Food-borne trematodiases in East Asia: epidemiology and burden

Food-borne trematodiases are a cluster of parasitic helminth infections in humans and animals and belong to the cluster of neglected tropical diseases. The causative helminths dispose of a complex life cycle. As with many helminth infections, most infected people may only experience mild and non-specific clinical signs and symptoms. However, repeated, heavy and long-term infections may lead to severe clinical manifestations and also potentially fatal complications such as cholangiocarcinoma. Diagnosis remains a challenge as reliable, affordable, rapid, and simple-to-use diagnostic techniques are not available. If correctly and early diagnosed, safe, cheap, efficacious, orally administered drugs are available. Globally, the disease burden of food-borne trematodiases is estimated to be well within the range of other and better known neglected tropical diseases (e.g. dengue, leishmaniasis, lymphatic filariasis, onchocerciasis, and schistosomiasis) with a concentration in East and Southeast Asia. Food-borne trematodiases are zoonoses and may also have a negative impact on agri- and aquacultural production in affected regions. Mathematical modelling and analysis of food-borne trematodiases transmission dynamics to inform control and prevention is still in a very early stage, also due to the very limited availability of essential data. The current mainstay of human food-borne trematodiases control is drug-based morbidity control. For improved control, prevention or even elimination, more integrated efforts adopting also an ecosystem and “One Health” perspective are needed.