Food-borne intestinal trematode infections in the Republic of Korea.

In Southeast Asia, a total of 59 species of foodborne intestinal flukes have been known to occur in humans. The largest group is the family Heterophyidae, which constitutes 22 species belonging to 9 genera (Centrocestus, Haplorchis, Heterophyes, Heterophyopsis, Metagonimus, Procerovum, Pygidiopsis, Stellantchasmus, and Stictodora). The next is the family Echinostomatidae, which includes 20 species in 8 genera (Artyfechinostomum, Acanthoparyphium, Echinochasmus, Echinoparyphium, Echinostoma, Episthmium, Euparyphium, and Hypoderaeum). The family Plagiorchiidae follows the next containing 5 species in 1 genus (Plagiorchis). The family Lecithodendriidae includes 3 species in 2 genera (Phaneropsolus and Prosthodendrium). In 9 other families, 1 species in 1 genus each is involved; Cathaemaciidae (Cathaemacia), Fasciolidae (Fasciolopsis), Gastrodiscidae (Gastrodiscoides), Gymnophallidae (Gymnophalloides), Microphallidae (Spelotrema), Neodiplostomidae (Neodiplostomum), Paramphistomatidae (Fischoederius), Psilostomidae (Psilorchis), and Strigeidae (Cotylurus). Various types of foods are sources of human infections. They include freshwater fish, brackish water fish, fresh water snails, brackish water snails (including the oyster), amphibians, terrestrial snakes, aquatic insects, and aquatic plants. The reservoir hosts include various species of mammals or birds.The host-parasite relationships have been studied in Metagonimus yokogawai, Echinostoma hortense, Fasciolopsis buski, Neodiplostomum seoulense, and Gymnophalloides seoi; however, the pathogenicity of each parasite species and host mucosal defense mechanisms are yet poorly understood. Clinical aspects of each parasite infection need more clarification. Differential diagnosis by fecal examination is difficult because of morphological similarity of eggs. Praziquantel is effective for most intestinal fluke infections. Continued efforts to understand epidemiological significance of intestinal fluke infections, with detection of further human cases, are required.

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Foodborne Intestinal Flukes in Southeast Asia

In Lao PDR, detailed investigations on Opisthorchis viverrini are scarce. The objective was to document epidemiological features of O. viverrini infections in a highly endemic district. A random sample was selected (13 villages, 15 households/village, all household members aged >6 months). Clinical examinations, short interviews and stool examinations (Kato-Katz technique) were performed. Fish samples were dissected for the presence of metacercaria. In total, 814 persons were enrolled (median age 16 years, 51.5% women). The prevalence was 58.5%. Infection rates increased with age (from 20.0 to 85.5%; P<0.001). Intensity of infection and the habit of consuming insufficiently cooked fish also increased with age. Of the study participants, 75.2% reported cooking fish insufficiently. Of the 23 different species of cyprinoid fish consumed in the study villages, 20 species were infected. At the village level, the prevalence of raw fish consumption was strongly associated with the infection status of O. viverrini (r=0.76, P=0.003). At individual level, age, the consumption of insufficiently cooked fish, and the absence of sanitation were strongly associated. The disease associated with O. viverrini infection needs to be assessed in order to develop and conduct adequate interventions.

Epidemiology of Opisthorchis viverrini in a rural district of southern Lao PDR

The prevalence of fish-borne trematodes (FBT), including Clonorchis sinensis, is still high in riverside areas of the Republic of Korea. The author reviewed the detection and identification methods, differential keys, fish intermediate hosts, and morphological characteristics of FBT metacercariae. FBT metacercariae found in freshwater fish are classified mainly into 4 families, i.e., Opisthorchiidae, Heterophyidae, Echinostomatidae, and Clinostomidae. The metacercariae of C. sinensis, found in 40 species of freshwater fish, are elliptical and 0.15-0.17 × 0.13-0.15 mm in size, have nearly equal sized oral and ventral suckers, brownish pigment granules, and an O-shaped excretory bladder. Their general morphologies are similar to those of Metorchis orientalis (except in the thickness of the cyst wall). Metagonimus spp. (M. yokogawai, M. takahashii, and M. miyatai) metacercariae are subglobular or disc-shaped, and 0.14-0.16 mm in diameter. They have yellow-brownish pigment granules, a ventral sucker deflectively located from median, and a V-shaped excretory bladder. The metacercariae and fish intermediate hosts of Centrocestus armatus, Clinostomum complanatum, and 3 echinostomatid flukes (Echinostoma hortense, E. cinetorchis, and Echinochasmus japonicus) were summarized. FBT metacercariae detected in brackish water fish are mainly members of the Heterophyidae. The morphological characters, identification keys, and fish intermediate hosts of 7 species (Heterophyes nocens, Heterophyopsis continua, Pygidiopsis summa, Stellantchasmus falcatus, Stictodora fuscata, Stictodora lari, and Acanthotrema felis) were also reviewed. The contents treated in this study will provide assistance at the laboratory bench level to those working on recovery of metacercariae from fish hosts and identifying them.

http://www.parasitol.kr/upload/pdf/kjp-47-S103.pdf

Fish-borne Zoonotic Trematode Metacercariae in the Republic of Korea

Ten species of the trematode family Heterophyidae (Metagonimus yokogawai, M. takahashii, Heterophyes nocens, H. heterophyes, H. dispar, Heterophyopsis continua, Pygidiopsis summa, Stellantchasmus falcatus, Centrocestus armatus and Stictodora fuscatum), and 3 species of the family Echinostomatidae (Echinostoma hortense, E. cinetorchis and Echinochasmus japonicus) have been found to infect humans in Korea. Biological and epidemiological studies on the above species have shown that Metagonimus, heterophyids and echinostomes are all prevalent indigenously in Korea except H. heterophyes and H. dispar, of which the human cases were infected when they came to the Middle East. Various kinds of fish have been proven to be the source of human infection with these flukes. For example, fresh water fish such as the sweetfish, carp, loach, etc., were found to carry the metacercarial stage of M. yokogawai, M. takahashii, C. armatus, E. hortense, E. cinetorchis and/or E. japonicus. Brackish water fish such as the mullet, perch and goby, were verified to be the second intermediate host of H. nocens, H. continua, P. summa, S. falcatus and/or S. fuscatum. Among the intestinal flukes, M. yokogawai is the most prevalent species in Korea.

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Intestinal trematodes of humans in Korea: Metagonimus, heterophyids and echinostomes.

In an attempt to clarify the epidemiological feature of distomiasis in Tongjin riverside area, the prevalence of distomiasis in the residents and infection rates of the metacercariae in fresh-water fishes were investigated at the upper, middle and lower reaches of the river from January to April 1984. The results obtained were summarized as follows: Out of a total of 931 fresh-water fishes which composed of 33 different species, 611 fishes (65.6 %) of 31 species were found positive with digenetic trematode metacercariae of 16 different species, and there were some differences in infection rates of the metacercariae among the fishes in the 3 parts of the river; 53.8 percent in upper, 80.7 % in middle, and 61.0 % in lower reaches, respectively. Infection rates of the metacercariae of Exorchis oviformis, Metagonimus yokogawai, Echinochasmus japonicus, Metorchis orientalis and Clonorchis sinensis in the fishes were 48 %, 29 %, 11 %, 7.9 % and 6.3 %, respectively. The average number of the encysted larvae of Clonorchis found in fish body/gram showed 4.44 in Pseudorasbora parva, Gnathopogon coreanus (1.2), Microphysogobio yaluensis(0.76), Abbottina springeri(0.4), Acanthorhodeus asmussi (0.21) and Cultriculus eigenmanni (0.17), respectively. The average number of the metacercariae of Metagonimus found in fish body/gram disclosed 34.01 in Zacco platypus, Zacco temmincki (16.46), Carassius carassius (5.35), Moroco oxycephalus (1.54), Aphyocypris chinensis (1.5) and etc., respectively. Detection rates of the eggs of Clonorchis and Metagonimus among residents were 1.1 % and 0.8 %, respectively, out of a total 923 persons.

[Survey On Encysted Cercaria Of Trematodes From Fresh-Water Fishes In Tongjin Riverside Areas In Korea]

In order to clarify infestation pattern for the encysted larvae of digenetic trematodes from fresh-water fishes, this survey was carried out from March to September, 1983. A total of 380 fishes of 32 species were collected with netting at the three reaches, upper, middle and lower in Mangyeong riverside area. After the fishes were dissected into small scraps, they were pressed under cover glass and examined for the presence of those of digenetic trematodes with a microscope. The results obtained were as follows: Out of a total of 380 fishes inspected, 320 fishes (84 %) from 31 species were found positive with digenetic trematode metacercariae; more than 10 species of the metacercariae were detected in Pseudorasbora parva; Gnathopogon majimae, Microphysogobio yaluensis, Cultriculus eigenmanni and Gnathopogon coreanus (more than 8 species); Aphyocypris chinensis(8 species) and etc. respectively. Clonorchis sinensis metacercariae were found positive from 93 fishes (25 %) from 12 species detection rates in other species of digenetic trematode metacercariae from various fishes were; Exorchis oviformis, 261 fishes (57 %) from 28 species; Cyathocotyle orientalis, 47 fishes (12 %) from 12 species; Metorchis orientalis, 21 fishes (6 %) from 12 species; Metagonimus yokogawai, 164 fishes (43 %) from 26 species; Pseudexorchis major, 71 fishes (19 %) from 18 species; Metacercaria hasegawai, 77 fishes (20 %) from 25 species; Centrocestus armatus, 24 fishes (6 %) from 7 species; Echinochasmus japonicus, 2 fishes (0.5 %) from 2 species, and unidentified species, 34 fishes (9 %) from 15 species respectively. The sums of average number of the encysted larvae of all species found in fish body/gram showed 83 in P. parva, Cobitis taenia (74.2), A. chinensis (28.5), Pseudoperilampus uyekii (26.6), G. majimae (19.6) and etc. respectively and the average peak number of each metacercaria in fish body/gram showed 21.7 C. sinensis, 24 E. oviformis, 15.3 M. orientalis and 6.1 E. japonicus in P. parva; 42.7 C. orientalis and 25.1 M. yokogawai in C. taenia; 8.3 C. armatus and 8.3 M. hasegawai in P. uyekii; 6.3 P. major in Carassius carassius, and 2.9 unidentified species in G. majimae respectively.

[Survey On Encysted Cercariae Of Trematodes From Fresh-Water Fishes In Mangyeong Riverside Area]

In order to judge appropriately the suitability as the second intermediate host of Clonorchis sinensis, the present experiments were proposed to survey the metacercaria of C. sinensis in the fish host, Cultriculus eigenmanni, in the field, and to observe, by experimental infection of the fish with Clonorchis cercaria, the penetrating ability of the cercaria, maturity, the process of degeneration and extinction, and infectivity of the metacercaria. The following is a brief summary of the leading facts gained through the experiments. All the ten fish (mean body weight 13.4 +/- 3.43g) which were caught in Ok-ku irrigation reservoir were infected with the metacercariae and the average number of the metacercariae found in the fish body/gram was 4.55. The fish was easily subject to invasion of the cercaria, and the examination of the cercariae after having the fish infected disclosed that 24 hours after the infection, all of the cercariae formed their cysts in muscle and the metacercariae kept growing, that 7 days later the metacercariae were found folding their bodies twice, and that in 15 days the characteristic structure of the metacercariae was complete and made a vigorous rotary movement intermittently. In the case of control fish, Pseudorasbora parva, both penetrating ability of the cercariae and the infective degree of the metacercariae to control host were stronger as compared with the fish host because that the control fish had higher suceptibility to C. sinensis. Afterwards, the metacercariae in the fish host came to a state of maturity and beyond this stage some metacercariae started the process of degeneration and extinction in as early as 30 days, and as more days elapsed, mortality of the metacercariae was not uniformly increased but difference of mortality appeared to be according to the individual of fish host. That is, in 390, 540 and 586 days, all of the metacercariae in the fish hosts became dead, meanwhile almost all of those found in the fish host of 596 days after the infection survived (mortality; 8.51 percent). Percentage of orally administered metacercariae developing to maturity in rabbit is 10.46 percent in the last case. As the days were progressed the shapes of the metacercariae in the fish host tended to change from ellipsoid to almost round shapes, the length became shorter while the width was wider. The results shown above revealed that C. eigenmanni was, though it could not be proper host than P. parva, suitable as the second intermediate host in addition to our previous observation results.

[Experimental studies on the second intermediate hosts of Clonorchis sinensis IV. Observations on the fate of metacercariae of Clonorchis sinensis in the fish host, Cultriculus eigenmanni]

Ho Il Lee

Papers

[Survey On Encysted Cercaria Of Trematodes From Fresh-Water Fishes In Tongjin Riverside Areas In Korea]

[Survey On Encysted Cercariae Of Trematodes From Fresh-Water Fishes In Mangyeong Riverside Area]

[Experimental studies on the second intermediate hosts of Clonorchis sinensis IV. Observations on the fate of metacercariae of Clonorchis sinensis in the fish host, Cultriculus eigenmanni]