Fatal infection with human pinworm, Enterobius vermicularis, in a captive chimpanzee

Observations on the transmission of Dientamoeba fragilis and the cyst life cycle stage

Little is known about the life cycle and mode of transmission of Dientamoeba fragilis. Recently it was suggested that fecal–oral transmission of cysts may play a role in the transmission of D. fragilis. In order to establish an infection, D. fragilis is required to remain viable when exposed to the pH of the stomach. In this study, we investigated the ability of cultured trophozoites to withstand the extremes of pH. We provide evidence that trophozoites of D. fragilis are vulnerable to highly acidic conditions. We also investigated further the ultrastructure of D. fragilis cysts obtained from mice and rats by transmission electron microscopy. These studies of cysts showed a clear cyst wall surrounding an encysted parasite. The cyst wall was double layered with an outer fibrillar layer and an inner layer enclosing the parasite. Hydrogenosomes, endoplasmic reticulum and nuclei were present in the cysts. Pelta-axostyle structures, costa and axonemes were identifiable and internal flagellar axonemes were present. This study therefore provides additional novel details and knowledge of the ultrastructure of the cyst stage of D. fragilis.

A pinworm's tale: The evolutionary history of Lemuricola (Protenterobius) nycticebi

Lemuricola (Protenterobius) nycticebi is the only pinworm species known to infect strepsirrhine primates outside Africa, and the only pinworm species yet described in slow lorises. Here, we provided a detailed morphological comparison of female and male worms, and a first description of fourth-stage larvae collected from free-living slow lorises (Nycticebus menagensis) in Sabah, Malaysian Borneo. Using mitochondrial and nuclear markers, we also reconstructed the species' phylogenetic relationship with other pinworms infecting primates. Both morphological and molecular results indicated a distinct association between L. (P.) nycticebi and its host. However, while taxonomy identified this species as a member of the Lemuricola clade and grouped pinworms infecting lemurs and slow lorises together, phylogenetic reconstruction split them, placing L. (P.) nycticebi within the Enterobius clade. Our results suggest that L. (P.) nycticebi may represent a different taxon altogether, and that it is more closely related to pinworm species infecting Old World primates outside Madagascar. Pongobius pongoi (Foitová et al., 2008) n. comb. is also proposed.

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Pinworms and their primate hosts have a long history of association.

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L. (P.) nycticebi was recovered from slow lorises in the wild.

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L. (P.) nycticebi was taxonomy classified within the Lemuricola clade.

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However, molecular phylogenetics placed it within the Enterobius clade.

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Taxonomic and molecular identifications should complement species descriptions.

Hypothesis: Multiple sclerosis is caused by three-hits, strictly in order, in genetically susceptible persons

Multiple Sclerosis is a chronic, progressive and debilitating neurological disease which, despite extensive study for over 100 years, remains of enigmatic aetiology. Drawn from the epidemiological evidence, there exists a consensus that there are environmental (possibly infectious) factors that contribute to disease pathogenesis that have not yet been fully elucidated. Here we propose a three-tiered hypothesis: 1) a clinic-epidemiological model of multiple sclerosis as a rare late complication of two sequential infections (with the temporal sequence of infections being important); 2) a proposal that the first event is helminthic infection with Enterobius Vermicularis, and the second is Epstein Barr Virus infection; and 3) a proposal for a testable biological mechanism, involving T-Cell exhaustion for Epstein-Barr Virus protein LMP2A. We believe that this model satisfies some of the as-yet unexplained features of multiple sclerosis epidemiology, is consistent with the clinical and neuropathological features of the disease and is potentially testable by experiment. This model may be generalizable to other autoimmune diseases.

Broad infectivity of Leidynema appendiculatum (Nematoda: Oxyurida: Thelastomatidae) parasite of the smokybrown cockroach Periplaneta fuliginosa (Blattodea: Blattidae)

Host specificity of parasites is important for the understanding of evolutionary strategies of parasitism that would be a basis of predictions of the disease expansion when parasitized hosts invade new environments. The nematode order Oxyurida is an interesting parasite group for studying the evolution of parasitism as it includes parasites of both invertebrates and vertebrates. In our survey, we found that the smokybrown cockroach Periplaneta fuliginosa was primarily infected with only one nematode species Leidynema appendiculatum. In two cases, L. appendiculatum was isolated from two additional cockroach species Pycnoscelus surinamensis, sold in Japan as a reptile food, and Blatta lateralis, captured in the field and cultured in the laboratory. Inoculation of L. appendiculatum into three additional cockroach species P. japonica, Blattella nipponica, and P. surinamensis also resulted in parasitism. Infection prevalence was high, and timing of postembryonic development from hatched nematode larva to mature adult in these hosts was identical with that in P. fuliginosa. While ecological interactions strongly determine the host range, such broad infectivity is still possible in this parasitic nematode.

Natural pathology of the captive chimpanzee (Pan troglodytes): A 35-year review

We present the spontaneous pathological lesions identified as a result of necropsy or biopsy for 245 chimpanzees (Pan troglodytes) over a 35-year period. A review of the pathology database was performed for all diagnoses on chimpanzees from 1980 to 2014. All morphologic diagnoses, associated system, organ, etiology, and demographic information were reviewed and analyzed. Cardiomyopathy was the most frequent lesion observed followed by hemosiderosis, hyperplasia, nematodiasis, edema, and hemorrhage. The most frequently affected systems were the gastrointestinal, cardiovascular, urogenital, respiratory, and lymphatic/hematopoietic systems. The most common etiology was undetermined, followed by degenerative, physiologic, neoplastic, parasitic, and bacterial. Perinatal and infant animals were mostly affected by physiologic etiologies and chimpanzee-induced trauma. Bacterial and physiologic etiologies were more common in juvenile animals. Degenerative and physiologic (and neoplastic in geriatric animals) etiologies predominated in adult, middle aged, and geriatric chimpanzees.

Natural mortality and cause of death analysis of the captive chimpanzee (Pan troglodytes): A 35-year review

We present the spontaneous causes of mortality for 137 chimpanzees (Pan troglodytes) over a 35-year period. A record review of the pathology database was performed and a primary cause of mortality was determined for each chimpanzee. The most common causes of mortality were as follows: cardiomyopathy (40% of all mortalities), stillbirth/abortion, acute myocardial necrosis, chimpanzee-induced trauma, amyloidosis, and pneumonia. Five morphologic diagnoses accounted for 61% of mortalities: cardiomyopathy, hemorrhage, acute myocardial necrosis, amyloidosis, and pneumonia. The most common etiologies were degenerative, undetermined, bacterial, traumatic, and neoplastic. The cardiovascular system was most frequently involved, followed by the gastrointestinal, respiratory, and multisystemic diseases. Degenerative diseases were the primary etiological cause of mortality of the adult captive chimpanzee population. Chimpanzee-induced trauma was the major etiological cause of mortality among the perinatal and infant population. This information should be a useful resource for veterinarians and researchers working with chimpanzees.

Intestinal Helminths of Wild Bonobos in Forest-Savanna Mosaic: Risk Assessment of Cross-Species Transmission with Local People in the Democratic Republic of the Congo

Phylogenetic and geographic proximities between humans and apes pose a risk of zoonotic transmission of pathogens. Bonobos (Pan paniscus) of the Bolobo Territory, Democratic Republic of the Congo, live in a fragmented forest-savanna mosaic setting, a marginal habitat for this species used to living in dense forests. Human activities in the forest have increased the risk of contacts between humans and bonobos. Over 21 months (September 2010-October 2013), we monitored intestinal parasites in bonobo (n = 273) and in human (n = 79) fecal samples to acquire data on bonobo parasitology and to assess the risk of intestinal helminth transmission between these hosts. Coproscopy, DNA amplification, and sequencing of stored dried feces and larvae were performed to identify helminths. Little difference was observed in intestinal parasites of bonobos in this dryer habitat compared to those living in dense forests. Although Strongylids, Enterobius sp., and Capillaria sp. were found in both humans and bonobos, the species were different between the hosts according to egg size or molecular data. Thus, no evidence of helminth transmission between humans and bonobos was found. However, because humans and this threatened species share the same habitat, it is essential to continue to monitor this risk.

Genetic analysis of Enterobius vermicularis isolated from a chimpanzee with lethal hemorrhagic colitis and pathology of the associated lesions

Human pinworms, Enterobius vermicularis, are normally recognized as minor pathogens. However, a fatal case of human pinworm infection has been reported in a nonhuman primate, a zoo reared chimpanzee. Here, we histopathologically examined the lesions in tissues from the deceased chimpanzee and genetically characterized the isolated worms to investigate the pathogenicity and determine the phylogeny. We identified ulcers deep in the submucosa where many parasites were found to have invaded the lamina propria mucosa or submucous tissue. An inflammatory reaction consisting mainly of neutrophils and lymphocytes but not eosinophils was observed around the parasites, and intense hemorrhage in the lamina propria was confirmed. The parasites were morphologically similar to E. vermicularis based on the shape of the copulatory spicules. Mitochondrial cytochrome c oxidase subunit 1 gene products were amplified from worm DNA by PCR and were genetically identified as E. vermicularis based on >98.7% similarity of partial sequences. Phylogenetic analysis revealed that the sequences clustered together with other chimpanzee E. vermicularis isolates in a group which has been referred to as type C and which differs from human isolates (type A). The samples were negative for bacterial pathogens and Entamoeba histolytica indicating that E. vermicularis could be pathogenic in chimpanzees. Phylogenetic clustering of the isolates indicated that the parasite may be host specific.

Trypanoxyuris (Paraoxyuronema)lagothricis (Nematoda: Oxyuridae) in Lagothrix cana (Primates: Atelidae) from Brazil

During necropsy of a specimen of Lagothrix cana (É. Geoffroy, 1812) (Primates: Atelidae) from the Brazilian Amazon, pinworms were found in the large intestine. The intensity of infection was 64 parasites (17 males and 47 females) and there were no gross pathological changes related to parasitism. After morphological analysis the parasites were identified asTrypanoxyuris (Paraoxyuronema)lagothricis (Buckley, 1931) (Nematoda: Oxyuridae). This is the first record of this oxyurid species in primates in Brazil.

Gastrointestinal parasites of the chimpanzee population introduced onto Rubondo Island National Park, Tanzania

The release of any species into a novel environment can evoke transmission of parasites that do not normally parasitize the host as well as potentially introducing new parasites into the environment. Species introductions potentially incur such risks, yet little is currently known about the parasite fauna of introduced primate species over the long term. We describe the results of long-term monitoring of the intestinal parasite fauna of an unprovisioned, reproducing population of chimpanzees introduced 40 years earlier (1966-1969) onto Rubondo Island in Lake Victoria, Tanzania, a non-native habitat for chimpanzees. Two parasitological surveys (March 1997-October 1998 and October 2002-December 2005) identified Entamoeba spp. including E. coli, Iodamoeba buetschlii, Troglodytella abrassarti, Chilomastix mesnili, Trichuris sp., Anatrichosoma sp., Strongyloides spp., Strongylida fam. gen. sp., Enterobius anthropopitheci, Subulura sp., Ascarididae gen. sp., and Protospirura muricola. The parasite fauna of the Rubondo chimpanzees is similar to wild chimpanzees living in their natural habitats, but Rubondo chimpanzees have a lower prevalence of strongylids (9%, 3.8%) and a higher prevalence of E. anthropopitheci (8.6%, 17.9%) than reported elsewhere. Species prevalence was similar between our two surveys, with the exception of Strongyloides spp. being higher in the first survey. None of these species are considered to pose a serious health risk to chimpanzees, but continued monitoring of the population and surveys of the parasitic fauna of the two coinhabitant primate species and other animals, natural reservoir hosts of some of the same parasites, is important to better understand the dynamics of host-parasite ecology and potential long-term implications for chimpanzees introduced into a new habitat.

Description of Lemuricola (Lemuricola) pongoi--male (Nematoda: Enterobiinae) parasitising orangutan Pongo abelii

The study presents the first description of male specimen (allotype) of the pinworm species Lemuricola (Lemuricola) pongoi, parasitising Sumatran orangutan (Pongo abelii) from Sumatra (Indonesia). The male specimen morphology presents all features fully corresponding with diagnose of the genus and subgenus Lemuricola. We are agreeing that Protenterobius is synonymous with Lemuricola because the length of tail appendix in males is not a sufficient feature for separation of the genera or subgenera. For L. (L.) pongoi male are characteristic features: body length (4,803 microm), total oesophagus length (530), tail length (235), tip of tail length (188) and spicule length (90).

Staphylococcal meningoencephalitis, nematodiasis, and typhlocolitis in a squirrel monkey (Saimiri sciureus)

BACKGROUND

Seizures were observed in a 16-year old male Guyanese squirrel monkey with a history of inappetence and weakness.

METHODS AND RESULTS

Complete blood count, biochemical profile, and urinalysis indicated systemic disease. Nematode larvae were detected in the feces. Cerebrospinal fluid (CSF) analysis revealed leukocytes and gram-positive cocci. Staphylococcus aureus was isolated from the CSF. Histopathological evaluation revealed systemic lesions with inflammation and nematodes in the small and large intestine.

CONCLUSION

This is the first report describing spontaneous staphylococcal CNS infection in a squirrel monkey.

Enterobiasis in ectopic locations mimicking tumor-like lesions

Both the clinical and the histopathological diagnostic difficulties of oxyuriasis in unusual sites and their importance from a clinical point of view are pointed out. The authors report two ectoptic cases of enterobiasis observed in Northern Italy, one located in a fallopian tube of a 57-year-old woman and the other in a perianal subcutaneous tissue of a 59-year-old man, mimicking tumor-like lesions. The authors take advantage of the occasion to focus the attention of the medical world on this subject, lamenting the scarce importance given to this parasitosis in university courses of medical schools and in medical textbooks as it is incorrectly considered “out-of-fashion.”

Mitochondrial cytochrome c oxidase subunit 1 gene and nuclear rDNA regions of Enterobius vermicularis parasitic in captive chimpanzees with special reference to its relationship with pinworms in humans

Sequences of mitochondrial cytochrome c oxidase subunit 1 (CO1) gene, nuclear internal transcribed spacer 2 (ITS2) region of ribosomal DNA (rDNA), and 5S rDNA of Enterobius vermicularis from captive chimpanzees in five zoos/institutions in Japan were analyzed and compared with those of pinworm eggs from humans in Japan. Three major types of variants appearing in both CO1 and ITS2 sequences, but showing no apparent connection, were observed among materials collected from the chimpanzees. Each one of them was also observed in pinworms in humans. Sequences of 5S rDNA were identical in the materials from chimpanzees and humans. Phylogenetic analysis of CO1 gene revealed three clusters with high bootstrap value, suggesting considerable divergence, presumably correlated with human evolution, has occurred in the human pinworms. The synonymy of E. gregorii with E. vermicularis is supported by the molecular evidence.

Morphology of chimpanzee pinworms, Enterobius (Enterobius) anthropopitheci (Gedoelst, 1916) (Nematoda: Oxyuridae), collected from chimpanzees, Pan troglodytes, on Rubondo Island, Tanzania

The chimpanzee pinworm, Enterobius (Enterobius) anthropopitheci (Gedoelst, 1916) (Nematoda: Oxyuridae), is redescribed based on light and scanning electron microscopy of both sexes collected from the feces of chimpanzees, Pan troglodytes, of an introduced population on Rubondo Island, Tanzania. Enterobius (E.) anthropopitheci is characterized by having a small body (males 1.13-1.83 mm long, females 3.33-4.73 mm long), a rather straight spicule with a ventral membranous formation in males, double-crested lateral alae in females, small eggs (53-58 by 24-28 microm), and a smooth eggshell with 3 longitudinal thickenings. Morphological comparison is made between the present and previous descriptions.

Unusual endoscopic and microscopic view of Enterobius vermicularis: a case report with a review of the literature

Enterobius vermicularis has the broadest geographic range of any helminth and is the most common intestinal parasite seen in the primary care setting. Underappreciated is the fact that it is not always a benign disorder and could even cause life-threatening medical problems. Visualization of the actual worms during endoscopy is probably underappreciated in part because endoscopists have never actually seen the worm and/or are not actively looking for, or anticipating, worms. This report describes a case of worm infection as documented during colonoscopy and confirmed by microscopy. The gross and microscopic appearance of the worm is described. Literature regarding the wide range of gastrointestinal and nongastrointestinal manifestations, including potentially life-threatening illnesses, as well as treatment options, are also reviewed.

EFFECTS OF REPEATED ANTHELMINTIC TREATMENT ON ENTEROBIUS VERMICULARIS INFECTION IN CHIMPANZEES

Effects of repeated treatment with pyrantel pamoate on Enterobius vermicularis infection in chimpanzees were assessed by observing worms discharged in the feces after administration of anthelmintic treatment. Three of 9 chimpanzees reared in a zoological garden in Japan were subjected to fecal worm count and morphometric observation, and all were given oral pyrantel pamoate 6 times at 10-day intervals simultaneously. Following the first and second treatments, more than 30,000 pinworms were discharged from 1 chimpanzee. The number of discharged worms abruptly decreased after the third treatment, and only a few worms were recovered after the fifth treatment, indicating that repeated treatment at short intervals was very effective. Complete eradication was not achieved, however, presumably because of reinfection. The female proportion among discharged worms tended to increase as the treatment was repeated.

Growth of Enterobius vermicularis in a chimpanzee after anthelmintic treatment

The growth of Enterobius vermicularis in a chimpanzee was investigated by observing worms discharged in feces after administration of pyrantel pamoate. Just after the final molting, immature adult male pinworms developed to a fully mature stage in 2 wk, after passing through a stage corresponding to the so-called Enterobius gregorii, which was surmised to be a younger adult form of E. vermicularis. The frequency distribution of body length forms 2 peaks in both male and female pinworms, with a depression in the transitional forms from the immature to the fully mature stage. This depression seems to be the result of more rapid growth or lower susceptibility to the drug in this transitional stage. Pyrantel pamoate effectively eradicated mature males, but gravid females were continuously observed in the feces after treatment. The complete eradication of pinworm infection by pyrantel pamoate could be achieved by repeated treatment at intervals shorter than 2 wk. This treatment would eradicate male worms first, resulting in females producing only unfertilized eggs, from which only males might hatch.