Less common parasitic infections in Southeast Asia that can produce outbreaks

The culturally deeply rooted habit of eating raw or undercooked foodstuffs, coupled with inadequate hygiene practices and lack of separation between foodstuff and wildlife in parts of Southeast Asia have repeatedly led to outbreaks due to rare parasitic infections. Trichinellosis, capillariasis and angiostrongyliasis are the three prime examples of such outbreaks occurring in Southeast Asia. We review the current knowledge of trichinellosis, capillariasis and angiostrongyliasis. Whilst infections-caused by nematodes-are rarely reported, their public health importance is considerable. Regarding trichinellosis, the large body of literature arises from a few countries only, indicating that available information underestimates the true extent and burden of this disease. Changes in socio-economic conditions in Southeast Asia and control efforts at the animal-human interface resulted in changing patterns of transmission and outbreaks of trichinellosis. Capillariasis is mainly found in the Philippines and Thailand. However, health service providers are mostly unaware of this disease due to its sporadic occurrence, delaying its diagnosis and commonly leading to inappropriate treatment and control. Angiostrongyliasis is an emerging parasitic infection with a number of significant outbreaks reported recently, particularly in the People's Republic of China. Angiostrongyliasis causes severe neurological disease and specialised health services are required for prompt diagnosis and adequate patient management. There is a need to improve preventive measures, stronger collaboration between veterinary and public health cadres and rigorous surveillance to adequately tackle trichinellosis, capillariasis, angiostrongyliasis and other uncommon parasitic diseases that have been linked to outbreaks.