Cercarial Dermatitis at Public Bathing Sites (Region Zealand, Denmark): A Case Series and Literature Review

High prevalence of natural infection by the ruminant blood fluke Schistosoma spindale in the intermediate snail host Indoplanorbis exustus in Uttaradit, Northern Thailand

Background and Aim

Freshwater snails belonging to the family Planorbidae serve as the first intermediate hosts of many species of important parasitic flukes of animals and humans. Information regarding the occurrence of planorbid snail larval trematode infection is limited in Northern Thailand. Thus, this study aimed to estimate the prevalence of larval trematode infection of the freshwater snail Indoplanorbis exustus in Uttaradit, Thailand, and to identify trematode species based on their morphological and molecular characteristics.

Materials and Methods

Planorbid snail specimens were collected from a water reservoir in Uttaradit, Thailand, from June to August 2023. Snails were assessed for larval trematode infection through cercarial shedding and crushing methods. The released cercariae were preliminarily identified on the basis of their morphological characteristics. In addition, species identification of the detected cercariae was conducted using 28S ribosomal RNA and cytochrome c oxidase subunit 1 gene sequence analyses.

Results

The overall prevalence of cercarial infection was 61.5% (107/174) in planorbid snails in Uttaradit province. Two species of cercarial trematodes, Schistosoma spindale (106/174, 60.9%) and Artyfechinostomum malayanum (1/174, 0.6%), were identified using morphological and molecular analyses, of which S. spindale was the most abundant species. Our studied snails did not have mixed infection with more than two cercarial species.

Conclusion

Our findings reveal a remarkably high prevalence of S. spindale cercariae infecting planorbid snails in Uttaradit, indicating that humans and animals across the study area are at risk of infection. Our data may contribute to the development of effective strategies to control this zoonotic infectious disease.

Diversity of trematode cercariae among naturally infected lymnaeid snails from Phayao, Thailand

Lymnaeids are aquatic snails playing an important role in the transmission of many parasitic trematode species of veterinary and medical importance. In this study, we assessed the presence of cercarial flukes in naturally infected lymnaeid snails from Phayao province, Thailand, and determined the species diversity of both the intermediate snail hosts and parasite larvae. A total of 3,185 lymnaeid snails were collected from paddy fields at 31 sites in eight districts of Phayao province between October 2021 and December 2022. Larval fluke infection was assessed using the cercarial shedding method. The collected snails as well as emerging cercariae were identified at the species level via morphological and molecular methods. The sequences of snail internal transcribed spacer region 2 (ITS2) and cercarial 28S ribosomal RNA gene (28S rDNA) and cytochrome C oxidase1 (Cox1) were determined by PCR amplification and sequencing. Three species of lymnaeid snails were detected in this study, including Radix (Lymnaea) rubiginosa (Michelin, 1831), Radix (Lymnaea) swinhoei (Adams, 1866) and Austropeplea viridis (Quoy & Gaimard, 1832), of which R. rubiginosa was the most abundant, followed by A. viridis and R. swinhoei. The overall rate of trematode cercarial infection in the lymnaeid snails was 2.8% (90/3,185); the cercarial infection rate in R. rubiginosa and A. viridis was 3.5% (60/1,735) and 3.1% (30/981), respectively. No larval fluke infection was observed in the studied R. swinhoei (0/469). Nine morphotypes of cercariae were detected at 15 sites from four districts. The emerging cercariae were molecularly identified as Clinostomum sp., Aporocotylidae sp., Apharyngostrigea sp., Trichobilharzia sp., Apatemon sp., Pegosomum sp., Petasiger sp., Echinostoma revolutum and Plagiorchis sp. These findings emphasize the occurrence and diversity of trematode cercariae among naturally infected lymnaeid snails in Phayao province and could contribute to broadening our understanding of the host-parasite relationships between trematodes and their first intermediate hosts as well as developing effective interventions to control trematode parasitic diseases.

A putative new genus of avian schistosome transmitted by Biomphalaria straminea (Gastropoda: Planorbidae) in Brazil, with a discussion on the potential involvement in human cercarial dermatitis

Human cercarial dermatitis (HCD) caused by avian schistosomes is an emerging health issue in different parts of the world. Nevertheless, parasite diversity, life cycle, and involvement in HCD remain poorly known or neglected in South America. Herein, we reported data obtained during a long-term malacological survey carried out in Pampulha Reservoir, an urban eutrophic waterbody from Brazil between 2009 and 2012. An ocellate brevifurcate cercaria emerged from 55 of 16,235 (0.34%) specimens of Biomphalaria straminea. Samples of the cercariae were subjected to morphological, experimental, and molecular study (analysis of partial sequences of nuclear 28S and mitochondrial cox1 genes). The molecular analysis revealed that the larva corresponds to an avian schistosome; however, it does not correspond to any named genus. A close related isolate was previously reported in Biomphalaria sudanica from Kenya (molecular divergences of 0.54% and 9.62% for 28S and cox1, respectively). The morphology of this cercaria was compared with other avian schistosome larvae from Biomphalaria spp. Attempts to infect experimentally ducks (Cairina moschata) and mice revealed cutaneous manifestations after exposure to cercariae, but adult parasites were not obtained in these hosts. Phylogenetic analysis suggests this parasite is a putative new genus and species of avian schistosome. The potential involvement of the larvae herein described in cases of HCD in Brazil cannot be ruled out. Surprisingly, HCD was not reported in the country so far, which can be related to difficulties in its diagnosis in areas of overlap with human schistosomes.