What About Me? Foodborne Parasites Often Get the Middle Child Treatment.

Despite posing a threat to human and a significant human medical concern, foodborne parasites often get left out.

Yes, E. coli and Salmonella flashy. And Vibrio is always in the news.

But what about foodborne parasites like Cryptosporidium or Trichinella? They need attention too. They too, can cause serious human illnesses.

Why Are Foodborne Parasites So Neglected?

Foodborne viral and bacterial infections are often diagnosed more quickly than their parasite counterparts. When ruling out an illness, these two categories are often thought of first.

But why?

Turns out, there may be a reason. It doesn’t make it better, but it does make some sense.

Here’s why.

Foodborne Parasites Usually Don’t Manifest as Acute Illnesses

For a parasite to survive, the host must also survive. For most parasitic infections, illness presents as a chronic problem. Slowly evolving from asymptomatic to symptoms with no discernible cause. The time between infection and discovery can also be quite long. This complicates finding the cause of the infection.

A parasitic infection will likely make the host sick enough to spread the illness. However, not debilitating enough to kill the host quickly.

A foodborne parasite infection is more like a marathon. A potentially long, arduous event needing extended recovery. Unless you know somebody in the race, most people don’t pay attention to it.

Whereas a foodborne viral or bacterial infection is more like a 5K walk/run with team outfits and a theme. Flashy, gets attention, and usually over quickly. Most active people can get back to daily life after a 5K race. However, the very young, the very old, and those with bodies not suited for the event can get knocked down by the activity.

Foodborne Parasites Often Occur in Underdeveloped Areas

Sadly, foodborne parasites are more likely to occur in underdeveloped areas. Populations that are more exposed to parasites are those where basic infrastructure, such as water supply, sanitation, and housing are inadequate.

These places are often ignored.

Diagnostic tests and treatments can be quite expensive for people already in survival mode. Without improvements to the living situation, infections become chronic and difficult to treat. Especially if access to medical care is scarce.

Foodborne Parasites Are Complicated

Foodborne parasites are complicated, much like the typical middle child.

First-borns are usually easy. Polite. Quiet. Gets things done.

The youngest is usually wild and in your face. You don’t have to look around for them. They make themselves known.

The middle child, much like foodborne parasites, are complicated. There is huge diversity.

Some foodborne parasites are protozoa. These organisms are often made up of a single cell and can only be seen with a microscope. Other foodborne parasites are worms. These worms can range in size from microscopic to easily visible with the naked eye. For example, a tapeworm can grow to several meters in length.

Lifecycles of foodborne parasites also vary. Certain parasites require a specific lifecycle stage to become infectious. Some may even require an intermediate host. These pathogens can also look very different depending on the stage they are in, making diagnosis quite difficult.

Common (And Not So Common) Foodborne Parasites

There are so many foodborne parasites. Some are more common than others. While not a complete list, here are a few of the more notable ones.

Cryptosporidium

Cryptosporidium is spore-forming microscopic parasite responsible for the diarrheal disease, cryptosporidiosis. Also known as “Crypto.”

There are several different morphologies that Crypto can present. First, it can be found as a spore. This spore has a protective outer shell that allows it to survive outside the body for long periods of time and protects it from a variety of disinfection methods. Including chlorine!

It is usually found in water and is a leading cause of human waterborne disease in the United States.

Echinococcus

Echinococcus granulosus are tiny tapeworms often around two to seven millimeters in length. The most common host is dogs. But they can also be found in sheep, goats, cattle, foxes, and pigs.

Humans become infected when the parasite is accidentally consumed in the soil, water of food that has come in contact with the fecal matter of infected dog.

Most of the time, human infection is asymptomatic. It does, however, cause what is known as a hydatid disease, creating slow-growing tumors in the liver, lungs, and other organs.

Trypanosoma or Chagas Disease

Trypanosoma cruzi, the parasite responsible for Chagas disease, is most commonly associated with the insect-borne transmission from triatomine “kissing” bugs. However, the feces from these insects often contain the parasite, Trypanosoma, and can infect people in multiple way.

Outbreaks of Chagas disease has been found when feces from these insects end up in food products, such as juices.

Chagas disease symptoms almost always involves a fever. Other common symptoms include swelling of the tissues on the leg or face (oedema), fluid buildup around the heart (pericardial effusion), abdominal pain, and muscle aches.

Trichinella

Trichinella spiralis is the most common parasite known to cause trichinellosis. However, other specifies have been known to infect wild animals. Most people acquire this disease from consuming raw or undercooked wild game or pork. Even small amounts, such as tasting or preparing can transmit the parasite to humans.

Symptoms of trichinellosis may vary. Abdominal symptoms, such as nausea, diarrhea, vomiting, and/or abdominal discomfort are often the first indication of infection. These symptoms usually appear within a few days of exposure.

Additional symptoms, such as headaches, fever, chills, cough, aching joints and muscle pains, face and eye swelling, itchy skin, and/or constipations may follow two to eight weeks later. Residual symptoms of fatigue, weakness, muscle pain, and diarrhea may go on for months.

In severe cases, patients may experience heart and breathing difficulties and have problems with coordination, or even die.

Many times, trichinellosis goes undiagnosed. Many of the symptoms are consistent with flu or other common illnesses. Specific antibody tests and sometimes a muscle biopsy is required for diagnosis.

Be Your Own Advocate

In some cases, you are forced to be your own advocate. Healthcare providers are used to the adage, when you hear hoof beats, think horses. Not zebras. But sometimes it is a zebra.

If you have risk factors, or believe you have been exposed to a parasite, scream like a middle child and throw a fit until you are heard. Specialized tests can provide an accurate diagnosis that may not come up in routine screening for non-specific symptoms.

While foodborne parasites may remain the middle child of the foodborne infectious diseases’ world, we haven’t forgotten about them.

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By: Heather Van Tassell (contributing writer, non-lawyer)