Potential for Emergence of Foodborne Trematodiases Transmitted by an Introduced Snail (Melanoides tuberculata) in California and Elsewhere in the United States

We document that 3 human-infectious trematodes and their introduced first intermediate host snail (Melanoides tuberculata) are widespread throughout southern California. We surveyed 41 fishing localities, 19 of which harbored snails infected with zoonotic trematodes. Two of the parasites, Haplorchis pumilio and Centrocestus formosanus, are fishborne intestinal trematodes recognized as being important human pathogens in other areas of the world; the third, Philophthalmus gralli, can infect the human eye. An additional 5 species detected infecting M. tuberculata are likely of little direct threat to people; however, they may be recently introduced to the Americas, highlighting the risk that additional pathogenic trematodes transmitted by the snail in its native range could be introduced to the United States. The current, possible human-infection risk in California clarifies the need to consider the introduced snail and its parasites from a public health perspective anywhere in the United States the snail has been introduced. Lay Summary We report that 3 human-infecting trematodes and their introduced intermediate host snail are widespread in southern California freshwater fishing localities. Eating undercooked or underfrozen fish is the way people get infected by 2 of the parasite species, which are recognized as important human pathogens in other areas of the world. We also found 5 non-human-infectious trematodes carried by the snail that may be cointroduced, highlighting the possibility that other dangerous pathogens transmitted by the snail where it is native could arrive later or already be present in the United States. The common presence of the human-infecting fishborne trematodes at fishing localities, the widespread popularity of eating uncooked fish (eg, as sashimi, sushi, poke, or ceviche), and the potential for additional human-infecting trematodes to also be introduced, all justify consideration of the introduced snail and its parasites from a public health perspective in California and other areas in the United States where the parasites or the host snail have already been reported. Three human-infecting (zoonotic) trematodes and their introduced intermediate host snail (Melanoides tuberculata) are widespread in southern California and already reported elsewhere in the United States, warranting consideration from a public health perspective.