Human Transmission

Humans become infected with metagonimiasis by ingesting M. yokogawai metacercariae in infected fish. This occurs when infected fish that is under-cooked or pickled. This is because the pickling process does not kill the metacercarieae, although thorough cooking will kill them.

In non-endemic areas, including the United States, infection usually occurs when fish imported from an endemic area is under-cooked (including sushi dishes) or pickled. Such infections are known to have occurred in the United States.

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