Case report: the first case of human infection by adult of SPIROMETRA ERINACEIEUROPAEI in VIETNAM

Gastrointestinal Helminthic Infection among the Population in Northern Thailand

PURPOSE

Gastrointestinal (GI) helminthic infections pose substantial public health threat, particularly in northern Thailand, with a heightened concern in Nan province. This study aims to evaluate the prevalence of GI helminthic infections in Nan province and identify associated risk factors in local population.

METHODS

A cross-sectional survey was conducted in 2022. Fecal specimens were collected and examined using Kato-Katz technique and Formalin Ethyl-Acetate Concentration Technique (FECT). Univariate analysis employed the Chi-square test to explore correlations, while logistic regression was defined risk factors associated with parasite infections.

RESULTS

Among 739 individuals surveyed, 14.34% were revealed GI helminthic infections. Notably, infection rates were higher in males (20.40%) compared to females (8.95%), with a notable prevalence among individuals aged ≥ 60 (17.78%) and high infection rate was demonstrated in Kiew Chan village (21.67%). The most commonly detected helminths were minute intestinal flukes (MIFs) (10.01%) and Capillaria spp. (3.11%). Males were significantly associated with GI helminthic infections, while individuals aged 40-49 and aged 50-59 commonly displayed of parasite infections. Additionally, Kiew Chan village exhibited a significant association with GI helminthic infections, followed by Sop Puen village. Furthermore, fecal specimens of 13 rodent specimens were frequency revealed Strongyloides spp. (92.30%) and mostly exposed Ancylostoma caninum (41.93%) among 93 canines.

CONCLUSION

These findings highlight the imperative for immediate public health interventions in Nan province and analogous areas in northern Thailand. Implementing strategies to enhance sanitation infrastructure and promote hygiene education can significantly contribute for reducing the prevalence of GI helminthic infections and improve overall community health.

Cestodiasis in 2 Puerto Rican crested anoles

Two adult male Puerto Rican crested anoles (Anolis cristatellus cristatellus) housed in a research facility were presented with debilitation and were euthanized. On autopsy, anole 1 had a large cystic white structure in the left pelvic limb, which protruded through the ruptured epidermis, and a large, poorly demarcated swelling in the right caudal abdomen. Anole 2 had masses in the mid-dorsum, caudal dorsum, left pelvic limb, and tail. These masses contained variably sized cestode larvae, which ruptured into the coelomic cavity. Evaluation of the larvae revealed a thickened and wrinkled anterior end, with a cleft-like invagination, consistent with either a plerocercoid sparganum or a tetrathyridium. Histologically, several cestode larvae were contained in the body wall of both anoles. These were up to 650 μm in diameter, with a thin tegument and a spongy parenchyma. The spongy parenchyma contained numerous, up to 30 μm diameter, sharply demarcated, basophilic-to-black structures (calcareous corpuscles). There was pneumonia and hepatitis in anole 2, suggestive of potential secondary infection subsequent to immunosuppression. Molecular amplification of the cytochrome C oxidase subunit 1 revealed 100% homology for the COX1 gene of the diphyllobothriid tapeworm Spirometra erinaceieuropaei, also known as Spirometra mansoni.

Description of Spirometra asiana sp. nov. (Cestoda: Diphyllobothriidae) found in wild boars and hound dogs in Japan

According to the latest taxonomy of Spirometra species, six species (lineages) have been tentatively classified as valid. These species are Spirometra erinaceieuropaei, S. folium, S. mansoni, undescribed Spirometra sp. 1, and S. decipiens complex 1 and 2. Among these species, the undescribed species was first discovered as plerocercoid larvae in wild boars in Japan and further studies have confirmed that this species is a new taxon belonging to the genus Spirometra. Here, we describe Spirometra asiana sp. nov., which is difficult to distinguish morphologically from known Spirometra species. However, it is genetically easily distinct from other Spirometra species, thus facilitating identification. We also emphasize that S. mansoni and S. asiana, but not S. erinaceieuropaei, are etiological agents that cause human sparganosis and/or spirometrosis in Asia.

Molecular identification of sparganum of Spirometra mansoni isolated from the abdominal cavity of a domestic cat in Vietnam

Cats normally play a role of the definitive host in which the plerocercoid (sparganum), the second larval form of Spirometra spp., develops into an adult in the intestines. However, some cases of cats with visceral or subcutaneous sparganosis were sporadically reported worldwide. We herein documented the discovery of a sparganum in abdominal cavity of a domestic cat during a surgery of dystocia. The larva was molecularly identified as Spirometra mansoni, belonging to Type I, that was recently misidentified to be S. erinaceieuropaei in several Asian countries. This is the first report for sparganum of S. mansoni in the cat. The future study is necessary to provide further insights into the species of Spirometra causing sparganosis and spirometrosis in humans and other animals.

Ups and downs of infections with the broad fish tapeworm Dibothriocephalus latus in Europe (Part II) and Asia from 1900 to 2020

The broad fish tapeworm, Dibothriocephalus latus (Diphyllobothriidea), is the most important causative agent of diphyllobothriosis, a fish-borne zoonosis, in Europe. Part I of this review focused on the occurrence of D. latus in northwestern and central Europe, particularly in Fennoscandia, the Baltic, the Alpine lakes and Danube River regions during 1900-2020. Part II summarises data on D. latus from the European and Asian parts of Russia and from Asian countries. The tapeworm has occurred throughout Russia, with the most important foci in (i) the Republic of Karelia in the northwest of European Russia, (ii) the Volga River basin in the central and southern parts of European Russia, (iii) the Ob-Irtysh rivers region in the Ural region, (iv) the Yenisei-Lena rivers region in Siberia, and (v) the Lake Baikal basin in Siberia. The incidence of diphyllobothriosis has declined in recent decades, especially in European Russia, but zoonosis is still prevalent in some regions of Siberia. Cases reported from Arctic regions, the region around Lake Baikal, and the Pacific coast, including the Amur basin, however, were probably misidentifications with D. dendriticus and/or D. nihonkaiensis. No other Asian country where D. latus findings represented either imported cases or misidentifications had natural focus of diphyllobothriosis. Patterns of distribution of D. latus occurrence were similar in all Eurasian foci between 1900 and 2020. The numbers of records were associated with historical and epidemiological milestones of particular time periods.

Medical Parasitology Taxonomy Update, June 2020-June 2022

The taxonomy of medically important parasites continues to evolve. This minireview provides an update of additions and updates in the field of human parasitology from June 2020 through June 2022. A list of previously reported nomenclatural changes that have not been broadly adapted by the medical community is also included.

An overview of human helminthioses in Vietnam: Their prevention, control and lessons learnt

In Vietnam, helminthioses remain a major threat to public health and contribute to the maintenance of poverty in highly endemic regions. Through increased awareness of the damaging effects caused by helminthioses, the Vietnamese government has implemented many national programs over the past 30 years for the prevention and control of the most important helminthioses, such as, lymphatic filariasis, soil transmitted helminths, food borne zoonotic helminths, and others. Various control strategies have been applied to reduce or eliminate these worms, e.g. mass drug administration, economic development, control of vectors or intermediate hosts, public health interventions through education, proper composting procedures for excreta potentially containing helminth eggs, and the expansion of food supply chains and improved technologies for the production and inspection of food products. These control measures have resulted in a significant reduction in the distribution and transmission of helminth infections and have improved the overall living conditions and health outcomes of the Vietnamese citizens. However, the persistence of several helminth diseases continues in some endemic areas, especially where poverty is widespread and local traditions include the consumption of raw foods, especially fish and meats. This manuscript provides an overview of the helminth infection prevention and control programs conducted in Vietnam, their achieved results, learned lessons, and future works.

Helminth infections in dogs in Phu Tho Province, northern Vietnam

Helminths are among the most-commonly encountered disease-causing agents in dogs all over the world, including Vietnam. A cross-sectional survey was carried out between March and December 2019 in four dog slaughter-slabs in Yen Lap District, Phu Tho Province, northern Vietnam, aiming to reveal the occurrence of gastrointestinal helminths in dogs. Worms were collected from 350 dog samples and identified by morphological techniques followed by molecular methods for tapeworms and hookworms. Nine species, including Taenia hydatigena, Spirometra erinaceieuropaei, Dipylidium caninum, Spirocerca lupi, Ancylostoma ceylanicum, Ancylostoma caninum, Toxocara canis, Toxascaris leonina and Trichuris vulpis, were found to occur in this area. Infection with at least one worm species was found in 272 dogs (77.7%; 95% Wilson score CI: 73.1-81.8%). The most common species was A. ceylanicum, with a prevalence of 45.1% (95% Wilson score CI: 40.0-50.4%) while T. hydatigena had a very low prevalence of 0.3% (95% Exact CI: 0.0-1.6%). Co-infection with hookworms and D. caninum was common. Five of the recovered helminth species have a zoonotic potential. Control of these parasites is necessary in order to protect human and animal health.

A case of human breast sparganosis diagnosed as Spirometra Type I by molecular analysis in Japan

A 92-year-old Japanese woman presented with a mass in the left breast, and sparganosis was suspected by biopsy of the mass. The mass disappeared once, but it reappeared at the same site one year later. For a definitive diagnosis, the mass was surgically removed, and a sparganum-like worm was detected. The causative agent was confirmed as Spirometra Type I (most probably Spirometra mansoni) by mitochondrial DNA analysis. The serological examination also proved the case as sparganosis. Considering the presence of two Spirometra species (Type I and II) in Asia, particularly Japan, molecular analysis of the causative agents is highly recommended to understand the epidemiology, infection sources, and pathogenicity in humans in both species, if the parasite specimens are available.

The first records of Spirometra erinaceieuropaei (Cestoda: Diphyllobothriidae), a causative agent of human sparganosis, in Latvian wildlife

Diphyllobothriid tapeworms of the genus Spirometra are causative agents of sparganosis, food-borne zoonotic parasitic disease. They have been recorded in broad spectrum of hosts, including humans, in all continents except Antarctica. Spirometra tapeworms have been intensively studied in several Asian countries; however, they have been rather neglected in Europe. The aim of this study was to provide a pilot screening of Spirometra spp. in Latvia, where data on sparganosis are not available. Tapeworms morphologically identified as diphyllobothriid species were isolated from grey wolves Canis lupus and Eurasian lynxes Lynx lynx from Latvia during the hunting periods 2013-2019. The parasites were subjected to molecular genotyping using sequences of the partial large (LSU rDNA; 615 bp) and small (SSU rDNA; 720 bp) subunits of the nuclear ribosomal RNA gene and complete (1566 bp) cytochrome c oxidase subunit I gene of the mitochondrial DNA (cox1 mtDNA). Analyses of both ribosomal subunits of 13 tapeworms revealed no intraspecific variation within the respective rDNA subunits. On the other hand, sequence analysis of mitochondrial cox1 revealed intraspecific polymorphism displayed by 12 cox1 haplotypes. Comparison of the current data with sequences of the corresponding DNA regions deposited in the GenBank revealed 99.3-99.5% (LSU rDNA), 99.2% (SSU rDNA) and 99.6-100% (cox1 mtDNA) identity of studied tapeworms with Spirometra erinaceieuropaei, which provided the first confirmation of this diphyllobothriid tapeworm in Latvia. Since S. erinaceieuropaei is probably prevalent in Latvian wildlife and may also occur in other potential host species, further studies are needed in order to acquire complex data on its geographic distribution and transmission in the natural environment of Latvia, as well as on the spectrum of its intermediate, paratenic, and definitive hosts.

Occurrence of Taenia species in pigs in slaughterhouses in Phu Tho province, northern Vietnam

Pigs act as the intermediate hosts of the zoonotic tapeworms Taenia solium and Taenia asiatica, as well as of the non-zoonotic Taenia hydatigena. In Vietnam, human taeniasis and cysticercosis have been reported throughout the country; however, data on porcine cysticercosis are scarce. Our study aimed to estimate the prevalence of Taenia spp. in slaughtered pigs in two districts in Phu Tho, a mountainous province in northern Vietnam from where neurocysticercosis patients commonly originate. The carcasses of 399 pigs from 51 small-scale abattoirs were checked for cysticerci, while tongue, liver, masseter muscles, diaphragm and heart were sliced and examined. Retrieved cysticerci underwent polymerase chain reaction-restriction fragment length polymorphism and sequencing for species confirmation. Blood was also collected to detect antibodies by lentil lectin-purified glycoprotein enzyme-linked immunoelectrotransfer blot (LLGP-EITB) and recombinant T24H antigen (rT24H)-EITB and circulating antigens by B158/B60 Ag-ELISA. In two pigs, T. asiatica cysticerci were found, confirming the presence of the parasite in pigs in Vietnam at a low prevalence (0.5%; 95% exact confidence interval (CI): 0-1.19%). Cysticerci of T. solium were found in none of the pigs, although one serum sample was positive for antibodies in both LLGP-EITB and rT24H-EITB. Furthermore, a high prevalence of T. hydatigena cysticercosis was observed (18.0%; 95% Wilson score CI: 14.6-22.1%). In more than half of the T. hydatigena-positive pigs, circulating antigens were detected by Ag-ELISA, confirming that this test cannot be used to diagnose T. solium cysticercosis in this region. Finally, Spirometra erinaceieuropaei was found in one pig liver. It is the first record of this zoonotic cestode species in pigs in Vietnam. Overall, the findings confirmed the complex epidemiology of Taenia spp. in pigs in Vietnam.

First identification and molecular phylogeny of Sparganum proliferum from endangered felid (Panthera onca) and other wild definitive hosts in one of the regions with highest worldwide biodiversity

After decades of being neglected, broad tapeworms now attract growing attention thanks to the increasing number of reports from humans but also thanks to many advancements achieved by application of molecular methods in diagnosis and epidemiological studies. Regarding sparganosis, unfortunately general uniformity of most species, their high intraspecific variability and lack of agreement among researchers has led to confusion about the classification of Spirometra/Sparganum species. For the first time we determined adult, eggs and plerocercoid life cycle stages and the molecular phylogeny of Sparganum proliferum obtained from endangered wild felids (Panthera onca, Leopardus pardalis, Leopardus guttulus and Herpailurus yagoauroundi) in one of the largest continuous remnants of worldwide biodiversity, the Atlantic Forest from South America. Our results showed that at least 57% of total species of wild felids in this natural area could act as definitive hosts of Sparganum proliferum. We conclude that the availability of more morphological characteristics are needed in order to secure reliable characterization and diagnosis of sparganosis. The integration of these data with molecular analysis of mitochondrial DNA sequences will be useful for species discrimination.

Spirometra species from Asia: Genetic diversity and taxonomic challenges

Despite considerable controversy concerning the taxonomy of species within the genus Spirometra, human sparganosis and spirometrosis mainly in Asia and Europe has long been confidently ascribed to Spirometra erinaceieuropaei. Recently, the mitochondrial genomes of purported "S. erinaceieuropaei", "Spirometra decipiens" and "Spirometra ranarum" from Asia have been determined. However, it has been pointed out that the morphological criteria used for identifying these species are unsuitable and thus these identifications are questionable. In the present study, therefore, Spirometra samples from Asia were re-examined based on mitochondrial cytochrome c oxidase subunit 1 gene sequences and the identification of these species was discussed. Haplotype network and phylogenetic analyses revealed that: i) two distinct Spirometra species, Type I and Type II, are present in Asia and neither of which is close to likely European "S. erinaceieuropaei"; ii) Type I is genetically diverse and widely distributed, however Type II is known so far from Japan and Korea; iii) "S. decipiens" and "S. ranarum" reported from Asia are conspecific with Type I; iv) Type I is probably conspecific with Spirometra mansoni, and Type II may represent an undescribed species.

Broad tapeworms (Diphyllobothriidae), parasites of wildlife and humans: Recent progress and future challenges

Tapeworms of the family Diphyllobothriidae, commonly known as broad tapeworms, are predominantly large-bodied parasites of wildlife capable of infecting humans as their natural or accidental host. Diphyllobothriosis caused by adults of the genera Dibothriocephalus, Adenocephalus and Diphyllobothrium is usually not a life-threatening disease. Sparganosis, in contrast, is caused by larvae (plerocercoids) of species of Spirometra and can have serious health consequences, exceptionally leading to host's death in the case of generalised sparganosis caused by 'Sparganum proliferum'. While most of the definitive wildlife hosts of broad tapeworms are recruited from marine and terrestrial mammal taxa (mainly carnivores and cetaceans), only a few diphyllobothriideans mature in fish-eating birds. In this review, we provide an overview the recent progress in our understanding of the diversity, phylogenetic relationships and distribution of broad tapeworms achieved over the last decade and outline the prospects of future research. The multigene family-wide phylogeny of the order published in 2017 allowed to propose an updated classification of the group, including new generic assignment of the most important causative agents of human diphyllobothriosis, i.e., Dibothriocephalus latus and D. nihonkaiensis. Genomic data of selected representatives have also begun to accumulate, promising future developments in understanding the biology of this particular group of parasites. The list of nominal species of taxonomically most complicated genus Spirometra as well as host-parasite list of 37 species of broad tapeworms parasitising marine mammals (pinnipeds and cetaceans) are also provided.