Foodborne intestinal flukes in Southeast Asia

Global distribution of zoonotic digenetic trematodes: a scoping review

BACKGROUND

Digenetic trematodes, including blood flukes, intestinal flukes, liver flukes, lung flukes, and pancreatic flukes, are highly diverse and distributed widely. They affect at least 200 million people worldwide, so better understanding of their global distribution and prevalence are crucial for controlling and preventing human trematodiosis. Hence, this scoping review aims to conduct a comprehensive investigation on the spatio-temporal distribution and epidemiology of some important zoonotic digenetic trematodes.

METHODS

We conducted a scoping review by searching PubMed, Web of Science, Google Scholar, China National Knowledge Infrastructure, and Wanfang databases for articles, reviews, and case reports of zoonotic digenetic trematodes, without any restrictions on the year of publication. We followed the inclusion and exclusion criteria to identify relevant studies. And relevant information of the identified studies were collected and summarized.

RESULTS

We identified a total of 470 articles that met the inclusion criteria and were included in the review finally. Our analysis revealed the prevalence and global distribution of species in Schistosoma, Echinostoma, Isthmiophora, Echinochasmus, Paragonimus, Opisthorchiidae, Fasciolidae, Heterophyidae, and Eurytrema. Although some flukes are distributed worldwide, developing countries in Asia and Africa are still the most prevalent areas. Furthermore, there were some overlaps between the distribution of zoonotic digenetic trematodes from the same genus, and the prevalence of some zoonotic digenetic trematodes was not entirely consistent with their global distribution. The temporal disparities in zoonotic digenetic trematodes may attribute to the environmental changes. The gaps in our knowledge of the epidemiology and control of zoonotic digenetic trematodes indicate the need for large cohort studies in most countries.

CONCLUSIONS

This review provides important insights into the prevalence and global distribution of some zoonotic digenetic trematodes, firstly reveals spatio-temporal disparities in these digenetic trematodes. Countries with higher prevalence rate could be potential sources of transmitting diseases to other areas and are threat for possible outbreaks in the future. Therefore, continued global efforts to control and prevent human trematodiosis, and more international collaborations are necessary in the future.

Metabarcoding of pathogenic parasites based on copro-DNA analysis of wild animals in South Korea

Four species of dominant wild animals, namely, Prionailurus bengalensis euptilurus, Nyctereutes procyonoides koreensis, Hydropotes inermis argyropus, and Sus scrofa coreanus, are hosts of potential infectious agents, including helminths and protozoa. Therefore, it is necessary to analyze the infectious agents present in these wild animals to monitor and control the spread of pathogens. In the present study, fecal samples from 51 wild animals were collected from the mountains of Yangpyeong, Hoengseong, and Cheongyang in South Korea and metabarcoding of the V9 region of the 18S rRNA gene was performed to identify various parasite species that infect these wild animals. Genes from nematodes, such as Metastrongylus sp., Strongyloides spp., Ancylostoma sp., and Toxocara sp., were detected in the fecal samples from wild animals. In addition, platyhelminthes, including Spirometra sp., Echinostomatidae gen. sp., Alaria sp., Neodiplostomum sp., and Clonorchis sp., and protozoa, including Entamoeba sp., Blastocystis sp., Isospora sp., Tritrichomonas sp., Pentatrichomonas sp., and Cryptosporidium sp., were detected. In the present study, various parasites infecting wild animals were successfully identified using metabarcoding. Our technique may play a crucial role in monitoring parasites within wild animals, especially those causing zoonoses.

Assessment of the genetic diversity of lymnaeid (Gastropoda: Pulmonata) snails and their infection status with trematode cercariae in different regions of Thailand

Lymnaeid snails are some of the most widespread snails and are the first intermediate host of trematode parasites that affect human and livestock health. A full understanding of the genetic relationship of hosts and parasites is of paramount importance for effective parasite management. The present study assessed the prevalence of trematode larvae in lymnaeid snails and examined the genetic diversity of these snails collected across Thailand. We collected 672 lymnaeid snails from 39 locations in 22 provinces of six regions in Thailand. Subsequently, cercarial infection in the snails was observed by using the shedding method. Lymnaeid snails released 5 types of trematode cercariae, namely, xiphidiocercariae, echinostome cercariae I, echinostome cercariae II, furcocercous cercariae, and strigea cercariae. The phylogenetic analysis based on ITS2 and 28S rDNA sequences revealed 5 cercaria types assigned to four trematode families, of which two belong to the group of human intestinal flukes. Combination of shell morphology and sequence analysis of the mitochondrial COI and 16S rDNA genes, the lymnaeid snails were classified into two species, Radix rubiginosa and Orientogalba viridis. Moreover, the combined dataset of mtDNA genes (COI + 16S rDNA) from R. rubiginosa and O. viridis revealed 32 and 15 different haplotypes, respectively, of which only a few haplotypes were infected with cercariae. The genetic diversity and genetic structure revealed that R. rubiginosa and O. viridis experienced a bottleneck phenomenon, and showed limited gene flow between populations. Population demographic history analyses revealed that R. rubiginosa and O. viridis experienced population reductions followed by recent population expansion. These findings may improve our understanding of parasite-lymnaeid evolutionary relationships, as well as the underlying molecular genetic basis, which is information that can be used for further effective control of the spread of trematode disease.

Immunology and pathology of echinostomes and other intestinal trematodes

Intestinal trematodes constitute a major group of helminths that parasitize humans and animals with relevant morbidity and mortality. Despite the importance of the intestinal trematodes in medical and veterinary sciences, immunology and pathology of these helminth infections have been neglected for years. Apart from the work focused on the members of the family Echnistomatidae, there are only very isolated and sporadic studies on the representatives of other families of digeneans, which makes a compilation of all these studies necessary. In the present review, the most salient literature on the immunology and pathology of intestinal trematodes in their definitive hosts in examined. Emphasis will be placed on members of the echinostomatidae family, since it is the group in which the most work has been carried out. However, we also review the information on selected species of the families Brachylaimidae, Diplostomidae, Gymnophallidae, and Heterophyidae. For most of these families, coverage is considered under the following headings: (i) Background; (ii) Pathology of the infection; (iii) Immunology of the infection; and (iv) Human infections.

Prevalence of Foodborne Trematodes in Small Indigenous Fish Species in Local Markets of Phnom Penh, Cambodia

Background: This study aimed to determine the prevalence and mean infection intensity of zoonotic foodborne trematodes (FBT) in small indigenous species (SIS) fish hosts. Materials and Methods: A total of 8630 specimens of unknown origin were collected from the markets in Phnom Penh City. Fish were identified, weighed, and separated into 20 g subsamples for each fish species, and were examined using the artificial digestion method. A total of 10 species of FBT were detected in 11 species of fish out of the 23 species of fish in the total sample. Results: All infected FBT species were intestinal flukes. No liver flukes were found. The overall prevalence of FBT infection was 29.3% ± 5.3%, and the mean intensity was 0.85 ± 1.89 metacercariae (Mc)/g. The highest FBT prevalence was observed for Isthmiophora hortensis (10.7%) and Centrocestus formosanus (7.9%). Other species identified were Diplostomum spp., Echinochasmus japonicus, Echinostoma revolutum, Echinostoma sudanense, Haplorchis taichui, Haplorchis pumilio Heterophyes spp., and Procerovum varium. The highest mean intensity was found for Diplostomum spp. (1.75 ± 3.03 Mc/g). Trichopsis vittata was one of the main species constituting the SIS in urban markets (31.72%) and showed the highest prevalence of FBT (75.0%). In addition, T. vittata had the highest diversity of intestinal flukes compared with other fish species. Amblypharyngodon chulabhornae showed the highest mean intensity. but low diversity (only two species) and low prevalence. Conclusions: T. vittata could be considered a potential indicator for targeted monitoring of FBT intestinal flukes, but A. chulabhornae could also be considered for quantitative studies considering its high mean intensity.

Environmental influence on abundance and infection patterns of snail intermediate hosts of liver and intestinal flukes in North and Central Vietnam

Liver and intestinal flukes (LIF) are important groups of foodborne zoonotic trematodes (FZTs) in Southeast Asia, including Vietnam. Their complex life cycles require specific freshwater snail species as the obligatory first intermediate hosts. In 2019, we conducted a longitudinal study in Yen Bai and Thanh Hoa provinces in North and Central Vietnam, respectively, to investigate the diversity of LIF and their infection prevalence in relation to snail host abundance and environmental factors. Using a combination of morphological and molecular identification techniques, we identified 10 LIF species infecting 11 snail host species. We observed significant seasonal variation in the mean abundance of several snail host species, with the majority of snails collected during the spring. We also detected seasonal changes in LIF species composition, with the highest species richness reported in the spring. Clonorchis sinensis and Fasciola gigantica, two medically important human liver flukes in Asia, were found only in the spring in Yen Bai. Our study revealed that not all snail host species have the same probability of becoming infected, and we recorded seasonal variations in the prevalence of LIF infection in different snail species in relation to water parameters.

Prevalence and risk factors associated with gastrointestinal parasites in goats (Capra hircus) and sheep (Ovis aries) from three provinces of China

Gastrointestinal (GI) parasites in small ruminants, especially goats and sheep, have caused significant socio-economic and public health challenges worldwide. The aim of the present study was to investigate the diversity and prevalence of GI parasites in goats and sheep in Jiangsu, Shaanxi and Hunan provinces of China, and to assess whether the age of animals, sampling season and feeding mode influence the distribution and infection of GI parasites. A total of 1,081 fecal samples collected from goats (n = 835) and sheep (n = 246) were detected by saturated saline flotation technique and nylon sifter elutriation and sieving method for eggs/oocysts, respectively. Based on the morphological observation of eggs and oocysts, one tapeworm, five nematodes, three trematodes and nineteen coccidia were identified, of which seven helminths belong to zoonotic parasites. The infection rate of parasites was 83.4% (902/1081) in total samples, 91.6% (765/835) in goats, and 55.7% (137/246) in sheep. The infection rate of coccidia was 71.0% (767/1081), and that of helminths was 56.2% (607/1081). The dominant species was E. alijeri (67.3%, 562/835) in goats, E. parva (30.1%, 74/246) in sheep. The highest prevalent helminths were Trichostrongylidae spp. in goats (58.3%, 487/835), and Moniezia spp. in sheep (22.76%, 56/246). Of 902 positive samples, 825 (91.5%, 825/902) contained multiple (2-10) parasites. The feeding mode, sampling season and regions were relevant risk factors which have significant influence on the occurrence of GI parasites in goats and sheep. The risk coefficient of parasite infection in autumn was 2.49 times higher than spring (Odds ratio = 2.49, 95% CI = 1.51-4.09, p < 0.001). Compared to raising on the high beds, the goats and sheep raising on the ground had the higher risk of parasite infection (OR = 3.91, 95% CI = 2.07-7.40, p < 0.001). The risk coefficient of parasite infection in Shaanxi and Hunan was 3.78 and 1.25 times higher than that in Jiangsu (OR = 3.78, 95% CI = 2.01-7.12, p < 0.001; OR = 1.25, 95% CI = 1.21-1.29, p < 0.001). These data are significant for the development of prevention strategies to minimise economic losses from small ruminant production and to reduce the risk of water and food infecting humans as vectors of zoonotic parasitic diseases.

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

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

Spatial parasitology and the unmapped human helminthiases

Helminthiases are a class of neglected tropical diseases that affect at least 1 billion people worldwide, with a disproportionate impact on resource-poor areas with limited disease surveillance. Geospatial methods can offer valuable insights into the burden of these infections, particularly given that many are subject to strong ecological influences on the environmental, vector-borne or zoonotic stages of their life cycle. In this study, we screened 6829 abstracts and analysed 485 studies that use maps to document, infer or predict transmission patterns for over 200 species of parasitic worms. We found that quantitative mapping methods are increasingly used in medical parasitology, drawing on One Health surveillance data from the community scale to model geographic distributions and burdens up to the regional or global scale. However, we found that the vast majority of the human helminthiases may be entirely unmapped, with research effort focused disproportionately on a half-dozen infections that are targeted by mass drug administration programmes. Entire regions were also surprisingly under-represented in the literature, particularly southern Asia and the Neotropics. We conclude by proposing a shortlist of possible priorities for future research, including several neglected helminthiases with a burden that may be underestimated.

Natural variation in the binding pocket of a parasitic flatworm TRPM channel resolves the basis for praziquantel sensitivity

The drug praziquantel (PZQ) is the key clinical therapy for treating schistosomiasis and other infections caused by parasitic flatworms. A schistosome target for PZQ was recently identified- a transient receptor potential ion channel in the melastatin subfamily (TRPM_PZQ)-however, little is known about the properties of TRPM_PZQ in other parasitic flatworms. Here, TRPM_PZQ orthologs were scrutinized from all currently available parasitic flatworm genomes. TRPM_PZQ is present in all parasitic flatworms, and the consensus PZQ binding site was well conserved. Functional profiling of trematode, cestode, and a free-living flatworm TRPM_PZQ ortholog revealed differing sensitives (~300-fold) of these TRPM_PZQ channels toward PZQ, which matched the varied sensitivities of these different flatworms to PZQ. Three loci of variation were defined across the parasitic flatworm TRPM_PZQ pocketome with the identity of an acidic residue in the TRP domain acting as a gatekeeper residue impacting PZQ residency within the TRPM_PZQ ligand binding pocket. In trematodes and cyclophyllidean cestodes, which display high sensitivity to PZQ, this TRP domain residue is an aspartic acid which is permissive for potent activation by PZQ. However, the presence of a glutamic acid residue found in other parasitic and free-living flatworm TRPM_PZQ was associated with lower sensitivity to PZQ. The definition of these different binding pocket architectures explains why PZQ shows high therapeutic effectiveness against specific fluke and tapeworm infections and will help the development of better tailored therapies toward other parasitic infections of humans, livestock, and fish.

A relatively high zoonotic trematode prevalence in Orientogalba ollula and the developmental characteristics of isolated trematodes by experimental infection in the animal model

Background

Food-borne parasitic diseases decrease food safety and threaten public health. The snail species is an intermediate host for numerous human parasitic trematodes. Orientogalba ollula has been reported as intermediate hosts of many zoonotic trematodes. Here, we investigated the prevalence of zoonotic trematodes within O. ollula in Guangxi, China, and assessed their zoonotic potential.

Methods

Snails were collected from 54 sites in 9 cities throughout Guangxi. The snail and trematode larvae species were determined by combining morphological characteristics and molecular markers. The trematodes prevalence and constituent ratio were calculated and compared among different habitat environments. Phylogenetic trees of the trematode species were constructed using the neighbor-joining method with nuclear internal transcribed spacer 2 (ITS2) sequences. The developmental cycles of the isolated trematodes were examined by experimental infection in ducks. The developmental characteristics of Echinostoma revolutum was recorded by dissecting infected ducklings from 1-day post infection (dpi) to 10 dpi.

Results

The overall prevalence of trematode larvae was 22.1% (1818/8238) in O. ollula from 11 sample sites. Morphological together with molecular identification, showed that E. revolutum, Australapatemon sp., Hypoderaeum conoideum, Pharyngostomum cordatum, and Echinostoma sp. parasitized O. ollula, with the highest infection rate of E. revolutum (13.0%). However, no Fasciola larvae were detected. The trematodes prevalence and constituent ratio varied in two sub-biotypes (P < 0.01). A neighbor-joining tree analysis of ITS2 sequences resulted in distinct monophyletic clades supported by sequences from isolated larvae with high bootstrap values. Ducklings exposed to O. ollula infected with Echinostoma sp., E. revolutum, and H. conoideum larvae were successfully infected. The animal model for Echinostoma revolutum was successfully established. E. revolutum matured from larvae to adult at 10 dpi in the intestine of the duck, and the developmental characteristics of E. revolutum were characterized by the maturation of the reproductive and digestive organs at 6–8 dpi.

Conclusions

This study revealed a high prevalence of zoonotic trematodes in O. ollula from Guangxi, China. Existing trematodes infection in animals and human clinical cases, coupled with the wide geographical distribution of O. ollula, necessitate further evaluations of the potential risk of spillover of zoonotic infection from animal to human and vice versa.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s40249-022-01014-7.

Performance of Mini Parasep® SF stool concentrator kit, Kato-Katz, and formalin-ethyl acetate concentration methods for diagnosis of opisthorchiasis in Northeast Thailand

BACKGROUND

Control and elimination of the liver fluke (Opisthorchis viverrini) is a primary preventive strategy against cholangiocarcinoma in Southeast Asia. A sensitive parasitological diagnostic method is required to facilitate a surveillance and control program. In this study, we evaluated the performance of Mini Parasep® SF stool concentrator kit (stool kit) compared with Kato-Katz (KK) and the quantitative formalin-ethyl acetate concentration technique (FECT) for detection of O. viverrini and co-endemic parasitic infections.

METHODS

A cross-sectional survey for parasitic infection in residents aged > 15 years in a community in Kalasin province, Northeast Thailand, was conducted in 2018. Fecal samples were collected and screened by KK method, and a subset of samples was further examined by the stool kit and FECT methods. The results were analyzed for prevalence of parasitic infections in addition to the diagnostic performance of the methods for qualitative and quantitative detection of helminthiases.

RESULTS

The initial survey of parasitic infection determined by the KK method (n = 567) showed the prevalence of O. viverrini was 32.63%, followed by Taenia 2.65%, echinostomes 1.76%, hookworms 1.41%, Trichuris trichiura 0.53% and Strongyloides stercoralis 0.53%. Within a subset of samples tested with multiple diagnostics (n = 150), the detection rates of O. viverrini by the stool kit, FECT and KK methods were 27.3%, 30.7% and 28.7%, respectively. The diagnostic sensitivity for opisthorchiasis was similar for FECT (75.5%), KK(66.0%) and the stool kit (67.3%). For other parasitic infections, FECT and stool kit methods performed better than KK, particularly in detecting minute intestinal flukes (MIF), S. stercoralis and coinfections. When measuring the intensity of O. viverrini infection (fecal egg counts), the stool kit results showed a significant positive correlation with KK and FECT (P < 0.05).

CONCLUSIONS

As the stool kit is simple to use and shows a comparable performance to FECT, it may serve as an alternative method of fecal examination for screening of helminthiasis including opisthorchiasis.

Pesticidal Activities of Callicarpa and Premna Essential Oils From Vietnam

Mosquito-borne diseases are a consistent problem in Vietnam. Additionally, freshwater snail species are agricultural pests and are known to be intermediate hosts for several parasitic worms. There is a need for new and complementary botanical pesticidal agents for controlling these pests and essential oils have shown promise. In this work, essential oils from 2 species of Callicarpa ( C. rubella and C. sinuata) and 4 species of Premna ( P. chevalieri, P. corymbosa, P. maclurei, and P. tomentosa) were screened for mosquito larvicidal activity against Aedes albopictus and Culex quinquefasciatus and for molluscicidal activity against 3 freshwater snail species, Gyraulus convexiusculus, Pomacea canaliculata, and Tarebia granifera. Callicarpa rubella essential oil showed exceptional larvicidal activity against Cx. quinquefasciatus with 24-h LC50 of 9.8 μg/mL. In addition to C. rubella, the essential oils of P. chevalieri and P. tomentosa showed notable molluscicidal activities against P. canaliculata with LC90 values ≤ 20 μg/mL. These Callicarpa and Premna essential oils were all rich in sesquiterpenes and should be considered for continued investigation as botanical pesticidal agents.

Zoonotic diseases of fish and their prevention and control

Fish and aquatic-derived zoonotic diseases have caused considerable problems in the aquaculture industry and fishery worldwide. In particular, zoonotic diseases can pose widespread threats to humans. With the world’s growing population and potential global trade of aquaculture and fish, the risk of environmental contamination and development of fish and aquatic-derived zoonoses in humans are increasing. The important causes of zoonoses include bacteria, parasites, viruses, and fungi. The zoonotic bacterial agents are divided into two main groups: Gram-positive (Mycobacteriaceae, Streptococcaceae, Erysipelothricaceae families) and Gram-negative (Aeromonadaceae, Vibrionaceae, Pseudomondaceae, Enterobacteriaceae, and Hafniaceae families). The premier parasitic agents include cestodes (tapeworm; e.g. Diphyllobothrium spp.), trematodes (fluke; e.g. Opisthorchis spp.), and nematodes (round worm; e.g. Anisakis spp.). In addition, protozoan organisms such as Cryptosporidium spp. are also considered fish-derived zoonotic pathogens. Two groups of fish-associated fungi causing basidiobolomycosis and sporotrichosis also pose a zoonotic risk for humans. The majority of the fish-derived zoonotic diseases are transmitted to humans mainly via the consumption of improperly cooked or raw fish or fish products. Therefore, the incidence of zoonotic diseases can be reduced by properly processing fish and fish products, e.g. by thermal (heat/freezing) treatment. The prevalence of zoonotic agents in fishes varies seasonally and should be regularly monitored to evaluate the prevalence of pathogens in both wild and cultured fish populations. This review focuses on the fish zoonotic agents/diseases and their control and prevention.

General overview of the current status of human foodborne trematodiasis

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

Neglected Food-Borne Trematodiases: echinostomiasis and gastrodiscoidiasis

In the present paper, we review two of the most neglected intestinal food-borne trematodiases: echinostomiasis, caused by members of the family Echinostomatidae, and gastrodiscoidiasis produced by the amphistome Gastrodiscoides hominis. Both parasitic infections are important intestinal food-borne diseases. Humans become infected after ingestion of raw or insufficiently cooked molluscs, fish, crustaceans, amphibians or aquatic vegetables. Thus, eating habits are essential to determine the distribution of these parasitic diseases and, traditionally, they have been considered as minor diseases confined to low-income areas, mainly in Asia. However, this scenario is changing and the population at risk are currently expanding in relation to factors such as new eating habits in developed countries, growing international markets, improved transportation systems and demographic changes. These aspects determine the necessity of a better understanding of these parasitic diseases. Herein, we review the main features of human echinostomiasis and gastrodiscoidiasis in relation to their biology, epidemiology, immunology, clinical aspects, diagnosis and treatment.

Ancient DNA of Metagonimus yokogawai Recovered from Joseon Period Human Remains Newly Discovered at Goryeong County in South Korea

PURPOSE

Metagonimiasis, commonly seen in East Asian countries, is a parasitic disorder caused by definitive hosts' ingestion of undercooked freshwater fishes. Recently, genetic analysis has proved 28S rRNA and cytochrome c oxidase subunit I (COI) mtDNA gene to be a successful marker differentiating species of the genus Metagonimus. In the present study, using specimens from the newly discovered Joseon Dynasty human remains of Goryeong, we obtained updated genetic data on genus Metagonimus, which was also prevalent during the Joseon period.

METHODS

The ancient DNA (aDNA) was retrieved from the coprolite sample of the seventeenth century, half-mummified individual discovered at Goryeong Country, South Korea. Cloning and sequencing were performed on PCR-amplified amplicons for M. yokogawai 28S rRNA and COI mtDNA gene. The consensus sequences were used for species identification and phylogenetic analysis using NCBI/BLAST and MEGA X software.

RESULTS

Based on the COI mtDNA gene region, the Goryeong sequence was confirmed as belonging to M. yokogawai, as it was shown to form a separate cluster with other M. yokogawai taxa that are distinct also from M. takahashii and M. miyatai.

CONCLUSION

In a series of our genetic analyses on genus Metagonimus using samples retrieved from Joseon-period cases, aDNA sequences of genus Metagonimus revealed in South Korea thus far are those of M. yokogawai, but not of M. miyatai or M. takahashii yet.

Iberian Distribution of the Freshwater Snail Genus Bithynia Leach, 1818 (Mollusca: Truncatelloidea), Vector of Opisthorchiasis and Metorchiasis

BACKGROUND

Opisthorchis felineus and Metorchis bilis are trematodes that cause opisthorchiasis and metorchiasis, respectively. The freshwater snails Bithynia hispanica and B. tentaculata are the respective intermediate hosts for these parasites in the Iberian Peninsula, where both parasites are present.

METHODS

To study the distribution of these snail species, an exhaustive literature review and revision of museum collections was performed.

RESULTS

A total of 370 localities were compiled and mapped. B. tentaculata were found throughout the Iberian Peninsula, both in Spain and Portugal, while B. hispanica was found only in the Mediterranean coast of Spain.

CONCLUSION

Knowing the distribution of the Bithynia species found in the Iberian Peninsula is highlighted in terms of public health, as the presence of the snail is related to the presence of the disease and can be used as a tool to face future outbreaks.

The use of alternative food sources to improve health and guarantee access and food intake

To feed and provide Food Security to all people in the world is a big challenge to be achieved with the 2030 Agenda. Undernutrition and obesity are to the opposite of a healthy nutritional status. Both conditions are associated with unbalanced nutrition, absence of food or excess of non-nutritive foods intake. These two nutritional conditions associated with food production are closely related to some goals highlighted by the United Nations in the 2030 Agenda to achieve sustainable world development. In this context, the search for alternative foods whose sustainable production and high nutritional quality guarantee regular access to food for the population must be encouraged. Alternative foods can contribute to Food Security in many ways as they contribute to the local economy and income generation. Popularizing and demystifying the uses of unconventional food plants, ancestral grains, flowers, meliponiculture products, and edible insects as sources of nutrients and non-nutrients is another challenge. Herein, we present an overview of alternative foods - some of them cultivated mostly in Brazil - that can be explored as sources of nutrients to fight hunger and malnutrition, improve food production and the economic growth of nations.

Morphology and Mitochondrial Genome of Fischoederius sp. 1 in Thailand

A rumen fluke Fischoederius elongatus is assigned to the type species of genus Fischoederius, family Gastrothylacidae. However, the mitochondrial sequences recently published are thought to be of inconsistent species, suggesting that several morphologically similar but genetically distinct species might be classified as Fischoederius elongatus. Thus, mentions of F. elongatus from South, Southeast, and East Asia might unintentionally refer to different species. The present work describes morphology and a full mitochondrial genome sequence of one of these species. The fluke specimens were collected from 2 infected cattle in Thailand. An interesting finding was the presence of a second tRNA-Asp gene next to a partial ND1 gene. It is suggested that these duplicated sequences are the remnants of non-reciprocal recombination events caused by inverted repeats located between ND2 and ND1 mitochondrial genes.

A review of molecular identification tools for the opisthorchioidea

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

Possibilities of the Development of Edible Insect-Based Foods in Europe

All over the world, a large proportion of the population consume insects as part of their diet. In Western countries, however, the consumption of insects is perceived as a negative phenomenon. The consumption of insects worldwide can be considered in two ways: on the one hand, as a source of protein in countries affected by hunger, while, on the other, as an alternative protein in highly-developed regions, in response to the need for implementing policies of sustainable development. This review focused on both the regulations concerning the production and marketing of insects in Europe and the characteristics of edible insects that are most likely to establish a presence on the European market. The paper indicates numerous advantages of the consumption of insects, not only as a valuable source of protein but also as a raw material rich in valuable fatty acids, vitamins, and mineral salts. Attention was paid to the functional properties of proteins derived from insects, and to the possibility for using them in the production of functional food. The study also addresses the hazards which undoubtedly contribute to the mistrust and lowered acceptance of European consumers and points to the potential gaps in the knowledge concerning the breeding conditions, raw material processing and health safety. This set of analyzed data allows us to look optimistically at the possibilities for the development of edible insect-based foods, particularly in Europe.

Lantana camara Essential Oils from Vietnam: Chemical Composition, Molluscicidal, and Mosquito Larvicidal Activity

Lantana camara is a troublesome invasive plant introduced to many tropical regions, including Southeast Asia. However, the plant does hold promise as a source of essential oils that may be explored for potential use. Fresh water snails such as Pomacea canaliculata, Gyraulus convexiusculus, and Tarebia granifera can be problematic agricultural pests as well as hosts for parasitic worms. Aedes and Culex mosquitoes are notorious vectors of numerous viral pathogens. Control of these vectors is of utmost importance. In this work, the essential oil compositions, molluscicidal, and mosquito larvicidal activities of four collections of L. camara from north-central Vietnam have been investigated. The sesquiterpene-rich L. camara essential oils showed wide variation in their compositions, not only compared to essential oils from other geographical locations (at least six possible chemotypes), but also between the four samples from Vietnam. L. camara essential oils showed molluscicidal activities comparable to the positive control, tea saponin, as well as other botanical agents. The median lethal concentrations (LC₅₀ ) against the snails were 23.6-40.2 μg/mL (P. canaliculata), 7.9-29.6 μg/mL (G. convexiusculus), and 15.0-29.6 μg/mL (T. granifera). The essential oils showed good mosquito larvicidal activities with 24-h LC₅₀ values of 15.1-29.0 μg/mL, 26.4-53.8 μg/mL, and 20.8-59.3 μg/mL against Ae. aegypti, Ae. albopictus, and Cx. quinquefasciatus, respectively. The essential oils were more toxic to snails and mosquito larvae than they were to the non-target water bug, Diplonychus rusticus (24-h LC₅₀ =103.7-162.5 μg/mL). Sesquiterpene components of the essential oils may be acting as acetylcholinesterase (AChE) inhibitors. These results suggest that the invasive plant, L. camara, may be a renewable botanical pesticidal agent.

Cercarial trematodes in freshwater snails from Bangkok, Thailand: prevalence, morphological and molecular studies and human parasite perspective

We investigated the prevalence, morphological characters and molecular classifications of trematode cercariae in freshwater snails randomly collected from 59 sampling localities in Bangkok from May 2018 to March 2019. We used a crushing technique to observe the cercarial stage inside each snail body and amplified the internal transcribed spacer 2 regions of cercarial DNA using polymerase chain reaction methodology. The associated phylogenetic tree was reconstructed using Bayesian inference analyses. A total of 517 of 15 621 examined snails were infected with trematode cercariae, and the infected snails were classified into 11 species of seven families with a 3.31% overall prevalence of the infection. The Bithynia siamensis siamensis snail displayed the highest prevalence of infection (16.16%), whereas the Physella acuta snail exhibited the lowest prevalence (0.08%) of infection. Eight morphological types of cercariae were observed. The highest prevalence of infection was observed in mutabile cercaria (1.86%). Based on molecular investigations, the phylogram revealed eight cercaria types assigned to at least nine digenean trematode families, of which five belong to groups of human intestinal flukes. Although, with the exception of schistosome cercaria, trematode cercariae are not known to directly damage humans, understanding the general biology of trematode cercariae (including diversity, distribution, infection rates and host range) is important and necessary for the prevention and control of parasitic transmission that impacts aquatic cultivations, livestock farming and human health.

Edible Insects and Toxoplasma gondii: Is It Something We Need To Be Concerned About?

ABSTRACT

Novel foods, such as edible insects and food products on the basis of insects, could play an important role in both human and animal nutrition in the future. The identification of dangers associated with insect consumption is fundamental to guarantee consumer safety and adequate regulatory guidelines for operators of the food sector. Although former studies have focused on the microbiological contamination of fresh or processed edible insects, so far little information is available about the occurrence of foodborne parasites, such as Toxoplasma gondii, whose life cycles make them candidates for potential insect breeding substrate contamination. Hence, we investigated the presence of contaminating T. gondii in farmed edible insects to rule out this further hazard for consumers. Four species of insects most commonly used as food for human consumption were analyzed: mealworm; African migratory locust, house cricket, and silkworm. Samples included live specimens but also minimally (dehydrated) and highly processed edible insects. Traces of T. gondii DNA were detected in samples of dehydrated mealworm. These results highlight the need for implementing good farming and processing practices with particular care paid to safe storage and handling of feed and substrates used for edible insects to reduce the chance of T. gondii entering the human food chain.

HIGHLIGHTS

The prevalence of cercarial infection and development of a duplex PCR for detection of the cercarial stage of Haplorchis taichui and H. pumilio in first intermediate hosts from Chai Nat province, Thailand

This study aimed to investigate the prevalence of cercarial infections in freshwater snails collected from the Chai Nat province of Central Thailand. Moreover, we aimed to develop a duplex PCR technique, using the ITS2 and candidate MT-ND1 gene, to determine the dissemination of H. taichui and H. pumilio, respectively. Six types of cercariae were discovered with an overall prevalence of 4.71% (59/1,252). The parapleurolophocercous cercariae were demonstrated to be the dominant type, infecting only Melanoides tuberculata snails. The duplex PCR was optimized for specific amplification of ITS2 for H. taichui (115 bp) and MT-ND1 for H. pumilio (335 bp). Both specific primers confirmed the specificity of the duplex PCR reaction, with no cross-reactivity with other heterophyids or related species. In addition, this duplex PCR could be used to detect co-infection at a concentration of 3.0 ng/µL. For the molecular identification, 9 of 22 parapleurolophocercous cercaria specimens in Chai Nat province generated the specific DNA fragment of H. pumilio. These results proved that the MT-ND1 gene is a species-specific method for heterophyid detection and provides a rapid method for identification based on larval and adult stages of H. taichui and H. pumilio in their intermediate and/or definitive hosts in the infected area.

Metagonimus yokogawai Ancient DNA Recovered from 16th- to 17th-Century Korean Mummy Feces of the Joseon Dynasty

Metagonimiasis is foodborne intestinal parasitism occurring by the definitive hosts' ingestion of raw or undercooked fish, mostly commonly sweetfish. Most Metagonimus infection is caused by Metagonimus yokogawai but also rarely by Metagonimus takahashii as well as Metagonimus miyatai. Despite recent molecular work on Metagonimus spp., there are still insufficient data to reveal the genetic characteristics of ancient M. yokogawai in a wide geo-historical scope. In this study, we were successful in the analysis of M. yokogawai ancient DNA (aDNA) using coprolite samples retrieved from 16th- to 17th-century Korean mummies. In BLAST and phylogenetic analyses, M. yokogawai 28S rDNA of Korean mummies were clustered along with the 28S rDNA taxa of M. takahashii and M. miyatai in GenBank. Conversely, the cytochrome c oxidase subunit I (COI) of M. yokogawai aDNA from Korean mummies was distinctly clustered apart from M. takahashii and M. miyatai sequences. This study is the first report of its kind to identify M. yokogawai aDNA retrieved from the archaeological specimens and confirms the usefulness of COI in molecular diagnosis of M. yokogawai. Considering the rarity of reports on the genetics of genus Metagonimus spp., our study will be fundamental for the future study of M. yokogawai paleogenetics.

Insights on foodborne zoonotic trematodes in freshwater snails in North and Central Vietnam

Foodborne zoonotic trematode (FZT) infections are common neglected tropical diseases in Southeast Asia. Their complicated life cycles involve freshwater snails as intermediate hosts. A cross-sectional study was conducted in Yen Bai and Thanh Hoa provinces in North and Central Vietnam, to investigate the diversity of cercariae of potential FZT and to construct the phylogenetic relationship of trematode cercariae based on the Internal Transcribed Spacer 2 (ITS2) region. Among 17 snail species collected from various habitats, 13 were infected by 10 cercarial groups among which parapleurolophocercous, pleurolophocercous, and echinostome cercariae were of zoonotic importance. The monophyletic tree separated cercarial sequences into different groups following the description of the cercariae families in which Haplorchidae, Opisthorchiidae, Echinochasmidae, and Echinostomatidae are important families of FZT. The overall prevalence was different among snail species and habitats and showed a seasonal trend. Parapleurolophocercous and echinostome cercariae emerged as the most common cercariae in snails in Yen Bai, while monostome, echinostome, and megalura cercariae were most common in Thanh Hoa. Using a molecular approach, we identified Parafossarulus striatulus as the first intermediate snail host of Clonorchis sinensis in Thac Ba Lake. Melanoides tuberculata and Bithynia fuchsiana were we identified preferred intermediate snail hosts of a diverse range of trematode species including intestinal flukes (i.e., Haplorchis pumilio and Echinochasmus japonicus) in Yen Bai and Thanh Hoa, respectively.

A Critical Appraisal of the Evidence Supporting Consumer Motivations for Alternative Proteins

Alternative proteins are receiving increased global attention. This burgeoning interest in plants (especially plant-based meat alternatives), insects, algae, and cultured meat has been attributed to their reported health benefits, lower environmental impact and improved animal welfare compared to conventional animal-based meat. Food producers and the media are promoting acceptance of these products, claiming superior nutritional, environmental and ethical credentials and a desirable novel sensory experience. However, the evidence supporting these claims remains unclear. In this review, we summarise the main evidence underlying the nutritional, sensorial, economical, ethical, and environmental reasons reported for the rise in consumer demand for alternative proteins. We found many of these reasons to lack a strong evidence base. For instance, evidence is emerging for the nutritional benefits of plant-based meat alternatives, but present claims are largely based on established evidence for plant-based diets. Significant research gaps remain, especially longitudinal evidence on the sustained effects of replacing conventional animal-based proteins with alternative sources. For many alternative proteins, challenges exist in achieving desirable sensory properties akin to animal-based meat to promote their acceptance by consumers. Overall, fundamental shifts in the food system are required to create a culture in which healthful and sustainable food choices are the norm.

Survey of Stenomelania Fisher, 1885 (Cerithioidea, Thiaridae): The potential of trematode infections in a newly-recorded snail genus at the coast of Andaman Sea, South Thailand

Stenomelania snails (Fisher 1885) have been reported from the coastal regions of the Indian Ocean and the Pacific Ocean, spanning India to Australia. Here, the species diversity and distribution of these snails in the south of Thailand are recorded. The snails were also examined for trematode infections in 13 locations in three Provinces, viz. Krabi, Trang and Satun, along the coast of the Andaman Sea. A total of 1,551 snails were in five morphs tentatively identified as Stenomelania aspirans, S. crenulata, S. punctata, S. torulosa and the closely-related Neoradina prasongi. With 10 infected snails, the trematode infection rate was 0.64%. The cercariae were categorised into three species from two morphologically-distinguishable types, viz. parapleurolophocercous cercariae (Haplorchis taichui and Procerovum cheni) and xiphidiocercariae (Loxogenoides bicolor), through the morphological characterisation of the larval stage. These trematodes were also analysed using the internal transcribed spacer subunit II region to confirm the species identity at generic and infrageneric levels.

Zoonotic Helminthiases in Rodents (Bandicota indica, Bandicota savilei, and Leopoldamys edwardsi) from Vientiane Capital, Lao PDR

Zoonotic helminths of three rodent species, Bandicota indiaca, Bandicota savilei, and Leopoldamys edwardsi, were investigated in Vientiane capital, Lao PDR. A total of 310 rodents were infected with 11 species of helminth parasites. There were 168 (54.2%) of 310 rodents infected with zoonotic helminths. From our results, there are six recorded zoonotic helminth species, and the highest prevalence was exhibited by Raillietina sp. (30.7%), followed by Hymenolepis diminuta (17.7%), Hymenolepis nana (2.6%), Echinostoma ilocanum (1.9%), Echinostoma malayanum (1.3%), and Angiostrongylus cantonensis (1%). This is the first study of zoonotic helminths in L. edwardsi and the first report of H. diminuta, H. nana, E. ilocanum, and E. malayanum in Bandicota indica and B. savilei, and the first demonstration of A. cantonenensis in B. indica in Lao PDR. From our results, these three rodents are potentially important reservoir hosts of zoonotic helminths. Thus, effective control programs should be considered for implementation to prevent the transmission of these zoonoses in this area.

Taxonomy of Echinostoma revolutum and 37-Collar-Spined Echinostoma spp.: A Historical Review

Echinostoma flukes armed with 37 collar spines on their head collar are called as 37-collar-spined Echinostoma spp. (group) or 'Echinostoma revolutum group'. At least 56 nominal species have been described in this group. However, many of them were morphologically close to and difficult to distinguish from the other, thus synonymized with the others. However, some of the synonymies were disagreed by other researchers, and taxonomic debates have been continued. Fortunately, recent development of molecular techniques, in particular, sequencing of the mitochondrial (nad1 and cox1) and nuclear genes (ITS region; ITS1-5.8S-ITS2), has enabled us to obtain highly useful data on phylogenetic relationships of these 37-collar-spined Echinostoma spp. Thus, 16 different species are currently acknowledged to be valid worldwide, which include E. revolutum, E. bolschewense, E. caproni, E. cinetorchis, E. deserticum, E. lindoense, E. luisreyi, E. mekongi, E. miyagawai, E. nasincovae, E. novaezealandense, E. paraensei, E. paraulum, E. robustum, E. trivolvis, and Echinostoma sp. IG of Georgieva et al., 2013. The validity of the other 10 species is retained until further evaluation, including molecular analyses; E. acuticauda, E. barbosai, E. chloephagae, E. echinatum, E. jurini, E. nudicaudatum, E. parvocirrus, E. pinnicaudatum, E. ralli, and E. rodriguesi. In this review, the history of discovery and taxonomic debates on these 26 valid or validity-retained species are briefly reviewed.

Rumen fluke, Fischoederius elongatus (Trematoda: Gastrothylacidae): Preliminary investigation of suitable conditions for egg hatching

Various temperatures may have different effects on the distribution of paramphistomes that cause amphistomosis in cattle, including Fischoederius elongatus. Therefore, this study aimed to investigate the effects of different temperature treatments on F. elongatus hatching, with specific identification using morphological, histological, and phylogenetic analysis. All specimens were collected from two buffalo (Bubalus bubalis) rumens in a slaughterhouse in Pathum Thani province, Thailand. F. elongatus adults were kept in phosphate buffered saline solution for egg collection. The egg specimens were incubated in tap water under four different temperature conditions: 4 °C, room temperature, 35 °C, and 55 °C. For 31 days, egg specimens of approximately 50 eggs per observation were randomly classified into three stages (undeveloped, developing (or pre-hatching), and hatched). To test the change of temperature, cold water was used for thermal shocking the egg specimens. The results indicated that rates of egg development and hatching were highest at 35 °C and significantly higher than in the other treatments (P < 0.001). In addition, statistical investigation of pre-thermal shock results also suggesting that 35 ºC may be a suitable condition for hatching F. elongatus eggs and could enhance the developing and hatching by longer periods of incubation for more than 26 days. Even changing the temperature could affect development and hatching but initial environment temperature remains an important factor. These data could be used for efficient epidemiological prediction of F. elongatus and applied in livestock management.

Possible food safety hazards of ready-to-eat raw fish containing product (sushi, sashimi)

It is undeniable that with the popularity of sushi and sashimi over the last decade the consumption of raw fish has extremely increased. Raw fish is very appreciated worldwide and has become a major component of human diet because of its fine taste and nutritional properties. Possible hazards concerning fish safety and quality are classified as biological and chemical hazards. They are contaminants that often accumulate in edible tissue of fish and transmit to humans via the food chain affecting the consumer's health. Although their concentration in fish and fishery products are found at non-alarming level of a daily basis period, they induce hazardous outcome on human health due to long and continuous consumption of raw fish. Regular sushi and sashimi eaters have to be aware of the contaminants found in the other components of their dish that often add up to acceptable residue limits found in fish. Hence, there is the urge for effective analytical methods to be developed as well as stricter regulations to be put in force between countries to monitor the safety and quality of fish for the interest of public health.

Mitochondrial Genome Sequence of Echinostoma revolutum from Red-Crowned Crane (Grus japonensis)

Echinostoma revolutum is a zoonotic food-borne intestinal trematode that can cause intestinal bleeding, enteritis, and diarrhea in human and birds. To identify a suspected E. revolutum trematode from a red-crowned crane (Grus japonensis) and to reveal the genetic characteristics of its mitochondrial (mt) genome, the internal transcribed spacer (ITS) and complete mt genome sequence of this trematode were amplified. The results identified the trematode as E. revolutum. Its entire mt genome sequence was 15,714 bp in length, including 12 protein-coding genes, 22 transfer RNA genes, 2 ribosomal RNA genes and one non-coding region (NCR), with 61.73% A+T base content and a significant AT preference. The length of the 22 tRNA genes ranged from 59 bp to 70 bp, and their secondary structure showed the typical cloverleaf and D-loop structure. The length of the large subunit of rRNA (rrnL) and the small subunit of rRNA (rrnS) gene was 1,011 bp and 742 bp, respectively. Phylogenetic trees showed that E. revolutum and E. miyagawai clustered together, belonging to Echinostomatidae with Hypoderaeum conoideum. This study may enrich the mitochondrial gene database of Echinostoma trematodes and provide valuable data for studying the molecular identification and phylogeny of some digenean trematodes.

Zoonotic transmission of intestinal helminths in southeast Asia: Implications for control and elimination

Intestinal helminths are extremely widespread and highly prevalent infections of humans, particularly in rural and poor urban areas of low and middle-income countries. These parasites have chronic and often insidious effects on human health and child development including abdominal problems, anaemia, stunting and wasting. Certain animals play a fundamental role in the transmission of many intestinal helminths to humans. However, the contribution of zoonotic transmission to the overall burden of human intestinal helminth infection and the relative importance of different animal reservoirs remains incomplete. Moreover, control programmes and transmission models for intestinal helminths often do not consider the role of zoonotic reservoirs of infection. Such reservoirs will become increasingly important as control is scaled up and there is a move towards interruption and even elimination of parasite transmission. With a focus on southeast Asia, and the Philippines in particular, this review summarises the major zoonotic intestinal helminths, risk factors for infection and highlights knowledge gaps related to their epidemiology and transmission. Various methodologies are discussed, including parasite genomics, mathematical modelling and socio-economic analysis, that could be employed to improve understanding of intestinal helminth spread, reservoir attribution and the burden associated with infection, as well as assess effectiveness of interventions. For sustainable control and ultimately elimination of intestinal helminths, there is a need to move beyond scheduled mass deworming and to consider animal and environmental reservoirs. A One Health approach to control of intestinal helminths is proposed, integrating interventions targeting humans, animals and the environment, including improved access to water, hygiene and sanitation. This will require coordination and collaboration across different sectors to achieve best health outcomes for all.

Foodborne intestinal flukes: A brief review of epidemiology and geographical distribution

Foodborne intestinal flukes are highly diverse consisting of at least 74 species with a diverse global distribution. Taxonomically they include 28 species of heterophyids, 23 species of echinostomes, and 23 species of miscellaneous groups (amphistomes, brachylaimids, cyathocotylids, diplostomes, fasciolids, gymnophallids, isoparorchiids, lecithodendriid-like group, microphallids, nanophyetids, plagiorchiids, and strigeids). The important heterophyid species (15 species) include Metagonimus yokogawai, M. takahashii, M. miyatai, Heterophyes heterophyes, H. nocens, Haplorchis taichui, H. pumilio, H. yokogawai, Heterophyopsis continua, Centrocestus formosanus, Pygidiopsis genata, P. summa, Stellantchasmus falcatus, Stictodora fuscata, and S. lari. The echinostome species of public health significance (15 species) include Echinostoma revolutum, E. cinetorchis, E. lindoense, E. ilocanum, Isthmiophora hortensis, Echinochasmus japonicus, E. perfoliatus, E. liliputanus, E. fujianensis, E. caninus, Acanthoparyphium tyosenense, Artyfechinostomum malayanum, A. sufrartyfex, A. oraoni, and Hypoderaeum conoideum. Among the other zoonotic intestinal flukes, Gastrodiscoides hominis, Brachylaima cribbi, Neodiplostomum seoulense, Fasciolopsis buski, Gymnophalloides seoi, Caprimolgorchis molenkampi, Phaneropsolus bonnei, Microphallus brevicaeca, Nanophyetus salmincola, and N. schikhobalowi (10 species) have drawn considerable medical attention causing quite a fair number of human infection cases. The principal mode of human infections include ingestion of raw or improperly cooked fish (heterophyids and echinostomes), snails including oysters (echinostomes and G. seoi), amphibians and reptiles (N. seoulense), aquatic vegetables (amphistomes and F. buski), and insect larvae or adults (C. molenkampi and P. bonnei). Epidemiological characteristics such as the prevalence, geographical distribution, and clinical and public health significance are poorly known in many of these species. Praziquantel has been proved to be highly effective against most species of intestinal fluke infections. Surveys and detection of human infection cases are urgently required for better understanding of the global status and public health significance of each species.

Diagnosis of Human Trematode Infections

Digenetic trematodes form a major group of human parasites, affecting a large number of humans, especially in endemic foci. Over 100 species have been reported infecting humans, including blood, lung, liver, and intestinal parasites. Traditionally, trematode infections have been diagnosed by parasitological methods based on the detection and the identification of eggs in different clinical samples. However, this is complicated due to the morphological similarity between eggs of different trematode species and other factors such as lack of sensitivity or ectopic locations of the parasites. Moreover, the problem is currently aggravated by migratory flows, international travel, international trade of foods, and changes in alimentary habits. Although efforts have been made for the development of immunological and molecular techniques, the detection of eggs through parasitological techniques remains as the gold standard for the diagnosis of trematodiases. In this chapter, we review the current status of knowledge on diagnostic techniques used when examining feces, urine, and sputum and also analyze the most relevant characteristics used to identify eggs with a quick key for the identification of eggs.

An Autochthonous Human Case of Fasciolopsiasis in Nepal

Fasciolopsiasis is rarely known as the parasitic disease in Nepal. Herein, we report a case of fasciolopsiasis in a 22-year-old man who was admitted in the hospital with abdominal pain, distension and loss of appetite for a month. He had previously diagnosed with acute viral hepatitis but, his abdominal pain was not resolving despite improvement in his liver function and general condition. During endoscopy an adult digenean worm was seen in the first part of the duodenum. After isolation, the worm was identified morphologically as Fasciolopsis buski. Microscogic examination of the patient’s stool revealed eggs with a morphology consistent with F. buski. Eggs were yellow-brown, ellipsoidal, unembmbryonated, operculated, filled with yolk cells, with thin shell and ranging 118–130 μm in length and 60–69 μm in width. The abdominal pain of the patient was resolved after treatment with praziquantel. By the present study, it was confirmed for the first time that fasciolopsiasis is indigenously transmitted in Nepal. Accordingly, the epidemiological studies in humans and reservoir host animals should be performed intensively in near future.

A case report of human gastrodiscoidiasis in Nepal

Gastrodiscoidiasis is a snail-transmitted zoonotic infection caused by the digenean trematode Gastrodiscoides hominis, which is the only species in the genus Gastrodiscoides infecting humans. We report a case of human gastrodiscoidiasis in a 66 years-old Nepali man without history of travels outside of Nepal who was admitted in the hospital with pain in upper abdomen for 4 months with history of passage of black-tarry stools, anemia and eosinophilia. During upper endoscopy a living trematode worm was seen in the antrum of the stomach. After isolation, the worm was identified morphologically as Gastrodiscoides hominis. Stool analysis of the patient revealed eggs of this parasite. The cause of the infection appeared to be related to the habit of the patient to eat raw watercress. This is the first report of human infection with Gastrodiscoides hominis in Nepal. However, the burden of this foodborne trematode infection in Nepal might be underestimated.

Epidemiology of Trematode Infections: An Update

Digenetic trematodes infecting humans are more than 91 species which belong to 46 genera all over the world. According to their habitat in definitive hosts, they are classified as blood flukes (Schistosoma japonicum. S. mekongi, S. mansoni, S. haematobium, and S. intercalatum), liver flukes (Clonorchis sinensis, Opisthorchis viverrini, O. felineus, Metorchis conjunctus, M. bilis, M. orientalis, Fasciola hepatica, F. gigantica, Dicrocoelium dendriticum, and D. hospes), lung flukes (Paragonimus westermani, P. heterotremus, P. skrjabini, P. miyazakii, P. kellicoti, P. mexicanus, P. africanus, and P. uterobilateralis), throat fluke (Clinostomum complanatum), pancreatic fluke (Eurytrema pancreaticum), and intestinal flukes (Metagonimus yokogawai, M. miyatai, M. takahashii, Heterophyes nocens, H. heterophyes, Haplorchis taichui, H. pumilio, H. yokogawai, Centrocestus formosanus, Echinostoma revolutum, E. ilocanum, Isthmiophora hortensis, Echinochasmus japonicus, E. lilliputanus, Artyfechinostomum malayanum, A. sufrartyfex, A. oraoni, Fasciolopsis buski, Gymnophalloides seoi, Neodiplostomum seoulense, Caprimolgorchis molenkampi, Phaneropsolus bonnei, and Plagiorchis muris). The mode of transmission to humans includes contact with cercariae contaminated in water (schistosomes) and ingestion of raw or improperly cooked fish (liver and throat flukes, heterophyids, and echinostomes), snails (echinostomes and gymnophallids), amphibia, reptiles (neodiplostomes), aquatic vegetables (amphistomes), or insect larvae or adults (plagiorchiids, lecithodendriids, and pancreatic fluke). Praziquantel has been proved to be highly effective against most species of trematode infections except fascioliasis. Epidemiological surveys and detection of human infections are required for better understanding of the geographical distribution and endemicity of each trematode species.

De novo genome and transcriptome analyses provide insights into the biology of the trematode human parasite Fasciolopsis buski

Many trematode parasites cause infection in humans and are thought to be a major public health problem. Their ecological diversity in different regions provides challenging questions on evolution of these organisms. In this report, we perform transcriptome analysis of the giant intestinal fluke, Fasciolopsis buski, using next generation sequencing technology. Short read sequences derived from polyA containing RNA of this organism were assembled into 30,677 unigenes that led to the annotation of 12,380 genes. Annotation of the assembled transcripts enabled insight into processes and pathways in the intestinal fluke, such as RNAi pathway and energy metabolism. The expressed kinome of the organism was characterized by identifying all protein kinases. A rough draft genome assembly for Fasciolopsis buski is also reported herewith with SRA accessions for crosschecking the findings in the analyzed transcriptome data. Transcriptome data also helped us to identify some of the expressed transposable elements. Though many Long Interspersed elements (LINEs) were identified, only two Short Interspersed Elements (SINEs) were visible. Overall transcriptome and draft genome analysis of F. buski helped us to characterize some of its important biological characteristics and provided enormous resources for development of a suitable diagnostic system and anti-parasitic therapeutic molecules.