Minute Intestinal Flukes Research Articles

Molecular Markers for Identification ofStellantchasmus falcatusand a Phylogenic Study using the HAT-RAPD Method

Stellantchasmus falcatus is a minute intestinal fluke in the family Heterophyidae. Metacercariae, the infective stage, were reported in a marine fish, mullet Liza subviridis, and a fresh water fish, Dermogenus pusillus, in Thailand. Adults were found in chicks, rats, cats, and humans. Morphological studies were done for comparing Stellantchasmus sp. worms found in 2 different fish hosts; their shapes and organ arrangements were very similar except for the prepharynx length. Therefore, the present study aimed to compare their DNA fingerprints using the HAT-RAPD method for both types of Stellantchasmus and several other related species. Ten arbitrarily selected primers (OPA-04, OPA-09, OPN-02, OPN-03, OPN-09, OPN-12, OPP-11, OPR-15, OPX-13, and OPAD-01) were used. It was found that OPA-09, OPN-03, and OPAD-01 were able to generate S. falcatus specific fragments in mullets which consisted of 200, 760, and 280 bp, respectively. In addition, the results of morphologic, DNA fingerprinting, and phylogenetic analyses strongly suggest that the fresh water and marine specimens of Stellantchamus may be different species.

Haplorchis taichuias a Possible Etiologic Agent of Irritable Bowel Syndrome-Like Symptoms

The aim of this study is to clarify the clinical features of Haplorchis taichui infection in humans in Nan Province, Thailand, and to correlate the clinical features with irritable bowel syndrome (IBS)-like symptoms. In this study area, only H. taichui, but neither other minute intestinal flukes nor small liver flukes were endemic. The degree of infection was determined by fecal egg counts and also by collecting adult worms after deworming. The signs and symptoms of individual patients together with their hematological and biochemical laboratory data were gathered to evaluate the relationship between the clinical features and the severity of infection. Special emphasis was made to elucidate the possible similarities of the clinical features of H. taichui infection and IBS-like symptoms. The results showed useful clinical information and the significant (> 50%) proportion of haplorchiasis patients complained of abdominal pain, lassitude, and flatulence, which were the important diagnostic symptoms of IBS. This study has reported a possible link between H. taichui and IBS, and H. taichui might probably play a role in the etiology of these IBS-like symptoms.

Emerging food-borne parasites

Parasitic food-borne diseases are generally underrecognised, however they are becoming more common. Globalization of the food supply, increased international travel, increase of the population of highly susceptible persons, change in culinary habits, but also improved diagnostic tools and communication are some factors associated with the increased diagnosis of food-borne parasitic diseases worldwide. This paper reviews the most important emerging food-borne parasites, with emphasis on transmission routes. In a first part, waterborne parasites transmitted by contaminated food such as Cyclospora cayetanensis, Cryptosporidium and Giardia are discussed. Also human fasciolosis, of which the importance has only been recognised in the last decades, with total numbers of reported cases increasing from less than 3000 to 17 million, is looked at. Furthermore, fasciolopsiosis, an intestinal trematode of humans and pigs belongs to the waterborne parasites as well. A few parasites that may be transmitted through faecal contamination of foods and that have received renewed attention, such as Toxoplasma gondii, or that are (re-)emerging, such as Trypanosoma cruzi and Echinococcus spp., are briefly reviewed. In a second part, meat-borne parasite infections are reviewed. Humans get infected by eating raw or undercooked meat infected with cyst stages of these parasites. Meat inspection is the principal method applied in the control of Taenia spp. and Trichinella spp. However, it is often not very sensitive, frequently not practised, and not done for T. gondii and Sarcocystis spp. Meat of reptiles, amphibians and fish can be infected with a variety of parasites, including trematodes ( Opisthorchis spp., Clonorchis sinensis, minute intestinal flukes), cestodes ( Diphyllobothrium spp., Spirometra), nematodes ( Gnathostoma, spp., anisakine parasites), and pentastomids that can cause zoonotic infections in humans when consumed raw or not properly cooked. Another important zoonotic food-borne trematode is the lungfluke ( Paragonimus spp.). Traditionally, these parasitic zoonoses are most common in Asia because of the particular food practices and the importance of aquaculture. However, some of these parasites may emerge in other continents through aquaculture and improved transportation and distribution systems. Because of inadequate systems for routine diagnosis and monitoring or reporting for many of the zoonotic parasites, the incidence of human disease and parasite occurrence in food is underestimated. Of particular concern in industrialised countries are the highly resistant waterborne protozoal infections as well as the increased travel and immigration, which increase the exposure to exotic diseases. The increased demand for animal proteins in developing countries will lead to an intensification of the production systems in which the risk of zoonotic infections needs to be assessed. Overall, there is an urgent need for better monitoring and control of food-borne parasites using new technologies.

PCR Diagnosis of Opisthorchis viverrini and Haplorchis taichui Infections in a Lao Community in an Area of Endemicity and Comparison of Diagnostic Methods for Parasitological Field Surveys

Opisthorchiasis is a major public health problem in Southeast Asia. Affected individuals often have mixed infections with the liver fluke Opisthorchis viverrini and minute intestinal flukes such as Haplorchis taichui. The usual methods of diagnosing these infections involve the demonstration of fluke eggs in stool samples under light microscopy, but sensitivity and specificity are low. We developed two PCR tests that detect and discriminate between O. viverrini and H. taichui infections. PCR tests were validated by stool samples from purged individuals. We then applied the PCR tests to estimate the prevalence of O. viverrini and H. taichui infections from a random sample of individuals selected from a community in an area of endemicity in Khong District, Laos. PCR results were compared with those from the Kato-Katz (KK) method and the formalin-ether concentration technique (FECT). When validated with purge results, PCR tests of O. viverrini and H. taichui had sensitivities of 93.7% (95% confidence interval [CI], 85.8 to 97.9%) and 73.3% (95% CI, 60.3 to 83.9%) and could detect as little as 0.75 pg DNA and 1.32 ng DNA, respectively. The PCR-determined community prevalences of O. viverrini and H. taichui infections were 63.9% (95% CI, 54.1 to 72.9%) and 30.6% (95% CI, 22.1 to 40.2%), respectively. Using PCR as the gold standard to detect O. viverrini, three KK thick smears performed comparably well, whereas one KK smear and FECT were poorer (sensitivities of 91.4% [95% CI, 81.0 to 97.1%,], 62.3% [95% CI, 49.8 to 73.7%], and 49.3% [95% CI, 37.0 to 61.6%], respectively). PCR may be a valuable and sensitive diagnostic tool, particularly for low-intensity O. viverrini and H. taichui infections.

Diversity of human intestinal helminthiasis in Lao PDR

Food-borne trematodiasis is an emerging public health problem, including in Lao PDR. We investigated the diversity of intestinal helminthes and polyparasitism in patients with hepatobiliary or intestinal symptoms in hospital and community-based surveys. Stool samples from 232 individuals aged >or=15 years were examined by the Kato-Katz method (three samples) and a formalin ethyl-acetate concentration technique (one sample). Opisthorchis viverrini and minute intestinal flukes (MIF) were common, with prevalences of 86.2% and 62.9%, respectively. Hookworm was the predominant soil-transmitted helminth (65.9%). The prevalences of Taenia spp., Strongyloides stercoralis and Trichuris trichiura were 22.8%, 10.3% and 8.6%, respectively. Additionally, 97 individuals were purged; O. viverrini and Haplorchis taichui were found in 95 and 76 participants, respectively. Other trematodes included Phaneropsolus bonnei (22.7%), Prosthodendrium molenkampi (14.4%), Haplorchis pumilio (5.2%), Haplorchis yokogawai (3.1%) and Echinochasmus japonicus (3.1%). Co-infection with O. viverrini and MIFs was rampant (81.4%). Polytrematode infection is highly prevalent in Lao PDR and hence requires urgent attention.

Discrimination of O. viverrini, C. sinensis, H. pumilio and H. taichui using nuclear DNA-based PCR targeting ribosomal DNA ITS regions

Small liver and minute intestinal flukes are highly prevalent in Southeast Asia, and in mixed infections, their eggs are difficult to differentiate morphologically in fecal samples. PCR assays targeting the ITS regions in ribosomal DNA were designed to identify and differentiate species. The PCR amplicons of Opisthorchis viverrini, Clonorchis sinensis, Haplorchis pumilio, and Haplorchis taichui were 800, 820, 1250, and 930 bp for the ITS1 region, and 380, 390, 380, and 530 bp for ITS2, respectively. The ITS1-region amplicon sizes successfully differentiated 4 species, while only H. taichui were significantly different from the other 3 species in the ITS2 region. PCR assays were employed for preliminary analysis using fecal samples diagnosed as having “small trematode eggs” by modified thick smear, showing 76.2% sensitivity for ITS1 and 95.2% for ITS2.

Evidence of Haplorchis taichui infection as pathogenic parasite: Three case reports

Haplorchis taichui is the minute intestinal fluke which parasitizes the small intestine of humans and other mammals. We present the pathology in the small intestine of 3 human cases caused by H. taichui. Microscopic examination revealed mucosal ulceration, mucosal and submucosal haemorrhages, fusion and shortening villi, chronic inflammation, and fibrosis of the submucosa. This finding clearly indicated H. taichui as pathogenic; thus prevention of infection and treatment should be paramount.

A review of Gymnophalloides seoi (Digenea: Gymnophallidae) and human infections in the Republic of Korea.

Studies on Gymnophalloides seoi (Digenea: Gymnophallidae) and human infections are briefly reviewed. This minute intestinal fluke was first discovered from a Korean woman suffering from acute pancreatitis and gastrointestinal troubles. It was described as a new species by Lee, Chai and Hong in 1993. The southwestern coastal village where the patient resided was found to be a highly endemic area, and additional endemic areas have been identified. The parasite is very small, 0.33-0.50 mm long and 0.23-0.33 mm wide, and characterized by the presence of a ventral pit. The first intermediate host remains unknown, but the second intermediate host has been found to be the oyster Crassostrea gigas. Man and the Palearctic oystercatcher Haematopus ostralegus have been shown to be natural definitive hosts, and wading birds including the Kentish plover Charadrius alexandrinus are highly susceptible to experimental infection. Gerbils, hamsters, cats, and several strains of mice were also susceptible laboratory hosts. In experimentally infected mice, the parasites inhabit the small intestine, pinching and sucking the root of villi with their large oral suckers, but they did not invade beyond the mucosa in immunocompetent mice. However, they were found to invade the submucosa in immunosuppressed mice. Human G. seoi infections have been found in at least 25 localities; 23 islands on the Yellow Sea or the South Sea, and 2 western coastal villages. The highest prevalence was found in a village on Aphaedo, Shinan-gun (49% egg positive rate); other areas showed 0.8-25.3% prevalence. Infected people complained of variable degrees of gastrointestinal troubles and indigestion. The infection can be diagnosed by recovery of eggs in the feces; however, an expert is needed to identify the eggs. Praziquantel, 10 mg/kg in single dose, is effective for treatment of human infections. Eating raw oysters in endemic areas should be avoided.

Pathogenicity and Lethality of a Minute Intestinal Fluke, Neodiplostomum seoulense, to Various Strains of Mice

Pathogenicity and lethality of Neodiplostomum seoulense to various strains of mice (mast cell-deficient W/Wv, their normal littermate +/+, C57BL/6, BALB/cA, C3H/HeJ), and a hybrid (BALB/cA x C3H/HeJ)F1 were investigated. When the mice were infected orally each with 200 metacercariae, their abdomen became distended, and all mice died by day 23 postinfection (PI) except BALB/cA, which were severely weakened but recovered after 28 days. Even a smaller infection dose of 25 metacercariae was highly lethal to C3H/HeJ mice. Despite treatment with praziquantel (3 mg/mouse) on day 10 PI, 80% of C57BL/ 6 mice did not recover and died. After day 14 PI, the whole intestine of C57BL/6 mice was contracted and significantly shortened in length, and charcoal meal transit was significantly faster compared with uninfected controls. After incubation in papaverine, the contracted intestines of C3H/HeJ mice did not relax, suggesting that the change is irreversible. In conclusion, N. seoulense has the potential to kill most strains of mice by causing irreversible damage to their intestine. The effects of mucosal mast cells on the survival rate of mice were negligible, because both W/Wv and +/+ mice died around day 20 PI.

Albendazole treatment of minute intestinal fluke infections and opisthorchiasis

Albendazole treatment of minute intestinal fluke infections and opisthorchiasis