Metagonimus suifunensis sp. n. (Trematoda: Heterophyidae) from the Russian Southern Far East: Morphology, life cycle, and molecular data

Small intestinal flukes of the genus Metagonimus (Digenea: Heterophyidae) in Europe and the Middle East: A review of parasites with zoonotic potential

The heterophyid trematode Metagonimus romanicus (Ciurea, 1915) (Digenea) is redescribed on the basis of type material from domestic dogs (Canis familiaris) in Romania, vouchers from experimentally infected cats (Felis catus) and adults recovered from golden hamsters (Mesocricetus auratus) infected with metacercariae from scales of chub (Squalius cephalus) and common nase (Chondrostoma nasus) (Cypriniformes: Leuciscidae) in Hungary. This trematode, endemic to Europe and neighbouring regions (northwestern Türkiye), was previously misidentified as M. yokogawai (Katsurada, 1912), a zoonotic parasite of humans in East Asia. However, the two species differ considerably both genetically and morphologically, e.g., in the position of the ventral sucker, the presence of the prepharynx, the anterior extent of the vitelline follicles and the posterior extent of the uterus. Metagonimus ciureanus (Witenberg, 1929) (syn. Dexiogonimus ciureanus Witenberg, 1929), described from domestic cats and dogs in Israel, is a valid species distributed in the Middle East and Transcaucasia, which is also confirmed by molecular data. It differs from all Metagonimus species, including M. romanicus, in having symmetrical testes instead of the oblique testes of the other congeners. The zoonotic significance of M. romanicus and M. ciureanus is unclear, but appears to be low in Europe, mainly because raw or undercooked, whole fish with scales are generally not consumed. Accidental infection of fishermen by metacercariae in the scales when cleaning fish is more likely, but has never been reported. Remains of cyprinoids with scales infected with metacercariae of Metagonimus spp. can be an important natural source of infection for dogs, cats, and other carnivores, which can serve as a reservoir for these parasites.

Infection characteristics of Metagonimus species (Digenea: Heterophyidae) metacercariae in fish from major rivers of Korea

This article analyzed the infection characteristics of metacercariae of Metagonimus spp. (MsMc) in fish from 9 major water systems in Korea. A total of 19,568 fish in 87 species were examined over a period of 10 years (2011-2020). MsMc were detected in fish from all 44 survey areas in 9 water systems. Most of the surveyed sites showed very low and low infection levels (66.7%), while 33.3% of the areas, such as Tamjin-gang and Seomjin-gang, revealed moderate and high infection levels. High endemicity depends on the abundance of susceptible fish species, especially sweet smelt (Plecoglosus altivelis). The susceptibility index (SI) with MsMc in index fish, Zacco spp., was very low and low levels in 62.0%, moderate in 28.0%, and high in 10.0% regions. The SI was highest in the following order: Yeongam-cheon (283.8), Hoeng-cheon (192.3), Togyo-jeosuji (131.2), Deokcheon-gang (119.1), and Joyang-gang (106.3). The recent infection status of MsMc in P. altivelis was analyzed by the survey localities. In addition, except for P. altivelis, 9 fish species were highly infected with MsMc in some survey areas, including Zacco platypus, Z. koreanus, Z. temminckii, Opsariichthys uncirostris, Rhynchocypris oxycephalus, Carassius auratus, Acheilognathus rhombeus, Onchorhynchus masou, and Tribolodon hakonensis. In Korea, 74 fish species (15 families) are collectively listed as second intermediate hosts of Metagonimus spp. This review provides several novel characteristics of MsMc infection and clarifies the fish species of second intermediate host of Metagonimus spp. in this country.

Epidemiology and Geographical Distribution of Human Trematode Infections

Digenetic trematodes infecting humans are more than 109 species that belong to 49 genera all over the world. According to their habitat in the definitive hosts, they are classified as 6 blood flukes (Schistosoma japonicum. S. mekongi, S. malayensis, S. mansoni, S. intercalatum, and S. haematobium), 15 liver flukes (Fasciola hepatica, F. gigantica, Clonorchis sinensis, Opisthorchis viverrini, O. felineus, Dicrocoelium dendriticum, D. hospes, Metorchis bilis, M. conjunctus, M. orientalis, Amphimerus sp., A. noverca, A. pseudofelineus, Pseudamphistomum truncatum, and P. aethiopicum), nine lung flukes (Paragonimus westermani, P. heterotremus, P. skrjabini, P. skrjabini miyazakii, P. kellicotti, P. mexicanus, P. africanus, P. uterobilateralis, and P. gondwanensis), 30 heterophyid intestinal flukes (Metagonimus yokogawai, M. takahashii, M. miyatai, M. suifunensis, M. katsuradai, M. pusillus, M. minutus, Heterophyes heterophyes, H. nocens, H. dispar, Haplorchis taichui, H. pumilio, H. yokogawai, H. vanissinus, Centrocestus formosanus, C. armatus, C. cuspidatus, C. kurokawai, Procerovum calderoni, P. varium, Pygidiopsis genata, P. summa, Stictodora fuscata, S. lari, Stellantchasmus falcatus, Heterophyopsis continua, Acanthotrema felis, Apophallus donicus, Ascocotyle longa, and Cryptocotyle lingua), 24 echinostome intestinal flukes (Echinostoma revolutum, E. cinetorchis, E. mekongi, E. paraensei, E. ilocanum, E. lindoense, E. macrorchis, E. angustitestis, E. aegyptica, Isthmiophora hortensis, I. melis, Echinochasmus japonicus, E. perfoliatus, E. lilliputanus, E. caninus, E. jiufoensis, E. fujianensis, Artyfechinostomum malayanum, A. sufrartyfex, A. oraoni, Acanthoparyphium tyosenense, Echinoparymphium recurvatum, Himasthla muehlensi, and Hypoderaeum conoideum), 23 miscellaneous intestinal flukes (Brachylaima cribbi, Caprimolgorchis molenkampi, Phaneropsolus bonnei, P. spinicirrus, Cotylurus japonicus, Fasciolopsis buski, Gastrodiscoides hominis, Fischoederius elongatus, Watsonius watsoni, Gymnophalloides seoi, Gynaecotyla squatarolae, Microphallus brevicaeca, Isoparorchis hypselobagri, Nanophyetus salmincola, N. schikobalowi, Neodiplostomum seoulense, Fibricola cratera, Plagiorchis muris, P. vespertilionis, P. harinasutai, P. javensis, P. philippinensis, and Prohemistomum vivax), one throat fluke (Clinostomum complanatum), and one pancreatic fluke (Eurytrema pancreaticum). The mode of transmission to humans includes contact with cercariae contaminated in water (schistosomes) or ingestion of raw or improperly cooked food, including fish (liver flukes, heterophyid flukes, echinostomes, and throat flukes), snails (echinostomes, brachylaimids, and gymnophallid flukes), amphibia, reptiles (neodiplostomes), aquatic vegetables (fasciolids and amphistomes), and insect larvae or adults (lecithodendriids, plagiorchiids, and pancreatic flukes). Praziquantel has been proven to be highly effective against almost all kinds of trematode infections except Fasciola spp. Epidemiological surveys and detection of human infections are required for a better understanding of the prevalence, intensity of infection, and geographical distribution of each trematode species.

Molecular evidence of the absence of Metagonimus yokogawai (Katsurada, 1912) in Europe: report of Metagonimus sp. in cyprinoid fish from the River Danube in Hungary

Trematodes of the genus Metagonimus Katsurada, 1912 (Digenea: Heterophyidae) are zoonotic parasites that cause infections in humans, with most cases reported in Southeast Asia. Larvae from the second intermediate host, called metacercariae, of one of human-infecting species, M. yokogawai (Katsurada, 1912), have been reported from cyprinoid fish in Europe. In the present study, we provided DNA-based evidence that metacercariae of Metagonimus, which are commonly found in the scales of various cyprinoids in Central Europe (Danube River in Hungary) do not belong to M. yokogawai. Sequence analysis of the ITS region, 28S rDNA, and cox1 genes showed that this species is clearly distinct from all Asian species, including M. yokogawai, which probably does not occur in Europe. Metacercariae from cyprinoids might belong to Metagonimus romanicus (Ciurea, 1915), an insufficiently known species described from Romania.

General overview of the current status of human foodborne trematodiasis

Foodborne trematodes (FBT) of public health significance include liver flukes (Clonorchis sinensis, Opisthorchis viverrini, O. felineus, Fasciola hepatica and F. gigantica), lung flukes (Paragonimus westermani and several other Paragonimus spp.) and intestinal flukes, which include heterophyids (Metagonimus yokogawai, Heterophyes nocens and Haplorchis taichui), echinostomes (Echinostoma revolutum, Isthmiophora hortensis, Echinochasmus japonicus and Artyfechinostomum malayanum) and miscellaneous species, including Fasciolopsis buski and Gymnophalloides seoi. These trematode infections are distributed worldwide but occur most commonly in Asia. The global burden of FBT diseases has been estimated at about 80 million, however, this seems to be a considerable underestimate. Their life cycle involves a molluscan first intermediate host, and a second intermediate host, including freshwater fish, crustaceans, aquatic vegetables and freshwater or brackish water gastropods and bivalves. The mode of human infection is the consumption of the second intermediate host under raw or improperly cooked conditions. The major pathogenesis of C. sinensis and Opisthorchis spp. infection includes inflammation of the bile duct which leads to cholangitis and cholecystitis, and in a substantial number of patients, serious complications, such as liver cirrhosis and cholangiocarcinoma, may develop. In lung fluke infections, cough, bloody sputum and bronchiectasis are the most common clinical manifestations. However, lung flukes often migrate to extrapulmonary sites, including the brain, spinal cord, skin, subcutaneous tissues and abdominal organs. Intestinal flukes can induce inflammation in the intestinal mucosa, and they may at times undergo extraintestinal migration, in particular, in immunocompromised patients. In order to control FBT infections, eating foods after proper cooking is strongly recommended.

Assessing the population structure of trematode Metagonimus suifunensis using three mitochondrial markers

In this work, for the first time, the genetic variability of the Metagonimus suifunensis population in the Russian southern Far East was estimated based on the full-length sequences of the nad1 gene of mitochondrial DNA. In addition, for a sample of the same size, the sequences of cox1 and cytb genes, previously used for population studies for M. suifunensis, were reanalysed. Three markers were combined to a common sequence, and the obtained data were studied. Despite the higher level of variability, nad1 and cox1 mtDNA genes did not reveal subdivisions within the population. The combined dataset made it possible to determine that the sample from the Odyr River was the centre of the species' range formation and clarified the continental migration route of the parasite from south to north. According to the data obtained, it was presumed that piscivorous birds participate in the life cycle of the parasite. The subdivision within population revealed that using all three mitochondrial markers is consistent with the features of differentiation within populations of related species, but the reasons for its formation remain unclear due to the insufficient amount of data and the use of different markers in studies of different species.

Morphological and molecular identification of Cryptocotyle lingua metacercariae isolated from Atlantic cod (Gadus morhua) from Danish seas and whiting (Merlangius merlangus) from the English Channel

Trematode larvae (metacercariae) causing black spot disease occur frequently in gills, fins, skin and the superficial muscle layers of marine fish. Species within the genus Cryptocotyle Lühe, 1899 are frequently associated with this disease. Descriptions of the metacercarial stage are relatively limited and none has hitherto been reported from fish from the English Channel. The present study reports the morphological and molecular identifications of encysted black spot-inducing parasites from whiting (Merlangius merlangus) and Atlantic cod (Gadus morhua) caught respectively from the north coast of France (English Channel) and from Danish sea waters. Metacercariae were characterised morphologically based on microscopic observations and molecularly using Sanger sequencing of fragments of the mitochondrial cox1 gene and rDNA ITS region. Morphological data were compared with available data in the literature. Phylogenetic trees including reference sequences were built to confirm morphological and molecular identifications. This survey constitutes the first description of C. lingua metacercariae in the English Channel ecosystems.

A review of molecular identification tools for the opisthorchioidea

The superfamily Opisthorchioidea encompasses the families Cryptogonimidae, Opisthorchiidae and Heterophyidae. These parasites depend on the aquatic environment and include marine and freshwater species. Some species, such as Clonorchis sinensis and Opisthorchis viverrini, have a high impact on public health with millions of infected people worldwide and have thus been the object of many studies and tool developments. However, for many species, tools for identification and detection are scarce. Although morphological descriptions have been used and are still important, they are often not efficient on the immature stages of these parasites. Thus, during the past few decades, molecular approaches for parasite identification have become commonplace. These approaches are efficient, quick and reliable. Nonetheless, for some parasites of the superfamily Opisthorchioidea, reference genomic data are limited. This study reviews available genetic data and molecular tools for the identification and/or the detection of this superfamily. Molecular data on this superfamily are mostly based on mitochondrial and ribosomal gene sequence analyses, especially on the cytochrome c oxidase subunit 1 gene and internal transcribed spacer regions respectively.

Cytochrome b as a more promising marker for analysing the distribution vector for Metagonimus suifunensis (Trematoda: Heterophyidae)

In this study of Metagonimus suifunensis (M. suifunensis) in the Russian Southern Far East, the variability of the full-length sequences of the cytochrome b (cytb) mtDNA gene was assessed for the first time. In addition, the cox1 mtDNA gene sequences were also obtained for this species from new localities. In total, 87 and 81 sequences of the cytb and cox1 genes, respectively, were used in the current study. The cytb gene proved more promising and revealed two haplogroups that are associated with the spatial distribution of the species: geographical isolation caused the fixation of differences between northern and southern populations. In addition, the results obtained for the cytb gene opened up new perspectives in the analysis of sequences of the cox1 gene, which was not sufficiently effective as a sole marker. Based on data for both mitochondrial genes, molecular processes influencing the formation of the modern population were analysed for M. suifunensis. The new data confirmed the previously expressed opinion that this species colonized the study territory from north to south and will form the basis for determining possible ways of its further expansion, which is important for predicting the emergence of new foci of metagonimosis.

Trematode diversity in freshwater snails from a stopover point for migratory waterfowls in Hokkaido, Japan: An assessment by molecular phylogenetic and population genetic analyses

The cryptic diversity of trematodes was evaluated in the Nagayama-Shinkawa River, an artificial canal of the Ishikari River System of Hokkaido, Japan. Numerous migratory waterfowls use the canal as a stopover point in every spring season. The lymnaeid snail, Radix auricularia, and the semisulcospirid snail, Semisulcospira libertina, colonize the static and flowing water areas, respectively. The trematode fauna of the two snails was assessed by molecular phylogenetic and population genetic analyses. Each of distinctive clades in mitochondrial DNA trees was arbitrarily set as a species. In total, 14 species of the families Diplostomidae, Echinostomatidae, Notocotylidae, Plagiorchiidae, and Strigeidae occurred in R. auricularia, wherease S. libertina harbored 10 species of the families Echinochasmidae, Heterophyidae, Notocotylidae, and Lecithodendridae and Cercaria creta, an unclassified species whose adult stage is still unknown. The species diversity of the larval trematodes could be recognized as a "hot spot", suggesting that the seasonal visit of waterfowls is very important to spread trematodes and to keep their diversity. A high intraspecific genetic diversity was observed in the echinostomatid, notocotylid, echinochasmid, and heterophyid species, whose definitive hosts include birds. It seems likely that each of the parasite populations is always disturbed by repeated visits of waterfowls.

An opisthorchiid concept of the genus Liliatrema (Trematoda: Plagiorchiida: Opisthorchioidea): an unexpected systematic position

Liliatrema is a small genus of trematodes consisting of two species. Its systematic position has long been debated, partly because of the confusing reports about the structure of male terminal genitalia. Here we test the phylogenetic position of the genus Liliatrema using data on complete 18S rRNA and partial 28S rRNA gene sequences obtained for Liliatrema skrjabini. We also provide a detailed description of terminal genitalia in adult specimens of L. sobolevi and metacercariae of both Liliatrema species. The results of the 28S rDNA-based phylogenetic analysis indicate that Liliatrema falls within a well-supported clade, which also includes Apophallus and traditional opisthorchiids. This clade, in turn, is nested within a well-supported clade, containing Euryhelmis, Cryptocotyle and Scaphanocephalus. In the 18S+8S rDNA analysis, Liliatrema appears as a sister-taxon to the Cryptocotyle + Euryhelmis group. The Liliatrema + (Cryptocotyle + Euryhelmis) clade is a well-supported sister-group to the traditional opisthorchiids. The morphology of the terminal genitalia of the liliatrematids also corresponds to that of the opisthorchioids. Thus, the results of our morphological and phylogenetic analyses favour an unexpected conclusion that the genus Liliatrema belongs to the Opisthorchioidea. We propose that the genera Liliatrema, Apophallus, Euryhelmis, Cryptocotyle and Scaphanocephalus belong, respectively, within the subfamilies Liliatrematinae, Apophallinae, Euryhelminthinae and Cryptocotylinae of the family Opisthorchiidae.

First description of genetic diversity for the genus Metagonimus using the complete cox1 gene sequence

The complete cox1 gene sequence was analysed for Metagonimus suifunensis from eight localities in the Russian southern Far East, and the level of variability was compared with that of Clonorchis sinensis from the same territory of Russia. These species belong to the superfamily Opisthorchioidea, have a similar distribution in the Russian southern Far East and share second intermediate and definitive hosts, but are distinguished by their first intermediate hosts belonging to different orders of caenogastropods. The data obtained showed that the nucleotide sequence variability of the M. suifunensis cox1 gene was significantly lower. This fact is considered in connection with a recent bottleneck passage for the M. suifunensis population, in contrast to C. sinensis, which could be due to the features of the Metagonimus life cycle under seasonal freezing temperatures, as well as historical geological and climatic changes in the Russian Far East. These factors could influence the microevolutionary processes and lead to a decrease in the level of variability in the M. suifunensis population. Based on the combination of genetic data and historical geo-processes in the region, the probable route of M. suifunensis expansion from the northern part of its current area in the Amur River basin to the southern territories of the Russian Far East is justified.

Galactosomum otepotiense n. sp. (Trematoda: Heterophyidae) infecting four different species of fish-eating birds in New Zealand: genetically identical but morphologically variable

Trematodes of the genus Galactosomum are cosmopolitan parasites that infect the intestines of fish-eating birds and mammals. Adults of named Galactosomum species have not been recorded from bird hosts in New Zealand, despite their cercarial stage being known from various studies of the first intermediate host, Zeacumantus subcarinatus. Here we describe a new species of Galactosomum infecting four different piscivorous birds in New Zealand: Caspian terns, red-billed and black-backed gulls and little blue penguins. Specimens from each of these hosts are genetically identical in the genes sequenced, but show considerable morphological variability. Galactosomum otepotiense n. sp. is distinguished from most other members of the ‘bearupi-group’ in having a single circle of spines on the ventral sucker, and spines, as opposed to scales, over most of the body. It is most similar to G. bearupi and G. angelae, both from Caspian terns in Australia, but differs in the relative sizes of the reproductive organs and in the possession of a very long forebody. Molecular data confirm that G. otepotiense is not conspecific with G. bearupi, but 28S and ITS2 phylogenies show its close relationship to G. bearupi and other Australian species. We use the cox1 sequence to confirm identity with the larval stage infecting Z. subcarinatus, as previously described in the literature. We discuss briefly the relationships between Australian and New Zealand Galactosomum spp. and their hosts, variability between genetically identical specimens found in different hosts and their potential for harm to mariculture economy.

Harmful Parasitoses on the Russian Southern Far East under Climatic and Demographic Changes

Progressive expansion of the most hazardous human parasitoses caused by trematodes, cestodes and nematodes has been found on the south of the Russian Far East. Decelerating expansion of the trematode Clonorchis sinensis, an agent of clonorchiasis towards the southern Primorye Territory from the Amur River basin, that began 10-15 years ago, was revealed. A prognosis was made on the activation of the natural foci of clonorchiasis and paragonimiasis. Circulation possibilities are discussed of the highly pathogenic trematode Pagonimus heterotremusar in the South Asian regional ecosystems. Our experiments showed that the freshwater gastropods of the Parajuga genus from the Amur River basin and those of Stenothyra genus from Primorsky Territory were resistant to this trematode infection. Nevertheless, this does not exclude the possibility of this parasite penetration into the Far East region via infection of the local gastropods of other genera.

Heterophyid trematodes (Digenea) from penguins: A new species of Ascocotyle Looss, 1899, first description of metacercaria of Ascocotyle (A.) patagoniensis Hernández-Orts et al. (2012), and first molecular data

Two species of heterophyid trematodes were found in the Magellanic penguin, Spheniscus magellanicus (Forster), from Patagonia, Argentina. Ascocotyle (Ascocotyle) patagoniensis Hernández-Orts et al. (2012) is re-described based on new, properly fixed specimens (original material from South American sea lion, Otaria flavescens Shaw, was from frozen hosts). Metacercariae of this species are reported and described for the first time from the heart of the silversides, Odontesthes argentinensis (Valenciennes) and O. smitti (Lahille), from Patagonia. Ascocotyle (Phagicola) cameliae n. sp. is described from the intestine of S. magellanicus. The new species is placed into the subgenus Phagicola Faust, 1920 because of the presence of a single row of circumoral spines and uterine loops and vitelline follicles being confined posterior to the ventral sucker. However, it differs distinctly from other members of this subgenus by the number (19-24) and length (23-31 μm) of massive circumoral spines and by the morphology of the ventrogenital sac with a large, simple gonotyl devoid of refractile bodies. Molecular data (partial 28S rDNA sequences) for both species are also provided. Matching sequences from metacercarial and adult stages helped elucidate partially the life-cycle of A. (A.) patagoniensis. The interspecific relationships and phylogenetic position of Ascocotyle were further assessed on a broad phylogeny on the Opisthorchioidea Looss, 1899. Ascocotyle (P.) ornamentata Shalaby et al. (1993) described from decomposed worms (all circumoral spines were detached) found in a dog in Egypt, with no type-specimens of this species deposited in a repository collection, is considered to be species inquirenda.

Description of Metagonimus pusillus sp. nov. (Trematoda: Heterophyidae): phylogenetic relationships within the genus

As a result of experimental studies conducted in the Russian southern Far East, adult worms from the genus Metagonimus were obtained. A comparative analysis of the morphometry of these worms with other Metagonimus representatives showed that they are most similar to M. katsuradai Izumi, 1935 and M. otsurui Shimazu & Urabe, 2002 found in Japan, due to the ratio of suckers and the positions of the testicle, uterus and vitellaria. However, Russian worms differ from species in Japan by other metric characters: they differ from M. otsurui by the maximum size of most organs and from M. katsuradai by body width, pharynx length, and maximum size of testes and ovary. At the same time, they are identical to a trematode from the Russian southern Far East, which was previously identified as M. katsuradai. The validity of this species was also confirmed by genetic data. According to the 28S gene and the internal transcribed spacer 2 (ITS2) region of rDNA, as well as the cytochrome c oxidase I (cox1) gene of mtDNA, the Metagonimus specimens found in Russia differ from published genetic data for other members of this genus. However, both morphological similarity and molecular data showed that M. pusillus sp. nov., M. katsuradai and M. otsurui are most likely cryptic species. Furthermore, additional data based on a mitochondrial marker were provided for M. suifunensis Shumenko, Tatonova & Besprozvannykh, 2017 from Russia.

Fishborne zoonotic heterophyid infections: An update

Fishborne heterophyid trematodes infecting humans are at least 29 species worldwide and belong to 13 genera. Its global burden is much more than 7 million infected people. They include Metagonimus (M. yokogawai, M. takahashii, M. miyatai, M. minutus, and M. katsuradai), Heterophyes (H. heterophyes, H. nocens, H. dispar, and H. aequalis), Haplorchis (H. taichui, H. pumilio, H. yokogawai, and H. vanissimus), Pygidiopsis (P. summa and P. genata), Heterophyopsis (H. continua), Stellantchasmus (S. falcatus), Centrocestus (C. formosanus, C. armatus, C. cuspidatus, and C. kurokawai), Stictodora (S. fuscata and S. lari), Procerovum (P. varium and P. calderoni), Acanthotrema (A. felis), Apophallus (A. donicus), Ascocotyle (A. longa), and Cryptocotyle (C. lingua). Human infections are scattered around the world but the major endemic areas are located in Southeast Asia. The source of human infection is ingestion of raw or improperly cooked fish. The pathogenicity, host-parasite relationships, and clinical manifestations in each species infection are poorly understood; these should be elucidated particularly in immunocompromised hosts. Problems exist in the differential diagnosis of these parasitic infections because of close morphological similarity of eggs in feces and unavailability of alternative methods such as serology. Molecular diagnostic techniques are promising but they are still at an infant stage. Praziquantel has been proved to be highly effective against most of the patients infected with heterophyid flukes. Epidemiological surveys and detection of human infections are required for better understanding of the geographical distribution and global burden of each heterophyid species. In this review, the most updated knowledge on the morphology, biology, epidemiology, pathogenesis and pathology, immunology, clinical manifestations, diagnosis and treatment, and prevention and control of fishborne zoonotic heterophyid infections is provided.