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- Cestode (tapeworm) parasite, found worldwide, but concentrated in certain endemic areas.
- The most important fish-borne zoonosis with complex 3-host life cycle:
- Eggs ingested by crustacean and form first larval stage → crustacean ingested by a freshwater fish where plerocercoid (second larval stage) develops → humans contract infection by eating raw or undercooked freshwater fish, and the parasite matures rapidly in the intestine [ Figure 1].
- Major species is Diphyllobothrium latum (especially U.S. Great Lakes region and Alaska, Scandinavia, Russia), D. nihonkaiense (Japan), D. pacificum (Pacific coast of South America).
- Cases also reported after eating imported fish.
- At least 10 other species reported occasionally in humans.