|Year : 2014 | Volume
| Issue : 4 | Page : 213-215
Food-borne parasitic infestations in India: Need for attention towards unattended
Praveen Kulkarni, D Sunil Kumar
Department of Community Medicine, JSS Medical College, Mysore, Karnataka, India
|Date of Web Publication||16-Oct-2014|
Department of Community Medicine, JSS Medical College, Mysore, Karnataka
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Kulkarni P, Kumar D S. Food-borne parasitic infestations in India: Need for attention towards unattended. Int J Health Allied Sci 2014;3:213-5
|How to cite this URL:|
Kulkarni P, Kumar D S. Food-borne parasitic infestations in India: Need for attention towards unattended. Int J Health Allied Sci [serial online] 2014 [cited 2020 Feb 21];3:213-5. Available from: http://www.ijhas.in/text.asp?2014/3/4/213/143047
"To eat is a necessity, but to eat intelligently is an art."
Food is not only a sole portal for energy and is also one of the broader gateways for the diseases. Food-borne infections, infestations and intoxications are one of the leading causes of morbidities and mortalities worldwide. Food-borne parasitic infestations have a major impact on the health and economy in developing countries in the tropics and sub-tropics. Complex socioeconomic and socio-cultural factors play a vital role in origin and maintenance of these conditions. Apart from their effects on health conditions of human beings, most of these illnesses being zoonotic diseases also influence the health and productivity of living stocks. Scenario of food-borne parasitic illnesses in India differs from the rest of the world due to varied food habits across the country. Other factors, however, such as unhygienic living conditions, lack of education, poor personal hygiene, poverty and occupation, also contribute to the dissemination of parasitic infections. Some of the common food-borne parasitic infestations in India are described below.
| Toxoplasmosis|| |
Toxoplasmosis is caused by the protozoan parasite Toxoplasma gondii. Humans usually become infected by ingesting food or water contaminated with cat feces containing oocysts or by eating under-cooked meat containing the encysted stage of the parasite (tissue cysts). Infection acquired during pregnancy can be transmitted to the fetus, sometimes with serious consequences. A pan India, sero-prevalence study conducted by Singh et al. reported that the seroprevalence of Toxoplasmosis among pregnant women was 22.4%; the highest prevalence being in South India (37.3%), followed by East India (21.2%) and North India (19.7%). Women residing in western part of India had the lowest seroprevalence (8.8%). Majority of these women were belonging to lower socioeconomic strata, residing at kachha houses, pet owners and had practice of eating raw meat and drinking untreated water. The incidence of Toxoplasmosis was estimated to be 1.43%. When the same data is extrapolated to the national population, we may expect that, every year 56,737 and 176,882 children a year may be born in India with a possible risk of congenital toxoplasmosis, which can manifest itself in-utero or several years after birth. 
| Teniasis|| |
Taeniasis is a zooanthroponosis in which man is an essential definitive host whereas cattle and pig act as an intermediate host for Taenia saginata and Taenia solium. respectively, Transmission from man to animals occurs by handling calves and piglets, contamination of feed and water with Taenia eggs. Transmission may also occur through the coprophigic activity of pigs on human night soil. Transmission from animal to man depends on ethnological factors, i.e. food processing and food preferences. In India, teniasis is most common among castes that consume half-baked or smoked meat, and where the slaughter of animals is: Unsupervised. The prevalence of T. solium in Man has been reported to be between 0.5% and 2%. The prevalence of teniasis is probably higher in northern than southern India. 
| Paragonimiasis|| |
Paragonimiasis, also known as endemic hemoptysis, oriental lung fluke infection is one of the most important food-borne parasitic zoonoses caused by one or more of the trematode species of the genus Paragonimus. There are about 50 species of which 11 are known to cause infections in humans, Paragonimus westermani has been regarded as the most common and widely distributed human pathogen in Asia.  Humans acquire infection, commonly by ingestion of uncooked or undercooked crustaceans containing larvae of the parasite, and rarely by ingestion of infected uncooked or undercooked meat of pig and wild boar, which serve as paratenic hosts. The parasites primarily infect lung, but extra-pulmonary infections are not infrequent. Human paragonimiasis is a serious public health concern in Northeastern states, especially, Manipur and Arunachal Pradesh. As paragonimiasis infestation mimics pulmonary tuberculosis, often it is misdiagnosed and underestimated. Thus, the physicians in endemic areas should have a high degree of suspicion toward this ailment.
| Cryptosporidiosis|| |
The coccidian parasites Cryptosporidium spp. have been increasingly reported worldwide from a variety of hosts, causing infection ranging from an asymptomatic carrier state to severe diarrhea, especially in the young. Cryptosporidiosis is observed almost all states of country with prevalence in children with diarrhea ranging from 1.1% to 18.9%.  Cryptosporidium is also observed as a predominant component of the spectrum of opportunistic enteric pathogens in HIV-infected patients. Contaminated water, insanitary conditions and contact with animals appear to be major sources of human infection. Zoonotic cryptosporidiosis was more severe and frequently associated with fever.
| Ascariasis (Round worm infestation)|| |
Ascaris lumbricoides is an intestinal nematode (roundworm); it is one of the most common helminthic human infections worldwide. It is estimated that more than 1.4 billion people are infected with A. lumbricoides, representing 25% of the world population Lancet in 1985 published an interesting observation that, if the round worms from all the infested individuals are extracted and joined to one another, it can encircle the globe for 50 times !!!!. It is estimated that, over half of the adolescents in India are infested with round worms. A number of features account for its high prevalence including a ubiquitous distribution, the durability of eggs under a variety of environmental conditions, the high number of eggs produced per parasite, and poor socioeconomic conditions that facilitate its spread. Transmission is enhanced by the fact that individuals can be asymptomatically infected and can continue to shed eggs for years, yet prior infection does not confer protective immunity. 
| Amoebiasis|| |
Entamoeba histolytica, associated with high morbidity and mortality continues to be a major public health problem throughout the world. Asymptomatic individuals account for almost 90 per cent of the infections. In the Indian subcontinent, the prevalence of intestinal amoebiasis among hospitalized patients is around 11.7% using microscopy. However, using molecular biology tools such as PCR, Entamoeba histolytica was shown to be in 3.5% of those infected (Khairnar et al., 2007). Poverty, ignorance, overcrowding, poor sanitation and malnutrition favor transmission and increased disease burden. Apart from these socio-environmental factors, increasing magnitude of HIV/AIDS is further widening the opportunity for this infection. Matter of serious concern is that the organism has reported to develop resistance to commonly used antibiotics in the treatment of dysentery which further increases the difficulty in the management of frequent attacks of illness. 
| Giardiaisis|| |
Giardia lamblia (also known as Giardia intestinalis) is an amito chondriate protozoan parasite that is an important cause of diarrhea in India. In addition to diarrhea, it can also lead to malnutrition and cognitive deficits in children. Giardia species attach via a sucker disk to epithelial cells lining the duodenum and cause diarrhea in children and adults by inhibiting absorption of nutrients and fats. In India, prevalence rates of Giardia infection in patients with diarrhea range from 0.4% to 70%, and asymptomatic cyst passage has been found to be as high as 50% in rural southern India. 
| Hydatidosis|| |
Echinococcosis in humans is a zoonotic infection caused by larval stages of a cestode parasite of genus Echinococcus. Man is an accidental host where the parasite reaches its dead end. Cystic echinococcosis is caused by Echinococcus granulosus, alveolar echinococcosis is caused by Echinococcus multilocularis. The highest prevalence of human hydatid disease in India has been reported from Andhra Pradesh, Saurashtra, and Tamil Nadu. The prevalence of the disease is reported to be high in food animals in India. 
| Prevention and Control|| |
Food-borne parasitic infestation is one of the serious public health problems in India. As most of these illnesses are largely preventable there is a need for a much concerted attention towards their prevention. Here I would like to suggest few preventive measures.
- Personal hygiene is the most important step towards prevention of majority of parasitic infestations as they are transmitted by feco-oral route. Meat hygiene extends from selection of animals for slaughtering to cooking of meat at consumption level
- Veterinary perspective: Regular examination, serological tests, adequate treatment of essential in prevention of these zoonotic parasitic infestations in man
- Water safety: Proper purification of water at a larger scale as well as at domestic level helps in bringing down the burden of these illnesses
- Health education: Educating people regarding the burden, modes of transmission, consequences (Health and Socioeconomic), personal hygiene, environmental sanitation, meat processing, responsible ownership of animals
- Food-borne parasitic infestations have a larger hidden portion of iceberg. Thus there is a need to conduct, nationwide sero epidemiological studies for assessing the magnitude of these infestations
- Production of vaccines for these illnesses in both man and animals is another area of priority as there are no vaccines available for these illnesses.
| References|| |
Singh S, Munawwar A, Rao S, Mehta S, Hazarika NK. Serologic prevalence of Toxoplasma gondii in Indian women of child bearing age and effects of social and environmental factors. PLoS Negl Trop Dis 2014;8:e2737.
Rajshekhar V. Epidemiology of taenia solium taeniasis/cysticercosis in India and Nepal. Southeast Asian J Trop Med Public Health 2004;35:247-51.
Singh TS, Sugiyama H, Rangsiruji A. Paragonimus and paragonimiasis in India. Indian J Med Res 2012;136:192-204.
Ajjampur SS, Liakath FB, Kannan A, Rajendran P, Sarkar R, Moses PD, et al.
Multisite study of cryptosporidiosis in children with diarrhea in India. J Clin Microbiol 2010;48:2075-81.
Monthly Newsletter of National Centre for Disease Control, Directorate General of Health Services, Government of India . CD Alert Food Borne Dis 2009;13:1-12.