Prevalence of zoonotic trematodes in fish from a Vietnamese fish-farming community

Prevalence of Parasitic Infections with Zoonotic Potential in Tilapia: A Systematic Review and Meta-Analysis

Tilapia has a high socioeconomic value in many countries worldwide. However, it has been identified as a zoonotic parasite reservoir. A systematic literature search and meta-analysis were carried out in order to estimate the global prevalence of zoonotic parasites that affect tilapia. The search was performed by three field experts to avoid reviewer bias. Polled prevalence was estimated using a logistic-normal random-effect regression model in the R software. We dealt with the heterogeneity among studies through subgroup analysis, taking into account the continent, country, genus of the host, parasite taxonomic group, sample origin, and type of diagnostic test as moderator variables. Fifty-two eligible articles were identified covering five tilapia genera with a pooled prevalence of 0.14 (95% CI: 0.10−0.20) showed significant heterogeneity (I2 = 98.4; p < 0.001). The subgroup analysis revealed that the most affected host was Sarotherodon, with a prevalence of 0.42 (95% CI: 0.22−0.65). Cestode was the taxonomic group with the largest prevalence (0.40; 95% CI:0.32−0.48), followed by amoeba (0.24; 95% CI: 0.16−0.35) and nematode (0.22; 95% CI: 0.11−0.38), among which, Schyzocotyle spp., Opistorchis spp., Gnathostoma spp. and Vermamoeba spp. have an impact on public health. Significant differences (p < 0.004) were found among continents and countries, with the highest value of prevalence detected in the African continent (0.28; 95% CI: 0.20−0.37), specifically in Tanzania (0.56; 95% CI: 0.22−0.87) and Egypt (0.43; 95% CI: 0.20−0.55). The origin of samples had a significant effect (p < 0.0001) on the detected prevalence, especially from those that showed the highest prevalence (0.24; 95% CI: 0.17−0.33). Finally, there were no differences in prevalence according to the diagnostic test (p = 0.97). Our results provide useful information on the development of epidemiological programs for the control of zoonoses associated with parasites in tilapia and in the design, planning, and implementation of future research.

Biology, Epidemiology, Clinical Features, Diagnosis, and Treatment of Selected Fish-borne Parasitic Zoonoses

Fish-borne parasites have been part of the global landscape of food-borne zoonotic diseases for many decades and are often endemic in certain regions of the world. The past 20 years or so have seen the expansion of the range of fish-borne parasitic zoonoses to new geographic regions leading to a substantial public health burden. In this article, we summarize current knowledge about the biology, epidemiology, clinical characteristics, diagnosis, treatment and control of selected fish-borne helminthic diseases caused by parasitic roundworm (Anisakis), tapeworm (Dibothriocephalus), and fluke (Metagonimus). Humans acquire infection via consumption of raw or improperly cooked fish or fish products. The burden from these diseases is caused by morbidity rather than mortality. Infected patients may present with mild to severe gastrointestinal (eg, abdominal pain, diarrhea, and indigestion) or allergic manifestations. Patients are often admitted to the hospital or clinic with acute symptoms and no prior health problems and no travel history. Diagnosis is often established based on the detection of the diagnostic parasite stages (eg, eggs or tapeworm segments) in the patient's feces. Sometimes imaging is required to exclude other causes and avoid unnecessary surgery. Dibothriocephalus and Metagonimus are mainly treated with praziquantel. Extraction of adult Dibothriocephalus or Anisakis larvae from the bowel ensures complete elimination of the parasites and prevents a relapse of infection. The development and implementation of more efficient food safety and public health strategies to reduce the burden of zoonotic diseases attributable to fish-borne parasites is highly desirable.

Helminth infections in fish in Vietnam: A systematic review

In Vietnam, fisheries play a key role in the national economy. Helminth infections in fish have a major impact on public health and sustainable fish production. A comprehensive summary of the recent knowledge on fish helminths is important to understand the distribution of parasites in the country, and to design effective control measures. Therefore, a systematic review was conducted, collecting available literature published between January 2004 and October 2020. A total of 108 eligible records were retrieved reporting 268 helminth species, among which are digeneans, monogeneans, cestodes, nematodes and acanthocephalans. Some helminths were identified with zoonotic potential, such as, the heterophyids, opisthorchiids, the nematodes Gnathostoma spinigerum, Anisakis sp. and Capillaria spp. and the cestode Hysterothylacium; and with highly pathogenic potential, such as, the monogeneans of Capsalidae, Diplectanidae and Gyrodactylidae, the nematodes Philometra and Camallanidae, the tapeworm Schyzocotyle acheilognathi, the acanthocephalans Neoechinorhynchus and Acanthocephalus. Overall, these studies only covered about nine percent of the more than 2400 fish species occurring in the waters of Vietnam. Considering the expansion of the aquaculture sector as a part of the national economic development strategy, it is important to expand the research to cover the helminth fauna of all fish species, to assess their potential zoonotic and fish health impacts.

Digenean trematodes in Hungarian freshwater aquacultures

Occurrence of metacercariae of potentially zoonotic trematodes (Platyhelminthes: Digenea) in the musculature of common carp (Cyprinus carpio L. 1758) was monitored in four Hungarian aquacultures. Four geographically distinct fish farms (located in the Northwestern, Southwestern, Northeastern and Southeastern parts of Hungary) were selected for the investigation. From each farm, a total of 258 one-summer-old fingerlings were sampled and examined in the years 2016 and 2017. In addition, in 2017, we examined 60 market size specimens (30 two-summers and 30 three-summers) sampled from the most infected aquaculture in the Northeastern part of Hungary. The fish were euthanized and decapitated whereafter their musculature (fillets) was digested in a pepsin solution to isolate metacercariae from the tissue whereafter morphological and molecular analyses (PCR and sequencing of ITS region) were performed. Opisthorchiid metacercariae were not recovered but in one of the farms numerous metacercariae were detected in the musculature of carp. They were identified as cyathocotylid trematodes based on their morphological characteristics and by sequencing the ITS region. The infection levels proved to be remarkably different among the four fish farms. Carps from the Northeastern farm were infected by large numbers of cyathocotylid metacercariae, while 8 Posthodiplostomum cuticola metacercariae were detected in the Northwestern aquaculture. In the other two farms (Southwestern and Southeastern) no infection was recorded. The infected farm is located close to a protected natural wetland habitat populated by a rich fauna of aquatic birds (potential final hosts) and snails (first intermediate host) which may create a higher risk of infection in the neighbouring fish farms.

High Prevalence of Clonorchis sinensis and Other Zoonotic Trematode Metacercariae in Fish from a Local Market in Yen Bai Province, Northern Vietnam

A small survey was performed to investigate the recent infection status of Clonorchis sinensis and other zoonotic trematode metacercariae in freshwater fish from a local market of Yen Bai city, Yen Bai province, northern Vietnam. A total of 118 fish in 7 species were examined by the artificial digestion method on March 2016. The metacercariae of 4 species of zoonotic trematodes, i.e., C. sinensis, Haplorchis pumilio, Haplorchis taichui, and Centrocestus formosanus, were detected. The metacercariae of C. sinensis were found in 62 (69.7%) out of 89 fish (5 species), and their intensity of infection was very high, 81.2 per fish infected. Prevalences of 3 intestinal flukes, H. pumilio, H. taichui and C. formosanus, were 75.0%, 47.6%, and 31.7% in positive fish species, respectively, with the metacercarial intensities of 15.5, 10.3, and 2.2 per fish infected. From the above results, it has been confirmed that various species of freshwater fish continue to play the role of the infection source of C. sinensis and other zoonotic trematodes in Yen Bai city, Yen Bai province, northern Vietnam. It is of particular note that the prevalence and intensity of C. sinensis metacercariae are much higher than those reported in previous studies in fish in northern Vietnam.

Infections of Digenetic Trematode Metacercariae in Wrestling Halfbeak, Dermogenys pusilla from Bangkok Metropolitan Region in Thailand

This study aimed to investigate metacercarial infections in the wrestling halfbeak, Dermogenys pusilla, collected from Bangkok metropolitan region of Thailand. A total of 4,501 fish from 78 study sites were commonly examined with muscle compression and digestion methods (only head part of fish) during September 2017 to July 2018. The overall prevalence of metacercarial infection was 86.1% (3,876/4,501 individuals), and the mean intensity was 48.9 metacercariae per fish infected. Four species, i.e., Posthodiplostomum sp., Stellantchasmus falcatus, Cyathocotylidae fam. sp., and Centrocestus formosanus, of digenetic trematode metacercariae (DTM) were detected. The prevalences were 65.8%, 52.0%, 2.1%, and 1.2%, respectively and their mean intensities were 23.1, 51.6, 1.4, and 3.2 per fish infected, respectively. The seasonal prevalences were 81.0% in winter, 87.8% in summer and 87.4% in rainy, and the mean intensities were 38.9, 46.6, and 55.2 metacercariae per fish infected, respectively. Conclusively, it was confirmed that the wrestling halfbeak play the role of second intermediate hosts of 4 species of digenetic trematodes including S. falcatus and Posthodiplostomum sp. in Bangkok metropolitan region. And then the metacercariae of C. formosanus and Cyathocotylidae fam. sp. are to be first found in the wrestling halfbeak by this study.

Prevalence, Species Distribution, and Related Factors of Fish-Borne Trematode Infection in Ninh Binh Province, Vietnam

Background. Clonorchis sinensis/Opisthorchis viverrini and minute intestinal flukes (MIF) such as Haplorchis pumilio and H. taichui are fish-borne trematodes (FBT) that may coexist in regions where local people have a habit of eating raw fish like Vietnam. Responses to FBT should be verified according to the data on the distribution of these flukes. This study aims to explore the prevalence of different species of FBT and related factors among local people in a northern province of Vietnam. Methods. A cross-sectional study was conducted in Kim Son and Yen Khanh districts, Ninh Binh province, between March 2016 and March 2017. Four hundred people aged 15 years or older were interviewed and gave stool samples. The FBT eggs in faecal samples were enumerated by modified formalin-ether technique and identified by sequencing of the second internal transcribed spacer (ITS2) region. Result. Among the 400 persons, 19.5% were infected with FBT. On univariate analysis, eating raw fish was the main risk factor (odds ratios (OR)) of 6.769 (95% confidence interval (CI) of 2.655-17.259) followed by being of male gender (3.994 (CI95% 2.117-7.536)) and drinking alcohol (2.680 (CI95% 1.440-4.986)), respectively. There was no risk of increased infection among those living at home without hygienic latrines, those living close to rivers or having ponds, or those raising cats or dogs. By multivariate analysis, FBT infection was only related to the consumption of raw fish and gender. Seventy stool samples with a sufficient amount of faecal matter were subjected to DNA extraction, 42.85% of them yielded DNA production, and all were of Clonorchis sinensis. Conclusion. Results of the study showed the high prevalence of infection of fish-borne trematode, mostly C. sinensis among humans in Ninh Binh province. The prevention of FBT should be strengthened with programs detailed according to the distribution of FBT in different endemic areas.

Zoonotic Trematode Metacercariae in Fish from Yangon, Myanmar and Their Adults Recovered from Experimental Animals

A survey was performed to investigate the infection status of zoonotic trematode (ZT) metacercariae in fish from a local market in Yangon City, Myanmar. A total of 264 fish (12 species) were collected through 4 times from December 2013 to June 2015. All collected fish were transferred to our laboratory on ice and examined by the artificial digestion method. More than 7 species of ZT metacercariae, i.e., Haplorchis taichui, H. pumilio, H. yokogawai, Centrocestus spp., Stellantchasmus falcatus, Pygidiopsis cambodiensis, and Procerovum sp. were detected. Metacercariae of H. taichui were collected in 58 (42.3%) out of 137 fish (5 species), and their average density was 42.9 per fish infected. Metacercariae of H. pumilio were detected in 96 (49.0%) out of 196 fish (9 species), and their average density was 23.6 per fish infected. H. yokogawai metacercariae were found in 40 (50.0%) out of 80 fish (5 species), and Centrocestus spp. metacercariae in 91 (50.8%) out of 179 fish (8 species), and their densities were 306 and 25.8 per fish infected, respectively. Metacercariae of S. falcatus and P. cambodiensis were detected only in mullets, Chelon macrolepis. A total of 280 Procerovum sp. metacercariae were found in 6 out of 12 climbing perch, Anabas testudineus. Morphological characteristics of adult flukes recovered from experimental animals were described. It has been first confirmed that fish from Yangon, Myanmar are commonly infected with various species of ZT metacercariae.

Infectious bacterial pathogens, parasites and pathological correlations of sewage pollution as an important threat to farmed fishes in Egypt

This paper is a part of a multi-disciplinary research "Application of Decentralized On-Site Water Treatment System in Egypt for Use in Agriculture and Producing Safe Fish and Animal Proteins". The project aimed to investigate the environmental impact of implementing sewage water before and after treatment using the effluent of the on-site decentralized Japanese' Johkasou system, in agriculture and producing fish protein. The aim is to establish such system in Egypt to strengthen the sanitary conditions of water resources. In the present study, the impact of the sewage pollution in some fish farms at El-Fayyum, Port Said and El-Dakahlia governorates in Egypt was carried out. Water and fish (Oreochromis niloticus and Mugil cephalus) samples were collected from private fish farms of such localities. Bacteriological and chemical examination of water samples revealed the existence of coliforms and many other bacterial species of significant human health hazards. The chemical parameters of water showed a marked deviation from normal levels while examination of fish flesh specimens indicated contamination with Streptococcus Sp., Staphylococcus Sp., and Salmonella in all examined localities. Other bacterial isolates of human health importance (Morganella morganii, Pseudomonas cepacia and Enterococcos durans) were identified. The parasitological examination revealed the presence of encysted metacercariae (EMC); Diplostomatidae, Prohemistomatidae and Heterphyidae. Moreover, two protozoan parasites (Mxyoboulus tilapiae and Ichthyophthirius multifilis) were also recorded. The histopathological examination revealed mild tissue reaction in case of bacterial infection and severe pathological lesions in different organs in case of EMC infection. Lamellar hyperplasia and mononuclear cell infiltration in branchial tissue was common findings. In skeletal muscles, atrophy of muscle fibres, myolysis and myophagia were detected.

Clonorchis sinensis and Opisthorchis spp. in Vietnam: current status and prospects

Clonorchis sinensis and Opisthorchis viverrini are clinically important small liver flukes because of their known association with development of cholangiocarcinoma. In Vietnam, high prevalence of C. sinensis infection in humans was previously reported in northern provinces, and O. viverrini infection has been detected in several central provinces. However, diagnosis of C. sinensis and O. viverrini infections in the past was merely based on faecal egg examination. This method alone can lead to misidentification at the species level because of morphological similarity between the eggs of these liver flukes and minute intestinal trematodes of the family Heterophyidae. In fact, recent surveys in Vietnam revealed that infection with several minute intestinal flukes, such as Haplorchis pumilio and H. taichui, are much more common than infection with C. sinensis or O. viverrini, and they often co-infect humans. Thus, previously reported prevalence of small liver fluke infection in Vietnam was likely over-estimated due to mis identification of parasites in copro-parasitological examinations. In addition, there is some confusion about identification of cercariae, metacercariae and also adults of C. sinensis and O. viverrini in intermediate and definitive hosts. The aim of this review is, therefore, to draw realistic pictures of the past and present scientific reports on the epidemiology and biology of C. sinensis and Opisthorchis spp. infection in Vietnam.

Stellantchasmus falcatus (Digenea: Heterophyidae) in Cambodia: Discovery of Metacercariae in Mullets and Recovery of Adult Flukes in an Experimental Hamster

Stellantchasmus falcatus (Digenea: Heterophyidae) is first reported from Cambodia through recovery of the metacercariae from mullet fish and adult flukes from an experimentally infected hamster. We purchased 7 mullets, Chelon macrolepis, in a local market of Phnom Penh, Cambodia, and each of them was examined by the artificial digestion method on May 2010. The metacercariae of S. falcatus were detected in all mullets (100%) examined, and their average density was 177 per fish. They were elliptical, 220×168 μm in average size. They were orally infected to an hamster to obtain adult flukes. Adults recovered at day 10 post infection were observed with a light microscope and a scanning electron microscope (SEM). They were small, 450×237 μm in average size, had a small oral sucker (41×50 μm), subglobular pharynx (29×21 μm), slender esophagus (57 μm), long and thick-walled expulsor (119×32 μm), spherical ovary (58×69 μm), and 2 ovoid testes (right: 117×74 μm; left: 114×63 μm). Eggs were small, yellow, and 23×12 μm in average size. In SEM observations, tegumental spines were densely distributed on the whole tegument, and single small type I sensory papillae were distributed around the lip of oral sucker. The small ventral sucker was dextrally located and had 8 type I sensory papillae on the left margin. It has been first confirmed in the present study that the mullet, C. macrolepis, is playing the role of a second intermediate host of S. falcatus in Cambodia.

Two-year intervention trial to control of fish-borne zoonotic trematodes in giant gourami (Osphronemus goramy) and striped catfish (Pangasianodon hypophthalmus) in nursery ponds in the Mekong Delta, Vietnam

Fish-borne zoonotic trematode parasites (FZT) pose a food safety and public health problem in Vietnam. The transmission cycle is complex as domestic animals, especially dogs, cats, fish-eating birds and pigs together with humans serve as reservoir hosts and contribute to FZT egg contamination of aquaculture ponds and the environment. This intervention trial was conducted to determine the effectiveness of various on-farm interventions, including reduction in FZT egg contamination through treatment of infected people and domestic animals, reduction in snail density through mud removal from aquaculture ponds prior to fish stocking, and various other measures in reducing FZT infection in juvenile striped catfish (Pangasianodon hypophthalmus) and giant gourami (Osphronemus goramy). Interventions were implemented on 5 farms for each fish species during production cycles in 2009 and 2010 while 5 similar farms for each species served as control. For both fish species, both prevalence and intensity of infection did not differ significantly between intervention and non-intervention farms prior to the interventions. The interventions significantly reduced both prevalence and intensity of FZT infection in the juvenile fish compared to control ponds. For giant gourami, odds of infection in intervention ponds was 0.13 (95% CL: 0.09-0.20; p<0.001) of that in non-intervention ponds after the 2009 trial and 0.07 (0.03-0.14; p<0.001) after the 2010 trial. For striped catfish, these figures were 0.17 (0.08-0.35; p<0.001) after the 2009 trial while after the 2010 trial all ponds with interventions were free from infection. Metacercariae intensity (no. of metacercariae/fish) in giant gourami from intervention ponds was 0.16 (0.11-0.23; p<0.001) of that in fish from non-intervention ponds after the 2009 trial and 0.07 (0.04-0.15; p<0.001) after the 2010 trial; for striped catfish these figures were 0.18 (0.09-0.36; p<0.001) and 0.00 (confidence limits not estimated), respectively. The aquaculture farm pond intervention approaches taken in this trial have the potential to reduce or eliminate FZT infections in fish and may be implemented across the entire region if adjusted to local conditions and fish species.

Current status of fish-borne zoonotic trematode infections in Gia Vien district, Ninh Binh province, Vietnam

BACKGROUND

Ninh Binh province is known as an endemic area of fish-borne zoonotic trematode (FZT) transmission in Vietnam. A cross-sectional study was conducted in Gia Minh and Gia Thinh communes of Gia Vien district, Ninh Binh province to investigate the infections with different stages of FZT in various host species.

METHODS

Faecal samples from 1,857 humans were examined for trematode eggs using the Kato-Katz method, while faecal samples from 104 dogs, 100 cats, and 100 pigs were examined using the Formalin-ethyl acetate concentration technique (FECT). A total of 483 specimens of freshwater fish, representing 9 species, were examined for metacercariae using the artificial digestion method. Three methods of cercarial detection (shedding, crushing and cutting) were applied for examination of 3,972 specimens of freshwater snails, representing 7 species. All relevant data e.g. location, sex, age group, animal species, and habitat were recorded for statistical analyses.

RESULTS

Helminth eggs were found in 65.5% of the human faecal samples, including 20.5% of faecal samples containing small trematode eggs. Infection with small trematodes differed among communes, age groups and sexes. Eggs of small trematodes were found in 32.7% of faecal samples from dogs, 49.0% from cats and 13.0% from pigs. The difference in prevalences and intensities were significant among species of animals but did not differ between the two communes. All fish species were infected with FZT, with an average prevalence of 56.1% and a mean intensity of 33.245 metacercariae per gram. Prevalence and intensity in fish differed significantly among cummunes and fish groups. Six species of zoonotic trematodes were identified. Metacercariae of the small liver fluke, Clonorchis sinensis, was only found in Hemiculter leucisculus. A total of 9 specimens from two snail species, Melanoides tuberculata and Bithynia fuchsiana, were infected with trematodes and four cercarial types were detected in the study sites.

CONCLUSIONS

We conclude that Gia Minh and Gia Thinh communes are continuing to be hot-spot endemic areas of FZT and other helminths infections where the habit of eating raw fish by the local people is still present.

Metacercarial infection of wild Nile tilapia (Oreochromis niloticus) from Brazil

Fingerlings of Oreochromis niloticus collected in an artificial urban lake from Belo Horizonte, Minas Gerais, Brazil, were evaluated for natural infection with trematodes. Morphological taxonomic identification of four fluke species was performed in O. niloticus examined, and the total prevalence of metacercariae was 60.7% (37/61). Centrocestus formosanus, a heterophyid found in the gills, was the species with the highest prevalence and mean intensity of infection (31.1% and 3.42 (1–42), resp.), followed by the diplostomid Austrodiplostomum compactum (29.5% and 1.27 (1-2)) recovered from the eyes. Metacercariae of Drepanocephalus sp. and Ribeiroia sp., both found in the oral cavity of the fish, were verified at low prevalences (8.2% and 1.6%, resp.) and intensities of infection (only one metacercaria of each of these species per fish). These species of trematodes are reported for the first time in O. niloticus from South America. The potential of occurrence of these parasites in tilapia farming and the control strategies are briefly discussed.

A review of foodborne bacterial and parasitic zoonoses in Vietnam

Vietnam has experienced unprecedented economic and social development in recent years, and the livestock sector is undergoing significant transformations. Although food animal production is still dominated by small-scale 'backyard' enterprises with mixed crop-livestock or livestock-aquatic systems, there is a trend towards more intensive and vertically integrated operations. Changes in animal production, processing and distribution networks for meat and animal products, and the shift from wet markets to supermarkets will undoubtedly impact food safety risks in Vietnam in unforeseen and complex ways. Here, we review the available published literature on bacterial and parasitic foodborne zoonoses (FBZ) in Vietnam. We report on clinical disease burden and pathogen prevalence in animal reservoirs for a number of important FBZ, and outline opportunities for future research.

Survival of heterophyid metacercaria in common carp (Cyprinus carpio)

Heterophyidae are small intestinal trematodes that infect vertebrates worldwide. Common carp (Cyprinus carpio) is one of the most preferred freshwater fish species by consumers in Asia, the region where fish-borne trematodes like Heterophyidae are most prevalent. How long Heterophyidae survive in common carp is unknown. The objective of this study was to quantify survival of Heterophyidae in common carp after experimental exposure. Fish of 0.18 g were either used as controls or exposed to 250 heterophyid cercaria for 24 h. Control fish did not become infected. Percentage infection of exposed fish at 0-2 (n = 53), >2-10 (n = 15), >10-20 (n = 11), and >20-27 (n = 33) weeks post exposure was 98, 80, 100, and 100 % respectively. The number of metacercaria per fish did not significantly decrease (P = 0.19) during 27 weeks after exposure: exp [3.6200-0.0193 × weeks post exposure]. All developed metacercaria were identified as Haplorchis spp. It was concluded that Heterophyidae may persist in carp for a long time, implying that harvestable carp are a risk to human health.

Prevention and control of fish-borne zoonotic trematodes in fish nurseries, Vietnam

Reducing snails and trematode eggs in nursery ponds lowered trematode transmission among fish.

Worldwide, >18 million persons were infected with fish-borne zoonotic trematodes in 2002. To evaluate the effectiveness of interventions for reducing prevalence and intensity of fish-borne zoonotic trematode infections in juvenile fish, we compared transmission rates at nurseries in the Red River Delta, northern Vietnam. Rates were significantly lower for nurseries that reduced snail populations and trematode egg contamination in ponds than for nurseries that did not. These interventions can be used in the development of programs for sustained control of zoonotic trematodes in farmed fish.

Relationship between snail population density and infection status of snails and fish with zoonotic trematodes in Vietnamese carp nurseries

BACKGROUND

Fish-borne zoonotic trematodes (FZT) are a food safety and health concern in Vietnam. Humans and other final hosts acquire these parasites from eating raw or under-cooked fish with FZT metacercariae. Fish raised in ponds are exposed to cercariae shed by snail hosts that are common in fish farm ponds. Previous risk assessment on FZT transmission in the Red River Delta of Vietnam identified carp nursery ponds as major sites of transmission. In this study, we analyzed the association between snail population density and heterophyid trematode infection in snails with the rate of FZT transmission to juvenile fish raised in carp nurseries.

METHODOLOGY/PRINCIPAL FINDINGS

Snail population density and prevalence of trematode (Heterophyidae) infections were determined in 48 carp nurseries producing Rohu juveniles, (Labeo rohita) in the Red River Delta area. Fish samples were examined at 3, 6 and 9 weeks after the juvenile fish were introduced into the ponds. There was a significant positive correlation between prevalence of FZT metacercariae in juvenile fish and density of infected snails. Thus, the odds of infection in juvenile fish were 4.36 and 11.32 times higher for ponds with medium and high density of snails, respectively, compared to ponds where no infected snails were found. Further, the intensity of fish FZT infections increased with the density of infected snails. Interestingly, however, some ponds with no or few infected snails were collected also had high prevalence and intensity of FZT in juvenile fish. This may be due to immigration of cercariae into the pond from external water sources.

CONCLUSIONS/SIGNIFICANCE

The total number and density of potential host snails and density of host snails infected with heterophyid trematodes in the aquaculture pond is a useful predictor for infections in juvenile fish, although infection levels in juvenile fish can occur despite low density or absence infected snails. This suggests that intervention programs to control FZT infection of fish should include not only intra-pond snail control, but also include water sources of allochthonous cercariae, i.e. canals supplying water to ponds as well as snail habitats outside the pond such as rice fields and surrounding ponds.

Foodborne trematode metacercariae in fish from northern Vietnam and their adults recovered from experimental hamsters

The prevalence of foodborne trematode (FBT) metacercariae was investigated in fish from 2 localities of northern Vietnam in 2004-2005. Freshwater fish (9 species) were collected from local markets in Hanoi City (n=76) and Nam Dinh Province (n=79), and were examined for FBT metacercariae using the artificial digestion technique. Adult flukes were obtained from hamsters experimentally infected with the metacercariae at day 8 post-infection. Three (Haplorchis pumilio, Centrocestus formosanus, and Procerovum varium) and 6 (Haplorchis taichui, H. pumilio, C. formosanus, P. varium, Stellantchasmus falcatus, and Heterophyopsis continua) species of FBT metacercariae were detected in the 2 regions, respectively. Overall, among the positive fish species, H. pumilio metacercariae were detected in 104 (80.0%) of 130 fish examined (metacercarial density per infected fish; 64.2). C. formosanus metacercariae were found in 37 (40.2%) of 92 fish (metacercarial density; 14.7). P. varium metacercariae were detected in 19 (63.3%) of 30 fish (Anabas testudineus and Mugil cephalus) (metacercarial density; 247.7). S. falcatus metacercariae were found in all 10 M. cephalus examined (metacercarial density; 84.4). H. continua metacercariae (2 in number) were detected in 1 fish of Coilia lindmani. Morphologic characteristics of the FBT metacercariae and their experimentally obtained adults were described. The results have demonstrated that various FBT species are prevalent in northen parts of Vietnam.

Genetic differences among Vietnamese Haplorchis taichui populations using the COI genetic marker

Adults of the fish-borne intestinal trematode species Haplorchis taichui were collected from humans in three provinces of Vietnam: Ha Giang, Thanh Hoa and Quang Tri. Genetic analysis revealed three groups of the parasite from clustering dendrograms, correlating with the localities in which they were collected. Measurements of evolutionary divergence over sequence pairs were greater between the different populations than within them, which indicated that the three populations were genetically different. The significance (Fst= 0.73; P value < 0.05) of the genetic variation of the three studied populations implied that genetic separation of the populations had already occurred, which may have been caused by a low gene flow among the different H. taichui populations. Factors contributing to the low gene flow may include isolation resulting from the intermediate-host fish rarely being sold outside of the rural commune where they are raised and the enclosed aquacultural areas themselves.

Echinostoma revolutum: metacercariae in Filopaludina snails from Nam Dinh Province, Vietnam, and adults from experimental hamsters

We detected metacercariae of Echinostoma revolutum in Filopaludina sp. snails purchased from a local market in Nam Dinh Province for the first time in Vietnam. Adult flukes were harvested from experimentally infected hamsters at days 14 and 17 post-infection. The metacercariae were round, 170-190 µm (n = 15) in diameter, with a cyst wall thickness of about 12 µm. A total of 37 collar spines were arranged around the head collar, and large excretory granules were seen in 2 canals of the excretory bladder. The 14-day old adult flukes were elongated, ventrally curved, and 5.0-7.2 × 0.8-1.3 mm (n = 20). The head collar had a total of 37 collar spines arranged in 2 alternating rows, including 5 corner spines on each side. The cirrus sac contained a saccular seminal vesicle, a prostatic gland, and an unarmed cirrus. Two tandem testes were smooth or slightly lobed. Eggs were ovoid to elliptical, 110-118 × 70-75 µm. These morphological characters were similar to those of E. revolutum and E. jurini. We tentatively identified it as E. revolutum because the validity of E. jurini remains to be elucidated. The taxonomic relationship of E. revolutum and E. jurini is discussed.

Freshwater aquaculture nurseries and infection of fish with zoonotic trematodes, Vietnam

TOC summary: Aquaculture nurseries should be included in control programs to produce parasite-free fish for human consumption.

Residents of the Red River Delta region of northern Vietnam have a long tradition of eating raw fish. Fish-borne zoonotic trematodes (FZTs) are estimated to infect ≈1 million persons in Vietnam. It remains uncertain at what stages in the aquaculture production cycle fish become infected with FZTs. Newly hatched fish (fry) from 8 hatcheries and juveniles from 27 nurseries were therefore examined for FZT infection. No FZTs were found in fry from hatcheries. In nurseries, FZT prevalence in juveniles was 14.1%, 48.6%, and 57.8% after 1 week, 4 weeks, and when overwintered in ponds, respectively. FZT prevalence was higher in grass carp (p<0.001) than in other carp species. Results show that nurseries are hot spots for FZT infections in fish. Thus, sustainable FZT prevention strategies must address aquaculture management practices, particularly in nurseries, to minimize the risk of distributing infected juveniles to grow-out ponds and, subsequently, to markets for human consumption.

Distribution of freshwater snails in family-based VAC ponds and associated waterbodies with special reference to intermediate hosts of fish-borne zoonotic trematodes in Nam Dinh Province, Vietnam

Fish-borne zoonotic trematodes, such as Clonorchis sinensis, heterophyids and others, constitute a public health concern in parts of northern Vietnam and infections with these trematodes are often thought to be linked to fish culture. One common fish culture system is the integrated fish-livestock (VAC) ponds where individual households have 1 or more ponds. Fish fry, mainly of various carp species, produced in hatcheries, not necessarily local, are introduced into nursery ponds and after approximately 6 weeks, juvenile fishes are transferred to household ponds, referred to as grow-out ponds. Grow-out ponds are usually fertilized with organic debris, including animal excreta, to stimulate algal growth and subsequently fish growth. This paper describes the distribution of freshwater snails and occurrence of trematode infections in these in VAC ponds and associated habitats as part of a major study on risk factors of FZT infections in cultured fish in two communes, Nghia Lac and Nghia Phu, Nghia Hung District, Nam Dinh Province. The area is under intense rice cultivation with an extensive canal network supplying fields and also household VAC ponds. A total of 16 snail species was found and four were widely distributed i.e. Angulyagra polyzonata, Melanoides tuberculata, Bithynia fuchsiana and Pomacea insularum. Snail diversity and counts were higher in nursery ponds than in grow-out ponds. Species of the families Thiaridae and Viviparidae were more abundant than other species in VAC ponds while species of the Bithyniidae, Stenothyridae and Planorbidae dominated in rice fields and small canals. Trematode infections were found in eight snail species and among these M. tuberculata had the highest overall prevalence of infection (13.28%). No trematode infections were found in species of the Viviparidae and Ampullaridae except for metacercariae. Parapleurolophocercous and pleurolophocercous cercariae constituted the most common type of cercariae recovered, contributing 40.6% of all infections followed by echinostome cercariae (35.0%) and xiphidiocercariae (17.3%). Bithynia fuschiana and M. tuberculata had the most diverse trematode fauna. C. sinensis was not recorded in this study. The VAC pond system in this area, is very important for transmission of minute intestinal trematodes while they play little role in transmission of C. sinensis as its intermediate hosts, bithynid snails, rarely occur in these ponds. From a public health perspective this is positive as the effects of infections with intestinal trematodes are considered mild. On the other hand it is possible that even such subtle effects could have importance in public health as transmission is very intense in the area. And this in combination with the aquaculture importance, reduced marketability of fishes with high metacercariae loads, warrants that control efforts against these trematodes are initiated to reduce transmission in this production system.

Farm-level risk factors for fish-borne zoonotic trematode infection in integrated small-scale fish farms in northern Vietnam

Background

Northern Vietnam is an endemic region for fish-borne zoonotic trematodes (FZT), including liver and intestinal flukes. Humans acquire the FZT infection by eating raw or inadequately cooked fish. The production of FZT-free fish in aquaculture is a key component in establishing a sustainable program to prevent and control the FZT transmission to humans. Interventions in aquaculture should be based on knowledge of the main risk factors associated with FZT transmission.

Methodology/Principal Findings

A longitudinal study was carried out from June 2006 to May 2007 in Nam Dinh province, Red River Delta to investigate the development and risk factors of FZT infections in freshwater cultured fish. A total of 3820 fish were sampled six times at two-month intervals from 96 fish farms. Logistic analysis with repeated measurements was used to evaluate potential risk factors based on information collected through questionnaire interviews with 61 fish farm owners. The results showed that the FZT infections significantly increased from first sampling in June to July 2006 (65%) to sixth sampling in April to May, 2007 (76%). The liver fluke, Clonorchis sinensis and different zoonotic intestinal flukes including Haplochis pumilio, H. taichui, H. yokogawai, Centrocestus formosanus and Procerovum varium were found in sampled fish. Duration of fish cultured (sampling times), mebendazole drug self-medication of household members, presence of snails in the pond, and feeding fish with green vegetation collected outside fish farms all had a significant effect on the development of FZT prevalence in the fish.

Conclusions/Significance

The FZT prevalence in fish increased by 11 percentage points during a one-year culture period and the risk factors for the development of infection were identified. Results also highlight that the young fish are already highly infected when stocked into the grow-out systems. This knowledge should be incorporated into control programs of FZT transmission in integrated small-scale aquaculture nursery and grow-out systems in Vietnam.

Fish-borne zoonotic trematodes in cultured and wild-caught freshwater fish from the Red River Delta, Vietnam

Nam Dinh province in Red River Delta, Vietnam, is an endemic area for the human liver fluke Clonorchis sinensis, but little is known about its occurrence in the fish intermediate host in this region. A cross-sectional study was carried out to identify fish-borne zoonotic trematodes (FZT) species diversity and to estimate the prevalence and infection densities of FZT in three major types of fish: cultured species and self-recruiting species from family ponds and wild-caught species from irrigation canals in Nam Dinh province. A total of 714 wild-caught fish from canals and 829 fish from family ponds were examined for FZT infection. Only a single fish from a pond was infected with Cl. sinensis. The intestinal fluke Haplorchis pumilio was very common and found in more than 50% of fish irrespective of origin. Four other intestinal FZT species were found at low prevalence (<4.0%) except Procerovum varium, which was found in 14.4% of wild-caught fish. There was no significant difference (p > 0.05) in FZT prevalence in cultured fish (64.3%) compared with wild-caught fish (68.9%), nor between cultured fish species (65.1%) and self-recruiting species obtained from ponds (58.1%). The prevalence of FZT in silver carp (Hypophthalmichthys molitrix) (82.7%), grass carp (Ctenopharyngodon idellus) (76.9%), and mrigal (Cirrhinus mrigala) (63.8%) was significantly higher than that in rohu (Labeo rohita) (49.1%) (p < 0.001). The density of FZT metacercariae in fish from canals (0.56 metacercariae/g) was significantly higher (p < 0.001) than that in fish from ponds (0.03 metacercariae/g). The frequent occurrence of intestinal flukes in all fish types indicates that wild-caught and cultured fish are equally at risk of infection with FZT, particularly in species commonly used in Nam Dinh to prepare raw fish dishes. These results underscore the need for greater awareness of the risk from raw fish dishes among public health agencies and consumers.

Survey for fishborne zoonotic metacercariae in farmed grouper in Vietnam

Because of the common and growing practice of consuming raw grouper in Vietnam, the potential for transmission of zoonotic parasites is unclear. An investigation of the prevalence of zoonotic parasites in cage-reared grouper (Epinephelus coioides and Epinephelus bleekeri) from marine waters of Cat Ba Island, Hai Phong city, Northern Vietnam, revealed the presence of two zoonotic trematode metacercariae species, Procerovum varium and Heterophysopsis continua. The identity of the metacercariae was confirmed from adult flukes recovered from mice experimentally inoculated with metacercariae. The prevalence of zoonotic parasites in 40 E. coioides was 10.0% and 1.2% in 172 E. bleekeri. Since little is known of their ecology and epidemiology, further investigation of these zoonotic parasites is needed to develop prevention guidelines.

Fishborne zoonotic trematodes in raw fish dishes served in restaurants in Nam Dinh Province and Hanoi, Vietnam

Fishborne zoonotic trematode (FZT) parasites are a serious food safety problem in Asian countries because of their tradition of eating raw fish. In northern Vietnam, the prevalence of FZT metacercariae (MC) in wild-caught and cultured fish is quite high. The objective of this study was to assess the risk for acquiring these parasites from raw fish dishes prepared in restaurants. Samples of fish meat (body muscle) and remainder parts (head, gills, fins, skin, and muscle tissue from the tail) were obtained from 39 restaurants located in Nam Dinh province, an area endemic for FZTs, and from 74 restaurants in the capital city of Hanoi. Six species of zoonotic intestinal trematodes were recovered from a total of nine freshwater and brackish water fish species. Overall, the prevalence of MC in meat samples was 6.1% and in remainder samples, 34.9%; freshwater fish were more often infected (39.4%) than brackish water species (16.0%). Dishes from Nam Dinh restaurants were more often infected (11.8%) than those from Hanoi (3.1%). The dominant trematode species, Haplorchis pumilio, exhibited a strong predilection for encystment in remainder fish parts (36.5%) compared with meat (3.9%). The mean density of MC in meat samples overall was low (1.0 to 1.5 MC per 50 g); however, the potential for parasites to accumulate over years of eating raw fish could result in significant clinical disease, as occurs with liver flukes. Also, the high densities of MC in the remainder parts (2.3 to 72.9 MC per 50 g) pose a threat for cross-contamination during dish preparation.

Prevalence and risks for fishborne zoonotic trematode infections in domestic animals in a highly endemic area of North Vietnam

Fishborne zoonotic trematodes (FZT) are endemic in humans and cultured fish in Vietnam but little is known about FZT in domestic animals. A study was designed to determine FZT prevalence and species diversity, and risk factors for infection, in dogs, cats and pigs. Faecal samples from 186 dogs, 94 cats and 168 pigs belonging to 132 households in Nghia Hung district, Nam Dinh province, were examined for small trematode eggs; those were trematode eggs with length less than 50 microm. Prevalence of FZT varied significantly between cats (70.2%), dogs (56.9%) and pigs (7.7%). Forty-nine of the egg-positive animals (25 dogs, 20 cats and 4 pigs) were necropsied to obtain adult trematodes for identification. The liver fluke, Clonorchis sinensis, and 11 species of intestinal flukes including Haplorchis, Stellantchasmus, Stictodora and Centrocestus were recovered from the infected animals. The practice of feeding raw fish to the animals was a significant risk factor for infection; this risk was reduced if the animals were periodically treated with anthelmintics. Based on the high prevalence of FZT and certain risky husbandry practices, domestic animals are likely to be major contributors of FZT eggs to the environment. Therefore, education of farmers to avoid feeding raw fish and to perform regular anthelmintic treatment of dogs, cats and pigs is needed in integrated FZT control programs.

Food-borne trematodiases

An estimated 750 million people are at risk of infections with food-borne trematodes, which comprise liver flukes (Clonorchis sinensis, Fasciola gigantica, Fasciola hepatica, Opisthorchis felineus, and Opisthorchis viverrini), lung flukes (Paragonimus spp.), and intestinal flukes (e.g., Echinostoma spp., Fasciolopsis buski, and the heterophyids). Food-borne trematodiases pose a significant public health and economic problem, yet these diseases are often neglected. In this review, we summarize the taxonomy, morphology, and life cycle of food-borne trematodes. Estimates of the at-risk population and number of infections, geographic distribution, history, and ecological features of the major food-borne trematodes are reviewed. We summarize clinical manifestations, patterns of infection, and current means of diagnosis, treatment, and other control options. The changing epidemiological pattern and the rapid growth of aquaculture and food distribution networks are highlighted, as these developments might be associated with an elevated risk of transmission of food-borne trematodiases. Current research needs are emphasized.

Animal reservoir hosts and fish-borne zoonotic trematode infections on fish farms, Vietnam

Cats, dogs, and pigs may be reservoir hosts.

Fish-borne zoonotic trematodes (FZT) pose a risk to human food safety and health and may cause substantial economic losses in the aquaculture industry. In Nghe An Province, Vietnam, low prevalence of FZT for fish farmers but high prevalence for fish indicate that reservoir hosts other than humans may play a role in sustaining transmission. To determine whether domestic animals may be reservoir hosts, we assessed prevalence and species composition of FZT infections in dogs, cats, and pigs in a fish-farming community in Vietnam. Feces from 35 cats, 80 dogs, and 114 pigs contained small trematode eggs at 48.6%, 35.0%, and 14.4%, respectively; 7 species of adult FZT were recovered from these hosts. These results, combined with data from previous investigations in this community, imply that domestic animals serve as reservoir hosts for FZT and therefore must be included in any control programs to prevent FZT infection in humans.

Prevalence of zoonotic metacercariae in two species of grouper, Epinephelus coioides and Epinephelus bleekeri, and flathead mullet, Mugil cephalus, in Vietnam

Fishborne zoonotic metacercariae have not been reported from brackish water and marine fish from Vietnam waters although these parasites are common in the country's freshwater fish. Both wild-caught and cultured grouper (Epinephelus coioides and Epinephelus bleekeri), and mullet (Mugil cephalus) from brackish and marine waters located in Khanh Hoa province in central coastal Vietnam were examined, and found positive for zoonotic trematode metacercariae. From grouper, Heterophyopsis continua and Procerovum varium were recovered. The prevalence of H. continua ranged from 2.0 to 6.0% and that for P. varium ranged from 11.6 to 15.8%. Mullet were infected with Pygidiopsis summa and H. continua both of these species are new records for Vietnam. The prevalence of P. summa in mullet was generally high, ranging from 17.6 to 75.5%, and was significantly higher than the prevalence of H. continua (2.5 to 32.4%). There were no significant differences in the prevalence of metacercariae between grouper from natural or cultured habitats, indicating that the highest risk of infection occurs in the wild-caught state prior to their placement in culture. Further, there was no difference in metacercarial prevalence between the 2 species of grouper. Infected wild-caught seed were only observed from January to October. Monthly variation in prevalence suggests seasonal variation in mullet infections occurs in this region with the highest transmission taking place from October to December. Basic investigations on the ecology and epidemiology of these intestinal flukes need to be carried out to determine their significance as a public health problem and the aspects of their biology that may be vulnerable to control interventions.