 In recent decades, regions with endemic diphyllobothriasis nihonkaiense have disappeared from Japan, though cases continue to be reported among urbanites who consume sushi or sashimi.In Kyoto, it is estimated that the average incidence in the past 20 years was 0.32 cases per 100,000 population per year, and that in 2008 was 1.0 case per 100,000 population, suggesting that "D. nihonkaiense" infection is equally as prevalent in Japan as "D. latum" is in some European countries.The disease is rare in the United States.