Genus Paragonimus Research Articles

Paragonimiasis.

Paragonimiasis is a zoonotic disease caused by lung flukes of the genus Paragonimus. Humans usually become infected by eating freshwater crabs or crayfish containing encysted metacercariae of these worms. However, an alternative route of infection exists: ingestion of raw meat from a mammalian paratenic host. Adult worms normally occur in pairs in cysts in the lungs from which they void their eggs via air passages. The pulmonary form is typical in cases of human infection due to P. westermani, P. heterotremus, and a few other species. Worms may occupy other sites in the body, notably the brain, but lung flukes have made their presence felt in almost every organ. Ectopic paragonimiasis is particularly common when infection is due to members of the P. skrjabini complex. Human paragonimiasis occurs primarily in the tropics and subtropics of Asia, Africa, and the Americas, with different species being responsible in different areas (Table 6.1).

Risk factors and clinical features for pulmonary paragonimiasis-associated pneumothorax.

Pulmonary paragonimiasis, a food-borne zoonotic helminthiasis, is a parasitic disease of the lung caused by infection with trematodes species of the genus Paragonimus. Although pneumothorax has been reported as occuring with paragonimiasis, to date no study has been performed concerning the clinical features and predictive risk factors for this condition. This retrospective study, which aims to fill this gap, was conducted at Jeonbuk National University Hospital. All patients (aged ≥19 years) were diagnosed with paragonimiasis between May 2011 and December 2021. Medical records were reviewed and information concerning age, sex, vital signs, underlying diseases, clinical signs and symptoms, laboratory findings, radiologic findings, treatment, and clinical outcomes was collected. An odds ratio (OR) for the risk factors associated with pneumothorax was calculated using the binary logistic regression model. Among 179 consecutive patients diagnosed with pulmonary paragonimiasis, the postive rate of pneumothorax was 10.6% (19/179). Pneumothorax occurred mostly in the right lung (78.9%, 15/19), and intrapulmonary parenchymal lesions showed an ipsilateral relationship with pneumothorax (94.7%, 18/19). Fifteen patients (78.9%, 15/19) of pneumothorax associated with pulmonary paragonimiasis are accompanied by pleural effusion. Most of patients with pneumothorax (89.5%, 17/19) underwent chest tube insertion as a first treatment. Three patients (15.8%) showed relapses but in no case was a death recorded. Asthma (odds ratio [OR] 8.10, 95% confidence interval [CI] 1.43-45.91), chest pain (OR 8.15, 95% CI 2.70-24.58), and intrapulmonary lesions (OR 8.94, 95% CI 1.12-71.36) were independent risk factors for pulmonary paragonimiasis-associated pneumothorax. Our findings suggest that clinicians should keep in mind the possibility of pneumothorax when approached by patients with pulmonary paragonimiasis complaining of chest pain, accompanied by intrapulmonary lesions or with asthma as an underlying disease.

Mitogenomic and nuclear ribosomal transcription unit datasets support the synonymy of Paragonimus iloktsuenensis and P. ohirai (Paragonimidae: Platyhelminthes).

The complete mitogenome (mtDNA) of nominal Paragonimus iloktsuenensis (Paragonimidae: Trematoda) and the nuclear ribosomal transcription unit (rTU) coding region (rTU*: from 5'-terminus of 18S to 3'-terminus of 28S rRNA gene, excluding the external spacer region) of this species and of P. ohirai were obtained and used to further support the previously suggested synonymy of these taxa in the P. ohirai complex. The complete mitogenome of P. iloktsuenensis was 14,827bp long (GenBank: ON961029) and nearly identical to that of P. ohirai (14,818bp; KX765277), with a 99.12% nucleotide identity. The rTU* was 7543bp and 6932bp in these two taxa, respectively. All genes and spacers in the rTU were identical in length, with exception of the first internal transcribed spacer, which contained multiple tandem repeat units (6.7 for P. iloktsuenensis and 5.7 for P. ohirai). There was near 100% identity for the rTU genes. The phylogenetic topology inferred from the mtDNA and from individual gene regions (partial cox1 of 387bp and the ITS-2 of 282bp - 285bp) indicated a very close relationship consistent with synonymy of P. iloktsuenensis and P. ohirai. The datasets provided here will be useful for taxonomic reappraisal as well as studies of evolutionary and population genetics of the genus Paragonimus and family Paragonimidae.

A Cluster of Paragonimiasis with Delayed Diagnosis Due to Difficulty Distinguishing Symptoms from Post-COVID-19 Respiratory Symptoms: A Report of Five Cases

Paragonimiasis caused by trematodes belonging to the genus Paragonimus is often accompanied by chronic respiratory symptoms such as cough, the accumulation of sputum, hemoptysis, and chest pain. Prolonged symptoms, including respiratory symptoms, after coronavirus disease 2019 infection (COVID-19) are collectively called post-COVID-19 conditions. Paragonimiasis and COVID-19 may cause similar respiratory symptoms. We encountered five cases of paragonimiasis in patients in Japan for whom diagnoses were delayed due to the initial characterization of the respiratory symptoms as a post-COVID-19 condition. The patients had consumed homemade drunken freshwater crabs together. One to three weeks after consuming the crabs, four of the five patients were diagnosed with probable COVID-19. The major symptoms reported included cough, dyspnea, and chest pain. The major imaging findings were pleural effusion, pneumothorax, and nodular lesions of the lung. All the patients were diagnosed with paragonimiasis based on a serum antibody test and peripheral blood eosinophilia (560-15,610 cells/μL) and were treated successfully with 75 mg/kg/day praziquantel for 3 days. Before diagnosing a post-COVID-19 condition, it is necessary to consider whether other diseases, including paragonimiasis, may explain the symptoms. Further, chest radiographic or blood tests should be performed in patients with persistent respiratory symptoms after being infected with COVID-19 to avoid overlooking the possibility of infection.

Origins, phylogenetic relationships and host-parasite interactions of Troglotrematoidea since the cretaceous

In the current study, we raise the issue concerning origins and historical relationships of the trematodes from the families Troglotrematidae and Paragonimidae using phylogenetic analysis and molecular-clock method for estimating evolutionary rates. For the first time we provided 28S rRNA gene fragment (1764bp) for the type species Troglotrema acutum - zoonotic trematodes that cause cranial lesions (troglotremiasis) in mustelid and canid mammals of the Central Europe, Iberian Peninsula, and North-West Caucasus. Molecular genetic analysis revealed that T. acutum belongs to the monophyletic family Troglotrematidae sister with the family Paragonimidae. The family Troglotrematidae includes five genera: Nanophyetus, Troglotrema, Skrjabinophyetus, Nephrotrema, and Macroorchis; and the family Paragonimidae is monotypic including the only genus Paragonimus. We recover the superfamily Troglotrematoidea for these two families. Divergence of the common ancestor of the superfamily Troglotrematoidea (common troglotrematoid ancestor) likely occurred during the Cretaceous period of the Mesozoic Era and potentially originated in the Asiatic region. The lineage of the family Troglotrematidae is much closer to the common troglotrematoid ancestor than the species of the family Paragonimidae. The radiation time of the common troglotrematoid ancestor (126Ma, the Early Cretaceous), and formation of the families Troglotrematidae and Paragonimidae (96Ma and 73Ma respectively, the Late Cretaceous) corresponds to the time of settling in East Asia by many species of mammaliaforms (about 130-70Ma).

Molecular identification of the trematode P. ichunensis stat. n. from lungs of siberian tigers justified reappraisal of Paragonimus westermani species complex.

Flukes from the genus Paragonimus Braun, 1899 are medically important foodborne trematodes predominantly occurring throughout Asian countries. Providing molecular genetic characteristics based on ITS2 and partial 28S rDNA of the paragonimids from the Russian Far East, Northeast, South, and Southeast Asian countries, we performed a partial reappraisal of Paragonimus westermani species complex. Members of this complex are genetically distinct worms with different divergence times and explosive expansion during Miocene-Pliocene epochs. We confirm the taxonomic status as valid species for P. ichunensis stat. n. (from the Russian Far East and Northern China), and P. filipinus (from the Philippines), which were previously considered subspecies of P. westermani, and reinstated the species name P. pulmonalis (from Japan). We suggest considering the worms from South Korea the Korean variety of P. ichunensis, because Korean specimens are sister and genetically closest to P. ichunensis from Northeast China and Primorsky region of Russia. Worms from South (India (type 2), Sri Lanka), Southeast (Malaysia, Vietnam, Thailand (types 1 and 2)) and East Asia (Taiwan) were left in the paragonimid systematics as Paragonimus sp. We propose to consider Indian worms of type 1 as true P. westermani, but in further revisions, due to the lack of holotype and unknown exact type locality, new type specimens (neotype) should be established.

Trematode Infection in a Freshwater Snail Hydrobioides Nassa (Gastropoda: Bithyniidae) in Thailand.

Summary1,024 individuals of Hydrobioides nassa were collected from 12 different localities in eight provinces from north, west, and central regions of Thailand. The infection of parasitic trematodes was investigated using shedding and crushing methods to search for cercariae and metacercariae. Trematode infection was found at a relatively low prevalence of 5.57%. Five different morphological types of cercariae were detected; xiphidio, monostome, mutabile, ophthalmoxiphidio, and microcercous, and three different morphological types of unknown metacercariae were observed. Microcercous cercariae of the lung fluke genus Paragonimus is reported here for the first time in a bithyniid snail. Our current finding show that H. nassa can serve as intermediate host for a range of parasitic trematodes in Thailand.

Co-infection Paragonimiasis-pulmonary Tuberculosis Discovered from a Man in Abidjan, Côte d’Ivoire: Case Report

Introduction: Paragonimiasis is a very uncommon zoonosis in sub-Saharan Africa. It is a trematodial disease contracted by eating fresh or undercooked crustaceans harboring a parasite of the genus Paragonimus. About fifteen species of Paragonimus are pathogenic to humans. In Africa, three species are frequently encountered: Paragonimus africanus, Paragonimus uterobilatéralis, and Paragonimus westermani. Clinically, it has similarities with pulmonary tuberculosis so that confusion is quickly made. Case Report: We report here a case of paragonimiasis discovered incidentally in a security guard man, 26 years old, originated from Côte d’Ivoire, who consulted in 2019 to the Medical Teaching Hospital of Cocody, for hemoptysis under a chronical mode. Results: After examination, the disease of paragonimiasis was diagnosed by positive direct smear. Otherwise, patient was positive to TB after a molecular test. An anti-tuberculosis cure was proposed, and a treatment with praziquantel 600 mg (2 tabs x3 / d for 4 days) allowed us to obtain biological cure without major side effects for paragonimiasis. Conclusion: The diagnostic issues of paragonimiasis constitute a great challenge for health systems already weakened by the instability due to covid-19 pandemic. The insufficient resources allocated to the health sector showing the lack of integration of the diagnostics of paragonimiasis to pulmonary tuberculosis program are crucial. The strengthening of human resources, as well as the improvement of the technical platform of reference laboratories in regions, are really needed.

The effect of landscape and human settlement on the genetic differentiation and presence of Paragonimus species in Mesoamerica

Foodborne diseases are a neglected research area, and despite the existence of many tools for diagnosis and genetic studies, very little is known about the effect of the landscape on the genetic diversity and presence of parasites. One of these foodborne disease is paragonimiasis, caused by trematodes of the genus Paragonimus, which is responsible for a high number of infections in humans and wild animals. The main Paragonimus sp reported in Mesoamerica is Paragonimus mexicanus, yet there are doubts about its correct identification as a unique species throughout the region. This, together with a lack of detailed knowledge about their ecology, evolution and differentiation, may complicate the implementation of control strategies across the Mesoamerican region. We had the goal of delimiting the species of P. mexicanus found throughout Mesoamerica and determining the effect of landscape and geology on the diversity and presence of the parasite. We found support for the delimitation of five genetic groups. The genetic differentiation among these groups was positively affected by elevation and the isolation of river basins, while the parasite’s presence was affected negatively only by the presence of human settlements. These results suggest that areas with lower elevation, connected rivers basins, and an absence of human settlements have low genetic differentiation and high P. mexicanus presence, which may increase the risk of Paragonimus infection. These demonstrate the importance of accurate species delimitation and consideration of the effect of landscape on Paragonimus in the proposal of adequate control strategies. However, other landscape variables cannot be discarded, including temperature, rainfall regime, and spatial scale (local, landscape and regional). These additional variables were not explored here, and should be considered in future studies.

Dynamic transcriptome landscape of Paragonimus proliferus developmental stages in the rat lungs

Paragonimus proliferus, a lung fluke of the genus Paragonimus, was first reported in Yunnan province, China. P. proliferus can infect Sprague-Dawley (SD) rats and cause lung damage, but there is still no direct evidence of human infection. Until now, there has been a lack of studies on P. proliferus parasitism and development in mammalian lung tissue. The aim of this study was to perform transcriptomic profiling of P. proliferus at different developmental stages. SD rats were infected with P. proliferus metacercariae obtained from crabs; worms isolated from the lungs at different time points as well as metacercariae were subjected to whole transcriptome sequencing. Overall, 34,403 transcripts with the total length of 33,223,828 bp, average length of 965 bp, and N50 of 1833 bp were assembled. Comparative analysis indicated that P. proliferus, similar to other Paragonimus spp., expressed genes related to catabolism, whereas P. proliferus-specific transcripts were related to the maintenance of cellular redox homeostasis, sensitivity to bacteria, and immune response. Transcriptional dynamics analysis revealed that genes involved in the regulation of catabolism and apoptosis had stable expression over the P. proliferus life cycle, whereas those involved in development and immune response showed time-dependent changes. High expression of genes associated with immune response corresponded to that of genes regulating the sensitivity to bacteria and immune protection. We constructed a P. proliferus developmental model, including the development of the body, suckers, blood cells, reproductive and tracheal systems, lymph, skin, cartilage, and other tissues and organs, and an immune response model, which mainly involved T cells and macrophages. Our study provides a foundation for further research into the molecular biology and infection mechanism of P. proliferus.

Genetic differentiation of Southeast Asian Paragonimus Braun, 1899 (Digenea: Paragonimidae) and genetic variation in the Paragonimus heterotremus complex examined by nuclear DNA sequences.

Southeast Asian lung flukes, the causative agents of human and animal paragonimiasis, comprise at least 14 species. Of these, seven species; Paragonimus bangkokensis, P. harinasutai, P. macrorchis, P. siamensis, P. westermani, P. heterotremus and P. pseudoheterotremus were studied. Two regions of domain 1 of taurocyamine kinase; TkD1 (exon) and TkD1Int2 (intron 2), were used as genetic markers for elucidating their genetic differentiation, genetic variation, and heterozygosity. The TkD1 region was conserved between these species but can potentially be used to differentiate all seven species. However, the TkD1Int2 region had a high level of polymorphism, which is suitable for investigation of genetic variation within or between closely related species, especially P. heterotremus and P. pseudoheterotremus as well as for a phylogenetic analyses of the genus Paragonimus. Heterozygosity was mostly observed in DNA samples extracted from adult P. heterotremus including samples taken from sputum of paragonimiasis patients, whereas DNA extracted from metacercariae was not, except in the samples from Myanmar. Our findings provide evidence of DNA recombination and incomplete lineage sorting of P. heterotremus and P. pseudoheterotremus in TkD1Int2, which suggesting gene flow between these two species.

Using a controversy about health, biology, and indigenous knowledge to promote undergraduates’ awareness of the importance of respecting the traditions and beliefs of indigenous communities: the case of paragonimiasis in Colombia

Paragonimiasis is an illness that involves both humans and animals. It is caused by parasites from the genus Paragonimus (Trematoda: Troglotrematidae). The illness is endemic to tropical and subtropical countries in Asia, Africa, and America, with different species being responsible in different areas. In Colombia, members of the Indigenous Embera community become infected when they eat raw crustaceans which contain the metacercarian form of the parasite, which lives in the lungs, leading to hemoptysis (bloodstained phlegm in the lungs). Eating raw crustaceans is part of the Embera traditions and beliefs. This article describes the effect of a teaching–learning sequence (TLS) based on a controversy about health, biology, and indigenous knowledge (IK) in promoting undergraduates’ awareness of the importance of respecting the traditions and beliefs of indigenous communities. It examines the written and oral arguments produced by 120 university students (59 females and 61 males, 16–28 years old) in Colombia during a complete TLS supervised by the same instructor. The data used in this analysis were derived from students’ written responses and audio recordings. The first aim of this study was to provide evidence that a controversial issue combining health, biology, and IK could be used to promote students’ awareness of the importance of respecting the traditions and beliefs of indigenous communities. The second objective was to assess the effectiveness of the TLS to engage students in argumentative classroom interactions (such as debates) relating to a controversial issue. The findings show that this issue can be useful for promoting undergraduates’ awareness of the importance of respecting the traditions and beliefs of indigenous communities.

Development of point-of-care testing tool using immunochromatography for rapid diagnosis of human paragonimiasis

Paragonimiasis, an important food-borne zoonosis, is caused by lung flukes of the genus Paragonimus. Several million people are actually infected or at risk. Paragonimiasis is a re-emerging disease in developing countries. Diagnosis of pulmonary paragonimiasis is made by finding eggs in sputa and/or fecal samples. Eggs are typically not found in ectopic paragonimiasis cases, so diagnosis depends on supportive information, such as a history of eating fresh water crabs or crayfishes, radiographic findings and immunological tests. Here, a new point-of-care-testing (POCT) tool is presented. It uses immunochromatography for serodiagnosis of human paragonimiasis using excretory-secretory antigen from Paragonimus heterotremus. It proved effective in diagnosing infections due to P. heterotremus, and was also successfully diagnosed with sera from infections with P. westermani and P. miyazakii. The diagnostic sensitivity, specificity, positive and negative predictive values and accuracy were 97.9%, 87.6%, 78%, 98.9%, and 90.8%, respectively. The developed POCT tool is rapid and simple to use not only for clinical diagnosis of paragonimiasis at the bedside or at well-equipped laboratories, but also at local and remote hospitals with limited facilities. Moreover, the POCT tool could be applied for epidemiological surveys of paragonimaisis in Asia where P. heterotremus, P. westermani and P. miyazakii are endemic.

The complete mitochondrial genome of Paragonimus ohirai (Paragonimidae: Trematoda: Platyhelminthes) and its comparison with P. westermani congeners and other trematodes.

We present the complete mitochondrial genome of Paragonimus ohirai Miyazaki, 1939 and compare its features with those of previously reported mitochondrial genomes of the pathogenic lung-fluke, Paragonimus westermani, and other members of the genus. The circular mitochondrial DNA molecule of the single fully sequenced individual of P. ohirai was 14,818 bp in length, containing 12 protein-coding, two ribosomal RNA and 22 transfer RNA genes. As is common among trematodes, an atp8 gene was absent from the mitogenome of P. ohirai and the 5′ end of nad4 overlapped with the 3′ end of nad4L by 40 bp. Paragonimusohirai and four forms/strains of P. westermani from South Korea and India, exhibited remarkably different base compositions and hence codon usage in protein-coding genes. In the fully sequenced P. ohirai individual, the non-coding region started with two long identical repeats (292 bp each), separated by tRNAGlu. These were followed by an array of six short tandem repeats (STR), 117 bp each. Numbers of the short tandem repeats varied among P. ohirai individuals. A phylogenetic tree inferred from concatenated mitochondrial protein sequences of 50 strains encompassing 42 species of trematodes belonging to 14 families identified a monophyletic Paragonimidae in the class Trematoda. Characterization of additional mitogenomes in the genus Paragonimus will be useful for biomedical studies and development of molecular tools and mitochondrial markers for diagnostic, identification, hybridization and phylogenetic/epidemiological/evolutionary studies.

Parasitic pneumonia caused by Paragonimus spp. in a wild Royal Bengal Tiger, Mysuru, South India.

Parasitic pneumonia induced by genus Paragonimus involves many species, which affects both humans and animals and it is a food borne zoonotic disease. In this report, we have described the gross and histopathological findings of Paragonimus fluke infection in lungs of tiger. The postmortem examination of sub adult male wild tiger (Panthera tigris tigris) died in captivity was conducted, earlier which was rescued by Forest Department, Mysuru, Karnataka, India. External examination of carcass revealed pale oral and conjunctival mucous membranes with sunken eye balls. During necropsy, moderate congestion, consolidation and numerous transparent to dark encysted lesions were found in the parenchyma of all lobes of lungs visible grossly on pleural surface. Lungs were hemorrhagic with necrotic foci around the cysts. The incision of encysted lesions revealed the presence of flukes (2-3 in numbers) in each cyst with brownish exudate. The lung tissues with lesions were collected in 10% formalin and haematoxylin and eosin staining was done for histopathological evaluation. The flukes were identified as Paragonimus spp. based on the morphology and micrometry. The histopathological examination revealed presence of longitudinal sections of flukes in bronchial lumen (in pair) with tegument and tegumental spines surrounded by connective tissue capsule as cystic encapsulation and numerous eggs in adjacent lung parenchyma. Necrosis and moderate fibrosis of lung parenchyma with infiltration of polymorphonuclear and mononuclear inflammatory cells were observed around fluke as well as eggs. The squamous cell metaplasia of lining bronchial epithelium and atelectasis of alveoli were also prominently seen.

Paragonimiasis.

Paragonimiasis is a zoonotic disease caused by lung flukes of the genus Paragonimus. Humans usually become infected by eating freshwater crabs or crayfish containing encysted metacercariae of these worms. However, an alternative route of infection exists: ingestion of raw meat from a mammalian paratenic host. Adult worms normally occur in pairs in cysts in the lungs from which they void their eggs via air passages. The pulmonary form is typical in cases of human infection due to P. westermani, P. heterotremus, and a few other species (Table 5.1). Worms may occupy other sites in the body, notably the brain, but lung flukes have made their presence felt in almost every organ. Ectopic paragonimiasis is particularly common when infection is due to members of the P. skrjabini complex (Table 5.1). Human paragonimiasis occurs primarily in the tropics and subtropics of Asia, Africa, and the Americas, with different species being responsible in different areas (Table 5.1).

Analysis of COI and ITS2 regions of DNA obtained from Paragonimus westermani eggs in ancient coprolites on Joseon dynasty mummies.

The genetic information of ancient Paragonimus westermani, the oriental lung fluke infecting over 20 million people worldwide, has not been thoroughly investigated thus far. We analysed genetic markers (COI and ITS2) of P. westermani from coprolite specimens (n = 6) obtained from 15th to 18th century Korean mummies. Our results indicated that all P. westermani sequences were generally distinct from the other species of the genus Paragonimus. The sequences were clustered into three groups: Group I for East Asia; Group II for South and Southeast Asia; and Group III for India and Sri Lanka. In this study, we found that ancient P. westermani sequences in Korea belong to Group I, adding invaluable information to the existing knowledge of Paragonimus paleogenetics.

Whole-genome sequence of the oriental lung fluke Paragonimus westermani.

BackgroundFoodborne infections caused by lung flukes of the genus Paragonimus are a significant and widespread public health problem in tropical areas. Approximately 50 Paragonimus species have been reported to infect animals and humans, but Paragonimus westermani is responsible for the bulk of human disease. Despite their medical and economic importance, no genome sequence for any Paragonimus species is available.ResultsWe sequenced and assembled the genome of P. westermani, which is among the largest of the known pathogen genomes with an estimated size of 1.1 Gb. A 922.8 Mb genome assembly was generated from Illumina and Pacific Biosciences (PacBio) sequence data, covering 84% of the estimated genome size. The genome has a high proportion (45%) of repeat-derived DNA, particularly of the long interspersed element and long terminal repeat subtypes, and the expansion of these elements may explain some of the large size. We predicted 12,852 protein coding genes, showing a high level of conservation with related trematode species. The majority of proteins (80%) had homologs in the human liver fluke Opisthorchis viverrini, with an average sequence identity of 64.1%. Assembly of the P. westermani mitochondrial genome from long PacBio reads resulted in a single high-quality circularized 20.6 kb contig. The contig harbored a 6.9 kb region of non-coding repetitive DNA comprised of three distinct repeat units. Our results suggest that the region is highly polymorphic in P. westermani, possibly even within single worm isolates.ConclusionsThe generated assembly represents the first Paragonimus genome sequence and will facilitate future molecular studies of this important, but neglected, parasite group.

First intermediate hosts of Paragonimus spp. in Vietnam and identification of intramolluscan stages of different Paragonimus species

BackgroundMembers of the genus Paragonimus require at least three hosts in their life-cycles. The obligatory first intermediate hosts are freshwater snails. In Vietnam, although seven Paragonimus species have been recorded, the natural first intermediate hosts of almost all species have not been confirmed. The aim of this study was, therefore, to investigate snail hosts of Paragonimus species in Vietnam, and to identify Paragonimus species at intramolluscan stages.MethodsFreshwater snails were collected from streams in Yen Bai and Quang Tri Provinces, where high prevalences of Paragonimus metacercariae in crab hosts have been reported. Snails were morphologically identified and then examined individually for Paragonimus cercariae using shedding and crushing methods. Chaetomicrocercous cercariae, the morphological class to which Paragonimus cercariae belong, were collected for morphological description and molecular species identification by analyses of ITS2 sequences. The infected snail species were identified based on analyses of nucleotide sequences of the cox1 gene.ResultsThree snail species were found to be infected with Paragonimus cercariae at low infection rates, ranging between 0.07–1.0%. The molecular analyses identified them as Sulcospira quangtriensis and 2 species of subfamily Triculinae. In a phylogenetic tree, these two triculine snails were related to the genera Gammatricula and Tricula with low posterior probabilities. Thus we named them as Triculinae sp. 1 and Triculinae sp. 2. Cercariae from the three snail species, Sulcospira quangtriensis, Triculinae sp. 1 and Triculinae sp. 2, were molecularly identified as Paragonimus westermani, P. heterotremus and P. proliferus, respectively. The cercariae of the three species are morphologically similar to each other, but their daughter rediae can be distinguished by the length of the intestine and the number of cercariae per redia. The rediae of P. westermani have a long intestine and each contain 6–8 cercariae. In contrast, those of P. heterotremus and P. proliferus have a short intestine and each redia contain 10–12 and 5–6 cercariae, respectively.ConclusionsThree snail species, Sulcospira quangtriensis, Triculinae sp. 1 and Triculinae sp. 2, serve as the first intermediate hosts of P. westermani, P. heterotremus and P. proliferus, respectively, in Vietnam. The length of the intestine of rediae and the number of cercariae per redia are valuable characteristics for distinguishing between larvae of these Paragonimus species.

Morphological and molecular characterization of Paragonimus caliensis Little, 1968 (Trematoda: Paragonimidae) from Medellin and Pichinde, Colombia

Paragonimiasis is a subacute to chronic inflammatory granulomatous lung disease caused by the genus Paragonimus. In Latin America Paragonimus mexicanus Miyazaki & Ishii, 1968 is the only confirmed species to cause human infections. Paragonimus caliensis Little, 1968 is an uncommon species often regarded as a synonym of P. mexicanus. Recently, the study of two types of Paragonimus metacercariae from Costa Rica has provided new molecular and morphological evidence that P. caliensis is a separate species from P. mexicanus. In the present study, molecular, morphological and phylogenetic tools have been used to characterize two populations of Paragonimus located at west of Medellin, Antioquia and at Pichinde, Valle del Cauca (type locality of P. caliensis), Colombia. Adults and metacercariae obtained from Medellin, and metacercariae from Pichinde were analyzed. For morphological observations we used light microscopy and scanning electron microscopy (SEM). Morphology of metacercariae and adults matched with the holotype of P. caliensis. The number and arrangement of sensory papillae in the acetabulum region differs from the morphotypes reported for P. caliensis in Costa Rica. Two morphotypes in branching patterns of ovary and two morphotypes in branching patterns of testes were identified. The main morphological differences between P. caliensis and P. mexicanus corresponded to the size of gonads and their relative positions in the body, and the occasional presence of a cyst wall in P. caliensis metacercariae. The molecular and phylogenetic analyses (using nuclear ribosomal ITS2 and partial cytochrome c oxidase subunit 1 CO1 sequences) confirmed that P. caliensis from the type locality is the same species from Medellin and Costa Rica. Furthermore, these analyses also suggest genetic as well as geographical separation of P. caliensis populations between Colombia and Costa Rica. Currently, P. mexicanus and P. caliensis are sympatric in the Colombian Pacific bioregion, and specific diagnosis based on their egg size is not possible. Therefore, it is necessary to determine the biogeographic distribution ranges of both species and to implement molecular techniques to establish the role of P. caliensis in human paragonimiasis in Colombia.