Epidemiology of taeniosis/cysticercosis in Europe, a systematic review: eastern Europe

Emerging and Re-Emerging Parasitic Infections of the Central Nervous System (CNS) in Europe

In a rapidly evolving global landscape characterized by increased international travel, migration, and ecological shifts, this study sheds light on the emergence of protozoal and helminthic infections targeting the central nervous system (CNS) within Europe. Despite being traditionally associated with tropical regions, these infections are progressively becoming more prevalent in non-endemic areas. By scrutinizing the inherent risks, potential outcomes, and attendant challenges, this study underscores the intricate interplay between diagnostic limitations, susceptibility of specific population subsets, and the profound influence of climate fluctuations. The contemporary interconnectedness of societies serves as a conduit for introducing and establishing these infections, warranting comprehensive assessment. This study emphasizes the pivotal role of heightened clinician vigilance, judicious public health interventions, and synergistic research collaborations to mitigate the potential consequences of these infections. Though rare, their profound impact on morbidity and mortality underscores the collective urgency required to safeguard the neurological well-being of the European populace. Through this multifaceted approach, Europe can effectively navigate the complex terrain posed with these emergent infections.

Seroprevalence of Taenia saginata Cysts in Cattle, Human Hospital Cases, and Risk Factors for Human Taeniasis in Kajiado County, Kenya

Taenia saginata is a zoonotic tapeworm that causes diseases in cattle and humans. A cross-sectional survey was conducted between June and July 2021 in Kajiado County, Kenya, to estimate the seroprevalence of Taenia saginata cysts in cattle presented for slaughter in Kitengela, Kiserian, and Keekonyokie slaughterhouses; determine the annual hospital reported cases of T. saginata in humans that visited all level 4 hospitals in Kajiado County between 2015 and 2021; and assess the risk factors for Taenia saginata in humans. Analyzed data in this study revealed that the seroprevalence of Taenia saginata cysts in cattle in the selected slaughterhouses was 2.67% (4/150). The meat inspectors recorded no cysts during the study period, confirming that antibody ELISA is three times as sensitive as meat inspection. Data from hospital records showed that a total of 1,487,687 patients visited different facilities in Kajiado County between 2015 and 2021. During the same period, 29 patients were diagnosed with human taeniasis. From the risk factors assessed, uninspected home slaughter (75%), consumption of raw/improperly cooked beef (100%), and open defecation by herders (11%) still pose a risk to humans getting infected by Taenia saginata, while the presence and use of latrines (89%) and availability, accessibility, and use of taenicides (89%) seem to have significantly contributed to the reduction of Taenia saginata prevalence in this region. It is recommended that control of the infection should be centered towards continuous focused education coupled with regular deworming of the herders and school going children. This will gradually result in behavior and culture change that will ultimately reduce the prevalence and lead to the elimination of the disease.

Prevalence of cysticercosis in cattle slaughterhouses in the western region of Minas Gerais, Brazil (2013-2020): Influence of sanitary regulations in reducing risks to human health

Bovine cysticercosis is a foodborne zoonosis that has a worldwide distribution, and its highest prevalence is found in developing countries with a large volume of cattle production, such as Brazil. The objective was to evaluate the prevalence of cysticercosis during seven years in three slaughterhouses located in the western region of Minas Gerais state, Brazil, and the impacts of the legislation on the identification and destination of infected carcasses. Three slaughterhouses (Sl) were selected for this study with averages of 200 (SlA), 721 (SlB) and 1138 (SlC) bovines slaughtered per day. The monthly number of slaughtered cattle, infected carcasses with cysticercosis and destination were used to calculate the condemnation occurrence index (COI) and the adjusted seasonal index (ASI). To assess the impact of the legislation, the prevalence rate and destination of infected carcasses were subdivided into the PRE (January 2013 to March 2017) and POST (April 2017 to December 2020) period of Decree 9013 of 2017 and the results were compared by chi-square (P < 0.05). SlA recorded the highest cysticercosis rate with 1.54 % and SlC the lowest rate with 0.33 %. In addition, it was observed that in the POST period there was an increase in the identification of infected carcasses in SlA and B (P < 0.05). The POST period also resulted in a change in the relative frequency of infected carcasses destination in the three slaughterhouses (P < 0.05). The ASI identified an increase in infected carcasses in February and a decrease in November for SlB, proving to be an important tool for planning the inspection team trainings. These results show that the disease is still present in the studied region and highlight the benefits of using the One Health concept in the evaluation of a time series prevalence of bovine cysticercosis by: identifying seasonality of the disease, trends during the time period and impacts brought by updates in the national sanitary legislation.

Taenia solium taeniasis and Cysticercosis Prevalence and Control Practice in China

Taenia solium taeniasis/cysticercosis is an important global food-borne zoonosis transmitted between humans and pigs. In China, the prevalence of Theridion solium taeniasis/cysticercosis has been marked decline in recent decades based on the data revealed by both national surveys and field prevalence investigations. Health education and promotion, meat inspection, and chemotherapy are unquestionably the main control measures for diseases. It is worth noting that a variety of socio-ecological variables have been identified in the process of controlling T. solium taeniasis/cysticercosis. It has become difficult for pigs to come into direct or indirect contact with or consume human excreta as pig farming practices have been shifted from traditional backyard farms to large-scale commercial pig raising systems that are still in progress. The human toilet revolution in rural areas of China has ensured hygienic separation of human excreta from contact, and thereby preventing human excreta from polluting the soil, feeds, and water. These two important fundamental preventive measures are crucial to establishing an environmental restriction between humans and pigs cannot be overlooked for interrupting or limiting T. solium transmission. In this chapter, we reviewed the epidemiology, traditional measures, and ecological determinants that significantly contributed to the dramatic decline of taeniasis/cysticercosis in China.

Clinical characteristics and management of neurocysticercosis patients: a retrospective assessment of case reports from Europe

OBJECTIVES

Neurocysticercosis (NCC) is a parasitic disease caused by the larval stage of the tapeworm Taenia solium. NCC mainly occurs in Africa, Latin America and South-East Asia and can cause a variety of clinical signs/symptoms. Although it is a rare disease in Europe, it should nonetheless be considered as a differential diagnosis. The aim of this study was to describe clinical characteristics and management of patients with NCC diagnosed and treated in Europe.

METHODS

We conducted a systematic search of published and unpublished data on patients diagnosed with NCC in Europe (2000-2019) and extracted demographic, clinical and radiological information on each case, if available.

RESULTS

Out of 293 identified NCC cases, 59% of patients presented initially with epileptic seizures (21% focal onset); 52% presented with headache and 54% had other neurological signs/symptoms. The majority of patients had a travel or migration history (76%), mostly from/to Latin America (38%), Africa (32%) or Asia (30%). Treatment varied largely depending on cyst location and number. The outcome was favorable in 90% of the cases.

CONCLUSIONS

Management of NCC in Europe varied considerably but often had a good outcome. Travel and migration to and from areas endemic for T. solium will likely result in continued low prevalence of NCC in Europe. Therefore, training and guidance of clinicians is recommended for optimal patient management.

Evolution of codon usage in Taenia saginata genomes and its impact on the host

The beef tapeworm, also known as Taenia saginata, is a zoonotic tapeworm from the genus Taenia in the order Cyclophyllidea. Taenia saginata is a food-borne zoonotic parasite with a worldwide distribution. It poses serious health risks to the host and has a considerable negative socioeconomic impact. Previous studies have explained the population structure of T. saginata within the evolutionary time scale and adaptive evolution. However, it is still unknown how synonymous codons are used by T. saginata. In this study, we used 90 T. saginata strains, applying the codon usage bias (CUB). Both base content and relative synonymous codon usage (RSCU) analysis revealed that AT-ended codons were more frequently used in the genome of T. saginata. Further low CUB was observed from the effective number of codons (ENC) value. The neutrality plot analysis suggested that the dominant factor of natural selection was involved in the structuring of CUB in T. saginata. Further analysis showed that T. saginata has adapted host-specific codon usage patterns to sustain successful replication and transmission chains within hosts (Bos taurus and Homo sapiens). Generally, both natural selection and mutational pressure have an impact on the codon usage patterns of the protein-coding genes in T. saginata. This study is important because it characterized the codon usage pattern in the T. saginata genomes and provided the necessary data for a basic evolutionary study on them.

Analysis of immune response in BALB/c mice immunized with recombinant plasmids pMZ-X3-Ts14-3-3.3 and pMZ-X3-sp-Ts14-3-3.3 of Taenia solium

There is a lack of vaccine against human cysticercosis, thus making a huge population at the risk of infection. In this study, we chose a novel potential antigen molecule Taenia solium 14-3-3.3 (Ts14-3-3.3) and optimized it as sp-Ts14-3-3.3 (sp is immunoglobulin H chain V-region precursor, partial) in order to construct recombinant plasmids pMZ-X3-Ts14-3-3.3 and pMZ-X3-sp-Ts14-3-3.3. BALB/c mice were divided into four groups for immunization: pMZ-X3-Ts14-3-3.3, pMZ-X3-sp-Ts14-3-3.3, pMZ-X3 plasmid control group and PBS control group. Compared with two control groups, the proliferation level of splenic lymphocytes increased significantly in pMZ-X3-Ts14-3-3.3 and pMZ-X3-sp-Ts14-3-3.3 groups and reached the maximum in week 6. And the same case arose as cytokines associated with Th1 response, IFN-γ, and IL-2 while those with Th2 response, IL-4, IL-10 went up and reached the maximum in week 4. The levels of serum specific IgG, IgG1 and IgG2a rose and reached the maximum in week 6, 4 and 6, respectively. Meanwhile, the proportion of CD4⁺/CD8⁺ splenic T lymphocytes increased and reached the peak in week 6. The results indicated that the recombinant plasmids pMZ-X3-Ts14-3-3.3 and pMZ-X3-sp-Ts14-3-3.3 can induce specific cellular and humoral immune responses in BALB/c mice with immunization. Notably, the recombinant plasmid pMZ-X3-sp-Ts14-3-3.3 has a better immune effect, which proves that Ts14-3-3.3 enjoys a higher possibility as a potential antigen molecule to T. solium vaccine.

Comparison of cone bioassay estimates at two laboratories with different Anopheles mosquitoes for quality assurance of pyrethroid insecticide-treated nets

Background

Quality assurance (QA) of insecticide-treated nets (ITNs) delivered to malaria-endemic countries is conducted by measuring physiochemical parameters, but not bioefficacy against malaria mosquitoes. This study explored utility of cone bioassays for pre-delivery QA of pyrethroid ITNs to test the assumption that cone bioassays are consistent across locations, mosquito strains, and laboratories.

Methods

Double-blinded bioassays were conducted on twenty unused pyrethroid ITNs of 4 brands (100 nets, 5 subsamples per net) that had been delivered for mass distribution in Papua New Guinea (PNG) having passed predelivery inspections. Cone bioassays were performed on the same net pieces following World Health Organization (WHO) guidelines at the PNG Institute of Medical Research (PNGIMR) using pyrethroid susceptible Anopheles farauti sensu stricto (s.s.) and at Ifakara Health Institute (IHI), Tanzania using pyrethroid susceptible Anopheles gambiae s.s. Additionally, WHO tunnel tests were conducted at IHI on ITNs that did not meet cone bioefficacy thresholds. Results from IHI and PNGIMR were compared using Spearman’s Rank correlation, Bland–Altman (BA) analysis and analysis of agreement. Literature review on the use of cone bioassays for unused pyrethroid ITNs testing was conducted.

Results

In cone bioassays, 13/20 nets (65%) at IHI and 8/20 (40%) at PNGIMR met WHO bioefficacy criteria. All nets met WHO bioefficacy criteria on combined cone/tunnel tests at IHI. Results from IHI and PNGIMR correlated on 60-min knockdown (KD60) (r_s = 0.6,p = 0.002,n = 20) and 24-h mortality (M24) (r_s = 0.9,p < 0.0001,n = 20) but BA showed systematic bias between the results. Of the 5 nets with discrepant result between IHI and PNGIMR, three had confidence intervals overlapping the 80% mortality threshold, with averages within 1–3% of the threshold. Including these as a pass, the agreement between the results to predict ITN failure was good with kappa = 0.79 (0.53–1.00) and 90% accuracy.

Conclusions

Based on these study findings, the WHO cone bioassay is a reproducible bioassay for ITNs with > 80% M24, and for all ITNs provided inherent stochastic variation and systematic bias are accounted for. The literature review confirms that WHO cone bioassay bioefficacy criteria have been previously achieved by all pyrethroid ITNs (unwashed), without the need for additional tunnel tests. The 80% M24 threshold remains the most reliable indicator of pyrethroid ITN quality using pyrethroid susceptible mosquitoes. In the absence of alternative tests, cone bioassays could be used as part of pre-delivery QA.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12936-022-04217-3.

Retrospective analysis and time series forecasting with automated machine learning of ascariasis, enterobiasis and cystic echinococcosis in Romania

The epidemiology of neglected tropical diseases (NTD) is persistently underprioritized, despite NTD being widespread among the poorest populations and in the least developed countries on earth. This situation necessitates thorough and efficient public health intervention. Romania is at the brink of becoming a developed country. However, this South-Eastern European country appears to be a region that is susceptible to an underestimated burden of parasitic diseases despite recent public health reforms. Moreover, there is an evident lack of new epidemiologic data on NTD after Romania's accession to the European Union (EU) in 2007. Using the national ICD-10 dataset for hospitalized patients in Romania, we generated time series datasets for 2008-2018. The objective was to gain deep understanding of the epidemiological distribution of three selected and highly endemic parasitic diseases, namely, ascariasis, enterobiasis and cystic echinococcosis (CE), during this period and forecast their courses for the ensuing two years. Through descriptive and inferential analysis, we observed a decline in case numbers for all three NTD. Several distributional particularities at regional level emerged. Furthermore, we performed predictions using a novel automated time series (AutoTS) machine learning tool and could interestingly show a stable course for these parasitic NTD. Such predictions can help public health officials and medical organizations to implement targeted disease prevention and control. To our knowledge, this is the first study involving a retrospective analysis of ascariasis, enterobiasis and CE on a nationwide scale in Romania. It is also the first to use AutoTS technology for parasitic NTD.

Risk Factors for Bovine Cysticercosis in North-West Italy: A Multi-Year Case-Control Study

Simple Summary

Bovine cysticercosis is a parasitic disease caused by Cysticercus bovis, the larval stage of the human tapeworm Taenia saginata, which is the causative agent of human taeniasis, a foodborne parasitic disease caused by the consumption of infected raw or undercooked beef meat. Although commonly asymptomatic, bovine cysticercosis has an important impact worldwide, causing huge economic losses to the meat industry due to carcass condemnation or downgrading. Given the lack of epidemiological case-control surveys carried out in Italy, the present survey’s aim was to assess the presence of farm-level risk factors for bovine cysticercosis in an endemic area in North-West Italy. The results of our survey show a significant association between the detection of bovine cysticercosis cases at slaughter and farm proximity to picnic spots, closeness of wastewater treatment plant effluents, presence of employees along with the family members and loose-housing systems. These findings highlight the need for enforced food chain information and surveillance strategies and the crucial role that hygiene-related campaigns would play to educate both the general public and farm operators on the transmission pathways of T. saginata.

Abstract

Taenia saginata is the causative agent of bovine cysticercosis, a zoonotic parasitic disease with a worldwide distribution. Bovine cysticercosis is considered to be an important food safety issue responsible for human taeniasis and a major economic concern since infected carcasses undergo condemnation, freezing and downgrading. The aim of the current investigation was to assess the presence of farm-level risk factors for bovine cysticercosis in an endemic area in North-West Italy. A questionnaire was designed to collect information relating to several farm structural features, as well as management practices, environmental characteristics and attitudes of farmers. The questionnaire was administered in two separate time intervals by direct interview to previously selected case and control farms. Overall, 32 case farms and 131 control farms were included between 2005 and 2011 and 50 case farms and 192 control farms were included between 2014 and 2020. The present survey showed a significant association between the detection of bovine cysticercosis cases at slaughter and farm proximity to picnic spots, closeness of wastewater treatment plant effluents, loose-housing systems and presence of employees along with the family members, highlighting the need for targeted awareness raising policies.

Epidemiology of Taenia solium infection in the Russian Federation in the last 20 years: a systematic review

Taenia solium is a zoonotic parasite that causes taeniasis and cysticercosis in humans (as final hosts) and cysticercosis in pigs (as intermediate hosts). The Russian Federation (RF) is traditionally considered as endemic for this zoonosis. However, the epidemiological data on T. solium infection have not been reviewed for the past 20 years, in which time dynamic economical and societal changes have occurred in the RF. The aim of this systematic review was to analyse the status of T. solium infection in RF in the 2000-2019 period. A literature search was conducted, which collected published articles, grey literature and official data on the epidemiology of T. solium taeniasis and cysticercosis in the RF published from 2000. From a total of 2021 articles and 24 official reports originally returned by the search, data were extracted from 12 full text articles and 11 official reports. Taenia solium taeniasis was continuously reported in the RF between 2000 and 2019, with a tenfold decrease in the incidence, from 0.2 per 100,000 population in 2000 to 0.023/100,000 in 2019. Also, the number of administrative units where taeniasis was detected continuously decreased. Cysticercosis in pigs had a declining trend after 2006. In conclusion, although decreasing, T. solium infection is still endemic in several regions and suspected to be endemic in most of the RF.

A Large Case Series of Neurocysticercosis in Kuwait, a Nonendemic Arabian Gulf Country in the Middle East Region

Neurocysticercosis (NCC), a leading global cause of severe progressive headache and epilepsy, in developed or affluent countries is mostly diagnosed among immigrants from poor or developing Taenia solium taeniasis-endemic countries. Taeniasis carriers in Kuwait are routinely screened by insensitive stool microscopy. In this study, enzyme-linked immunoelectrotransfer blot (EITB) was used as a confirmatory test for NCC. Screening was performed on 970 patients referred for suspected NCC on the basis of relevant history and/or ring-enhancing lesions on computed tomography and/or magnetic resonance imaging during a 14-year period in Kuwait. Demographic data and clinical details were retrieved from laboratory or hospital records. EITB was positive in 150 subjects (15.5%), including 98 expatriates mostly originating from taeniasis-endemic countries and, surprisingly, 52 Kuwaiti nationals. The clinical details of 48 of 50 NCC cases diagnosed during 2014–2019 were available. Most common symptoms included seizures, persistent headache with/without fever, and fits or loss of consciousness. Cysticercal lesions were located at various brain regions in 39 of 48 patients. Multiple members of 3 families with NCC were identified; infection was linked to domestic workers from taeniasis-endemic countries and confirmed in at least 1 family. Our data show that NCC is predominantly imported in Kuwait by expatriates originating from taeniasis-endemic countries who transmit the infection to Kuwaiti citizens.

Genetic Diversity of Taenia solium and its Relation to Clinical Presentation of Cysticercosis

In this perspectives paper, we discuss fertilization strategies for Taenia saginata and Taenia saginata asiatica as well as heterogeneity in Taenia solium, the causative agent of human cysticercosis. Two different genotypes of T. solium (Asian and Afro/American) were confirmed by mitochondrial DNA analysis approximately two decades ago. Since then, outcrossings of the two genotypes have been identified in Madagascar where the two genotypes are distributed sympatrically. Outcrossings were confirmed by the presence of discordance between mitochondrial and nuclear DNA. Since multiple tapeworm infections are common in endemic areas, outcrossing events likely occur quite frequently. Therefore, mitochondrial DNA from T. solium specimens collected from humans and pigs in endemic areas should be analyzed. If variations are found between specimens, nuclear DNA analysis should be performed to confirm the presence of discordance between mitochondrial and nuclear genes. Additional outcrossings likely add complexity to understanding the existing genetic diversity. Serological surveys are also recommended since serodiagnostic glycoprotein can also differentiate between the two genotypes. Viable eggs from different genotypes or from hybrids of two different genotypes should be used for experimental infection of pigs or dogs in order to observe any pathological heterogeneity in cysticercosis development. Although genetic diversity of T. solium is expected to result in clinical heterogeneity of cysticercosis in humans and pigs, there is currently no evidence showing that this occurs. There are also no comparative experimental studies on this topic. Therefore, studies evaluating the link between parasite heterogeneity and clinical outcome are warranted.

Collaborative Studies for the Detection of Taenia spp. Infections in Humans within CYSTINET, the European Network on Taeniosis/Cysticercosis

Laboratory tools for diagnosing taeniosis/cysticercosis in non-endemic countries are available; however, there is little data on their performance. To provide information on the sensitivity, specificity, and reproducibility of these tools, inter-laboratory studies were organized within the EU COST-Action CYSTINET (TD1302). Two serological and one coprological Ring Trials (RTs) were organized to test a panel of human-derived sera and stool samples using assays routinely conducted by the participating laboratories to detect Taenia spp. infections. Four Western blots (WBs) and five ELISAs were used by nine laboratories for cysticercosis diagnosis. In the first serological RT, the overall sensitivity was 67.6% (95% CI, 59.1–75.4), whereas specificity was 97% (95% CI, 89.8–99.6). WBs recorded the best accuracy. A second serological RT was organized, to assess the three tests most frequently used during the first RT. Two out of six laboratories performed all the three tests. The overall sensitivity and specificity were 52.8% (95% CI, 42.8–62.7) and 98.1% (95% CI, 93.2–99.7), respectively. Laboratory performance strongly affected test results. Twelve laboratories participated in the coprological RT using conventional microscopy and six laboratories used molecular assays. Traditional diagnosis by microscopy yielded better results than molecular diagnosis. This may have been influenced by the lack of standardization of molecular tests across participating laboratories.

Meat Safety from Farm to Slaughter—Risk-Based Control of Yersinia enterocolitica and Toxoplasma gondii

The implementation of the traditional meat safety control system has significantly contributed to increasing food safety and public health protection. However, several biological hazards have emerged in meat production, requiring a comprehensive approach to their control, as traditional methods of meat inspection at the slaughterhouse are not able to detect them. While national control programs exist for the most important meat-related hazards, similar data are still lacking for certain neglected threats, such as Yersinia enterocolitica or Toxoplasma gondii. The obstacle in controlling these hazards in the meat chain is their presence in latently infected, asymptomatic animals. Their effective control can only be achieved through systematic preventive measures, surveillance or monitoring, and antimicrobial interventions on farms and in slaughterhouses. To establish such a system, it is important to collect all relevant data on hazard-related epidemiological indicators from the meat chain, which should provide relevant guidance for interventions at the harvest and post-harvest stage. The proposed approach is expected to improve the existing system and provide many opportunities to improve food safety and public health.

Meat-borne parasites in the Arab world: a review in a One Health perspective

Meat-borne parasitic zoonoses are generally not well-monitored, and so understanding extent and overall prevalence is problematic. Without sufficient attention, their prevalence can become unexpectedly and unacceptably high. This review sheds light on meat-borne parasites in the Arab world, which includes all the Arab countries situated in the continents of Asia and Africa, with more than 400 million inhabitants distributed in 22 countries. Meat-borne parasites can be divided into two main categories-helminths and protozoa. The main helminths included in this review are Taenia saginata, Taenia solium, Taenia asiatica, Echinococcus spp., Fasciola spp., and Trichinella spiralis, while the meat-borne protozoan parasites are Toxoplasma gondii, Cryptosporidium spp., and Sarcocystis spp. In addition, Linguatula serrata, which belongs to the class Pentastomida, was included. Among those, the genus Taenia is the most frequently reported in the Arab world, particularly T. saginata. Many parasitic infections that are mainly transmitted through pork, although widespread in many parts of the world, are rare in the Arab countries, primarily due to religious proscriptions. The majority of the publications concerning meat-borne parasites were from Egypt, which contains the largest population in the Arab world and the highest population density, in addition to various economic, social, and environmental reasons.

Cysticercus bovis in cattle slaughtered in North Egypt: Overestimation by the visual inspection method

Background and Aim

The World Health Organization and the Food and Agriculture Organization list Taenia saginata, a foodborne cestode, as the most widely distributed human tapeworm worldwide. The larval stage of T. saginata, Cysticercus bovis, causes cysticercosis in bovines and infects humans who eat raw or undercooked beef. The existing detection methods of C. bovis in cattle depend on the visual inspection of meat. This study aimed to confirm the identification of C. bovis through visual inspection at the slaughterhouses in North Egypt with a molecular diagnosis.

Materials and Methods

A total of 687 locally bred cattle (Baladi), including 428 cows and 259 buffaloes, slaughtered in four slaughterhouses in North Egypt from April 2018 to February 2019 were inspected for C. bovis using the traditional meat inspection method. Positive samples were verified through polymerase chain reaction (PCR) amplification and HDP2 gene sequencing.

Results

Through visual inspection, C. bovis was detected in 4.2% and 12.4% of the slaughtered cows and buffaloes, respectively. Molecular analysis confirmed that 1.9% of the animals, all of which were cows, had C. bovis infection. DNA sequencing verified the identity of the PCR-amplified product.

Conclusion

The rate of C. bovis infection in slaughterhouses detected through meat inspection is overestimated compared with that through PCR. Although meat inspection can be used as a primary screening tool for C. bovis, a more specific molecular method is required to achieve an accurate diagnosis.

The effectiveness of anti-inflammatory and anti-seizure medication for individuals with single enhancing lesion neurocysticercosis: A meta-analysis and expert group-based consensus recommendations

Single brain enhancing lesions (SEL) are the most common presentation of neurocysticercosis (NCC) observed on neuroimaging in people presenting with epileptic seizures not only on the Indian sub-continent and in travelers returning from cysticercosis-endemic regions, but are also present in other parts of the world. The aim of this study, which consisted of a systematic review (CRD42019087665), a meta-analysis and an expert group consultation, was to reach consensus on the best anti-seizure medication and anti-inflammatory treatment for individuals with SEL NCC. Standard literature review methods were used. The Cochrane risk of bias tool was used and random effects model meta-analyses were performed. The quality of the body of evidence was rated using GRADE tables. The expert committee included 12 gender and geographically balanced members and recommendations were reached by applying the GRADE framework for guideline development. The 1-1.5-year cumulative incidence of seizure recurrence, cyst resolution or calcification following anti-seizure medication (ASM) withdrawal was not statistically different between ASM of 6, 12 or 24 months. In contrast, in persons whose cyst calcified post treatment, longer ASM decreased seizure recurrence. The cumulative incidence ratio (CIR) 1-1.5 years after stopping ASM was 1.79 95% CI: (1.00, 3.20) for patients given 6 versus 24 months treatment. Anti-inflammatory treatment with corticosteroids in patients treated with ASM compared to patients treated with ASM only showed a statistically significant beneficial effect on seizure reduction (CIR 0.44, 95% CI 0.23, 0.85) and cyst resolution (CIR 1.37, 95%CI: 1.07, 1.75). Our results indicate that ASM in patients with SEL NCC whose cysts resolved can be withdrawn, while patients whose cysts calcified seem to benefit from prolonged anti-seizure medication. Additional corticosteroid treatment was found to have a beneficial effect both on seizure reduction and cyst resolution.

Parasites in the changing world - Ten timely examples from the Nordic-Baltic region

The world is changing, and parasites adapt. The Nordic-Baltic region in northern Europe - including the Nordic countries Denmark, Finland, Iceland, Norway and Sweden, and the Baltic States Estonia, Latvia and Lithuania - is facing new parasitological challenges due to changes in populations of parasites and their hosts and the spread of new parasites to the region due to climate change. Some changes can also be ascribed to increased awareness and detection. In this paper, we review and discuss a convenience selection of ten timely examples of recent observations that exemplify trends and challenges from different fields of parasitology, with particular focus on climate change and potential changes in epidemiology of pathogens in northern Europe. The examples illustrate how addressing parasitological challenges often requires both intersectoral and international collaboration, and how using both historical baseline data and modern methodologies are needed.

Cysticercosis and taeniasis cases diagnosed at two referral medical institutions, Belgium, 1990 to 2015

Background

Few case reports on human infections with the beef tapeworm Taenia saginata and the pork tapeworm, Taenia solium, diagnosed in Belgium have been published, yet the grey literature suggests a higher number of cases.

Aim

To identify and describe cases of taeniasis and cysticercosis diagnosed at two Belgian referral medical institutions from 1990 to 2015.

Methods

In this observational study we retrospectively gathered data on taeniasis and cysticercosis cases by screening laboratory, medical record databases as well a uniform hospital discharge dataset.

Results

A total of 221 confirmed taeniasis cases were identified. All cases for whom the causative species could be determined (170/221, 76.9%) were found to be T. saginata infections. Of those with available information, 40.0% were asymptomatic (26/65), 15.4% reported diarrhoea (10/65), 9.2% reported anal discomfort (6/65) and 15.7% acquired the infection in Belgium (11/70). Five definitive and six probable cases of neurocysticercosis (NCC), and two cases of non-central nervous system cysticercosis (non-CNS CC) were identified. Common symptoms and signs in five of the definitive and probable NCC cases were epilepsy, headaches and/or other neurological disorders. Travel information was available for 10 of the 13 NCC and non-CNS CC cases; two were Belgians travelling to and eight were immigrants or visitors travelling from endemic areas.

Conclusions

The current study indicates that a non-negligible number of taeniasis cases visit Belgian medical facilities, and that cysticercosis is occasionally diagnosed in international travellers.

Parasitic diseases as a cause of acute abdominal pain: imaging findings

Acute abdominal pain can be seen in cases with parasitic diseases delivered to emergency departments. The diagnosis of the parasitic disease can be delayed because of the similar clinical signs encountered in other frequently seen causes of acute abdomen. Nevertheless, the features detected in imaging scans can be helpful in the diagnosis. The present study aims to raise awareness about abdominal parasitosis in emergency conditions and also to underline the association between imaging findings and the life cycle of parasites with illustrative cases.

Bovine cysticercosis and human taeniasis in a rural community in Ethiopia

BACKGROUND

Bovine cysticercosis is a worldwide zoonotic disease that affects cattle caused by the larval stage of the tapeworm Taenia saginata, the adult parasite that causes taeniasis in humans. Although bovine cysticercosis, and the associated human taeniasis, is controlled in developed countries, it is one of the neglected tropical diseases. Like other parts of Ethiopia, raw or undercooked beef consumption is common in the rural community of Yem district with no meat inspection services.

METHODS

We conducted an abattoir survey to estimate the prevalence of bovine cysticercosis in cattle and a questionnaire survey to determine the level of historical human taeniasis infection in Yem district of Ethiopia.

RESULTS

Bovine cysticercosis was detected in 3.1% of 485 cattle examined. Although animal level prevalence was low, a subset of positive animals had a higher rate of cysticercosis infection widely distributed in various parts of the body. Over two-fifths (40%) of the cysts were found in the tongue making it an important organ to look for during meat inspection. Over half of the cysts were viable indicating their potential to infect people. History of taeniasis was reported by 71.5% of 151 residents interviewed during the study. Raw meat consumption was very common (89.4%) among the residents; people who consumed raw meat were 25 times more likely to report taeniasis than those who did not. In addition, traditional treatments using herbs and chemicals of unknown efficacy and risk were very common.

CONCLUSIONS

Bovine cysticercosis and human taeniasis are important in this rural community. Providing meat inspection services and public health education on intervention measures such as proper cooking of meat, access to latrines and clean water are effective strategies that can break the lifecycle of the parasite and ensure beef safety and public health.

Taenia solium Cysticercosis and Its Impact in Neurological Disease

Taenia solium neurocysticercosis (NCC) is endemic in most of the world and contributes significantly to the burden of epilepsy and other neurological morbidity. Also present in developed countries because of immigration and travel, NCC is one of few diseases targeted for eradication. This paper reviews all aspects of its life cycle (taeniasis, porcine cysticercosis, human cysticercosis), with a focus on recent advances in its diagnosis, management, and control. Diagnosis of taeniasis is limited by poor availability of immunological or molecular assays. Diagnosis of NCC rests on neuroimaging findings, supported by serological assays. The treatment of NCC should be approached in the context of the particular type of infection (intra- or extraparenchymal; number, location, and stage of lesions) and has evolved toward combined symptomatic and antiparasitic management, with particular attention to modulating inflammation. Research on NCC and particularly the use of recently available genome data and animal models of infection should help to elucidate mechanisms of brain inflammation, damage, and epileptogenesis.

Human Taeniases in Slovakia (2010-2019): Genetic Analysis of Taenia saginata Isolates

Taenia saginata and Taenia solium, known as beef and pork tapeworm, are foodborne pathogens of global importance having a substantial impact on human health and economy. The study aimed to summarize the occurrence of human Taenia spp. infection in past 10 years in Slovakia based on reports of clinicians and diagnostic laboratories to Public Health Authority of the Slovak Republic. Altogether, 19 human cases were reported in Slovakia in 2010-2019, with the incidence of infection ranging from 0.00 to 0.12/100,000 inhabitants per year. In two patients T. saginata infection was confirmed molecularly. Nucleotide sequences of the analyzed nad1 gene fragments derived from both patients were identical and in a phylogenetic tree clustered together with T. saginata Tsa isolate (AM503345), as well as with a homologous sequence of the completely sequenced mitochondrial genome of T. saginata. Similarly, cox1 nucleotide sequences derived from one of the patients and isolates from Asia and/or Europe were identical. A cluster for cox1 partial gene sequence was placed separately from closely related Taenia asiatica and/or T. solium isolates in the phylogenetic tree.

Update on the major imported helminth infections in travelers and migrants

Helminth infections cause considerable morbidity worldwide and may be frequently underdiagnosed especially in areas of lower endemicity. Patients may harbor latent infections that may become symptomatic years or decades after the initial exposure and timely diagnosis may be critical to prevent complications and improve outcomes. In this context, disease in special populations, such as immunosuppressed patients, may be of particular concern. Heightened awareness and recent diagnostic developments may contribute to the correct management of helminth infections in nonendemic regions. A review of the main helminth infections in travelers and migrants (strongyloidiasis, taeniasis-neurocysticercosis and schistosomiasis) is presented, focusing on epidemiology, developments in diagnosis, treatment and prevention.

Epidemiology and surveillance of human (neuro)cysticercosis in Europe: is enhanced surveillance required?

OBJECTIVES

To report on relevant national surveillance systems of (N)CC and taeniasis (the infection with the adult tapeworm) in the European Union/European Economic Area and to assess the magnitude of (N)CC occurrence by retrieving information on cases for the period 2000-2016.

METHODS

(N)CC cases were retrieved via national reporting systems, a systematic literature search, contact with clinicians and a search for relevant 'International Statistical Classification of Diseases and Related Health Problems' (ICD)-based data.

RESULTS

Mandatory notification systems for (N)CC were found in Hungary, Iceland and Poland. Ten cases were reported in Poland and none in Hungary and Iceland. Through the systematic literature review and information given by clinicians, 263 individual and 721 aggregated (N)CC cases from 19 European countries were identified. ICD-based data were obtained from five countries. From 2000 to 2016, a total of 3489 cases (N)CC cases were coded: 832 in Italy, eight in Latvia, 357 in Portugal, 2116 in Spain and 176 in Sweden.

CONCLUSION

Despite being classified as a possible eradicable disease, (N)CC is still diagnosed across Europe, yet its true extent and impact remain unclear.

Development of multi-epitope chimeric vaccine against Taenia solium by exploring its proteome: an in silico approach

Objective: Taenia solium is a neglected tropical disease; larvae of this parasite infect central nervous system i.e. Neurocysticercosis, and adults mature and survive into intestine i.e. Taeniasis. Globally more than 50 million people are at the risk of infection. This is one of the main etiological agents for onset of new early epilepsy in developing countries. However, there is no vaccine available to protect human from its infection. Hence, there is an urgent need for a good vaccine.Methods: We applied immune-informatics approach to design a multi-epitope chimeric vaccine consisting of both B and T-cell epitopes.Results: From the whole transcriptome of Taenia, we identified five suitable peptides present on cell membrane, epitope identification on these peptides were done by using various immunoinformatic software. Physiochemical properties were determined and the tertiary structure of vaccine was predicted, validated and refined, and to increase antigenicity we added linker to them. Best-modeled protein-complex was used for docking study with TLR1-2, TLR4, TLR3 and TLR7 and stability of molecular complex was determined by molecular dynamics simulation.Conclusions: Overall, we attempted to design an efficient subunit chimeric vaccine, which could stimulate humoral and cellular immune responses and could protect against both neurocysticercosis and taeniasis.

Currently Available Monitoring and Surveillance Systems for Taenia spp., Echinococcus spp., Schistosoma spp., and Soil-Transmitted Helminths at the Control/Elimination Stage: A Systematic Review

An increasing global focus on neglected tropical diseases (NTDs) has resulted in the set up of numerous control and elimination activities worldwide. This is partly true for Taenia solium taeniasis/cysticercosis, the most important foodborne parasitic infection. Despite substantial progress, adequate monitoring and surveillance (M&S) are required to sustain a status of control/elimination. This is often lacking, especially for T. solium. Therefore, the objective was to conduct a systematic literature review of the currently available M&S systems at the control/elimination stage of the four top-ranked helminth NTDs. Specifically, Taenia spp., Echinococcus spp., Schistosoma spp., and soil-transmitted helminths (STHs) were considered to determine if there are any similarities between their M&S systems and whether certain approaches can be adopted from each other. The systematic review demonstrated that rigorous M&S systems have been designed for the control/elimination stage of both STHs and schistosomiasis, particularly in China. On the other hand, a concept of M&S for Taenia spp. and Echinococcus spp. has not been fully developed yet, due to a lack of epidemiological data and the fact that many endemic countries are far away from reaching control/elimination. Moreover, accurate diagnostic tools for all four diseases are still imperfect, which complicates proper M&S. Finally, there is an urgent need to develop and harmonize/standardize M&S activities in order to reliably determine and compare the epidemiological situation worldwide.

The World Health Organization 2030 goals for Taenia solium: Insights and perspectives from transmission dynamics modelling: CystiTeam Group for Epidemiology and Modelling of Taenia solium Taeniasis/Cysticercosis

Taenia solium (TS), responsible for porcine cysticercosis, human taeniasis and (neuro)cysticercosis, was included in the World Health Organization neglected tropical disease (NTD) roadmap published in 2012. Targets set in this roadmap have not been met, but T. solium has been included in the consultation process for the new 2030 goals proposed for priority NTDs. Taenia solium transmission dynamics models can contribute to this process. A recent review has compared existing T. solium transmission models, identifying their similarities and differences in structure, parameterization and modelled intervention approaches. While a formal model comparison to investigate the impact of interventions is yet to be conducted, the models agree on the importance of coverage for intervention effectiveness and on the fact that human- and pig-focused interventions can be optimally combined. One of these models, cystiSim, an individual-based, stochastic model has been used to assess field-applicable interventions, some currently under evaluation in on-going trials in Zambia. The EPICYST, population-based, deterministic model has highlighted, based on simulating a generic sub-Saharan Africa setting, the higher efficacy (measured as the percentage of human cysticercosis cases prevented) of biomedical interventions (human and pig treatment and pig vaccination) compared to improved husbandry, sanitation, and meat inspection. Important questions remain regarding which strategies and combinations thereof provide sustainable solutions for severely resource-constrained endemic settings. Defining realistic timeframes to achieve feasible targets, and establishing suitable measures of effectiveness for these targets that can be quantified with current monitoring and evaluation tools, are current major barriers to identifying validated strategies. Taenia solium transmission models can support setting achievable 2030 goals; however, the refinement of these models is first required. Incorporating socio-economic elements, improved understanding of underlying biological processes, and consideration of spatial dynamics are key knowledge gaps that need addressing to support model development.

The World Health Organization 2030 goals for Taenia solium: Insights and perspectives from transmission dynamics modelling: CystiTeam Group for Epidemiology and Modelling of Taenia solium Taeniasis/Cysticercosis

Taenia solium (TS), responsible for porcine cysticercosis, human taeniasis and (neuro)cysticercosis, was included in the World Health Organization neglected tropical disease (NTD) roadmap published in 2012. Targets set in this roadmap have not been met, but T. solium has been included in the consultation process for the new 2030 goals proposed for priority NTDs. Taenia solium transmission dynamics models can contribute to this process. A recent review has compared existing T. solium transmission models, identifying their similarities and differences in structure, parameterization and modelled intervention approaches. While a formal model comparison to investigate the impact of interventions is yet to be conducted, the models agree on the importance of coverage for intervention effectiveness and on the fact that human- and pig-focused interventions can be optimally combined. One of these models, cystiSim, an individual-based, stochastic model has been used to assess field-applicable interventions, some currently under evaluation in on-going trials in Zambia. The EPICYST, population-based, deterministic model has highlighted, based on simulating a generic sub-Saharan Africa setting, the higher efficacy (measured as the percentage of human cysticercosis cases prevented) of biomedical interventions (human and pig treatment and pig vaccination) compared to improved husbandry, sanitation, and meat inspection. Important questions remain regarding which strategies and combinations thereof provide sustainable solutions for severely resource-constrained endemic settings. Defining realistic timeframes to achieve feasible targets, and establishing suitable measures of effectiveness for these targets that can be quantified with current monitoring and evaluation tools, are current major barriers to identifying validated strategies. Taenia solium transmission models can support setting achievable 2030 goals; however, the refinement of these models is first required. Incorporating socio-economic elements, improved understanding of underlying biological processes, and consideration of spatial dynamics are key knowledge gaps that need addressing to support model development.

Taeniosis and cysticercosis in Serbia, 1990-2018: Significance of standard of living

OBJECTIVES

As is the case for all of Southeast Europe, Serbia is an area traditionally endemic for Taenia saginata and Taenia solium infections. This study was performed to analyse the epidemiological data on taeniosis and cysticercosis in Serbia for the period 1990-2018.

METHODS

Data on cases of T. saginata and T. solium infection were collected via a systematic search of published articles, the grey literature, and official reports, as well as by performing clinical observational studies of patients treated in the departments for infectious diseases of hospitals and university clinics in Serbia.

RESULTS

A total of 212 cases of taeniosis were reported, all between 1997 and 2004 when taeniosis was notifiable (incidence range 0.04-0.9/100 000 population/year). From 1990 to 2018, 170 cases of cysticercosis (all but one of neurocysticercosis), were registered (incidence range 0-0.29/100 000 population/year), with a strong decrease since 2000 and a single case in the last 9 years. The annual number of cases of both taeniosis (Pearson's r = 0.914, p =  0.001) and cysticercosis (Pearson's r = 0.582, p = 0.014) correlated with the consumer price index.

CONCLUSIONS

In Serbia, T. saginata and T. solium infections are autochthonous but occur only sporadically. However, the potential for re-emergence exists, depending on the socio-economic state of the country.

Epidemiology of Taenia saginata taeniosis/cysticercosis: a systematic review of the distribution in West and Central Africa

BACKGROUND

The zoonotic tapeworm Taenia saginata, although causing only minor discomfort in humans, is responsible for considerable economic losses in the livestock sector due to condemnation or downgrading of infected beef carcasses. An overview of current knowledge on the distribution and prevalence of this parasite in West and Central Africa is lacking.

METHODS

We conducted a systematic review, collecting information on published and grey literature about T. saginata taeniosis and bovine cysticercosis from 27 countries/territories in West and Central Africa, published between January 1st, 1990 and December 31st, 2017.

RESULTS

The literature search retrieved 1672 records, of which 51 and 45 were retained for a qualitative and quantitative synthesis, respectively. Non-specified human taeniosis cases were described for Nigeria, Cameroon, Senegal, Burkina Faso, Democratic Republic Congo, Guinea, and Ivory Coast (seven out of 27 countries/territories), while T. saginata taeniosis specifically was only reported for Cameroon. Most prevalence estimates for taeniosis ranged between 0-11%, while three studies from Nigeria reported prevalence estimates ranging between 23-50%. None of the studies included molecular confirmation of the causative species. The presence of bovine cysticercosis was reported for Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Democratic Republic Congo, Ghana, Guinea, Ivory Coast, Mali, Niger, Nigeria, Senegal, and Tristan da Cunha (14 out of 27 countries/territories). Prevalence estimates ranged between 0-29%.

CONCLUSIONS

Our systematic review has revealed that human taeniosis and bovine cysticercosis are seriously understudied in West and Central Africa. The high prevalence estimates of both conditions suggest an active dissemination of this parasite in the region, calling for a concerted One Health action from public health, veterinary health and food surveillance sectors.

Epidemiology of Taenia saginata taeniosis/cysticercosis: a systematic review of the distribution in central and western Asia and the Caucasus

Background

The zoonotic parasite Taenia saginata transmits between humans, the definitive host (causing taeniosis), and bovines as the intermediate host (causing cysticercosis). Central and western Asia and the Caucasus have large cattle populations and beef consumption is widespread. However, an overview of the extent of human T. saginata infection and bovine cysticercosis is lacking. This review aims to summarize the distribution of T. saginata in this region.

Methods

A systematic review was conducted, that gathered published and grey literature, and official data concerning T. saginata taeniosis and bovine cysticercosis in central and western Asia and the Caucasus published between January 1st, 1990 and December 31st, 2018. Where no data were available for a country within this period, published data from 1985–1990 were also accessed.

Results

From 10,786 articles initially scanned, we retrieved 98 full-text articles from which data were extracted. In addition, two unpublished datasets were provided on the incidence of human taeniosis. Data for human taeniosis and bovine cysticercosis were found for all countries except Turkmenistan. Human taeniosis prevalence varied from undetected to over 5.3%, with regional variations. Where bovine cysticercosis was detected, prevalences varied from case reports to 25%.

Conclusions

The public health burden of T. saginata is assumed to be small as the parasite is of low pathogenicity to humans. However, this review indicates that infection continues to be widespread and this may result in a large economic burden, due to the resources utilized in meat inspection and condemnation or processing with subsequent downgrading of infected carcasses.

Electronic supplementary material

The online version of this article (10.1186/s13071-019-3438-3) contains supplementary material, which is available to authorized users.

Epidemiology of Taenia saginata taeniosis/cysticercosis: a systematic review of the distribution in the Middle East and North Africa

BACKGROUND

The zoonotic parasite Taenia saginata utilizes bovines as an intermediate host (causing cysticercosis) and humans as the definitive host (causing taeniosis). The public health burden of T. saginata is assumed to be low, but the economic burden is large, due to the resources utilized in the detection and condemnation of infected carcasses and carcass parts. As part of a collaborative effort to synthesize worldwide epidemiological data on this parasite, we present here the results of a systematic review on the distribution of T. saginata taeniosis and bovine cysticercosis in the Middle East and North Africa (MENA).

METHODS

Information on the occurrence and prevalence of T. saginata taeniosis and cysticercosis in the MENA region was obtained through a systematic review of published and grey literature, including OIE reports, published between January 1st, 1990 and December 31st, 2017.

RESULTS

A total of 63 publications were retrieved across the 21 MENA countries. Taenia saginata taeniosis was reported in 11 of these countries, whereas unspecified taeniosis was reported for a further seven. Microscopy-based prevalence values ranged between 0.02-8.6%. Bovine cysticercosis prevalence estimates based on meat inspection were only reported for Egypt and Israel, with prevalence data ranging between 0.2-20% and 0.1-9.1% for cattle and buffaloes, respectively. The presence of bovine cysticercosis could be confirmed for 10 additional countries through OIE reports.

CONCLUSIONS

Human taeniosis occurrence was confirmed for 86% (18/21) of the countries in the MENA region, although in several of these countries the species responsible was not specified. Religious prohibitions on the consumption of pork and the limited extent of pig farming across much of this region, however, suggest that many reported taeniosis cases are likely to be attributable to T. saginata rather than Taenia solium or Taenia asiatica. There was a paucity of data regarding both the prevalence and economic impact of bovine cysticercosis. More detailed epidemiological data on both T. saginata taeniosis and bovine cysticercosis could be obtained by adopting an integrated "One Health" approach, considering the characteristics (e.g. ecosystem related and sociopolitical aspects) of the MENA region. Compared with more conventional approaches, this could lead to an enhanced performance and cost-effectiveness of surveillance systems.

A quantitative risk assessment for human Taenia solium exposure from home slaughtered pigs in European countries

BACKGROUND

Taenia solium, a zoonotic tapeworm, is responsible for about a third of all preventable epilepsy human cases in endemic regions. In Europe, adequate biosecurity of pig housing and meat inspection practices have decreased the incidence of T. solium taeniosis and cysticercosis. Pigs slaughtered at home may have been raised in suboptimal biosecurity conditions and slaughtered without meat inspection. As a result, consumption of undercooked pork from home slaughtered pigs could pose a risk for exposure to T. solium. The aim of this study was to quantify the risk of human T. solium exposure from meat of home slaughtered pigs, in comparison to controlled slaughtered pigs, in European countries. A quantitative microbial risk assessment model (QMRA) was developed and porcine cysticercosis prevalence data, the percentage of home slaughtered pigs, meat inspection sensitivity, the cyst distribution in pork and pork consumption in five European countries, Bulgaria, Germany, Poland, Romania and Spain, were included as variables in the model. This was combined with literature about cooking habits to estimate the number of infected pork portions eaten per year in a country.

RESULTS

The results of the model showed a 13.83 times higher prevalence of contaminated pork portions from home slaughtered pigs than controlled slaughtered pigs. This difference is brought about by the higher prevalence of cysticercosis in pigs that are home raised and slaughtered. Meat inspection did not affect the higher exposure from pork that is home slaughtered. Cooking meat effectively lowered the risk of exposure to T. solium-infected pork.

CONCLUSIONS

This QMRA showed that there is still a risk of obtaining an infection with T. solium due to consumption of pork, especially when pigs are reared and slaughtered at home, using data of five European countries that reported porcine cysticercosis cases. We propose systematic reporting of cysticercosis cases in slaughterhouses, and in addition molecularly confirming suspected cases to gain more insight into the presence of T. solium in pigs and the risk for humans in Europe. When more data become available, this QMRA model could be used to evaluate human exposure to T. solium in Europe and beyond.