Genetic diversity of an avian nasal schistosome causing cercarial dermatitis in the Black Sea-Mediterranean migratory route

Zoonotic Threats: The (Re)emergence of Cercarial Dermatitis, Its Dynamics, and Impact in Europe

Cercarial dermatitis (CD), or "Swimmer's itch" as it is also known, is a waterborne illness caused by a blood fluke from the family Schistosomatidae. It occurs when cercariae of trematode species that do not have humans as their definitive host accidentally penetrate human skin (in an aquatic environment) and trigger allergic symptoms at the site of contact. It is an emerging zoonosis that occurs through water and is often overlooked during differential diagnosis. Some of the factors contributing to the emergence of diseases like CD are related to global warming, which brings about climate change, water eutrophication, the colonization of ponds by snails susceptible to the parasite, and sunlight exposure in the summer, associated with migratory bird routes. Therefore, with the increase in tourism, especially at fluvial beaches, it is relevant to analyze the current epidemiological scenario of CD in European countries and the potential regions at risk.

Threat of cercarial dermatitis in Hungary: A first report of Trichobilharzia franki from the mallard (Anas platyrhynchos) and European ear snail (Radix auricularia) using molecular methods

Cercarial dermatitis in humans is a re-emerging zoonotic disease caused by infectious larvae of avian blood flukes within the Schistosomatidae family. Upon water contact, these avian schistosome larvae directly penetrate human skin and cause irritation. Between September 2018 and September 2020, carcasses of 94 mallards (Anas platyrhynchos), two green-winged teals (Anas crecca) along with one ferruginous duck (Aythya nyroca) were examined. Birds were collected within 12 regions of Hungary, representative of 9 different counties. Inspecting both morphological characters and molecular data, the cytochrome oxidase subunit I (COI) and large subunit ribosomal DNA (LSU rDNA) sequences, Bilharziella polonica and Dendritobilharzia pulverulenta were each identified. Most importantly, Trichobilharzia franki was found for the first time in Hungary and in 5 dispersed counties in conjunction with of 3 counties where other avian schistosomes were found. Of note, these avian blood flukes were predominately encountered in wild mallards (∼50%) and not in birds reared for hunting (∼1%). In total, 245 European ear snails (Radix auricularia), a known intermediate host of Trichobilharzia spp., were collected from an urban pond in Eger, Hungary. Five snails (∼2%) consistently shed numerous furcocercariae of T. franki that were confirmed by molecular methods. Our findings help to pinpoint a contemporary life cycle of this avian schistosome within an urban environment, a location regularly visited by various wild waterfowl and the possible species of avian schistosomes responsible for cercarial dermatitis in Hungary. Taken as a whole, we demonstrate the actual and potential risk zone for cercarial dermatitis, particularly with reference to R. auricularia distributions, within Hungary and across Central Europe.

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Molecular confirmed presence of three species of avian schistosomes in birds in Hungary.

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Molecularly confirmed Tricobilharzia franki invasion in Radix auricularia in Eger.

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Potential risk of swimmers itch related to the spread of R.auricularia.

Diversity of Trichobilharzia in New Zealand with a new species and a redescription, and their likely contribution to cercarial dermatitis

In response to annual outbreaks of human cercarial dermatitis (HCD) in Lake Wanaka, New Zealand, ducks and snails were collected and screened for avian schistosomes. During the survey from 2009 to 2017, four species of Trichobilharzia were recovered. Specimens were examined both morphologically and genetically. Trichobilharzia querquedulae, a species known from four continents, was found in the visceral veins of the duck Spatula rhynchotis but the snail host remains unknown. Cercaria longicauda [i.e. Trichobilharzia longicauda (Macfarlane, 1944) Davis, 2006], considered the major aetiological agent of HCD in Lake Wanaka, was discovered, and redescribed from adults in the visceral veins of the duck Aythya novaeseelandiae and cercariae from the snail Austropeplea tomentosa. Recovered from the nasal mucosa of Ay. novaeseelandiae is a new species of Trichobilharzia that was also found to cycle naturally through Au. tomentosa. Cercariae of a fourth species of Trichobilharzia were found in Au. tomentosa but the species remains unidentified.

Association between human cercarial dermatitis (HCD) and the occurrence of Trichibilarizia in duck and snail in main wetlands from Mazandaran Province, northern Iran

Background

Avian schistosomes are considered as main causative agents of human cercarial dermatitis (HCD) in Iran. The study was conducted to determine bird schistosomes in their final and intermediate hosts, in main wetlands of Mazandaran.

Methods

A total of 255 domestic and wild ducks were collected and the infection of nasal tissues of five (Anas platyrhynchos domesticus, Aythya ferina, Cairina moschata, Anas platyrhynchos and Spatula clypeata) species were analyzed using morphological techniques. Also, 1687 freshwater snails were collected and surveyed by cercarial shedding and crushing tests. Detection of HCD was performed for the presence of clinical symptoms of itching and maculopapular rashs by physical examination.

Results

Of 255 ducks, in 41 (16%) infection with nasal Trichibilarizia spp. were recognized by observing eggs and/or adult worms. The most infected ducks were Anas clypeata and Anas platyrhynchos domesticus. Overall, 0.17% of snails were infected with avian schistosomes. Also, clinical examination of 951 rice farmers revealed that 588 (61.82%) of them were suffered from HCD.

Conclusion

Our data suggest that domestic ducks could play a prominent role as a reservoir host for establishing life cycle of Trichobilharzia in the area. Also, existence of domestic reservoir ducks and suitable snail hosts in ponds and paddy fields of this area, climate conditions of the wetlands in Mazandaran leads to a high incidence of HCD.

Migratory routes, domesticated birds and cercarial dermatitis: the distribution of Trichobilharzia franki in Northern Iran

Background: One of the major migration routes for birds going between Europe and Asia is the Black Sea-Mediterranean route that converges on the Volga Delta, continuing into the area of the Caspian Sea. Cercarial dermatitis is a disorder in humans caused by schistosome trematodes that use aquatic birds and snails as hosts and is prevalent in areas of aquaculture in Northern Iran. Before the disorder can be addressed, it is necessary to determine the etiological agents and their host species. This study aimed to document whether domestic mallards are reservoir hosts and if so, to characterize the species of schistosomes. Previous work has shown that domestic mallards are reservoir hosts for a nasal schistosome. Results: In 32 of 45 domestic mallards (Anas platyrhynchos domesticus) (71.1%), the schistosome Trichobilharzia franki, previously reported only from Europe, was found in visceral veins. Morphological and molecular phylogenetic analysis confirmed the species designation. These findings extend the range of T. franki from Europe to Eurasia. Conclusion: The occurrence of cercarial dermatitis in Iran is high in areas of aquaculture. Previous studies in the area have shown that domestic mallards are reservoir hosts of T. regenti, a nasal schistosome and T. franki, as shown in this study. The genetic results support the conclusion that populations of T. franki from Iran are not differentiated from populations in Europe. Therefore, the schistosomes are distributed with their migratory duck hosts, maintaining the gene flow across populations with compatible snail hosts in Iran.

An efficient method for collecting the full-length adults, fragments, and eggs of Trichobilharzia spp. from the liver of definitive hosts

Precise identification of avian schistosomes in the genus Trichobilharzia at the species level is difficult and requires both traditional morphological and molecular techniques. To obtain satisfactory results by traditional methods, the characteristics of the intact adults or large fragments of male and females are necessary. The present study aimed to introduce a more efficient method for collecting eggs and both fragments and intact worms for morphological identification of visceral Trichobilharzia spp. Thirty-eight domestic ducks (twenty-eight fresh and ten frozen) were studied. For fresh samples, warm saline (40-45 °C) was injected into the portal vein or liver tissue, followed by slicing of the liver to small pieces in a large Petri dish. All materials were then transferred into the laboratory sieves arranged from the largest to the smallest mesh size and while crushed with the hand, washed, and filtered using a trigger water sprayer. The collected materials were studied under a stereomicroscope for parasite eggs, fragments, and full-length worms. Out of 28 freshly killed ducks, 19 (67.9%) and of 10 frozen ducks 6 (60%) were positive for visceral Trichobilharzia spp. The full-length worms and large fragments of male worms were mostly recovered with the mesh no. 150 (diameter of 106 μm) and small fragments, especially of females, and eggs with the mesh no. 270 (diameter of 53 μm). In addition to large numbers of fragments, 15 full-length adults were obtained from fresh and 2 from frozen ducks. The number of collected full-length adults was related to the worm burden. Since morphological description of different species of the genus Trichobilharzia is primarily based on the availability of adult worms, the application of methods that provide a higher number of intact males and females will result in better characterization of the species and deposition of appropriate voucher specimens. These results show the present method as a suitable tool for the collection of quality adults of visceral Trichobilharzia spp. in ducks.