Distribution of Taenia saginata metacestodes: a comparison of routine meat inspection and carcase dissection results in experimentally infected calves

Bovine cysticercosis epidemiology and the economic impact of the triceps brachii incision in a South African export abattoir

Taenia saginata is a zoonotic tapeworm of humans with bovines as its intermediate host (bovine cysticercosis). Traditional meat inspection is the main measure to identify the larval stage in carcasses and prevent human infection, but has a notoriously low sensitivity, especially in low prevalence settings. The legislation in multiple African countries mandates an incision in both triceps brachii muscles to detect the parasite as part of the normal post-mortem inspection, but this has an economic cost and is not universally mandated in other countries. The primary aim of this study was to investigate the epidemiology of bovine cysticercosis at an export abattoir in South Africa and determine the validity and cost of the triceps incision. Risk factors were investigated, and the effect of additional heart incisions on the current inspection. Four incisions were made into the heart in addition to the normal post-mortem inspection in 3353 carcasses. The proportion of positive animals with and without the cardiac and triceps incisions were compared using McNemar's chi-square tests, while risk factors were assessed using binary logistic regression. The economic impact of the triceps incision was estimated using a stochastic economic cost model. Thirty-three positive carcasses were identified for an apparent prevalence of 0.98 % (95 %CI, 0.69-1.36 %), while the true prevalence was estimated at 6.6 % (95 %CI, 4.3-8.8 %). All cysts were confirmed as T. saginata on histopathology with 70 % (95 %CI, 53-83 %) located in the heart. The additional cardiac incisions resulted in the detection of significantly more cases compared to the normal inspection method prevalence of 0.72 % (95 %CI, 0.47-1.05 %; P < 0.001). The apparent prevalence of T. saginata when omitting the triceps incision was not significantly lower compared to the prevalence when included in the inspection (P = 0.480). External feedlots (OR= 4.17, 95 %CI: 2.04-8.54, P < 0.001) and older animals (OR=3.90, 95 %CI: 1.17-13.03, P = 0.027) were associated with a positive detection. The current median annual financial cost to the food business operator from the triceps incision was estimated at $30387 (95 %CI: $0-$130696), with the proportion of deboned meat exported identified as the most important factor affecting cost (Spearman's rho=0.853). The identification of risk factors could aid in the development of a more effective risk-based inspection system. The current inspection should be modified to increase exposure of the heart and remove the triceps incisions. The latter should especially be considered given the minimal contribution to cysticercosis detection, the unsupported requirement for its inclusion specifically in Africa, and its economic impact, especially as beef exports increase.

Prevalence of Taenia saginata cysticerci in Addis Ababa Abattoir Enterprise, Ethiopia

An abattoir-based survey was conducted in Addis Ababa from December 2018 to April 2019 with the objectives of determining the prevalence of bovine cysticercosis and the viability of Taenia saginata cysticerci. Routine meat inspection was performed on the study animals. Palpation followed by incision of the heart, tongue, triceps muscle, masseter muscle and diaphragm were made to detect the presence of T. saginata cysts. From the detected cysts, 41 were randomly selected and subjected to viability test. From the total 500 study animals, 14(2.8%) had varying number of T. saginata cysts. The highest proportion of T. saginata cyst was observed in the triceps muscle 6(42.8%), followed by heart 3(21.4%), tongue 2(14.3%) and masseter muscle 2(14.3%). There was no cyst observed in the liver or diaphragm. Of the total randomly selected 41 cysticerci, 20(48.8%) were found to be viable while the rest 21(51.2%) cysticerci were found to be non-viable. Sex, breed, age, and body condition of the study animals were found to have no significant association with the occurrence of cysticerci (P > 0.05). Even though routine meat inspection has low sensitivity and usually under-estimates the prevalence of the disease, bovine cysticercosis was found to be prevalent in the study area. Therefore, an appropriate control program involving enforcement of meat inspection, promoting public awareness and improving personal and environmental hygiene should be designed and implemented.

Estimating prevalence and diagnostic test characteristics of bovine cysticercosis in Belgium in the absence of a 'gold standard' reference test using a Bayesian approach

A Bayesian model was developed to estimate values for the prevalence and diagnostic test characteristics of bovine cysticercosis (Taenia saginata) by combining results of four imperfect tests. Samples of 612 bovine carcases that were found negative for cysticercosis during routine meat inspection collected at three Belgian slaughterhouses, underwent enhanced meat inspection (additional incisions in the heart), dissection of the predilection sites, B158/B60 Ag-ELISA and ES Ab-ELISA. This Bayesian approach allows for the combination of prior expert opinion with experimental data to estimate the true prevalence of bovine cysticercosis in the absence of a gold standard test. A first model (based on a multinomial distribution and including all possible interactions between the individual tests) required estimation of 31 parameters, while only allowing for 15 parameters to be estimated. Including prior expert information about specificity and sensitivity resulted in an optimal model with a reduction of the number of parameters to be estimated to 8. The estimated bovine cysticercosis prevalence was 33.9% (95% credibility interval: 27.7-44.4%), while apparent prevalence based on meat inspection is only 0.23%. The test performances were estimated as follows (sensitivity (Se) - specificity (Sp)): enhanced meat inspection (Se 2.87% - Sp 100%), dissection of predilection sites (Se 69.8% - Sp 100%), Ag-ELISA (Se 26.9% - Sp 99.4%), Ab-ELISA (Se 13.8% - Sp 92.9%).

High prevalence of bovine cysticercosis found during evaluation of different post-mortem detection techniques in Belgian slaughterhouses

Bovine cysticercosis (BCC), caused by the helminth Taenia saginata, is currently diagnosed solely by official meat inspection (MI) based on macroscopic detection of viable cysticerci or typical lesions of degenerated larvae. MI has a known low sensitivity (<16%), leading to a large proportion of infected cattle carcasses entering the human food chain and posing a risk to public health. Prevalence in Belgium based on MI results is estimated at around 0.22%. Due to the low sensitivity of MI, alternative techniques to detect BCC should be considered. This study evaluates MI, MI with additional incisions in the heart, specific antibody detection against excretory/secretory (E/S) in the Ab-ELISA and circulating antigens in the B158/B60 Ag-ELISA on 715 (101 MI-positive and 614 MI-negative) samples collected from carcasses at slaughterhouses in Belgium. Full dissection of the predilection sites was considered the reference test. During the study, mostly carcasses with (very) light infections were detected containing predominantly degenerated or calcified cysticerci and only few viable cysticerci. Dissection of the predilection sites detected 144 (23%) additional infections in the 614 MI-negative carcasses. When sequentially performing first the dissection of the predilection sites, followed by the Ag-ELISA and the Ab-ELISA, an additional 36% of MI-negative carcasses were found positive for BCC, resulting in a prevalence very much higher than the above mentioned 0.22%. The B158/B60 Ag-ELISA showed a sensitivity of 40% for the detection of carcasses containing viable cysticerci and a specificity of 100%, and detected 70 positive carcasses of which only 14 had been identified as positive during MI. If Ag-ELISA were implemented as a detection technique for BCC in the slaughterhouses, many infected carcasses would still not be detected due to the sensitivity of 40%. But as sensitivity increases with increasing number of cysticerci in the carcass, the infected carcasses passing inspection will be the ones containing only a few viable cysticerci and thus posing a smaller food safety problem. Ag-ELISA is preferred over the ES Ab-ELISA in this study, which had a sensitivity of 13.3% and a specificity of 91.7% in a population with overall low infection burdens.