Evaluation of two analytical methods of detection for intestinal parasites in curly lettuce sold in food stalls

Abstract This study aimed to investigate the occurrence of parasitic structures in curly lettuce (Lactuca sativa L.) sold in food stalls open markets in Cuiabá city, in the Brazilian state of Mato Grosso (MT). For this purpose, 50 samples were evaluated using spontaneous sedimentation and centrifugal flotation methods. These techniques showed positivity in 96% (48/50) and 78% (39/50) of the samples, respectively. The sedimentation method was statistically (p ≤ 0.05) more effective in detecting parasitic structures of the pathogens as Entamoeba histolytica, Ascaris spp., Strongyloides spp., Larvae and Hookworm eggs, when comparing both methods. However, these methods did not differ significantly for the detection of Giardia lamblia. Ascaris spp and Entamoeba coli occurred in 64% (32/50) and 46% (23/50) of the positive samples, respectively, with the highest percentages observed. The occurrence of Blastocystis spp., Fasciola spp., Dipylidium caninum and Ascaris lumbricoides revealed detection exclusively by the spontaneous sedimentation method, while Iodamoeba butschlii and Enterobius vermicularis were detected by centrifugal– flotation procedure. These results could reinforce the need to use methods based on sedimentation and the fluctuation of parasite structures in the analysis of lettuce. The presence of parasites in lettuce by fecal origin, with recognized pathogenicity, represents a risk to consumer health and demonstrates a deficit in good agricultural practices in the production, distribution and commercialization of lettuce.

Foodborne Parasites Dominate Current Parasitic Infections in Hunan Province, China

Great progress has been made in the prevention and treatment of human parasitic diseases in China over the past six decades, but parasitic diseases are still one of the most serious public health problems in the world. The specific prevalence of parasitic diseases varies in different provinces due to their geographical environment and the dietary habits of people. In this study, a total of 4,428 patients suspected to have parasitic infection by clinicians or themselves from January 1, 2016, to December 31, 2020 were recommended to our laboratory for further testing. In total, 5,246 samples including fecal, blood, and other body fluids were detected by etiological and immunological methods. Approximately 15.20% (673/4,428) of all suspected patients were infected by at least one species of parasite, and the overall positive rate of suspected patients from Hunan Province was 15.10% (594/3,933). A total of 18 species of parasites, namely, nematodes (4 species), trematodes (5 species), cestodes (4 species), protozoa (2 species), and medical arthropods (3 species), and 3 of them were imported parasites outside of Hunan Province. There are 9 species of foodborne parasites, accounting for 89.92% (464/516) of patients infected by one species of parasite. Common parasites in Hunan Province include plerocercoid, Paragonimus westermani, Clonorchis sinensis, cysticercus, Toxoplasma gondii, and Schistosoma japonicum. In this study, we found that the incidence of soilborne nematode infections has decreased significantly. However, foodborne parasites gradually become the main parasitic infections as well as multiple infections are becoming more common. Therefore, we should not only continue the prevention and control of soil-derived nematodes but also focus on the prevention and control of foodborne parasites in the future.

Investigation of the Food-Transmitted Parasites Trichinella spp. and Alaria spp. in Wild Boars in Greece by Classical and Molecular Methods and Development of a Novel Real-Time PCR for Alaria spp. Detection

Simple Summary

There are many parasites that may be transmitted to humans via food, and meat is a major source of such infections. Trichinella spp. is one of the most important meat-transmitted parasites, while Alaria spp. may be considered an emerging pathogen, albeit to date rarely reported in humans. Raw and undercooked wild boar meat has been proven as a major source of human infection by both parasites. In the present study, an investigation of the presence of these parasites in wild boar meat was conducted for the first time in Greece. Classical parasitological methods and molecular techniques were implemented for the examination of samples collected from 128 hunted wild boars, and none of them were found positive for Trichinella spp. or Alaria spp. For the detection of Alaria spp., a novel molecular method was developed, offering a powerful complementary diagnostic tool that may be useful for the epizootiological surveillance of the parasite. The epizootiology/epidemiology, clinical implications, and importance of monitoring of these parasitic infections are briefly discussed.

Abstract

Foodborne parasitic diseases represent a major threat to public health. Trichinellosis, caused by the nematode parasite Trichinella spp., is one of the most important foodborne diseases, while alariosis, caused by the trematode parasite Alaria spp., is less common in humans, and rare cases have been reported only in the USA and Canada. Both parasites can infect humans via the consumption of raw or undercooked wild boar meat. In order to investigate the prevalence of these parasites in wild boar meat in Greece, samples from the diaphragm pillars and the region of the mandibular angle from 128 wild boars, hunted in Greece, were collected. The samples were examined by classical parasitological (compression, artificial digestion, and Alaria spp. migration) and by molecular (real-time PCR) methods. For Trichinella spp. an existent real-time PCR detecting all species likely to be present in Greece was applied, while for Alaria spp. a real-time PCR was developed, employing an LNA TaqMan probe targeting the large subunit ribosomal RNA gene. All examined wild boar samples from Greece resulted negative for Trichinella and Alaria species, indicating a low prevalence of infection in the examined population. The novel real-time PCR for Alaria spp. has 81.5% amplification efficiency and is able to detect 0.12 larvae per 50 g of tissue and could be utilized as a complementary to AMT diagnostic tool in surveillance.

The effect of landscape and human settlement on the genetic differentiation and presence of Paragonimus species in Mesoamerica

Foodborne diseases are a neglected research area, and despite the existence of many tools for diagnosis and genetic studies, very little is known about the effect of the landscape on the genetic diversity and presence of parasites. One of these foodborne disease is paragonimiasis, caused by trematodes of the genus Paragonimus, which is responsible for a high number of infections in humans and wild animals. The main Paragonimus sp reported in Mesoamerica is Paragonimus mexicanus, yet there are doubts about its correct identification as a unique species throughout the region. This, together with a lack of detailed knowledge about their ecology, evolution and differentiation, may complicate the implementation of control strategies across the Mesoamerican region. We had the goal of delimiting the species of P. mexicanus found throughout Mesoamerica and determining the effect of landscape and geology on the diversity and presence of the parasite. We found support for the delimitation of five genetic groups. The genetic differentiation among these groups was positively affected by elevation and the isolation of river basins, while the parasite's presence was affected negatively only by the presence of human settlements. These results suggest that areas with lower elevation, connected rivers basins, and an absence of human settlements have low genetic differentiation and high P. mexicanus presence, which may increase the risk of Paragonimus infection. These demonstrate the importance of accurate species delimitation and consideration of the effect of landscape on Paragonimus in the proposal of adequate control strategies. However, other landscape variables cannot be discarded, including temperature, rainfall regime, and spatial scale (local, landscape and regional). These additional variables were not explored here, and should be considered in future studies.

Cryptosporidium in fish: Implications for aquaculture and beyond

Aquaculture industries are expanding worldwide and control of Cryptosporidium is of great importance. Cryptosporidiosis is a serious waterborne/foodborne disease, responsible for infectious outbreaks globally. Current knowledge on the Cryptosporidium species in the aquatic environment and their occurrence in piscine hosts is steadily increasing since the Cryptosporidium species have been detected in marine, freshwater, cultured, captive and ornamental fish in a wide range of geographical regions. The zoonotic potential of these parasites and their pathological impact on piscine hosts have been increasingly reported and the fishborne zoonotic risk from Cryptosporidium spp. is of major importance from a public health point of view. Zoonotic subtypes in fish have been described in various studies and are probably related to water contamination from animal and human wastes. This review critically evaluated existing scientific data, related to Cryptosporidium species in piscine hosts, emphasizing transmission routes and the potential impact of piscine cryptosporidiosis in aquaculture. This knowledge will facilitate consumers, authorities and water industries such as fisheries and aquaculture, the prevention and control of waterborne and fishborne cryptosporidiosis in fish products.

Contamination of fresh produce sold on the Italian market with Cyclospora cayetanensis and Echinococcus multilocularis

To investigate the presence of Cyclospora cayetanensis, Toxoplasma gondii and Echinococcus spp. in fresh produce sold in Italy, 324 locally produced 'ready-to-eat' (RTE) mixed-salad packages belonging to three brands and 324 berries packages (blueberries and blackberries imported from Peru and Mexico, respectively, and raspberries grown in Italy) were purchased at retail. Nine individual packages from each of the six types of fresh produce were collected monthly for one year, and with the same produce pooled, this resulted in a total of 72 pools for the whole year. Using microscopy (FLOTAC), a Cyclospora-like oocyst was detected in a blueberry sample and a taeniid egg was detected in a RTE-salad sample. Molecular tools confirmed these to be C. cayetanensis and Echinococcus multilocularis, respectively. Toxoplasma gondii was not detected in any of the samples. This study shows for the first time in Europe that imported berries on the Italian market may be contaminated with C. cayetanensis and RTE salads grown in Italy with E. multilocularis. The results indicate a new epidemiological scenario and highlight that current management of fresh produce, locally produced or imported, does not ensure products are free from parasite contamination.

Emerging infectious disease: An underappreciated area of strategic concern for food security

Emerging infectious diseases (EIDs) increasingly threaten global food security and public health. Despite technological breakthroughs, we are losing the battle with (re)emerging diseases as treatment costs and production losses rise. A horizon scan of diseases of crops, livestock, seafood and food-borne illness suggests these costs are unsustainable. The paradigm of coevolution between pathogens and particular hosts teaches that emerging diseases occur only when pathogens evolve specific capacities that allow them to move to new hosts. EIDs ought to be rare and unpredictable, so crisis response is the best we can do. Alternatively, the Stockholm Paradigm suggests that the world is full of susceptible but unexposed hosts that pathogens could infect, given the opportunity. Global climate change, globalized trade and travel, urbanization and land-use changes (often associated with biodiversity loss) increase those opportunities, making EID frequent. We can, however, anticipate their arrival in new locations and their behaviour once they have arrived. We can 'find them before they find us', mitigating their impacts. The DAMA (Document, Assess, Monitor, Act) protocol alters the current reactive stance and embodies proactive solutions to anticipate and mitigate the impacts of EID, extending human and material resources and buying time for development of new vaccinations, medications and control measures.

Helminths of the Wild Boar (Sus scrofa) from Units of Conservation Management and Sustainable Use of Wildlife Installed in the Eastern Economic Region of Mexico

Wild boars (Sus scrofa) were introduced in Mexico for sport hunting and meat trading for human consumption, but the available data regarding their role in pathogen transmission are limited. This research and field work aimed to identify the helminths of the wild boar produced in three units of conservation management and sustainable use of wildlife placed in the eastern economic region of Mexico. Samples of feces and serum were collected from 90 animals that came from three different ranches. Stool examination and antibody determination to Fasciola hepatica, Taenia crassciceps, Ascaris suum, Toxocara canis (ELISA), and Trichinella spiralis (Western blot) were performed. In addition, 30 diaphragm samples from one ranch were obtained for artificial digestion. Eggs of Strongyloides sp. (72.2%), Metastrongylus sp. (57.7%), Oesophagostomum sp. (53.3%), and Trichuris sp. (37.7%) were found in addition to oocysts of Eimeria sp. (75.6%). Antibodies to Fasciola (8.9%), Taenia (4.4%), Ascaris (32.2%), Toxocara (20%), and Trichinella (5.5%) were found. The eggs of Strongyloides and Oesophagostomum were associated to female hosts. One nematode larva was found by artificial digestion. This is the first report to identify helminths from wild boars in Mexico. In addition, this study identifies the potential risk of the wild boar as a transmission channel of parasites that can have an impact on public health.

The wild boar (Sus scrofa, Linnaeus, 1758) as an important reservoir host for Alaria alata in the Baltic region and potential risk of infection in humans

Alaria alata trematode is widely distributed throughout Europe and has a complex life cycle in which wild boar serve as a reservoir host. The primary aims of the present study are to establish the occurrence of A. alata mesocercariae in naturally infected wild boar in Latvia and to assess the risk for humans to acquire A. alata infection via consumption of wild boar meat. By summarizing long-term data using the Trichinella inspection method from 2014 to 2019, the overall A. alata prevalence was 8.3%, of which significantly higher A. alata prevalence was observed during the summer seasons. Additionally, 43.9% (n = 485) of wild boar were found to be infected with A. alata using Alaria mesocercariae migration technique. The present study indicates that the probability for humans to acquire A. alata mesocercariae is possible, yet improbable and varies from 0.2% to 2.2%. Most likely, it depends on both frequency of A. alata presence in wild boar population and of a method of preparing wild boar meat for consumption that will allow for the parasite inactivation.

Investigation of Anisakis larvae in different products of ready-to-eat fish meat and imported frozen fish in Turkey

Globalization opens new market areas and affects food consumption habits, resulting in rapid and remarkable cultural change. Food habits such as consumption of raw fish meat have become popular, resulting in increased risk of emerging infectious diseases. Anisakis simplex sensu stricto (s.s) and A. pegreffii are the most common and important fish-borne zoonotic nematodes responsible for human anisakiasis, which occurs through the consumption of raw or undercooked fish as well as cooked fish due to their heat-stable allergens. Here, we investigated the prevalence, intensity, and abundance of Anisakis larvae in imported fish and ready-to-eat local fish products in Turkey. A total of 205 ready-to-eat fish products, 100 imported frozen Atlantic salmon (Salmo salar) fillets, and 100 imported frozen whole Atlantic mackerel (Scomber scombrus) were sampled from supermarkets, sushi restaurants, and fish markets. All samples were individually examined using a pepsin digestion technique. In total, 602 Anisakis type I larvae were recovered from 98/100 mackerel. No larvae were found in ready-to-eat products or frozen Atlantic salmon fillets. Overall, 8.8% of the larvae were found in the muscle tissue. The overall mean intensity and abundance of infection in mackerel were 6.14 and 6.02, respectively. The larvae were molecularly identified and their phylogenetic relationships with the relevant Anisakis sequences in GenBank were investigated. For this purpose, a subsample of randomly selected 100 Anisakis larvae were analyzed with PCR-RFLP of the ITS region. The larvae were identified as A. simplex (s.s.) (n = 87) and hybrids (n = 13). ITS and cox2 gene regions of all hybrids and randomly selected 50 A. simplex (s.s.) larvae were sequenced for species confirmation and phylogenetic analyses. No intraspecific nucleotide variation was found among the ITS sequences of either species. Seven and three haplotypes, respectively, were identified for A. simplex (s.s.) and hybrid species according to DNA polymorphism of the cox2 gene. Hybrids in our study clustered within the common A. simplex (s.s.) clade in the cox2 phylogenetic tree indicating the dominance of A. simplex (s.s) in the catching area of Atlantic mackerel. Consequently, our study indicates high occurrence of A. simplex (s.s.) larvae with an overall 98.0% prevalence in imported Atlantic mackerel, and highlights the importance of these fish as potential reservoirs for human allergic anisakiasis in Turkey and possibly in other countries.

Occurrence and Spatial Distribution of Dibothriocephalus Latus (Cestoda: Diphyllobothriidea) in Lake Iseo (Northern Italy): An Update

Dibothriocephalus latus (Linnaeus, 1758) (Cestoda: Diphyllobothriidea; syn. Diphyllobothrium latum), is a fish-borne zoonotic parasite responsible for diphyllobothriasis in humans. Although D. latus has long been studied, many aspects of its epidemiology and distribution remain unknown. The aim of this study was to investigate the prevalence, mean intensity of infestation, and mean abundance of plerocercoid larvae of D. latus in European perch (Perca fluviatilis) and its spatial distribution in three commercial fishing areas in Lake Iseo (Northern Italy). A total of 598 specimens of P. fluviatilis were caught in 2019. The total prevalence of D. latus was 6.5%. However, there were significant differences between areas (10.2% North; 7.3% Center; 1.5% South) (Chi-square test, p = 0.0018). The mean intensity of infestation ranged from 1 larva in southern area to 1.2 larvae in both the central and northern (Pisogne) areas. In addition, the mean abundance ranged from 0.02 in the southern area to 0.26 in the northern area (Pisogne). The total number of larvae (anterior dorsal—AD = 21; anterior ventral—AV = 1; posterior dorsal—PD = 15; posterior ventral—PV = 5) differed significantly between the four anatomical quadrants (Kruskal–Wallis test; p = 0.0001). The prevalence of D. latus plerocercoid larvae in European perch from Lake Iseo has long been investigated, but without an appropriate sampling design. With the present study, a broader analysis in spatial distribution has been added to the existing literature, revealing new information about D. latus distribution and occurrence in Lake Iseo, with new data that will be useful for health authorities and future studies.

Comparative Proteomics Analysis of Anisakis simplex s.s.-Evaluation of the Response of Invasive Larvae to Ivermectin

Ivermectin (IVM), an antiparasitic drug, has a positive effect against Anisakis simplex s.s. infection and has been used for the treatment and prevention of anisakiasis in humans. However, the molecular mechanism of action of IVM on A. simplex s.s. remains unknown. Herein, tandem mass tag (TMT) labeling and extensive liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) analysis were used to identify the effect of IVM on the proteome of A. simplex s.s. in vitro. During the study, 3433 proteins, of which 1247 had at least two protein unique peptides, were identified. Comparative proteomics analysis revealed that 59 proteins were differentially regulated (DRPs) in IVM-treated larvae, of which 14 proteins were upregulated and 38 were downregulated after 12 h of culture, but after 24 h, 12 proteins were upregulated and 22 were downregulated. The transcription level of five randomly selected DRPs was determined by real-time PCR as a supplement to the proteomic data. The functional enrichment analysis showed that most of the DRPs were involved in oxidoreductase activity, immunogenicity, protein degradation, and other biological processes. This study has, for the first time, provided comprehensive proteomics data on A. simplex s.s. response to IVM and might deliver new insight into the molecular mechanism by which IVM acts on invasive larvae of A. simplex s.s.

Use of Veterinary Vaccines for Livestock as a Strategy to Control Foodborne Parasitic Diseases

Foodborne diseases (FBDs) are a major concern worldwide since they are associated with high mortality and morbidity in the human population. Among the causative agents of FBDs, Taenia solium, Echinococcus granulosus, Toxoplasma gondii, Cryptosporidium spp., and Trichinella spiralis are listed in the top global risk ranking of foodborne parasites. One common feature between them is that they affect domestic livestock, encompassing an enormous risk to global food production and human health from farm to fork, infecting animals, and people either directly or indirectly. Several approaches have been employed to control FBDs caused by parasites, including veterinary vaccines for livestock. Veterinary vaccines against foodborne parasites not only improve the animal health by controlling animal infections but also contribute to increase public health by controlling an important source of FBDs. In the present review, we discuss the advances in the development of veterinary vaccines for domestic livestock as a strategy to control foodborne parasitic diseases.

Why we need a European focus on foodborne parasites

Foodborne parasites (FBP) are recognized as being a neglected pathogen group, often associated with marginalized or disadvantaged populations, especially those living in regions where water supply or sanitation are inadequate. Nevertheless, we are also increasingly recognising that FBP are not just restricted to such places, and even those that do have a circumscribed endemic area may also travel further in our globalised world; FBP are relevant everywhere, including Europe. Against this background, COST Action Euro-FBP (FA1408) was established and ran for a period of 4 years, addressing a number of different questions related to FBP, particularly in the European setting. In this special issue (SI), some of the issues and outputs associated with Euro-FBP are considered in greater depth, as an output also of the final Euro-FBP meeting. As well as more general issues regarding, for example, globalization and climate change, use of economic models, and the value of risk-based surveillance that puts the topic in perspective, individual articles are included that address specific parasites. These include protozoan parasites, such as Cryptosporidium, Giardia, and Toxoplasma, as contaminants of water, shellfish, and fresh produce, fishborne parasites such as Anisakid nematodes, and meatborne parasites, such as Trichinella. Some of the works provide specific data on occurrence or outbreaks, whilst others are concerned with techniques. In addition, implementation of some of the educational and collaborative tools that are unique to COST Actions are described. COST Actions are not generally intended to deliver a scientific endpoint, and Euro-FBP does not do so. However, the articles in this SI, along with other articles published elsewhere during and subsequent to the course of the Action, as direct outputs of the Euro-FBP activities, indicate that FBP are indeed a relevant topic for European scientists.

Food hazards on the European Union market: The data analysis of the Rapid Alert System for Food and Feed

The aim of the study was to examine similarities in notifications on main hazards within food reported in the Rapid Alert System for Food and Feed (RASFF) in 1979-2017. The main problems were mycotoxins in nuts, pathogenic microorganisms in poultry meat and fish, pesticide residues in fruits and vegetables, and heavy metals in fish. The increase in the number of notifications has been observed since 2002/2003. Products were notified mainly by Italy, Germany, and United Kingdom and originated from Asian and European Union countries. The notification basis was border control and official control, and the notification type was border rejections, information, and alerts. Notified products were not distributed and not placed on the market, distribution status could be also not specified, or distribution was possible, also to other countries. The risk decision on hazard was usually not made. Products were redispatched, withdrawn from the market, and destroyed, or import was not authorized. Remarks, which can be used to improve the RASFF database, were also presented. It was further pointed out that European law should significantly reduce the use of pesticides, drugs, and food additives, and European agriculture should be reoriented from an intensive farming to a more sustainable and ecological one.

Opinions and knowledge on globally important foodborne parasites among healthcare professionals at a tertiary teaching hospital in Nigeria

Foodborne diseases are important everywhere in the world, but the level of attention they receive varies by region. We surveyed the current opinions and knowledge regarding the globally most important foodborne parasites (FBP) among healthcare professionals in Abakaliki, Ebonyi State, Nigeria, by conducting a questionnaire survey among healthcare professionals in a tertiary hospital. We focused on the FBP ranked as the top five globally: Taenia solium, Echinococcus granulosus, Echinococcus multilocularis, Toxoplasma gondii, and Cryptosporidium spp., and gathered local expert opinions regarding their importance in Nigeria. Moreover, we surveyed the extent of healthcare community knowledge on transmission, manifestations and pathologies, and prevention of infections with these five FBP. Among the 205 healthcare professionals completing the survey, T. solium was selected as important in Nigeria by 143 (70%), E. granulosus by 91 (44%), E. multilocularis by 62 (30%), T. gondii by 132 (64%), and Cryptosporidium spp. by 123 (60%). Only 44 (21%) of the participants selected at least 15 of the 25 answers to knowledge questions that we considered as correct to select. The proportion selecting at least 15 of the correct answers was not statistically significantly associated with gender nor with experience level. Our results suggest that further education about FBP should target healthcare professionals at all levels.

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Knowledge on global top-5 foodborne parasites was evaluated at a Nigerian hospital.

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21% of the respondents selected ≥15 of 25 correct answers to knowledge questions.

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Further education on foodborne parasites for healthcare professionals is needed.

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70% of the respondents considered Taenia solium to be important in Nigeria.

Why do we need training? - A "Training school on molecular methods used for foodborne parasite diagnostics in different matrices" is a example of knowledge transfer to foster research quality in EU

Foodborne parasites with zoonotic potential are of particular concern for human health, being responsible for serious and potentially life threatening diseases. In the last decades, the development of molecular biology techniques have been successfully implemented for clinical diagnosis of FBPs in animal or human samples providing cheaper, less labor intensive, reliable and more sensitive tests. It is apparent from recent publications that unsubstantiated molecular methods for parasite detection that have undergone scant evaluation for sensitivity and specificity are becoming increasingly common. The aim of the organized Training Schools was to transfer knowledge on application, optimization and troubleshooting for methods used to extract, amplify, and sequence nucleic acids from contaminated matrices and isolated FBPs. The organized Training Schools fulfilled the trainees' expectations, whom acquired useful knowledge for their research activities.

Detection methods and prevalence of transmission stages of Toxoplasma gondii, Giardia duodenalis and Cryptosporidium spp. in fresh vegetables: a review

One of the ways of human parasitic infection is the accidental ingestion of vegetables contaminated with parasites, which represents a major human health hazard. This non-exhaustive review aims to evaluate studies carried out on five types of vegetables (lettuce, parsley, coriander, carrot and radish) since 2000, particularly the methods used for recovery, concentration, detection and identification of protozoan parasites such as Toxoplasma gondii, Giardia duodenalis and Cryptosporidium spp., and the results of each work. Various studies have determined the presence of pathogenic parasites in fresh vegetables with different rates; this variation in rate depends particularly on the detection method used which is related to each parasite and each vegetable type. The variation in parasitic prevalence in food could be due to different factors such as the geographical location, the size of analysed samples and the methods used for parasite detection.

How globalization and climate change could affect foodborne parasites

Foodborne parasites, most of which are zoonotic, represent an important human health hazard. These pathogens which include both protozoa (e.g., Cryptosporidium spp., Cyclospora cayetanensis, Toxoplasma gondii) and helminths (e.g., liver and intestinal flukes, Fasciola spp., Paragonimus spp., Echinococcus spp., Taenia spp., Angiostrongylus spp., Anisakis spp., Ascaris spp., Capillaria spp., Toxocara spp., Trichinella spp., Trichostrongylus spp.), have accompanied the human species since its origin and their spread has often increased due to their behavior. Since both domesticated and wild animals play an important role as reservoirs of these pathogens the increase/decrease of their biomasses, migration, and passive introduction by humans can change their epidemiological patterns. It follows that globalization and climate change will have a tremendous impact on these pathogens modifying their epidemiological patterns and ecosystems due to the changes of biotic and abiotic parameters. The consequences of these changes on foodborne parasites cannot be foreseen as a whole due to their complexity, but it is important that biologists, epidemiologists, physicians and veterinarians evaluate/address the problem within a one health approach. This opinion, based on the author's experience of over 40 years in the parasitology field, takes into consideration the direct and indirect effects on the transmission of foodborne parasites to humans.

A systematic review and meta-analysis of canine, feline and human Toxocara infections in sub-Saharan Africa

Toxocariasis is an emerging zoonotic disease caused by Toxocara canis and T. cati. Toxocariasis and its etiological agents are of global public health importance, whose burden appears underestimated, especially in sub-Saharan Africa (SSA). The diversity in the transmission routes of these parasites contributes to disease prevalence and often hinders disease control measures. This study aimed to review the epidemiological distribution of Toxocara infections in SSA region. A systematic review and meta-analysis were performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). We identified 94 relevant, peer-reviewed articles, out of which, 75 articles were found eligible based on Toxocara infections in dogs, cats and humans. Overall, 27,102 samples were examined for T. canis in dogs, T. cati in cats and Toxocara serology in humans, out of which 6142 were positive for Toxocara infection: 3717 (13.7%) in dogs (faecal, 3487; necropsy, 180; hair, 50); 266 (1%) in cats (faecal, 101; necropsy, 165); and 2159 (8%) in humans (serology). Overall mean prevalences of 19% (95% confidence interval (CI): 14-23%), 9% (95% CI: 0-28%) and 36% (95% CI: 24-49%) were recorded in dogs, cats and humans, respectively. Substantial heterogeneity was observed between studies and subgroups (I2 = 99%, P < 0.01). Findings from the review showed that studies on the epidemiology of Toxocara infections in the SSA region are limited. We strongly recommend focused, collaborative and coordinated studies to determine Toxocara spp. prevalence in various hosts, including food animals and the environment, through a 'One Health' approach across SSA countries.

Foodborne Parasites in Europe: Present Status and Future Trends

Although foodborne parasites (FBPs) are becoming recognized as important foodborne pathogens, they remain neglected compared with bacterial and viral foodborne pathogens. As drivers for infection with FBPs are variable, it is often unclear for funding bodies where research should be prioritized. Through a COST Action (Euro-FBP; FA1408), we harnessed Europe-wide expertise to address these questions, using an Expert Knowledge Elicitation approach. Eating habits, lack of food-chain control, lack of awareness from relevant agencies, globalization, and water quality were identified as major drivers for FBP infection. Prioritized research needs to be largely focused on methodological gaps, but also on surveillance concerns, impact-assessment issues, and the role of microbiota. Despite the European focus, these responses should be relevant to those concerned with FBPs globally.

Paragonimiasis

Paragonimiasis is a zoonotic disease caused by lung flukes of the genus Paragonimus. Humans usually become infected by eating freshwater crabs or crayfish containing encysted metacercariae of these worms. However, an alternative route of infection exists: ingestion of raw meat from a mammalian paratenic host. Adult worms normally occur in pairs in cysts in the lungs from which they void their eggs via air passages. The pulmonary form is typical in cases of human infection due to P. westermani, P. heterotremus, and a few other species (Table 5.1). Worms may occupy other sites in the body, notably the brain, but lung flukes have made their presence felt in almost every organ. Ectopic paragonimiasis is particularly common when infection is due to members of the P. skrjabini complex (Table 5.1). Human paragonimiasis occurs primarily in the tropics and subtropics of Asia, Africa, and the Americas, with different species being responsible in different areas (Table 5.1).

Transuterine infection by Baylisascaris transfuga: Neurological migration and fatal debilitation in sibling moose calves (Alces alces gigas) from Alaska

Larval Baylisascaris nematodes (L3), resulting from transuterine infection and neural migration, were discovered in the cerebrum of sibling moose calves (Alces alces gigas) near 1-3 days in age from Alaska. We provide the first definitive identification, linking morphology, biogeography, and molecular phylogenetics, of Baylisascaris transfuga in naturally infected ungulates. Life history and involvement of paratenic hosts across a broader assemblage of mammals, from rodents to ungulates, in the transmission of B. transfuga remains undefined. Neural infections, debilitating young moose, may seasonally predispose calves to predation by brown bears, facilitating transmission to definitive hosts. Discovery of fatal neurological infections by L3 of B. transfuga in mammalian hosts serves to demonstrate the potential for zoonotic infection, as widely established for B. procyonis, in other regions and where raccoon definitive hosts are abundant. In zones of sympatry for multi-species assemblages of Baylisascaris across the Holarctic region presumptive identification of B. procyonis in cases of neurological larval migrans must be considered with caution. Diagnostics in neural and somatic larval migrans involving species of Baylisascaris in mammalian and other vertebrate hosts should include molecular-based and authoritative identification established in a phylogenetic context.

Sources and contamination routes of microbial pathogens to fresh produce during field cultivation: A review

Foodborne illness resulting from the consumption of contaminated fresh produce is a common phenomenon and has severe effects on human health together with severe economic and social impacts. The implications of foodborne diseases associated with fresh produce have urged research into the numerous ways and mechanisms through which pathogens may gain access to produce, thereby compromising microbiological safety. This review provides a background on the various sources and pathways through which pathogenic bacteria contaminate fresh produce; the survival and proliferation of pathogens on fresh produce while growing and potential methods to reduce microbial contamination before harvest. Some of the established bacterial contamination sources include contaminated manure, irrigation water, soil, livestock/ wildlife, and numerous factors influence the incidence, fate, transport, survival and proliferation of pathogens in the wide variety of sources where they are found. Once pathogenic bacteria have been introduced into the growing environment, they can colonize and persist on fresh produce using a variety of mechanisms. Overall, microbiological hazards are significant; therefore, ways to reduce sources of contamination and a deeper understanding of pathogen survival and growth on fresh produce in the field are required to reduce risk to human health and the associated economic consequences.

Human taeniasis/cysticercosis: a potentially emerging parasitic disease in Europe

Taenia saginata (T. saginata)/Taenia solium (T. solium) taeniasis/cysticercosis disease complexes remain a significant challenge for food safety and public health. Human taeniasis is an infectious disease caused by the ingestion of the metacestode larval stage, the cysticerci of T. saginata in beef or T. solium in pork. Humans can also become infected via the ingestion of T. solium eggs. In this case, the cysticerci can establish in the central nervous system, causing the infection called neurocysticercosis. T. solium is of higher importance than T. saginata because the former species can cause neurocysticercosis in humans, a major cause of neurological morbidity in the world. The taeniasis/cysticercosis complex is included in the list of neglected zoonotic diseases by the World Health Organization and Food and Agriculture Organization, with T. solium being the number one foodborne parasite; it occurs mostly in developing countries, such as regions of Asia, Africa and Latin America, where the disease remains endemic. Long absent in Western Europe and other developed countries, cysticercosis has been recently re-emerged as a result of immigration, travel and commerce. In this review, cysticercosis is presented with special emphasis on some aspects of this neglected disease: the main clinical manifestations, risk factors and epidemiology. In addition, any recent advances in diagnostic approaches and treatment are discussed. Finally, the complexities involved in the control of the disease and the need to revise current management strategies are highlighted.

Development of an Electrochemical DNA Biosensor to Detect a Foodborne Pathogen

Vibrio parahaemolyticus (V. parahaemolyticus) is a common foodborne pathogen that contributes to a large proportion of public health problems globally, significantly affecting the rate of human mortality and morbidity. Conventional methods for the detection of V. parahaemolyticus such as culture-based methods, immunological assays, and molecular-based methods require complicated sample handling and are time-consuming, tedious, and costly. Recently, biosensors have proven to be a promising and comprehensive detection method with the advantages of fast detection, cost-effectiveness, and practicality. This research focuses on developing a rapid method of detecting V. parahaemolyticus with high selectivity and sensitivity using the principles of DNA hybridization. In the work, characterization of synthesized polylactic acid-stabilized gold nanoparticles (PLA-AuNPs) was achieved using X-ray Diffraction (XRD), Ultraviolet-visible Spectroscopy (UV-Vis), Transmission Electron Microscopy (TEM), Field-emission Scanning Electron Microscopy (FESEM), and Cyclic Voltammetry (CV). We also carried out further testing of stability, sensitivity, and reproducibility of the PLA-AuNPs. We found that the PLA-AuNPs formed a sound structure of stabilized nanoparticles in aqueous solution. We also observed that the sensitivity improved as a result of the smaller charge transfer resistance (Rct) value and an increase of active surface area (0.41 cm²). The development of our DNA biosensor was based on modification of a screen-printed carbon electrode (SPCE) with PLA-AuNPs and using methylene blue (MB) as the redox indicator. We assessed the immobilization and hybridization events by differential pulse voltammetry (DPV). We found that complementary, non-complementary, and mismatched oligonucleotides were specifically distinguished by the fabricated biosensor. It also showed reliably sensitive detection in cross-reactivity studies against various food-borne pathogens and in the identification of V. parahaemolyticus in fresh cockles.

Parasites in Food: From a Neglected Position to an Emerging Issue

Foodborne parasites have long been a neglected group of pathogens, as they often have insidious, chronic effects, rather than being acute diseases, and they are often associated with impoverished or marginalized populations. In addition, due to the long incubation period for most foodborne parasites, source attribution is often difficult, if not impossible. However, global trends have enabled foodborne parasites to emerge in different populations in new locations, transmitted through different food types, and sometimes with unexpected symptoms. This emergence of foodborne parasites has brought them into focus. In this chapter, six foodborne parasites are used as examples on emergence: Echinococcus multilocularis is spreading to new locations; Cryptosporidium spp. are beginning to be associated not only with water, but also with salads; Trypanosoma cruzi is being manifest with acute disease due to foodborne transmission, particularly transmitted with juices; Trichinella spp. have become less of a burden regarding transmission via pork in many countries, but now game animals are becoming a concern; anisakiasis is becoming a global problem as the world develops a taste for sushi, and similarly for opisthorchiasis, which is increasingly being associated with cholangiocarcinoma. However, the emergence of these foodborne parasites provides an incentive for increased efforts being made toward control. In this chapter, having described how the parasites are emerging from their neglected position, the focus turns toward control. In addition to considering control measures that may be applied to the specific parasites, an overview is provided of some of the organized collaborations, projects, and consortia, as well as some of their outputs, that have in focus the control of these emerging and important pathogens.

Prioritisation of food-borne parasites in Europe, 2016

Background and aimsPriority setting is a challenging task for public health professionals. To support health professionals with this and in following a recommendation from the Food and Agriculture Organization of the United Nations (FAO) and World Health Organization (WHO), 35 European parasitologists attended a workshop from 8-12 February 2016 to rank food-borne parasites (FBP) in terms of their importance for Europe and regions within Europe. Methods: Countries were divided into European regions according to those used by the European Society of Clinical Microbiology and Infectious Diseases. We used the same multicriteria decision analysis approach as the FAO/WHO, for comparison of results, and a modified version, for better regional representation. Twenty-five FBP were scored in subgroups, using predefined decision rules. Results: At the European level, Echinococcus multilocularis ranked first, followed by Toxoplasma gondii and Trichinella spiralis. At the regional level, E. multilocularis ranked highest in Northern and Eastern Europe, E. granulosus in South-Western and South-Eastern Europe, and T. gondii in Western Europe. Anisakidae, ranking 17th globally, appeared in each European region's top 10. In contrast, Taenia solium, ranked highest globally but 10th for Europe. Conclusions: FBP of importance in Europe differ from those of importance globally, requiring targeted surveillance systems, intervention measures, and preparedness planning that differ across the world and across Europe.

Clinical characteristics and epidemiology of intestinal tapeworm infections over the last decade in Tokyo, Japan: A retrospective review

BACKGROUND

Tapeworm (cestode) infections occur worldwide even in developed countries and globalization has further complicated the epidemiology of such infections. Nonetheless, recent epidemiological data on cestode infections are limited. Our objectives were to elucidate the clinical characteristics and epidemiology of diphyllobothriosis and taeniosis in Tokyo, Japan.

METHODOLOGY/PRINCIPAL FINDINGS

We retrospectively reviewed 24 cases of human intestinal cestode infection from January 2006 to December 2015 at a tertiary referral hospital in Tokyo, Japan. The patients included were diagnosed with cestode infection based on morphological and/or molecular identification of expelled proglottids and/or eggs and treated in our hospital. Fifteen and 9 patients were diagnosed with diphyllobothriosis and taeniosis, respectively. The median patient age was 31 years (interquartile range [IQR]: 26-42 years), and 13 (54%) were male. Most of the patients (91.7%) were Japanese. All patients were successfully treated with praziquantel without recurrence. Diphyllobothriosis was caused by Diphyllobothrium nihonkaiense in all patients. Taeniosis was due to infection of Taenia saginata in 8 [88.9%] patients and T. asiatica in 1 [11.1%] patient. All patients with taeniosis were infected outside Japan, as opposed to those with diphyllobothriosis, which were domestic. The source locations of taeniosis were mostly in developing regions. The median duration of the stay of the patients with taeniosis at the respective source location was 1 month (IQR: 1-8).

CONCLUSIONS/SIGNIFICANCE

The cestode infection, especially with D. nihonkaiense, has frequently occurred, even in Japanese cities, thereby implicating the probable increase in the prevalence of diphyllobothriosis among travelers, as the number of travelers is expected to increase owing to the Tokyo Olympics/Paralympics in 2020. In addition, medical practitioners should be aware of the importance of providing advice to travelers to endemic countries of taeniosis, including the potential risks of infection and preventive methods for these infections.

The Sources of Chemical Contaminants in Food and Their Health Implications

Food contamination is a matter of serious concern, as the high concentration of chemicals present in the edibles poses serious health risks. Protecting the public from the degrees of the harmfulness of contaminated foods has become a daunting task. This article highlights the causes, types, and health implications of chemical contamination in food. The food contamination could be due to naturally occurring contaminants in the environment or artificially introduced by the human. The phases of food processing, packaging, transportation, and storage are also significant contributors to food contamination. The implications of these chemical contaminants on human health are grave, ranging from mild gastroenteritis to fatal cases of hepatic, renal, and neurological syndromes. Although, the government regulates such chemicals in the eatables by prescribing minimum limits that are safe for human consumption yet measures still need to be taken to curb food contamination entirely. Therefore, a variety of food needs to be inspected and measured for the presence of chemical contaminants. The preventative measures pertaining about the food contaminants problems are pointed out and discussed.

High Throughput Sequencing for Detection of Foodborne Pathogens

High-throughput sequencing (HTS) is becoming the state-of-the-art technology for typing of microbial isolates, especially in clinical samples. Yet, its application is still in its infancy for monitoring and outbreak investigations of foods. Here we review the published literature, covering not only bacterial but also viral and Eukaryote food pathogens, to assess the status and potential of HTS implementation to inform stakeholders, improve food safety and reduce outbreak impacts. The developments in sequencing technology and bioinformatics have outpaced the capacity to analyze and interpret the sequence data. The influence of sample processing, nucleic acid extraction and purification, harmonized protocols for generation and interpretation of data, and properly annotated and curated reference databases including non-pathogenic "natural" strains are other major obstacles to the realization of the full potential of HTS in analytical food surveillance, epidemiological and outbreak investigations, and in complementing preventive approaches for the control and management of foodborne pathogens. Despite significant obstacles, the achieved progress in capacity and broadening of the application range over the last decade is impressive and unprecedented, as illustrated with the chosen examples from the literature. Large consortia, often with broad international participation, are making coordinated efforts to cope with many of the mentioned obstacles. Further rapid progress can therefore be prospected for the next decade.

The intricate connection between diet, microbiota, and cancer: A jigsaw puzzle

The microbial community has a decisive role in determining our health and disease susceptibility. Presumably, this is closely associated with the complex community network of bacteria, fungi, archaea and viruses that reside our guts. This dynamic ecosystem exists in a symbiotic relationship with its host and plays a fundamental role in the hosts' physiological functions. The microbial community is highly personalized and therefore exhibits a high degree of inter-individual variability, which is dependent on host specifics such as genetic background, physiology and lifestyle. Although the gut microbiota is shaped early on during birth, there are several factors that affect the composition of microbiota during childhood and adulthood. Among them diet appears to be a consistent and prominent one. The metabolic activity of bacteria affects food digestion, absorption, energy production, and immunity. Thus, definition of the microbiota composition and functional profiles in response to a particular diet may lead to critical information on the direct and indirect role/use of the bacterial community during health and disease. In this review, I discuss gut microbiota and its potential link to cancer with specific emphasis on metabolism and diet.

Present status of laboratory diagnosis of human taeniosis/cysticercosis in Europe

Human cysticercosis (CC) is a parasitic zoonosis caused by the larval stage (cyst) of the Taenia solium. Cysts can establish in the human central nervous system (neurocysticercosis, NCC) and other organs and tissues; they also develop in pigs, the natural intermediate host. Human taeniosis may be caused by T. solium, Taenia saginata and Taenia asiatica tapeworms; these infections are usually asymptomatic, but show a significant relevance as they perpetuate the parasites’ life cycle, and, in the case of T. solium, they are the origin of (N)CC. In European Union (EU) member states and associated countries, the occurrence of autochthonous T. solium cases is debated, and imported cases have significantly increased lately; the status of T. asiatica has been never reported, whereas T. saginata is prevalent and causes an economic impact due to condemned carcasses. Based on their effects on the EU society, the specific diagnosis of these pathologies is relevant for their prevention and control. The aims of this study were to know the diagnostic tests used in European laboratories for human taeniosis/cysticercosis by means of a questionnaire, to determine potential gaps in their detection, and to obtain preliminary data on the number of diagnosed taeniosis/CC cases.

Brachylaimiasis: Brachylaima spp. (Digenea: Brachylaimidae) Metacercariae Parasitizing the Edible Snail Cornu aspersum (Helicidae) in Spanish Public Marketplaces and Health-Associated Risk Factors

The edible land snail Cornu aspersum (Pulmonata: Stylommatophora) acts as a second intermediate host in the terrestrial life cycle of Brachylaima spp. trematodes, harboring unencysted metacercariae in its kidney. The ingestion of undercooked infected snails by humans may allow metacercariae to potentially develop to adult stage in the intestine, causing brachylaimiasis, as already seen in Australia. The prevalence and dynamics of C. aspersum parasitization by Brachylaima spp. metacercariae in specimens intended for human consumption in Spanish marketplaces were studied. In total, 3,710 C. aspersum specimens were analyzed over 5 yr, which were obtained from public marketplaces in the Spanish cities of Barcelona, Bilbao, Madrid, Tudela, Valencia, and Zaragoza. The overall prevalence was 41.97% (95% CI: 40.38-45.56%). The Tudela marketplace had the highest values for both the seasonal prevalence and abundance in all studies during autumn (93.57% and 3.09, respectively). This market also gave the highest individual metacercarial burden recorded, 212 metacercariae in a single specimen. Overall, the highest prevalence of Brachylaima spp. occurred in autumn (58.65%) and the lowest in winter (22.64%). There was a seasonal effect on prevalence, which increased from summer to autumn and then decreased in winter. In total, 96 experimental Brachylaima adults were obtained from the metacercariae parasitizing the analyzed snails. These were identified through morphometric tools (principal component analysis) as Brachylaima mascomai (56 in Barcelona, 1 in Bilbao, 7 in Tudela, and 3 in Valencia), and Brachylaima llobregatensis (17 in Barcelona, 8 in Bilbao, 1 in Valencia, and 3 in Zaragoza). Logistic regression modeling, conducted to predict the probability of purchasing parasitized snails using city and season as predictors showed a correct prediction overall of 79.0%, with a significant (p = 0.001) risk effect in the Barcelona-autumn interaction (2.551-38.442), a significant (p = 0.049) protection effect in the Tudela-spring interaction (0.076-0.997), a significant (p < 0.001) risk effect in the Tudela-autumn interaction (4.330-78.584), and a significant (p = 0.014) protection effect in the Valencia-spring interaction (0.033-0.687). The high overall prevalence of Brachylaima spp. metacercariae should be a matter of concern for public health authorities, mainly in countries where C. aspersum is consumed.