Food-borne Parasitic disease in Aisa

Transcription

1 Food-borne Parasitic disease in Aisa Liu Mingyuan OIE Collaborating Centre for Food-Borne Parasite from the Asian-Pacific Region; Institute of Zoonosis, Jilin University, China

2 Food-borne parasitic disease Food-borne parasitic disease that are caused by helminths and (or) protozoans through the consumption of infected or contaminated meat, fish, shellfish, mollusk, plants, water and reptile, amphibian-borne. Food-borne Parasites have been the major problems of public health and socioeconomic. To date, there are 95 species of food-borne parasites. 2

3 Ranking of Food-borne Parasite Public health, microbial ecology, animal health, agribusiness and trade, and socio-economic impact. International trade importance in primary food vehicles. Trichinella spiralis Taenia solium Taenia saginata Anisakidae Cyclospora cayetanensis Taenia solium Echinococcus granulosus Echinococcus multilocularis Toxoplasma gondii Cryptosporidium spp. ASIA Trichinella spiralis Opisthorchiidae Taenia solium Echinococcus granulosus Anisakidae Socio-economic impact to vulnerable communities. Taenia solium Cyclospora cayetanensis Echinococcus granulosus Echinococcus multilocularis Opisthorchiidae 3

4 Epidemic Features Food-borne parasites varied Frequent Outbreaks Great economic losses High Infection rate Extended Epidemic areas Threaten to human health 4

5 Meat-borne Fish-borne Shellfish-, molluskborne Plant-borne Water-borne Main contaminated source Beef Pork Mutton Horse meat Epidemic Features 1. The types of food-borne parasites are various Fish Crabs Shrimp Snails Mussels Fruits Vegetables Water Milk Food-borne parasite species Protozoa Helminths Arthropods Toxoplasma gondii Sarcocystis spp. Trypanosoma cruzi Giardia spp. Cryptosporidium spp. Cyclospora cayetanensis Taenia spp. Anisakis spp. Clonorchis sinensis Opisthorchis spp. Minute intestinal flukes Capillaria philippinensis Gnathostoma spp. Diphyllobothrium spp. Echinostoma spp. Paragonimus spp. Angiostrongylus cantonensis Fasciola spp. Fasciolopsis buski Echinococcus granulosus Echinococcus multilocularis Reptile-, amphibian- Snake Spirometra mansoni 5 Pentastomatidae

6 Epidemic Features 2. Outbreaks maintain a high level. Parasite species Region Cases Reported Sarcocystosis Taeniasis /cysticercosis Toxoplasmosis Trichinellosis Echinococcosis Malaysia 3 outbreaks during , >225 people. India 2 cases in 2012; 1 case in Thailand 1 case, Indonesia 9 cases, , Bali. Nepal 1 case, Mongolia 30 cases in 2010, 26 in 2011, and 16 in China 171/783 participants, 2007, Taiwan. Iran 286/1480 blood donors, Vietnam korea China North Vietnam in 2012, involving 24 patients. 8 patients, , Yanggu-gun, Gangwon-do 12 patients, , Gangwon-do 6 patients, , Jincheon-gun, Chungcheongbuk-do 1 outbreak: 9 patients, including 1 death, 2009, Yunnan. 1 outbreak:108 patients, including 1 death, 2013, Yunnan. China 1 case, Iran India 1 case, Clonorchiasis Japan 1 case, Anisakiasis China 1 case, Some cases have been reported in Iran. 6

7 Epidemic Features 2. Outbreaks maintain a high level. Parasite species Region Cases Diphyllobothrium latum Gnathostomiasis China 1 case, Korea 1 case, Thailand 3 Cases, India 1 case, Capillariasis India 1 case, 2014 Paragonimiasis Angiostrongyliasis China 1 outbreak with 7 patients, Japan China 200 cases. 160 cases, 2006, Beijing. 1 outbreak, 2008, Yunnan Thailand 172 cases, Cryptosporidiosis Japan 1 case, 2009 Fascioliasis Sparganosis mansoni Vietnam 1 outbreak: 24 patients, China 29 patients, 2011 China 26 patients, Japan 1 case, India 1 case, Kudoa septempunctata Japan 1 case, 3 patients,

8 3. Great economic losses. Epidemic Features Food-borne parasites not only lead to enormous economic losses in the animal husbandry, meat industry, agribusiness and trade, but also pose a severe threat to public health. Fascioliasis, more than 700 million domestic animals are at risk all over the world and economic loss exceeds 2 billion USD per year. The cost of inspection of food and the fees for prevention and control of food-borne parasites remain high. Costs of inspection for Trichinella spp. is about 2.2 billion CNY per year in China, 0.62 billion EUR per year in European Union, 1.2 billion USD per year in the United States. 8

9 Epidemic Features 4. Infection rate remain high. Echinococcosis/hydatidosis 2014 Country Human cases Human deaths China Iran Iraq Israel 3 0 Japan 19 0 Kyrgyzstan Mongolia Nepal Palestinian Auton. Territories Sri Lanka Uzbekistan :Disease present, but without quantitive data Echinococcosis/hydatidosis 9

10 5. Epidemic areas extend Epidemic Features Globalization is the spread and exchange of people, animals, goods, resources, ideas, and other physical or cultural materials.globalization also facilitates the spread of infectious diseases, and this can have enormous negative consequences regarding food security, food safety, and food sovereignty, among which the spread of pathogens, including food-borne parasites, ranks highly. Main reasons of food-borne parasites epidemic extend Movement of people Movement of animals Movement of food and feed Culture globalization 10

11 Epidemic Features 6. Severe threaten to human health Some parasitic infection, lead to severe clinical syndrome, even potentially fatal, such as Taenia solium, Trichinella spp. Some parasites could infect human chronically, even have carcinogenic potential, such as Opisthorchiidae, Cryptosporidium spp. 11

12 Meat-borne parasite infections Taeniasis/cysticercosis Trichinellosis Toxoplasmosis 12

13 Taeniasis/Cysticercosis 13

14 Taeniasis/Cysticercosis >50 million persons infected worldwide. one of the 17 neglected tropical diseases prioritized by WHO. 14

15 Prevalence in Asia Epidemic areas: Vietnam: > 50 provinces; Taeniasis, %; Cysticercosis, %. China: 29 provinces; Taeniasis, ~0.55 million people; Cysticercosis,~0.81 million people. Laos: Taeniasis 46.7% and cysticercosis 66.7% respectively, in Om Phalong, Mongolia: T. saginata, 13.4%-7.2%. India: T. solium, 18.6%; T. saginata, 5.3%. Indonesia : Nepal: ~43%. Philippines: %. Human,2.4%(33/1371);Pig,15.8%(36/228). 15

16 T. asiatica distribution Distribution: Korea, Indonesia, Philippines, Thailand, China, Vietnam, Japan and Nepal. 16

17 Public health Events Philippines: 1 outbreak, Indonesia : 9 case in Bali, during Nepal: 1 case, Mongolia: 16 cases, T. saginata expelled after anamnesis and microscopy in Gianyar in the island of Bali, Indonesia. 17

18 Trichinellosis 18

19 L1 Muscle (L1M) L2, L3, L4 Adults New born larvae (Ad) (NBL) L1 Muscle (L1M) 19

20 Trichinellosis Trichinellosis is a public health problem and regarded as an emergent/re-emergent disease in the world. ~11 million people are infected with Trichinella worldwide. > cases of human trichinellosis with a mortality rate of about 0.2%, average yearly. 20

21 Geographic distribution in Asia Epidemic areas: northern Thailand(0.9-9%) northwest Vietnam(2.1%) southwest and eastern China(~ 20 million) northern Laos(19.1%) Animals: Vietnam (pigs, wild boars, dogs, cats), Nepal (pigs), China (pigs,wild boars, dogs), Laos (pigs) and Korea (wild boars), Iran (dogs and jackals). 21

22 Public Health Events 1 outbreak with 9 patients, including 1 death, 2009, Yunnan, China. 1 outbreak with 108 patients, including 1 death, 2013, Yunnan, China. 1 outbreak with 24 patients, North Vietnam. Single sporadic cases: Japan, Korea and India. 22

23 Toxoplasmosis Tachyzoites (trophozoites) sporulated oocyst cyst 23

24 Fish-borne parasite infections Clonorchiasis and Opisthorchiasis Anisakiasis Gnathostomiasis 24

25 Clonorchiasis and Opisthorchiasis The liver flukes, C. sinensis and Opisthorchis spp. are considered an emerging public health problem. 25

26 Clonorchiasis and Opisthorchiasis >45 million people infected worldwide. About 600 million and 80 million people are at risk for infection with C. sinensis and Opisthorchis spp., respectively. Clonorchiasis is included in control programs of neglected tropical diseases by WHO in C. sinensis and O. viverrini are known to cause cholangiocarcinoma in humans and both reclassified as a group 1 biocarcinogens by the International Agency of Cancer Research (IARC). 26

27 Clonorchiasis geographic distribution in Asia Foci in east Asia: China: 12.5million people, in 27 provinces. Korea: 1.3 million people, prevalence of 2.9%. Vietnam: 1 million people, prevalence of %in northern. Distribution of clonorchiasis in China, based on national survey data Distribution of clonorchiasis by provinces 27 in Korea along the rivers, in 2006.

28 Opisthorchiasis geographic distribution in Asia Opisthorchiasis caused by Opisthorchis spp. (specifically, Opisthorchis viverrini and Opisthorchis felineus). Opisthorchis viverrini : Foci in Southeast Asia Thailand: ~6 million people infection,2003 Laos: 1.5~2 million people infection (WHO, 2008) Vietnam: % in 9/64 provinces of south. Kampuchea: 7.77%(1232/16082), in 5 provinces (2013) Opisthorchis felineus: Mainly in Eastern Europe and Russia, Sporadic cases in Asia. Adult worm of O. viverrini Adult of O. felineus 28

29 Anisakiasis L3 larva 29

30 Geographic distribution in Asia Japan: ~2000 human anisakiasis /per year. China: fish infection rate 39.06% (2722/ 6969); 95.1% (116/122), East China Sea. Korea: primarily distributed in 3 sea areas,

31 Distribution of anisakid isolated from different fish species from the East China Sea and the Pacific coast of central Japan 31

32 Gnathostomiasis Human gnathostomiasis,a deleterious food-borne parasitic zoonoses, is a regional disease mainly in Asia and the Americas. The disease is caused by a spirurid roundworm of the Gnathostoma. 32

33 Geographic distribution in Asia Foic in SouthEast Asia Thailand, Japan, China, Vietnam and India. China: in total 57 cases, distribution in 23 Provinces. Freshwater fish in Hongze Lake is seriously infected by Gnathostoma, and the local residents have the habit of eating undercooked Cuttlefish, they are easily to get infected with Gnathostoma. In some area, people have habit of eating ice Ricefield eel and infection of Gnathostomiasis. 33 Ice Ricefield eel

34 Shellfish-, mollusk-borne parasite 34

35 Angiostrongyliasis Angiostrongylus sp. male worm Angiostrongylus cantonensis (L3) Angiostrongylus cantonensis (L3) 35

36 Geographic distribution in Asia Foci in Southeast Asia 36

37 Geographic distribution in Asia China: ~400 human cases have been reported. Thailand: ~ per 100,000 in Single sporadic cases: India, Japan, Vietnam, Sri Lanka, Indonesia, Nepal 37

38 Public Health Events One tourist eating Pomacea canaliculata ( Fresh apple snails ), in a restaurant of Beijing, After dinner, onset of symptoms: have a fever, severe headache, neck rigidity and bodily pain. finally be diagnosed as Angiostrongyliasis. 38

39 Paragonimiasis Paragonimiasis is a food-borne parasitic zoonosis caused by infection with lung flukes of the genus Paragonimus. Paragonimus westermani is considered to be of socioeconomic importance in humans and in animals. Adult of Paragonimus sp Eggs of P. westermani 39

40 Epidemic areas: Geographic distribution in Asia China: prevalence of % in 24 provinces. Philippines: % in some areas. Japan: >200case Vietnam: prevalence of % in 10/64 provinces. Thailand: case reported in 23/68 provinces. India: North Eastern states, prevalence of 6.7% in Manipur. Geographical distribution of Paragonimus species in northern and central Vietnam. 40

41 Diagnosed in Laboratory of Veterinary Parasitic Diseases, University of Miyazaki, Japan. ( ). Annual number of paragonimiasis cases Geographical distribution of paragonimiasis cases 41

42 Plant-borne parasites 42

43 Echinococcosis Echinococcosis is a worldwide lethal food-borne zoonosis caused by adult or larval stages of the Echinococcus spp. Echinococcus granulosus adult Echinococcus egg 43

44 Echinococcosis -The second Cancer ( Worm Cancer ) 44

45 Foci in Central Asia: 270 million people (58% of the total population) living in rural areas are at risk of infection. Epidemic areas: China Mongolia Kazakhstan Kyrgyzstan Tajikistan Turkmenistan Uzbekistan Afghanistan Iran Pakistan Geographic distribution in Asia Japan: imported case 45

46 The overall annual echinococcosis incidence in Asia 46

47 Public Health Events Alveolar echinococcosis (AE) The First Cancer in Tibet, China In western China, dogs are serving as definitive hosts and have transmitted the infection to humans. reaching10% (range from 0.8 to 11.9%) in some Tibetan communities in western China. 47

48 Diagnosis Modern techniques have been applied to detection of foodborne parasitic disease Polymerase chain reaction (PCR) Flinders technology associates (FTA) Loop-mediated isothermal amplification (LAMP) Microarray (DNA chip) Colloidal gold immune chromato-graphy (GICA) 48

49 Diagnosis The LAMP test is a high-performance method for detecting DNA, which holds promise for use in molecular diagnosis of helminths and protozoa. LAMP uses a set of primers that initiate large-scale nucleic acid synthesis by Best DNA polymerase at isothermal conditions. Multiplex ligation-dependent probe amplification (MLPA) is a simple, robust and fast method designed for specific infections. MLPA has been used for rapid and specific detection of single nucleotide acid differences between C. sinensis, O. viverrini and O. felineus in endemic areas. An artificial enzymatic digestion procedure based on Regulation EU 2075/2005 with appropriate modifications has been applied on readyto-eat preparations containing raw or practically raw fish products obtained from potentially dangerous fish species. Real-time fluorescence resonance energy transfer (FRET) PCR with melting curve analysis has not been used for the detection and differential diagnosis of T. papuae from T. spiralis and T. pseudospiralis, which all are indigenous in some countries. 49

50 Control Strategies Formulation of laws and regulations Developing and enacting a series of laws and regulation for the prevention and control of infectious diseases in humans, domestic animals, and wild animals. Establishment of the disease reporting systems Establishing disease reporting systems for humans, domestic animals, and wild animals. Implementation of special projects for important foodborne parasites Carrying out a special project for the prevention and control of important food-borne parasites, Aims: reduce the incidence and mortality of food-borne parasitic diseases and to improve the emergency response and capabilities of disease prevention and control. 50

51 Control Strategies Surveillance of exotic diseases To prevent certain exotic diseases that are emerging abroad, the government should strengthen surveillance and control of crossborder transmission of exotic diseases and established the Joint Control Mechanism of Trans Boundary food-borne Parasitic Diseases. Emphasis on interdisciplinary and international cooperation Establishing interdisciplinary and cross-sector collaborations and communications among human, animal, and environment health services, which reflect the One Health strategy to confront emerging food-borne parasitic disease. Health education Pets may be another important source of zoonotic diseases. The public are educated about the risk factors associated with wildlife and pets. 51