Tripartite

Meeting: Accelerate Prevention and Control of Neglected Foodborne Parasitic Zoonoses

Foodborne parasitic zoonoses such as foodborne trematodiases, taeniasis/cysticercosis and echinococcosis are neglected tropical diseases (NTDs) with significant burden in Asia. Long term infection with clonorchiasis and opisthorchiasis is known to cause bile duct cancer. Neurocysticercosis caused by cysticercosis in the brain is the most common cause of epilepsy in endemic areas. Cystic echinococcosis can cause hydatid cysts throughout the body and could be fatal if untreated. Alveolar echinococcosis too is generally a severe disease with over 90% mortality in untreated patients. The latest estimate of the global burden of foodborne diseases by WHO Foodborne Disease Burden Epidemiology Reference Group (FERG) in 2015 reported that the Western Pacific Region has the highest death rate from foodborne parasites. Clonorchiasis alone infects more than 30,000 people in the Region a year, causing death among 1 in 5 cases.

These foodborne parasitic zoonoses are caused by trematodes (flatworms or “flukes”) or tapeworms that are acquired through ingestion of food contaminated with the larval stages, eggs or proglottids of the parasite or ingestion of food or water that contains the eggs of the parasite released from infected animals and/or humans.  Their transmission is maintained due to poor hygiene and sanitation, food habit or farming system. They are also considered climate-sensitive diseases as climate change can affect geographical habitats of vector and other animal reservoirs species. However, lessons learnt from past experience show that parasitic zoonoses can be controlled, prevented and possibly eliminated using integrated mix of effective and feasible interventions such as preventive chemotherapy, treatment, vaccination and management of animal reservoirs, safe food handling and preparation, and provision of safe water, hygiene and sanitation (WASH) delivered through strong intersectoral collaboration and partnership. 

Meeting in 2017

In May 2017, WHO held an Expert Consultation to Accelerate Control of Foodborne Trematode Infections, Taeniasis and Cysicercosis in Seoul, Republic of Korea, to review progress in epidemiological mapping of these diseases, advances in diagnostics and treatment, implementation of control interventions and discuss the challenges and priorities to accelerate control of these diseases. The Consultation recommended expansion of focus from reliance on preventive chemotherapy alone to a comprehensive One Health approach, considering multiple factors contributing to high-reinfection rates immediately following treatment, such as poor sanitation and food hygiene status, presence of animal reservoirs and specific food habits. The Consultation also recommended WHO to strengthen collaboration with Food and Agriculture Organization (FAO) and World Organisation for Animal Health (Organisation mondiale de la santé animale: OIE) to jointly support countries to build capacity to effectively control these diseases, under the overall umbrella of the existing high-level regional OIE-FAO-WHO tripartite framework for multisectoral collaboration on the prevention and control of zoonoses. Since then, a number of countries have made progress with implementation of the recommendations. Similar progress has been made in a number of high burden countries in the Southeast Asia Region too. Considering the burden of neglected parasitic zoonoses in Asia, the ongoing efforts for overall strengthening of national food safety systems following the endorsement of the Regional Framework for Action on Food Safety in the Western Pacific by the Regional Committee in 2017 (WPR/RC68.R6), and the recommendations from the WHO Consultation, the FAO Regional Office for Asia and the Pacific, OIE Regional Representation for Asia and the Pacific, WHO WPRO and SEARO also agreed to establish a tripartite initiative to accelerate prevention and control of neglected foodborne parasitic zoonoses in Asia. 

Objectives

The objectives of the meeting were:

  • To review the progress of prevention and control of neglected foodborne parasitic zoonoses in Asia;
  • To share experience, issues, challenges and opportunities to leverage existing platforms and frameworks and strengthen intersectoral collaboration and partnership for accelerating prevention and control of neglected foodborne parasitic zoonoses; and 
  • To agree on multisectoral action priorities to address identified issues and challenges and accelerate prevention and control of neglected foodborne parasitic zoonoses in Asia.

Conclusions

  • The meeting provided valuable opportunities to bring different sectors involved in the prevention and control of neglected foodborne parasitic zoonoses together, namely public health, animal health, food safety and water, sanitation and hygiene (WASH).
  • Insights, experience and updates on new guidance and development to accelerate prevention and control of neglected foodborne parasitic zoonoses were shared among meeting participants.
  • Field trip to a local pig slaughterhouse, a fish and meat market and a community where pigs are raised at household level illustrated examples of the reality of animal production, food safety and hygiene practices in rural communities in Asia. 
  • The first sets of food safety risk communication and country-specific action plans to accelerate prevention and control of neglected foodborne parasitic zoonoses were developed.