Human Papillomavirus Vaccination Strategies

with no adverse effects reported. One patient treated herself with albendazole (400 mg/day for 3 days) before she was seen at a hospital. All patients became asymptomatic and had negative stool examination results 2–10 weeks after treatment. None of the patients reported previous or subsequent consumption of raw freshwater fi sh. Raw fi sh preparations such as sushi, sashimi, carpaccio, and ceviche are increasingly popular and are now also prepared with local freshwater fi sh. These new food habits represent a clear risk factor for human infection (5,7). The plerocercoid larvae in the fi sh muscles are easily missed during food preparation. Nor are local fi sh systematically inspected, as imported fi sh are. The role of paratenic hosts (e.g., dogs, foxes) in transmission is not fully understood. Information given to the public and professionals such as food handlers, restaurant owners, and fi shermen is a key measure to promote safer food practices. Avoiding serving preparations of raw freshwater fi sh or selecting fi sh that are not intermediate hosts of D. latum would decrease parasite transmission. Cooking the fi sh at 55°C for 5 minutes effi ciently kills the larvae. Freezing the fi sh at –20°C for 24 hours is also effi cient. International regulations recommend freezing all fi sh that are expected to be served raw. Notable exceptions are fi sh from farm culture or from areas where strong evidence proves no source or cases of infection (European community rules 853/2004 annexe III, available from www.paquethygiene. com/reglement_ce_853_2004/reglements_ce_853_2004_du_parlement_ europeen_et_du_conseil_annexe_ 3_section_8.asp#debut). However, enforcing these rules proves very diffi cult for food safety administrations.