Foodborne trematode (FBT) infections, taeniasis and cysticercosis are noteworthy neglected tropical diseases. They are caused by trematodes (flatworms or “flukes”) or pork tapeworms that are acquired through ingestion of food contaminated with the larval stages, eggs or proglottids of the parasite. Transmission is linked to practices in producing, processing and preparing foods and livestock. These diseases are also zoonotic infections affecting domestic or wild animals. Strong intersectoral cooperation is accordingly required for control of their transmission. The morbidity burden is significant in the Western Pacific Region: liver flukes are classified as carcinogenic, long-term infections causing cholangiocarcinoma or bile duct cancer, and cysticercosis, particularly neurocysticercosis, is known to cause epilepsy and sometimes death.
The participants in the Expert Consultation to Accelerate Control of Foodborne Trematode Infections, Taeniasis and Cysticercosis acknowledged progress in epidemiological mapping of foodborne trematode infections, taeniasis and cysticercosis at country level in many affected countries of the Western Pacific Region. Countries that have sufficient information to accelerate control interventions and those that urgently need to complete risk mapping were respectively identified. Significant progress has also been made worldwide over the past decade in developing guidance and tools for the control and management of foodborne trematode infections, taeniasis and cysticercosis, both from public health and food safety standpoints.
The Consultation acknowledged that while preventive chemotherapy intervention has proven effective in reducing the prevalence of opisthorchiasis, clonorchiasis and taeniasis, multiple factors contribute to high reinfection rates immediately following preventive chemotherapy such as poor sanitation, poor food hygiene, the presence of animal reservoirs in close proximity to communities and cultural food habits. Therefore, preventive chemotherapy accompanied by community empowerment through the One Health approach, composed of effective risk communication, animal treatment, agricultural interventions, improved food safety, and water, sanitation and hygiene (WASH), was recommended anew as the core strategy to accelerate and sustain control of foodborne trematode infections, taeniasis and cysticercosis.
Regular monitoring and evaluation of interventions and associated severe adverse events for control of foodborne trematode infections, taeniasis and cysticercosis is essential. A procedure for systematic reporting of epidemiological and treatment data within countries, and from countries to WHO, and the standardization of diagnostic methods for foodborne trematode infections, taeniasis and cysticercosis both in humans and animals should be established with the support of WHO collaborating centres and other academic and research institutions.
WHO should also strengthen collaboration with other relevant international agencies, such as the Food and Agriculture Organization of the United Nations and World Organisation for Animal Health, in sharing information related to foodborne trematode infections, taeniasis and cysticercosis, and jointly supporting countries in building their capacities to intervene throughout the food value chain for effective control of foodborne parasitic diseases.
Download PDF:Report of Expert Consultation on FBT, Taeniais and Cysticercosis, 17-19 May 2017