Foodborne protozoan parasites

Filters comprised of sand and Zero Valent Iron hold promise as tools to mitigate risk posed by Cyclospora cayetanensis oocysts

Irrigation water contaminated by human fecal material may elevate the risk of produce contamination with the enteric parasite Cyclospora cayetanensis. Oocysts of C. cayetanensis are resistant to commonly used disinfectants and a method of removing C. cayetanensis from irrigation water would mitigate this risk. We evaluated zero valent iron (ZVI) sand filtration as one such method. We sought to determine if sand filters containing ZVI outperformed those without ZVI. We first evaluated the abundant poultry parasites Eimeria maxima, E. tenella and E. acervulina as surrogates for C. cayetanensis. We determined if a miniaturized gravity fed ZVI-sand filter, scaled to evaluate scarce supplies of C. cayetanensis oocysts, provided useful information about the performance of larger filtration systems. Filters were inoculated with oocysts, rinsed, and the resulting filtrate examined microscopically for oocysts. We performed experiments to measure the effect of varying ZVI concentrations, repeated filter use, simulated agricultural water, and oocyst size and condition. We then compared the performance of mini filters to that of larger, gravity-fed pool filters and found that ZVI-sand filtration was far more effective at removing Eimeria spp. from water when compared to sand filtration, at both scales. Sand mini filters retained 13-54 % of E. acervulina oocysts, and pool filters retained 82 %, but when combined with 50 % (mini filter) or 35 % (pool filter) v/v ZVI, mini filters retained 89-99 % of oocysts and pool filters retained >99 %. The effectiveness of the mini filters increased with increasing ZVI concentration, and the addition of ZVI far outweighed the influence of any other measured variable. We then performed experiments including C. cayetanensis, which provided similar results to those utilizing Eimeria; 59 % of inoculated C. cayetanensis oocysts were retained in sand mini filters, and 97 % in mini filters composed of 35 % v/v ZVI. In sum, ZVI is highly effective in removing oocysts from water and Eimeria is a useful surrogate for C. cayetanensis to assess filtration. ZVI-sand filtration shows promise as a tool to mitigate the risk of C. cayetanensis contamination of irrigation water. Further studies should evaluate the performance of ZVI-sand in pressurized fast filtration systems under a range of field conditions.

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.

Parallel detection of multiple zoonotic parasites using a real-time fluorogenic loop-mediated isothermal amplification-based quadruple-sample microfluidic chip

Zoonotic parasites pose significant health risks globally. In the present study, we combined a microfluidic chip with loop-mediated isothermal amplification (on-chip LAMP) to detect five zoonotic parasites: Toxoplasma gondii, Cryptosporidium parvum, Cryptosporidium hominis, Clonorchis sinensis, and Taenia solium. This method enabled the simultaneous parallel analysis of five genetic markers from a maximum of four samples per chip. The on-chip LAMP assay was conducted in a highly automated format via the addition (by pipetting) of each sample in a single operation. The reaction was performed in volumes as low as 5 μL at a temperature of 65°C for 60 min, achieving limits of detection ranging from 10-2 to 10-3 pg./μL of recombinant plasmid DNA. All the time-to-positive values were less than 40 min, and almost all the coefficients of variation were less than 10%, even when using limit of detection concentrations for multiple pathogens, indicating robust reproducibility among replicates. The clinical sensitivity and specificity for detecting 135 field samples were 98.08 and 97.59%, respectively, compared with traditional biological methods, indicating good applicability in the detection of field samples. This on-chip LAMP assay allows for low reagent consumption, ease of operation, and multiple analyses of samples and genetic targets, and is applicable for on-site detection and the routine monitoring of multiple zoonotic parasites.

Persistence and survival of Cryptosporidium parvum oocysts on lamb's lettuce leaves during plant growth and in washing conditions of minimally-processed salads

Cryptosporidium is the causative agent of cryptosporidiosis, which results, among others, in profuse diarrhoea. Transmission to humans occurs via the faecal-oral route directly by contact with infected hosts or indirectly by waterborne or foodborne routes. For the latter, parasite transmission is closely linked to the oocyst's ability to persist and survive in food matrices. In this study, we evaluated the persistence and survival of Cryptosporidium oocysts in lamb's lettuce: i) during plant growth and ii) in conditions mimicking the industrial washing process applied in minimally-processed vegetables (MPV). Results show that oocysts persisted during the growth of lamb's lettuce, i.e. two months from the 2-leaf stage until the 8-leaf harvest time (-0.89 Log10 of oocysts). However, their survival decreased from as early as one week (-0.61 Log10), and only 6 % of oocysts remained infective at the time of harvest. The washing process had a limited effect on parasite load (<0.5 Log10) and no effect on survival; chlorination of washing water did not improve the efficiency (removal and inactivation) of the process. The ability of C. parvum to persist and survive throughout the food chain may drive its transmission to humans through MPV products. Appropriate management measures should be implemented at each operational level to limit contamination and ensure food safety of fresh produce.

Advances in pulsed electric stimuli as a physical method for treating liquid foods

There is a need for alternative technologies that can deliver safe and nutritious foods at lower costs as compared to conventional processes. Pulsed electric field (PEF) technology has been utilised for a plethora of different applications in the life and physical sciences, such as gene/drug delivery in medicine and extraction of bioactive compounds in food science and technology. PEF technology for treating liquid foods involves engineering principles to develop the equipment, and quantitative biochemistry and microbiology techniques to validate the process. There are numerous challenges to address for its application in liquid foods such as the 5-log pathogen reduction target in food safety, maintaining the food quality, and scale up of this physical approach for industrial integration. Here, we present the engineering principles associated with pulsed electric fields, related inactivation models of microorganisms, electroporation and electropermeabilization theory, to increase the quality and safety of liquid foods; including water, milk, beer, wine, fruit juices, cider, and liquid eggs. Ultimately, we discuss the outlook of the field and emphasise research gaps.

Molecular investigation of ready-to-eat salads for Giardia duodenalis and Cryptosporidium spp. in Portugal

Foodborne outbreaks are often associated with the consumption of salads. However, published studies on the detection of foodborne pathogens in ready-to-eat salads are scarce. The aim of this study was to detect Giardia duodenalis and Cryptosporidium DNA in ready-to-eat salads, by applying techniques of molecular biology to study the frequency of contamination in salads. A total of 100 packages of ready-to-eat salads containing assorted leafy green vegetables were randomly purchased from hypermarkets located in central regions of Portugal (Coimbra and Viseu). Nested-PCR and qPCR methods were used to detect G. duodenalis and Cryptosporidium DNA. Species and assemblages of the parasites were identified by sequence analysis and PCR. Eighteen of the 100 samples (18%) were positive for G. duodenalis and twelve were sequenced and identified as assemblage A. Cryptosporidium spp. were not detected in any salads. Overall, pre-harvest and post-harvest preventive measures may be need for G. duodenalis control throughout the food production industry, from the field to consumers.

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.

Comparative Evaluation of an Easy Laboratory Method for the Concentration of Oocysts and Commercial DNA Isolation Kits for the Molecular Detection of Cyclospora cayetanensis in Silt Loam Soil Samples

Cyclospora cayetanensis is a protozoan parasite that causes foodborne outbreaks of diarrheal illness (cyclosporiasis) worldwide. Contact with soil may be an important mode of transmission for C. cayetanensis and could play a role in the contamination of foods. However, there is a scarcity of detection methods and studies for C. cayetanensis in soil. Traditional parasitology concentration methods can be useful for the detection of C. cayetanensis, as found for other protozoa parasites of similar size. The present study evaluated a concentration method using flotation in saturated sucrose solution, subsequent DNA template preparation and qPCR following the Bacteriological Analytical Manual (BAM) Chapter 19b method. The proposed flotation method was compared to three commercial DNA isolation kits (Fast DNATM 50 mL SPIN kit for soil (MP Biomedicals, Irvine, CA, USA), Quick-DNATM Fecal/Soil Microbe Midiprep kit (Zymo Research, Irvine, CA, USA) and DNeasy® PowerMax® Soil Kit (Qiagen, Hilden, Germany)) for the isolation and detection of DNA from experimentally seeded C. cayetanensis soil samples (5−10 g with 100 oocysts). Control unseeded samples were all negative in all methods. Significantly lower cycle threshold values (CT) were observed in the 100 oocyst C. cayetanensis samples processed via the flotation method than those processed with each of the commercial DNA isolation kits evaluated (p < 0.05), indicating higher recovery of the target DNA with flotation. All samples seeded with 100 oocysts (n = 5) were positive to the presence of the parasite by the flotation method, and no inhibition was observed in any of the processed samples. Linearity of detection of the flotation method was observed in samples seeded with different levels of oocysts, and the method was able to detect as few as 10 oocysts in 10 g of soil samples (limit of detection 1 oocyst/g). This comparative study showed that the concentration of oocysts in soil samples by flotation in high-density sucrose solutions is an easy, low-cost, and sensitive method that could be implemented for the detection of C. cayetanensis in environmental soil samples. The flotation method would be useful to identify environmental sources of C. cayetanensis contamination, persistence of the parasite in the soil and the role of soil in the transmission of C. cayetanensis.

Protozoa as the “Underdogs” for Microbiological Quality Evaluation of Fresh Vegetables

The monitoring of the microbial quality of fresh products in the industrial environment has mainly focused on bacterial indicators. Protozoa, such as Giardia duodenalis, Cryptosporidium spp., Toxoplasma gondii, and Cyclospora cayetanensis, are routinely excluded from detection and surveillance systems, despite guidelines and regulations that support the need for tracking and monitoring these pathogens in fresh food products. Previous studies performed by our laboratory, within the scope of the SafeConsume project, clearly indicated that consumption of fresh produce may be a source of T. gondii, thus posing a risk for the contraction of toxoplasmosis for susceptible consumers. Therefore, preliminary work was performed in order to assess the microbiological quality of vegetables, highlighting not only bacteria (Escherichia. coli, Listeria monocytogenes, and Salmonella spp.), but also the zoonotic protozoa G. duodenalis and Cryptosporidium spp. Although all samples were found to be acceptable based on bacteriological parameters, cysts of G. duodenalis and oocysts of Cryptosporidium spp. were observed in vegetables. Moreover, it was possible to genetically characterize G. duodenalis positive samples as assemblage A, a genotype that poses risks to human health. Although these are preliminary results, they highlight the need to include protozoa in the microbiological criteria for foodstuffs, as required by EU Law No. 1441/2007, and to improve inactivation and removal procedures of (oo)cysts in fresh produce and water.

Prevalence of Protozoan Parasites Cryptosporidium sp. and Callimastix equi in the Edible Oyster Saccostrea cucullata and Its Relationship with Selected Water Quality Parameters in Sundarbans Region of West Bengal, India

PURPOSE

Prevalence of protozoan parasites Cryptosporidium sp. and Callimastix equi in the edible oyster resources Saccostrea cucullata, and its relationship with selected water quality parameters such as temperature, pH and salinity in Sundarbans region of West Bengal, India, have been assessed and discussed elaborately.

METHODS

Edible oysters S. cucullata were collected randomly from the selected study site Frasergunj of Sundarbans region and protozoan parasites such as Cryptosporidium sp. and C. equi were isolated, stained and determined its prevalence. Relationship of water temperature, pH and salinity with the prevalence of protozoan parasite had been assessed and analyzed.

RESULTS

Prevalence of infection of Cryptosporidium sp. is much more than the C. equi found in S. cucullata. The infections of the parasites are higher during monsoon then pre-monsoon season. Significant negative correlation (P < 0.05) occurs between pH of water and prevalence of Cryptosporidium sp. and C. equi in the edible oyster S. cucullata collected from Frasergunj of Sundarbans region, South 24 Parganas of West Bengal. The C. equi parasite follows a seasonal pattern of infection varying significantly with salinity (P < 0.01) of the water in the edible oyster, S. cucullata collected from Frasergunj of South 24 Parganas of West Bengal.

CONCLUSION

These results indicate that the Cryptosporidium sp. and C. equi contamination is accompanying with public health risks if edible oysters are consumed uncooked of undercooked. Extremes and/or rapid fluctuations of important environmental factors such as water temperature, salinity, pH can seriously compromise oyster health and outcome of aquaculture.

Influence of Environmental Pollution and Living Conditions on Parasite Transmission among Indigenous Ecuadorians

The purpose of this study was to evaluate the influence of environmental pollution and the living conditions of indigenous Ecuadorians on the transmission of enteroparasites in an Andean agricultural area located at high altitude. Environmental pollution was recorded after observation in each community. The parasites were identified by microscopic sediment analysis using physiological saline solution from macerated arthropods, washed vegetables, and human stools, utilizing four coproparasitological techniques (direct examination, Kato–Katz, ether concentration, and Ziehl–Neelsen). The results show that the inadequate disposal of human and animal excreta that contaminate soil and water, incorrect food hygiene, inadequate sanitary infrastructure in houses, a lack of animal veterinary care, and rodent proliferation are important reservoirs of zoonotic parasites. The use of excrement as fertilizer increases the number of flies, which act as mechanical vectors, and vegetables grown in areas with disperse infective parasitic forms act as vehicles that are marketed at the local, regional, and international levels. These analyses verify contamination levels of 52.7% in mechanical vectors, 70.6% in vegetables, and 98.2% in human stools. The agricultural communities analyzed maintained poor hygienic–sanitary and environmental conditions, which had a significant influence on the transmission of enteroparasites that affect human health.

The Diverse World of Protists-an Ideal Community with which to Introduce Microscopy in the Microbiology Teaching Laboratory

Protists and other eukaryotes are present in diverse terrestrial and aquatic environments. They can easily be collected from local ponds and streams. Although they are typically larger in size than prokaryotes, making them easy to study with even basic microscopes, microbiology laboratory courses often do not discuss them in detail and may only dedicate a short time to observing preserved samples. This laboratory exercise allows students to develop microscope skills, experience real world application of collecting and processing field samples, and delve deeper into the diverse world of protists and other microbial eukaryotes. Students may also engage by sharing their findings on the website iNaturalist to contribute to the scientific knowledge collected around the world. This laboratory module was initially designed for in-person learning but has been successfully adapted to remote learning and can also be applied to a complete online learning environment.

Seroprevalence of Toxoplasma gondii in Females Aged 15-45 Years from Bihor County, Western Romania

Toxoplasma gondii is a protozoan parasite that causes an important worldwide zoonosis called toxoplasmosis. This infection is often asymptomatic in immunocompetent people. If the infection occurs in pregnant women, it poses great risks to the infant due to its clinical manifestations as mental retardation, seizures, or chorioretinitis. In this study, we evaluated the seroprevalence of IgG antibodies against T. gondii in females aged 15-45 years in Bihor County, Romania. Serum samples drawn from 1935 females aged 15-45 years were screened for IgG antibodies against T. gondii. T. gondii antibodies were found in 706 females (36.48%) and the proportion of IgG positive females tended to increase with age. The seroprevalence was higher in females residing in rural areas (47.79%) compared with those from urban areas (30.95%). This is the first study on the seroprevalence of toxoplasmosis in females aged 15-45 years from Bihor County, Romania. Our survey brings new and important data regarding the seroepidemiology of T. gondii and provides an insight into the demographic risk factors as a basis for a future prevention program for toxoplasmosis.

A scoping review of risk factors and transmission routes associated with human giardiasis outbreaks in high-income settings

The flagellated pathogen Giardia duodenalis is one of the leading causes of parasitic gastrointestinal illness worldwide. In many higher income countries, such as the United Kingdom, the disease is often perceived as being travel-related, likely leading to the under-reporting of sporadic cases and outbreaks. A summary of the literature describing outbreaks and risk factors in higher income countries is necessary to improve our understanding of this pathogen and identify existing knowledge gaps. Initial literature searches were carried out in September 2016 and updated at regular intervals until November 2021, using appropriate search terms in Medline, Embase and PubMed databases. A total of 75 papers met the inclusion criteria, revealing that the consumption of contaminated water and contact with young children of diaper-wearing age were the most common transmission routes leading to outbreaks of giardiasis. Of the ten studies where food was primarily associated with outbreaks, food handlers accounted for eight of these. Another reported transmission route was direct contact with fecal material, which was reported in six studies as the primary transmission route. Travel-associated giardiasis was considered the sole transmission route in two studies, whereas multiple transmission routes contributed to giardiasis outbreaks in eleven studies. The evidence around zoonotic transmission was less clear and hampered by the lack of robust and regularly applied parasite molecular typing techniques. This literature review summarizes the findings of Giardia outbreak investigations and epidemiological studies in high-income countries. Transmission routes are identified and discussed to highlight the associated risk factors. These data also indicate gaps in our current knowledge that include the need for robust, in-depth molecular studies and have underscored the importance of water as a transmission route for Giardia cysts. These future molecular studies will improve our understanding of Giardia epidemiology and transmission pathways in higher income countries to prevent spread of this significantly under-reported pathogen.

Cyst detection and viability assessment of Balantioides coli in environmental samples: Current status and future needs

The ciliate Balantioides coli is a human enteric parasite that can cause life-threatening infections. It is a food- and waterborne parasite, with cysts being the infective stage. Despite its importance as a potential pathogen, few reports have investigated its presence in environmental samples, and some issues need attention including i) The accuracy of B. coli identification. In most cases, the protozoa is identified only by its morphological traits, which can be identical to those from other parasitic ciliates of animals. Genetic analysis of cysts recovered from environmental samples is necessary for species confirmation. In addition, genetic methods used with faecal samples need to be adequately validated with environmental matrices. ii) The methodology for searching this parasite in environmental samples. The protocols include an initial phase to isolate the cysts from the matrix followed by a second phase in which concentration procedures are usually applied. The methods may be valid but are not standardised and differences between studies could affect the results obtained. iii) The areas that needs further research. The development of genetic identification methods and standardised analytical protocols in environmental samples are required, as well as the assessment of viability and infectivity of B. coli cysts. The development of axenic culture systems will boost research on this parasite.

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Balantioides coli is mainly considered a foodborne parasite for humans.

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Detection methods in environmental samples are not standardised.

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Correct identification should be made by genetic analysis.

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Methods for B. coli cyst viability and infectivity assessment are to be developed.

RAA-Cas12a-Tg: A Nucleic Acid Detection System for Toxoplasma gondii Based on CRISPR-Cas12a Combined with Recombinase-Aided Amplification (RAA)

Toxoplasmosis, caused by the intracellular protozoon Toxoplasma gondii, is a significant parasitic zoonosis with a world-wide distribution. As a main transmission route, human infection can be acquired by the ingestion of T. gondii oocysts from the environment (e.g., soil, water, fruits and vegetables). Regarding the detection of T. gondii oocysts in environmental samples, the development of a time-saving, cost-effective and highly sensitive technique is crucial for the surveillance, prevention and control of toxoplasmosis. In this study, we developed a new method by combining recombinase-aided amplification (RAA) with CRISPR-Cas12a, designated as the RAA-Cas12a-Tg system. Here, we compared this system targeting the 529 bp repeat element (529 bp-RE) with the routine PCR targeting both 529 bp-RE and ITS-1 gene, respectively, to assess its ability to detect T. gondii oocysts in soil samples. Our results indicated that the 529 bp RE-based RAA-Cas12a-Tg system was able to detect T. gondii successfully in nearly an hour at body temperature and was more sensitive than the routine PCR assay. The sensitivity of this system reached as low as 1 fM with high specificity. Thus, RAA-Cas12a-Tg system provided a rapid, sensitive and easily operable method for point-of-care detection of T. gondii oocysts in soil, which will facilitate the control of T. gondii infection in humans and animals.

The Level of Knowledge about Toxoplasmosis among University Students in Rabat in Morocco

The aim of this descriptive cross-sectional study is to evaluate the knowledge of toxoplasmosis among medical, biology, and veterinary students in Rabat in Morocco. The data was collected by using a questionnaire which includes demographic characteristics, epidemiology, diagnosis, and clinical issues related to knowledge of toxoplasmosis. During analysis, the study groups were divided based upon their specialty of students who were medical, biology, and veterinary students. Out of 230 students, 55.2% were female and 44.8% were male. The average age of the study population is 21.7 ± 02 years. Less than half (42.6%) have heard of the disease; most of them have heard from faculty during studies in classrooms with 75.8%, and 3.2% were from the internet. Only 36.5% knew the correct causative agent of toxoplasmosis, and 32.1% were aware of the definitive host. The current study documented that there are gaps in the knowledge of the students regarding toxoplasmosis. Therefore, the present study puts the basis for future studies highlighting the importance of educating students to improve knowledge and attitudes towards toxoplasmosis.

A metabarcoding approach for detecting protozoan pathogens in wild oysters from Prince Edward Island, Canada

Food and waterborne protozoan pathogens including Cryptosporidium parvum, Giardia enterica and Toxoplasma gondii are a global concern for human public health. While all three pathogens have been detected in commercial shellfish, there is currently no standard approach for detecting protozoan parasites in shellfish. Common molecular and microscopic methods are limited in the number of pathogens they can simultaneously detect and are often targeted at one or two of these pathogens. Previously, we developed and validated a novel 18S amplicon-based next-generation sequencing assay for simultaneous detection of Cryptosporidium spp., Giardia spp. and T. gondii in shellfish. In this study, we applied the assay for protozoan pathogen detection in wild oysters from Prince Edward Island (PEI). Oysters were harvested from restricted and prohibited areas, classified by the Canadian government according to fecal coliform counts in surrounding waters, and different fractions (whole tissue homogenate and hemolymph) were analyzed. Protozoan DNA was detected using metabarcoding in 28%, of oysters tested (N = 128), and the pathogen read counts in oyster homogenate were considerably higher than those in hemolymph. Protozoan read count thresholds were established for classifying probable oyster contamination with pathogens to account for low levels of background protozoan reads detected in negative controls. Assay results showed protozoan contamination was not associated with harvesting site classifications, suggesting that using fecal indicators for ensuring food safety may be insufficient. Due to the complex matrix, an oyster DNA reduction step may further improve the pathogen detection sensitivity of the assay. Results from this study affirm that novel metabarcoding is a promising screening tool for detection of protozoan pathogens in shellfish.

Detection of Cyclospora cayetanensis, Echinococcus multilocularis, Toxocara spp. and microsporidia in fresh produce using molecular methods: - A review

The current trend for a healthy lifestyle corresponds with a healthy diet, which is associated with regular and frequent consumption of raw fruit and vegetables. However, consumption of ready-to-eat (RTE) food without heat treatment or sufficient washing may pose a risk to consumers. Among the well-known protozoan parasites associated with RTE food and water are Cryptosporidium spp., Giardia duodenalis and Toxoplasma gondii. These belong among prioritized parasitic pathogens, as they are associated with numerous disease outbreaks in humans all around the world. Nevertheless, other parasitic agents such as Cyclospora cayetanensis, Toxocara cati, Toxocara canis, Echinococcus multilocularis and zoonotic microsporidia should not be neglected. Although these selected parasites belong to phylogenetically diverse groups, they have common characteristics associated with fresh produce and each of them poses a health risk to humans. Ensuring healthy food is produced requires the standartization of laboratory methods for the detection of parasitic agents. This article reviews the molecular methods currently used in laboratories for detection of Cyclospora cayetanensis, Toxocara cati, Toxocara canis, Echinococcus multilocularis and zoonotic microsporidia in fresh produce.

Occurrence of Toxoplasma gondii on Raw Leafy Vegetables in Gaza, Palestine

ABSTRACT

Toxoplasma gondii, a ubiquitous obligate intracellular parasite that can infect homeothermic animals, is one of the main pathogens causing foodborne diseases worldwide. In Gaza, Palestine, leafy vegetables are frequently eaten raw. The present study was carried out to investigate the occurrence of T. gondii oocyst in local leafy vegetables. Fifty samples each of six species of leafy plants sold in open-air markets, in supermarkets, and by retail sellers were randomly collected from March to August 2019, for a total of 300 samples. The samples were examined by light microscopy after flotation in Sheather's sucrose solution and by PCR assay of the pelleted samples. All suspect T. gondii oocysts were confirmed with a PCR assay. With the PCR assay of the pelleted samples, only 19 (6.33%) of the 300 samples were positive for T. gondii, whereas with the Sheather's flotation method, 35 (11.66%) of the 300 samples were positive. With the PCR assay, among the six plant types mint had the highest T. gondii prevalence (10.00% of samples) followed by watercress and dill (both 8.00%), parsley (6.00%), thyme (4.00%), and lettuce (2.00%). Even though the relative prevalence of T. gondii in the contaminated plant species was similar with both the PCR and Sheather's flotation methods, the actual prevalences were different. With Sheather's flotation, T. gondii prevalence was highest in mint (18.00% of samples) followed by watercress (14.00%), dill (13.00%), parsley (10.00%), thyme (10.00%), and lettuce (6.00%). The relationship between T. gondii contamination and the time of year the samples were collected was also significant. The highest prevalence recorded was in July followed by June and August. These findings indicate that leafy vegetables, particularly mint, can be contaminated with T. gondii and are a potential risk factor for transmitting T. gondii to humans in Gaza, Palestine.

HIGHLIGHTS

A review of Cryptosporidium spp. and their detection in water

Cryptosporidium spp. are one of the most important waterborne pathogens worldwide and a leading cause of mortality from waterborne gastrointestinal diseases. Detection of Cryptosporidium spp. in water can be very challenging due to their low numbers and the complexity of the water matrix. This review describes the biology of Cryptosporidium spp. and current methods used in their detection with a focus on C. parvum and C. hominis. Among the methods discussed and compared are microscopy, immunology-based methods using monoclonal antibodies, molecular methods including PCR (polymerase chain reaction)-based assays, and emerging aptamer-based methods. These methods have different capabilities and limitations, but one common challenge is the need for better sensitivity and specificity, particularly in the presence of contaminants. The application of DNA aptamers in the detection of Cryptosporidium spp. oocysts shows promise in overcoming these challenges, and there will likely be significant developments in aptamer-based sensors in the near future.

Food and waterborne protozoan parasites: The African perspective

Parasitic food-borne diseases, particularly those caused by the protozoan parasites Cryptosporidium, Giardia, Cyclospora cayetanensis and Entamoeba are increasingly becoming common and have received considerable attention in the last two decades. The ability of the transmission stages of the parasites to survive in the environment for prolonged periods, globalization of the food industry and changes in eating habits have contributed to the numbers of human infections. This systematic scoping review highlights these important water- and foodborne parasites in the African context, detailing the burden in African water sources, wastewater/effluents and fresh produce. A scoping review search targeting African countries was conducted in Medline, Web of science and African journals online as well as back referencing from included studies covering the period 1990 to January 2020. Out of 1134 studies, 68 were included in the review. The articles covered 17 out of 54 African countries. There were 39/68 studies reporting on water sources while the rest reported on fresh produce. Cryptosporidium prevalence ranged from 6 to 100% in surface water, 4 to 100% in tap water and up to 100% in wastewater and sludge. In fresh produce, Cryptosporidium was reported from five countries with prevalence of 0.8-75%. Giardia was reported in 47 out of 68 articles; prevalence ranged from 2.4% in surface water; 1% to over 70% in tap water; 28-100% in wastewater and 2% - 99% in fresh produce. Prevalence of Cyclospora cayetanensis was lower. Prevalence of Entamoeba was 78% in surface water; 100% in wastewater and up to 99% in fresh produce. This study finds that Africa is no exception to the risk presented by the subject parasites from water and/or food sources. Routine screening for these parasites particularly at household level and provision of adequate and safe drinking water would help to control the parasites.

Detection of human intestinal protozoan parasites in vegetables and fruits: a review

Diarrheal diseases caused by intestinal protozoan parasites are a major food-borne public health problem across the world. Vegetables and fruits provide important nutrients and minerals, but are also common sources of some food-borne human pathogenic microorganisms. The contamination of raw vegetables and fruits with human pathogenic parasites are now a global public health threat, despite the health benefits of these foods in non-pharmacological prophylaxes against diseases. A large number of reports have documented the contamination of vegetables or fruits with human pathogenic microorganisms. In this paper, we reviewed the contamination and detection methods of human pathogenic intestinal protozoans that are frequently recovered from raw vegetables and fruits. The protozoan parasites include Cryptosporidium spp., Giardia duodenalis, Cyclospora cayetanensis, Entamoeba spp., Toxoplasma gondii, Balantioides coli, Blastocystis sp., Cystoisospora belli and Enterocytozoon bieneusi. The risk factors involved in the contamination of vegetables and fruits with parasites are also assessed.

Bayesian risk assessment model of human cryptosporidiosis cases following consumption of raw Eastern oysters (Crassostrea virginica) contaminated with Cryptosporidium oocysts in the Hillsborough River system in Prince Edward Island, Canada

Cryptosporidium spp. has been associated with foodborne infectious disease outbreaks; however, it is unclear to what extent raw oyster consumption poses a risk to public health. Control of Cryptosporidium in shellfish harvest seawater in Canada is not mandatory and, despite relay/depuration processes, the parasite can remain viable in oysters for at least a month (depending on initial loads and seawater characteristics). Risks of human infection and illness from exposure to oysters contaminated with Cryptosporidium oocysts were assessed in a Bayesian framework. Two data sets were used: counts of oocysts in oysters harvested in Approved, Restricted, and Prohibited zones of the Hillsborough River system; and oocyst elimination rate from oysters exposed to oocysts in laboratory experiments. A total of 20 scenarios were assessed according to number of oysters consumed in a single serving (1, 10 and 30) and different relay times. The median probability of infection and developing cryptosporidiosis (e.g. illness) due to the consumption of raw oysters in Prince Edward Island was zero for all scenarios. However, the 95th percentiles ranged from 2% to 81% and from 1% to 59% for probability of infection and illness, respectively. When relay times were extended from 14 to 30 days and 10 oysters were consumed in one serving from the Restricted zones, these probabilities were reduced from 35% to 16% and from 15% to 7%, respectively. The 14-day relay period established by Canadian authorities for harvesting in Restricted zones seems prudent, though insufficient, as this relay period has been shown to be enough to eliminate fecal coliforms but not Cryptosporidium oocysts, which can remain viable in the oyster for over a month. Extending relay periods of 14 and 21 days for oysters harvested in Restricted zones to 30 days is likely insufficient to substantially decrease the probability of infection and illness. The highest risk was found for oysters that originated in Prohibited zones. Our findings suggest that Cryptosporidium oocysts are a potential cause of foodborne infection and illness when consuming raw oysters from Hillsborough River, one of the most important oyster production bays on Prince Edward Island. We discuss data gaps and limitations of this work in order to identify future research that can be used to reduce the uncertainties in predicted risks.

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Risk of infection and illness of cryptosporidiosis in humans by consuming raw oysters from PEI is likely to be negligible.

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Depuration time of 14 days might not be enough to reduce Cryptosporidium oocysts contamination in oysters in bays of PEI.

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More field data need to be obtained to reduce uncertainties in predicted risks.

Seroprevalence of toxoplasmosis in pregnant women of the Marrakech-Safi region, Morocco

BACKGROUND

Toxoplasmosis is a parasitic infection caused by an intracellular protozoan named Toxoplasma gondii. Its prevalence had been investigated in several studies throughout the world showing that it varied from one country to another. In contrast, few studies had been carried out on this infection across the kingdom of Morocco, hence the objective of this work, which is the determination of Toxoplasma gondii seroprevalence in the region of Marrakech-Safi.

METHODS

The serological results of a cohort of 5692 patients were reviewed retrospectively. Those patients had been into different public and private medical laboratories in the region of Marrakech-Safi for a toxoplasmosis serology, requested between the 1st January, 2014 and 31st December, 2016. According to each laboratory, the techniques adopted for this serology were ELISA (ELFA, MEIA, EIA) and CMIA.

RESULTS

The results showed that for pregnant women, the overall seroprevalence in the study region were 28.88%.

CONCLUSION

The variation of Toxoplasma gondii seroprevalence is related not only to climatic factors but also to lifestyle, eating habits, socio-economic status and hygiene conditions. In this study, we noticed that in Morocco, as in other countries, pregnant women encounter several difficulties when serologic screening for toxoplasmosis.

Prevalence of Intestinal Parasitic Infections among the Bulgarian Population Over a Three Year Period (2015 - 2017)

The aim of the present study is to perform a retrospective analysis of the prevalence of intestinal parasitic infections among the Bulgarian population over the period 2015 - 2017. The study involved all Bulgarians and foreign nationals residing in the country who had been tested for intestinal protozoa and helminths. A total of 23,785 infections have been revealed, of which 17,712 (74.47 %) were helminth and 6,073 (25.53 %) protozoan invasions. Enterobiasis was found to be the most prevalent among patients infected with intestinal helminths (81.75 %), while giardiasis (62.05 %) was the most common among those diagnosed with protozoan infections. In spite of improved living conditions and increasing public health awareness, parasitic diseases in general, and intestinal parasitic infections in particular, still represent a significant part of the overall morbidity in Bulgaria, thus posing a major issue for the public health care system.

Microbiological Contamination of Strawberries from U-Pick Farms in Guangzhou, China

This study quantified the association of rodent fruit damage and the microbiological quality of irrigation water on the risk of microbiological contamination of strawberries collected from 18 U-pick farms across five different districts in the Guangzhou metropolitan region of southern China. Fifty-four composite strawberries samples, with or without evidence of rodent or avian foraging damage (i.e., bitten), along with 16 irrigation water samples, were collected during the spring of 2014 and winter of 2015 from our cohort of 18 farms. Composite strawberry samples and irrigation water were analyzed for total coliforms, E. coli, Salmonella, E. coli O157, Giardia, and Cryptosporidium. Total coliforms and E. coli were detected in 100% and ~90% of irrigation water samples, respectively. In contrast, Cryptosporidium was detected in only two water samples, while Salmonella, E. coli O157, and Giardia were not detected in any water samples. Strawberries with signs of being bitten by wildlife had significantly higher concentrations of total coliforms and E. coli, compared to strawberries with no physical evidence of rodent damage (p < 0.001). Similarly, Cryptosporidium was detected in 7/18 (39%) of bitten, 4/18 (22%) of edge, and 5/18 (28%) of central strawberry samples, respectively. Concentration of E. coli on strawberries (p < 0.001), air temperature (p = 0.025), and presence of Cryptosporidium in irrigation water (p < 0.001) were all associated with the risk of Cryptosporidium contamination on strawberries. Salmonella and Giardia were detected in <4% strawberry samples and E. coli O157 was not detected in any samples. These results indicate the potential food safety and public health risks of consuming unwashed strawberries from U-pick farms, and the need for improved rodent biosecurity of U-pick strawberry fields and enhanced microbiological quality of irrigation water used at these facilities.

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.

Microbial Contamination of Fresh Produce: What, Where, and How?

Promotion of healthier lifestyles has led to an increase in consumption of fresh produce. Such foodstuffs may expose consumers to increased risk of foodborne disease, as often they are not subjected to processing steps to ensure effective removal or inactivation of pathogenic microorganisms before consumption. Consequently, reports of ready-to-eat fruit and vegetable related disease outbreak occurrences have increased substantially in recent years, and information regarding these events is often not readily available. Identifying the nature and source of microbial contamination of these foodstuffs is critical for developing appropriate mitigation measures to be implemented by food producers. This review aimed to identify the foodstuffs most susceptible to microbial contamination and the microorganisms responsible for disease outbreaks from information available in peer-reviewed scientific publications. A total of 571 outbreaks were identified from 1980 to 2016, accounting for 72,855 infections and 173 deaths. Contaminated leafy green vegetables were responsible for 51.7% of reported outbreaks. Contaminated soft fruits caused 27.8% of infections. Pathogenic strains of Escherichia coli and Salmonella, norovirus, and hepatitis A accounted for the majority of cases. Large outbreaks resulted in particular biases such as the observation that contaminated sprouted plants caused 31.8% of deaths. Where known, contamination mainly occurred via contaminated seeds, water, and contaminated food handlers. There is a critical need for standardized datasets regarding all aspects of disease outbreaks, including how foodstuffs are contaminated with pathogenic microorganisms. Providing food business operators with this knowledge will allow them to implement better strategies to improve safety and quality of fresh produce.

Cyclospora cayetanensis and Cyclosporiasis: An Update

Cyclospora cayetanensis is a coccidian parasite of humans, with a direct fecal-oral transmission cycle. It is globally distributed and an important cause of foodborne outbreaks of enteric disease in many developed countries, mostly associated with the consumption of contaminated fresh produce. Because oocysts are excreted unsporulated and need to sporulate in the environment, direct person-to-person transmission is unlikely. Infection by C. cayetanensis is remarkably seasonal worldwide, although it varies by geographical regions. Most susceptible populations are children, foreigners, and immunocompromised patients in endemic countries, while in industrialized countries, C. cayetanensis affects people of any age. The risk of infection in developed countries is associated with travel to endemic areas and the domestic consumption of contaminated food, mainly fresh produce imported from endemic regions. Water and soil contaminated with fecal matter may act as a vehicle of transmission for C. cayetanensis infection. The disease is self-limiting in most immunocompetent patients, but it may present as a severe, protracted or chronic diarrhea in some cases, and may colonize extra-intestinal organs in immunocompromised patients. Trimetoprim-sulfamethoxazole is the antibiotic of choice for the treatment of cyclosporiasis, but relapses may occur. Further research is needed to understand many unknown epidemiological aspects of this parasitic disease. Here, we summarize the biology, epidemiology, outbreaks, clinical symptoms, diagnosis, treatment, control and prevention of C. cayetanensis; additionally, we outline future research needs for this parasite.

Prevalence of Giardia and Cryptosporidium in young livestock and dogs in Magude District of Maputo Province, Mozambique

BACKGROUND

Giardia and Cryptosporidium species are significant zoonotic parasites of humans and domesticated animals.

OBJECTIVES

The study aimed to determine the prevalence of Giardia and Cryptosporidium in livestock and dogs of the Magude District.

METHOD

The flotation technique (Willis), modified Ziehl-Neelsen (mZN) and direct and indirect immunofluorescence (DIF and IIF) techniques were applied to determine the prevalence of Giardia and Cryptosporidium species in faecal samples of dog pups (156), goat kids (60) and calves (480) from the Magude District of Mozambique from February to September 2015.

RESULTS

Using Willis, IIF and DIF, the prevalence of Giardia in calves was 0%, 8.1%, and 6.0%; in dogs 0.6%, 8.3% and 5.7% and for goats 0% and 13.3% (IIF was not performed), respectively. The prevalence of Cryptosporidium in calves using Willis, mZN, IIF and DIF was 0%, 3.8%, 4.7% and 0.4% and in dogs 0%, 0.6%, 6.4% and 0.6%, respectively. The parasite was not detected in goats.

CONCLUSION

Results from the present study showed that IIF performed better diagnosis of Giardia and Cryptosporidium, and that the mZN can be used as an alternative for Cryptosporidium because of the high cost of IIF. There is a need for identification of genotypes or subtypes of these parasites through application of molecular techniques in order to determine their zoonotic potential, and we advocate a 'one health' approach in the control and prevention of these parasites.

Safety of Water Used in Food Production

Water has a major and fundamental role in safety of food production. It is a critical resource for the food industry with wide uses. In most of the food preparation and processing operations, water is often taken for granted. Water is very commonly used in food production at various levels, apart from being used as an ingredient. Water quality and its impact on food products and various operations in food industries are often underestimated. Such underestimation often leads to mismanagement of water, equipment operation and maintenance issues, loss of revenue, food safety, and product quality. This chapter deals with several aspects of water as applicable to the food production.

Agriculture is the largest consumer of water, requiring over 100 times more than that used for personal needs. The concept of water footprint is used to discern the importance of relative value in terms of water. The water footprint of any animal product is larger than the water footprint of a wisely chosen crop product with equivalent nutritional value. The production of meat requires between 6 and 20 times more water than for cereals and vegetables or fruits. Water is indispensible in cleaning and sanitization in food production, which is an integral part in processing operations in food production. In food storage and preservation, water plays a key role. The water activity of food helps a great deal in deciding shelf-life and food safety. The quality of water is the fundamental consideration in any food production process. The quality depends on the source of water and the actual application in food production.

The pollution of water occurs at any stage in various ways. Physical, chemical, or biological agents cause significant health hazards in safe production of food. Contamination of water by several pathological microorganisms creates major challenges in food safety and threats to human and animal health. The majority of diseases which are transmitted through contaminated fresh water, are caused by pathogenic microorganisms. Whenever water is used as an ingredient in food product, it must be free from undesirable taste, odor, color, and impurities, including pathogenic organisms that could jeopardize consumers’ health and gravely affect product quality. The quality of water must adhere to the safe drinking water standard.

Various techniques and methods of water treatments should be used to purify water as per the guidelines of government authorities to improve food safety. Soil has multiple roles in deciding water quality. Good quality soil has better ability to remove all types of contaminants of water, whereas deteriorated soil becomes a source of heavy metals, organic chemicals, and soil pathogens in water contamination. Use of genetically modified food is gaining much publicity recently. Even though a controversial topic, great care must be taken when genetically modified food is used. It is mandatory that one should review the basic principles of food safety before consuming any food.

Public health risks associated with food-borne parasites

Parasites are important food‐borne pathogens. Their complex lifecycles, varied transmission routes, and prolonged periods between infection and symptoms mean that the public health burden and relative importance of different transmission routes are often difficult to assess. Furthermore, there are challenges in detection and diagnostics, and variations in reporting. A Europe‐focused ranking exercise, using multicriteria decision analysis, identified potentially food‐borne parasites of importance, and that are currently not routinely controlled in food. These are Cryptosporidium spp., Toxoplasma gondii and Echinococcus spp. Infection with these parasites in humans and animals, or their occurrence in food, is not notifiable in all Member States. This Opinion reviews current methods for detection, identification and tracing of these parasites in relevant foods, reviews literature on food‐borne pathways, examines information on their occurrence and persistence in foods, and investigates possible control measures along the food chain. The differences between these three parasites are substantial, but for all there is a paucity of well‐established, standardised, validated methods that can be applied across the range of relevant foods. Furthermore, the prolonged period between infection and clinical symptoms (from several days for Cryptosporidium to years for Echinococcus spp.) means that source attribution studies are very difficult. Nevertheless, our knowledge of the domestic animal lifecycle (involving dogs and livestock) for Echinoccocus granulosus means that this parasite is controllable. For Echinococcus multilocularis, for which the lifecycle involves wildlife (foxes and rodents), control would be expensive and complicated, but could be achieved in targeted areas with sufficient commitment and resources. Quantitative risk assessments have been described for Toxoplasma in meat. However, for T. gondii and Cryptosporidium as faecal contaminants, development of validated detection methods, including survival/infectivity assays and consensus molecular typing protocols, are required for the development of quantitative risk assessments and efficient control measures.

Toxoplasma gondii seroprevalence among pregnant women attending antenatal clinic in Northern Tanzania

BACKGROUND

Acute Toxoplasma gondii infection during pregnancy represents a risk for congenital disease, especially among women without previous exposure to infection. There is, however, a paucity of information about the epidemiology of T. gondii infection in pregnant women in Tanzania. This study aimed to determine the seroprevalence of T. gondii infection and associated demographic, clinical, and behavioral risk factors in pregnant women attending ante-natal clinic (ANC) at Kilimanjaro Christian Medical Center (KCMC), a referral medical center in Northern Tanzania.

METHODS

A hospital-based cross-sectional study was carried out from 1 February to 30 April 2017. Data on maternal demographic characteristics, obstetric history, knowledge, and practices related to T. gondii infection were collected from 254 pregnant women attending antenatal care at KCMC. A sample of 4 mL of blood was collected from each participant and sera prepared from each sample. Serum samples were tested for the presence of specific T. gondii IgG and IgM antibodies by indirect Enzyme-Linked Immunosorbent Assay (ELISA). DNA was extracted from whole blood for polymerase chain reaction (PCR) testing, targeting the DNA sequence coding for the Internal Transcribed Spacer 1 (ITS1).

RESULTS

The overall T. gondii seroprevalence, including both IgM- and IgG-positive individuals, was 44.5%. Of the 254 tested women, 102 and 23 were seropositive for T. gondii-specific IgG and IgM antibodies respectively and 113 individuals had antibodies of either or both classes. All IgM-positive samples were also tested by PCR, and all were negative. The majority (90%) of the women surveyed had never heard about toxoplasmosis. Consumption of raw vegetables [aOR = 0. 344; 95% CI 0.151-0.784; p = 0.011] and having regular contact with soil [aOR = 0.482; 95% CI 0.268-0.8681; p = 0.015] were both associated with T. gondii antibody status. Inverse relationships with probability of T. gondii exposure were observed, such that these practices were associated with reduced probability of antibody detection.

CONCLUSION

Based on serology results, we report widespread exposure to T. gondii infection among pregnant women attending ANC in KCMC. The complex interaction of risk factors for T. gondii infection needs to be studied in larger longitudinal studies.

Giardia: an under-reported foodborne parasite

Foodborne zoonotic pathogens are a serious public health issue and result in significant global economic losses. Despite their importance to public health, epidemiological data on foodborne diseases including giardiasis caused by the enteric parasite, Giardia duodenalis, are lacking. This parasite is estimated to cause ∼28.2 million cases of diarrhoea each year due to contamination of food, but very few foodborne outbreaks have been documented due to the limitations of current detection as well as surveillance methods. The current method for the recovery of Giardia cysts from food matrices using immunomagnetic separation requires further standardisation and cost reduction before it can be widely used. It also should incorporate downstream molecular procedures for genotyping, and traceback and viability analyses. Foodborne giardiasis can be potentially controlled through improvements in national disease surveillance systems and the establishment of Hazard Analysis and Critical Control Point interventions across the food chain. Studies are needed to assess the true prevalence and public health impact of foodborne giardiasis.

PREVALENCE OF CRYPTOSPORIDIUM SPP. AMONG ASYMPTOMATIC HEALTHY EXPATRIATE WORKERS IN SHARJAH, UNITED ARAB EMIRATES

Background:

Epidemiological data on Cryptosporidium infections in the United Arab Emirates (UAE) is scarce. Therefore, the main objective of this study was to determine the prevalence of Cryptosporidium species among a community of expatriates in Sharjah, UAE working in different sectors, including the food industry, house maids and other domestic occupations.

Materials and Methods:

One hundred and thirty four stool samples were collected from asymptomatic individuals presenting to the Sharjah Municipality Public Health Clinic (SMPHC) for screening of intestinal parasites for work permission purposes between 2009 and 2011. Demographic information such as age, sex, and country of origin was collected. Genomic DNA extracted from the stool samples were tested for Cryptosporidium species using real-time PCR (qPCR).

Results:

Twenty-six individuals (19.4%) were positive for Cryptosporidium sp. by PCR. The infection rate was found to be highest in Afghan nationals (33%; 3/9) compared with the rest of the study population; yet, no significant association existed between nationality and infection rate. Moreover, no association was observed between infection rate and gender (χ² = 2.439; P = 0.118), nor infection rate and age group (χ² = 1.219; P = 0.544).

Conclusion:

Infection by Cryptosporidium sp. was common in the study group, and further studies are needed within the native Emirati population before any conclusions can be made about foreigners potentially transmitting the parasite. Furthermore, data provided in this study could help determine its public and veterinary significance particularly in outbreaks in the country.

Microbial pollution and food safety

Microbial pollution is a serious food safety issue because it can lead to a wide range of foodborne diseases. A great number of foodborne diseases and outbreaks are reported in which contamination of fresh produce and animal products occurs from polluted sources with pathogenic bacteria, viruses and protozoa and such outbreaks are reviewed and the sources are revealed. Investigations of foodborne outbreaks involved meat production and fresh produce, namely, that occurred at the early stages of the food chain have shown certain sources of contamination. Domesticated food animals, as well as wild animals, flies and rodents can serve as a source of contamination of nearby produce-growing fields and can lead to human infection through direct contact at farms and, mostly, mail order hatcheries. The most of the fresh produce associated outbreaks have followed wildlife intrusion into growing fields or fecal contamination from nearly animal production facilities that likely led to produce contamination, polluted water used for irrigation and improper manure. Preventive measures, as part of implemented good agricultural practice systems are described. Controlling and minimizing pre-harvest contamination may be one of the key aspects of food safety.

Changes in the incidence of intestinal giardiosis in Mexican population during five years (2011-2015)

Giardiosis is a parasitic disease caused by the protozoan Giardia intestinalis, which is distributed worldwide. Most of the data on the prevalence of giardiosis in Mexico comes from research, but it is also necessary to study the data provided by the Mexican Health Ministry and issued by the General Directorate of Epidemiology. The aim of this work was analyse the national surveillance data for human giardiosis in order to update the epidemiological data of this disease in Mexico. A retrospective observational analysis of giardiosis (from January 2011 to December 2015) was performed in the annual reports emitted by the GDE in Mexico. The cases were classified by year, state, age group, gender and seasons of the year. During the period of 2011-2015, a reduction of 38.51% was observed in the total number of new cases of giardiosis reported in the whole country The states of Sinaloa, Yucatan, and Chiapas presented the highest number of new cases reported during the analysed period. Giardiosis rates were always higher among women in all age groups, but the maximum incidence was observed in both sexes in the age group of 1-4 years old (the most susceptible group). On the other hand, the number of cases increased dramatically in southern states during warmer months. Giardiosis is influenced by ambient temperature changes along the year, although this study suggests that tends to decrease in all the analysed states and could be related to the overall improvement of hygienic practices within the Mexican population.

An overview of methods/techniques for the detection of Cryptosporidium in food samples

Cryptosporidium is one of the most important parasitic protozoa of concern within the food production industry, worldwide. This review describes the evolution and its development, and it monitors the methodology that has been used for Cryptosporidium in food material since 1984, when the first publication appeared regarding the detection of Cryptosporidium parvum in food materials. The methods that are currently being used for the detection of Cryptosporidium oocysts in food material (mainly vegetables) and all of the other available published methods are discussed in this review. Generating more consistent and reliable data should lead to a better understanding of the occurrence, transport and fate of the oocysts in food material. Improvements in monitoring and developing effective methodology, along with food security, offer more practical possibilities for both the developed and developing worlds.

Seroepidemiology of Toxoplasma gondii infection in patients with liver disease in eastern China

The role of the protozoan parasite Toxoplasma gondii in the pathogenesis of liver disease has recently gained much interest. The aim of this study was to determine the prevalence and risk factors associated with T. gondii infection in patients with liver disease from three cities in Shandong and Henan provinces, China. A case-control study was conducted from December 2014 to November 2015 and included 1142 patients with liver disease and 1142 healthy controls. Serum samples were collected from all individuals and were examined with enzyme-linked immunosorbent assay for the presence of anti-T. gondii IgG and IgM antibodies. Information on the demographics, clinical, and lifestyle characteristics of the participants was collected from the medical records and by the use of a questionnaire. The prevalence of anti-T. gondii IgG was 19·7% in patients with liver disease compared with 12·17% in the controls. Only 13 patients had anti-T. gondii IgM antibodies compared with 12 control individuals (1·14% vs. 1·05%, respectively). The highest seroprevalence was detected in patients with liver cancer (22·13%), followed by hepatitis patients (20·86%), liver cirrhosis patients (20·42%), and steatosis patients (20%). Multivariate logistic regression analysis indicated that consumption of raw meat (odds ratio (OR) = 1·32; 95% confidence interval (CI) 1·01-1·71; P = 0·03) and source of drinking water from wells (OR = 1·56; 95% CI 1·08-2·27; P = 0·01) were independent risk factors for T. gondii infection in liver disease patients. These findings indicate that T. gondii infection is more likely to be present in patients with liver disease. Therefore, efforts should be directed toward health education of populations at high risk of T. gondii infection and measures should be taken to protect vulnerable patients with liver disease.

Toxoplasma gondii as a Parasite in Food: Analysis and Control

Foodborne infections are a significant cause of morbidity and mortality worldwide, and foodborne parasitic diseases, though not as widespread as bacterial and viral infections, are common on all continents and in most ecosystems, including arctic, temperate, and tropical regions. Outbreaks of disease resulting from foodstuffs contaminated by parasitic protozoa have become increasingly recognized as a problem in the United States and globally. Increased international trade in food products has made movement of these organisms across national boundaries more frequent, and the risks associated with infections have become apparent in nations with well-developed food safety apparatus in place.

Geospatial distribution of intestinal parasitic infections in Rio de Janeiro (Brazil) and its association with social determinants

BACKGROUND

Intestinal parasitic infections remain among the most common infectious diseases worldwide. This study aimed to estimate their prevalence and provide a detailed analysis of geographical distribution of intestinal parasites in the metropolitan region of Rio de Janeiro, considering demographic, socio-economic, and epidemiological contextual factors.

METHODS/PRINCIPAL FINDINGS

The cross-section survey was conducted among individuals attending the Evandro Chagas National Institute of Infectious Diseases (FIOCRUZ, RJ) during the period from April 2012 to February 2015. Stool samples were collected and processed by sedimentation, flotation, Kato-Katz, Baermann-Moraes and Graham methods, iron haematoxylin staining and safranin staining. Of the 3245 individuals analysed, 569 (17.5%) were infected with at least one parasite. The most common protozoa were Endolimax nana (28.8%), Entamoeba coli (14.8%), Complex Entamoeba histolytica/Entamoeba dispar (13.5%), Blastocystis hominis (12.7%), and Giardia lamblia (8.1%). Strongyloides stercoralis (4.3%), Schistosoma mansoni (3.3%), Ascaris lumbricoides (1.6%), and hookworms (1.5%) were the most frequent helminths. There was a high frequency of contamination by protozoa (87%), and multiple infections were observed in 141 participants (24.8%). A positive association between age (young children) and gender (male) with intestinal parasites was observed. Geospatial distribution of the detected intestinal parasitic infections was not random or homogeneous, but was influenced by socioeconomic conditions (through the material deprivation index (MDI)). Participants classified in the highest levels of deprivation had higher risk of having intestinal parasites.

CONCLUSIONS/SIGNIFICANCE

This study provides the first epidemiological information on the prevalence and distribution of intestinal parasitic infections in the Rio de Janeiro metropolitan area. Intestinal parasites, especially protozoa, are highly prevalent, indicating that parasitic infections are still a serious public health problem. MDI showed that intestinal parasites were strongly associated with the socioeconomic status of the population, thus making it possible to identify social vulnerable areas.

Virulence of Trypanosoma cruzi in Açai ( Euterpe oleraceae Martius) Pulp following Mild Heat Treatment

Outbreaks of acute Chagas disease (ACD) in northern Brazil can be caused by the ingestion of unprocessed açai pulp contaminated with Trypanosoma cruzi . The aim of this study was to determine the minimum thermal process required to inactivate T. cruzi in açai pulp. Trypomastigotes (100,000) of T. cruzi Y strain were added to 0.15 M NaCl or açai pulp and continuously mixed while being heat treated at 37 to 49°C for up to 1 h. When necessary, parasites were separated from açai pulp by forced sieving. Inocula were administrated intraperitoneally in inbred immunodeficient C.B-17-Prkdc^scid/Pas Unib mice, and the recipients were monitored for parasitemia and mortality. Mice received prophylactic antibiotic therapy by using cephalexin to prevent bacterial infection from the açai pulp. T. cruzi retained its virulence in 0.15 M NaCl and açai pulp at 44 ± 0.1°C for 10 min and at 43 ± 0.1°C for 20 min, respectively, causing ACD and death in mice up to 24 days after infection. Incubation of açai pulp inoculum above 43°C for 20 min neutralized T. cruzi virulence, thereby preventing ACD and death in murine recipients. The heating of açai pulp above 43°C for 20 min is a practical and effective measure to prevent foodborne ACD caused by T. cruzi .