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Public Health and Prevention Strategies for Gnathostomiasis

            Gnathostomiasis can be a painful and damaging parasitic infection. However, the frequency of human gnathostomiasis has relegated it to the proverbial backburner in the world of parasitology. Today, it is a minor problem in a global context, but when examined at a regional level, it demands attention. Localized primarily in Third World populations that consume raw or semi-cooked fish, poultry, or pork, many of the cases in the U.S. are due to travel or immigration. With increases in the movements of people and animals throughout various areas of the world, gnathostomiasis can be recognized as an emerging health concern. Because human hosts usually do not facilitate worm development to reproductive maturity and because the parasite cannot normally be transmitted person-to-person, primary concerns arise with the displacement of secondary and definitive hosts.

            The best strategy to prevent human gnathostomiasis is likely education. Indigenous peoples, migrants, and travelers with a proper understanding of safe cooking and eating practices are unlikely to acquire gnathostomiasis. Perhaps the most delicate aspect of gnathostomiasis awareness revolves around the preservation of cultural practices. Raw fish or meat are important to many traditional and culturally significant dishes in areas with high incidence of human gnathostomiasis (Ogata et al. 1998). Gnathostoma has been shown to persist in many species of animals and it is likely that any organism that feeds in or drinks freshwater containing the first intermediate host--Cyclops--will probably pick up a parasitic infection. Thus, the potential for substitution of different species of fish into traditional dishes is small. Although extermination of definitive hosts might be a way to solve the problem of gnathostomiasis, such a tactic is neither likely nor advisable as these animals are usually of significant ecological, economic, and emotional importance. The global distribution of Gnathostoma spinigerum suggests that human gnathostomiasis could be acquired in many places around the world. Differences in cultural food preparation practices may be the factor determining the current patterns of gnathostomiasis incidence around the world.

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