SCIENTIFIC OPINION ADOPTED: 25 October 2018 doi: 10.2903/j.efsa.2018.5495 Public health risks associated with food-borne parasites EFSA Panel on Biological Hazards (BIOHAZ), Kostas Koutsoumanis, Ana Allende, Avelino Alvarez-Ord  o ~ nez, Declan Bolton, Sara Bover-Cid, Marianne Chemaly, Robert Davies, Alessandra De Cesare, Lieve Herman, Friederike Hilbert, Roland Lindqvist, Maarten Nauta, Luisa Peixe, Giuseppe Ru, Marion Simmons, Panagiotis Skandamis, Elisabetta Suffredini, Simone Cacci  o, Rachel Chalmers, Peter Deplazes, Brecht Devleesschauwer, Elisabeth Innes, Thomas Romig, Joke van der Giessen, Michaela Hempen, Yves Van der Stede and Lucy Robertson Abstract Parasites are important food-borne pathogens. Their complex lifecycles, varied transmission routes, and prolonged periods between infection and symptoms mean that the public health burden and relative importance of different transmission routes are often difficult to assess. Furthermore, there are challenges in detection and diagnostics, and variations in reporting. A Europe-focused ranking exercise, using multicriteria decision analysis, identified potentially food-borne parasites of importance, and that are currently not routinely controlled in food. These are Cryptosporidium spp., Toxoplasma gondii and Echinococcus spp. Infection with these parasites in humans and animals, or their occurrence in food, is not notifiable in all Member States. This Opinion reviews current methods for detection, identification and tracing of these parasites in relevant foods, reviews literature on food-borne pathways, examines information on their occurrence and persistence in foods, and investigates possible control measures along the food chain. The differences between these three parasites are substantial, but for all there is a paucity of well-established, standardised, validated methods that can be applied across the range of relevant foods. Furthermore, the prolonged period between infection and clinical symptoms (from several days for Cryptosporidium to years for Echinococcus spp.) means that source attribution studies are very difficult. Nevertheless, our knowledge of the domestic animal lifecycle (involving dogs and livestock) for Echinoccocus granulosus means that this parasite is controllable. For Echinococcus multilocularis, for which the lifecycle involves wildlife (foxes and rodents), control would be expensive and complicated, but could be achieved in targeted areas with sufficient commitment and resources. Quantitative risk assessments have been described for Toxoplasma in meat. However, for T. gondii and Cryptosporidium as faecal contaminants, development of validated detection methods, including survival/infectivity assays and consensus molecular typing protocols, are required for the development of quantitative risk assessments and efficient control measures. © 2018 European Food Safety Authority. EFSA Journal published by John Wiley and Sons Ltd on behalf of European Food Safety Authority. Keywords: food-borne parasites, Cryptosporidium, Toxoplasma gondii, Echinococcus, public health risk, detection, control Requestor: European Food Safety Authority Question number: EFSA-Q-2017-00460 Correspondence: biohaz@efsa.europa.eu EFSA Journal 2018;16(12):5495 www.efsa.europa.eu/efsajournal