Risk-based inspection as a cost-effective strategy to reduce human exposure to cysticerci of Taenia saginata in low-prevalence settings

Background: Taenia saginata cysticercus is the larval stage of the zoonotic parasite Taenia saginata, with a life-cycle involving both cattle and humans. The public health impact is considered low. The current surveillance system, based on post-mortem inspection of carcasses has low sensitivity and leads to considerable economic burden. Therefore, in the interests of public health and food production efficiency, this study aims to explore the potential of risk-based and cost-effective meat inspection activities for the detection and control of T. saginata cysticercus in low prevalence settings. Methods: Building on the findings of a study on risk factors for T. saginata cysticercus infection in cattle in Great Britain, we simulated scenarios using a stochastic scenario tree model, where animals are allocated to different risk categories based on their age, sex and movement history. These animals underwent different types of meat inspection (alternative or current) depending on their risk category. Expert elicitation was conducted to assess feasibility of scenarios and provide data for economic analysis. The cost-effectiveness of these scenarios was calculated as an incremental cost-effectiveness ratio, using the number of infected carcasses detected as the technical outcome. Results: Targeting the high-risk population with more incisions into the heart while abandoning incisions into the masseter muscles was found to reduce the total number of inspections and cost, while simultaneously increasing the number of infected carcasses found. Conclusions: The results suggest that, under reasonable assumptions regarding potential improvements to current inspection methods, a more efficient and sensitive meat inspection system could be used on animals categorised according to their risk of harbouring T. saginata cysticercus at slaughter. Such a system could reduce associated cost to the beef industry and lower microbial contamination of beef products, improving public health outcomes.