Chapter 11 - Food-Borne Trematodiases in Southeast Asia: Epidemiology, Pathology, Clinical Manifestation and Control

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Abstract

The food-borne trematodiases are an important group of neglected tropical diseases (NTDs). Over 40 million people are infected with food-borne trematodes and 750 million (> 10% of the world's population) are at risk of these NTDs. Here, we review the life cycles, epidemiology, clinical manifestations, pathology and pathogenesis, diagnosis, treatment, and prevention and control of the major food-borne trematodiases in Southeast Asia. We focus particularly on opisthorchiasis caused by Opisthorchis viverrini and clonorchiasis caused by Clonorchis sinensis, which people contract by ingestion of metacercariae in flesh of raw or undercooked freshwater fishes, on fascioliasis caused by Fasciola species, where infection arises from ingestion of metacercariae on water plants such as watercress, and on Paragonimus species, the lung flukes, which use freshwater crabs and other crustaceans as intermediate hosts. We also include information on the intestinal flukes Fasciolopsis buski, the echinostomes and the so-called ‘minute intestinal flukes’ of the family Heterophyidae. Ecological information, placing emphasis on reservoir hosts, intermediate snail hosts and secondary hosts where applicable, is also reviewed and research needs are highlighted.

Introduction

Food-borne trematodiases are one major group of the so-called neglected tropical diseases (NTDs) worldwide with more than 40 million people infected and 750 million (> 10% of the world's population) at risk (Hotez et al., 2008, Keiser & Utzinger, 2005). Over 100 species of food-borne trematodes are known to infect humans. These infections usually occur focally, are still endemic in many parts of the world, particularly Southeast Asia (Graczyk and Fried, 2007). Common clinical important trematodes in this region include Opisthorchis viverrini, Clonorchis sinensis, Fasciola spp., Paragonimus spp. and intestinal flukes (Table 11.1) (WHO, 2002). Most trematodiases affect the poor and poorest people in rural areas. Many factors contribute to the high prevalence of these infections, including lack of education, poor recognition of the trematode infections because of their asymptomatic clinical presentation, poverty, malnutrition, a lack of food inspection and poor sanitation (Graczyk and Fried, 2007).

This review highlights on the life cycles, epidemiology, clinical manifestations, pathology and pathogenesis, diagnosis, and prevention and control of the most important trematodiases in Southeast Asia, particularly opisthorchiasis and clonorchiasis. Fascioliasis, one of the clinically important trematodiasis in the region, has been extensively updated in this journal recently (Mas-Coma et al., 2009a). For detailed biology of other trematodes, several recent in-depth reviews are recommended, that is Dorny et al., 2009, Keiser & Utzinger, 2009.

Section snippets

Opisthorchiasis and Clonorchiasis

The human liver flukes, O. viverrini, O. felineus and C. sinensis remain important public health problems in many parts of the world (Fig. 11.1). C. sinensis is widespread in the People's Republic of China (P.R. China), Korea and north Vietnam, while O. viverrini is endemic in Southeast Asia, including Thailand, Lao People's Democratic Republic (Lao PDR), Cambodia and central Vietnam. Human infection follows the consumption of raw or undercooked cyprinoid (freshwater) fish habouring infective

Fascioliasis

There are an estimated 2.4–17 million people worldwide, including Asia, infected with one or both species of the liver fluke Fasciola, namely F. hepatica and F. gigantica, often causing serious acute and chronic morbidity (Mas-Coma et al., 2005, Mas-Coma et al., 2009a). The estimated at-risk population is 80 million (Keiser and Utzinger, 2005). In the past, Fasciola infections were limited to specific and typical geographical areas, but more recently, this liver fluke has spread throughout the

Paragonimiasis

Paragonimus spp., the lung flukes, represent one of the most injurious of the food-borne helminths. These flukes cause paragonimiasis in people and other crab-eating mammals in Asia, parts of West Africa, and South and Central America. About 20 million people are infected with lung flukes (WHO, 1995) and an estimated 293 million people are at-risk (Keiser and Utzinger, 2005). There are about 15 species of Paragonimus known to infect humans. P. westermani infection is the most common elsewhere,

Intestinal Flukes

The intestinal fluke category comprises a large assemblage of trematode species that induce food-borne parasitic zoonoses. Collectively, these parasites have a major impact on the health and economy in developing countries of the tropics and sub-tropics in Asia, Africa, Europe and the Americas.

Conclusions and Research Implications

The food-borne trematodiases not only remain major NTDs in South East Asia and sub-Saharan Africa, throughout much of the developing world, they are emerging and re-emerging, including developed regions, such as O. felineus in Western Europe (Armignacco et al., 2008), P. westermani in Miyazaki prefecture, Japan (Nakano et al., 2009) and fascioliasis in the Bolivian Altiplano (Parkinson et al., 2007).

There is a need to undertake risk mapping using geographical information systems (GIS) and

Acknowledgements

We gratefully acknowledge support from award number UO1AI065871 from the National Institute of Allergy and Infectious Diseases (NIAID), the Thailand Research Fund (grant no. BRG4580016) and the Thailand-Tropical Diseases Research Programme (T-2, grant number ID 02-2-HEL-05-054). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the NIAID or the National Institutes of Health (NIH).

References (179)

  • A.K. Dixit et al.

    Immunodiagnostic/protective role of cathepsin L cysteine proteinases secreted by Fasciola species

    Vet. Parasitol.

    (2008)
  • P. Dorny et al.

    Emerging food-borne parasites

    Vet. Parasitol.

    (2009)
  • D.B. Elkins et al.

    A high frequency of hepatobiliary disease and suspected cholangiocarcinoma associated with heavy Opisthorchis viverrini infection in a small community in north-east Thailand

    Trans. R. Soc. Trop. Med. Hyg.

    (1990)
  • T.K. Graczyk et al.

    Human waterborne trematode and protozoan infections

    Adv. Parasitol.

    (2007)
  • S.T. Hong et al.

    The Kato-Katz method is reliable for diagnosis of Clonorchis sinensis infection

    Diagn. Microbiol. Infect. Dis.

    (2003)
  • J.E. Huffman et al.

    Echinostoma and echinostomiasis

    Adv. Parasitol.

    (1990)
  • M.V. Johansen et al.

    Towards improved diagnosis of zoonotic trematode infections in Southeast Asia

    Adv. Parasitol.

    (2010)
  • P. Jongsuksuntigul et al.

    Opisthorchiasis control in Thailand

    Acta Trop.

    (2003)
  • S. Kaewkes

    Taxonomy and biology of liver flukes

    Acta Trop.

    (2003)
  • M. Kasný et al.

    Peptidases of trematodes

    Adv. Parasitol.

    (2009)
  • J. Keiser et al.

    The drugs we have and the drugs we need against major helminth infections

    Adv. Parasitol.

    (2010)
  • T.H. Le et al.

    Paragonimus heterotremus Chen and Hsia (1964), in Vietnam: a molecular identification and relationships of isolates from different hosts and geographical origins

    Acta Trop.

    (2006)
  • T.H. Le et al.

    Clonorchis sinensis and Opisthorchis viverrini: development of a mitochondrial-based multiplex PCR for their identification and discrimination

    Exp. Parasitol.

    (2006)
  • T.H. Le et al.

    Human fascioliasis and the presence of hybrid/introgressed forms of Fasciola hepatica and Fasciola gigantica in Vietnam

    Int. J. Parasitol.

    (2008)
  • Q. Liu et al.

    Paragonimiasis: an important food-borne zoonosis in China

    Trends Parasitol.

    (2008)
  • Z.R. Lun et al.

    Clonorchiasis: a key foodborne zoonosis in China

    Lancet Infect. Dis.

    (2005)
  • S. Lv et al.

    Helminth infections of the central nervous system occurring in Southeast Asia and the Far East

    Adv. Parasitol.

    (2010)
  • E. Mairiang et al.

    Clinical manifestation of opisthorchiasis and treatment

    Acta Trop.

    (2003)
  • E. Mairiang et al.

    Reversal of biliary tract abnormalities associated with Opisthorchis viverrini infection following praziquantel treatment

    Trans. R. Soc. Trop. Med. Hyg.

    (1993)
  • S. Mas-Coma et al.

    Fascioliasis and other plant-borne trematode zoonoses

    Int. J. Parasitol.

    (2005)
  • S. Mas-Coma et al.

    Fasciola, lymnaeids and human fascioliasis, with a global overview on disease transmission, epidemiology, evolutionary genetics, molecular epidemiology and control

    Adv. Parasitol.

    (2009)
  • S. Mas-Coma et al.

    Climate change effects on trematodiases, with emphasis on zoonotic fascioliasis and schistosomiasis

    Vet. Parasitol.

    (2009)
  • L. McGonigle et al.

    The silencing of cysteine proteases in Fasciola hepatica newly excysted juveniles using RNA interference reduces gut penetration

    Int. J. Parasitol.

    (2008)
  • R.M. Morphew et al.

    Comparative proteomics of excretory-secretory proteins released by the liver fluke Fasciola hepatica in sheep host bile and during in vitro culture ex host

    Mol. Cell. Proteomics

    (2007)
  • A. Nkouawa et al.

    Paragonimiasis in Cameroon: molecular identification, serodiagnosis and clinical manifestations

    Trans. R. Soc. Trop. Med. Hyg.

    (2009)
  • M.H. Abdulla et al.

    Schistosomiasis mansoni: novel chemotherapy using a cysteine protease inhibitor

    PLoS Med.

    (2007)
  • C. Africa et al.

    Intestinal heterophyidiasis with cardiac involvement: a contribution to etiology of heart failure

    J. Philipp. Islands Med. Assoc.

    (1935)
  • M.T. Anantaphruti

    Parasitic contaminants in food

    Southeast Asian J. Trop. Med. Public Health

    (2001)
  • O. Armignacco et al.

    Human illnesses caused by Opisthorchis felineus flukes, Italy

    Emerg. Infect. Dis.

    (2008)
  • P.C. Beaver et al.

    Clinical Parasitology

    (1984)
  • V. Belizario et al.

    Pulmonary paragonimiasis and tuberculosis Sorsogon, Philippines

    Southeast Asian J. Trop. Med. Public Health

    (1997)
  • N. Bhamarapravati et al.

    Liver changes in hamsters infected with a liver fluke of man, Opisthorchis viverrini

    Am. J. Trop. Med. Hyg.

    (1978)
  • P.J. Brindley et al.

    Helminth genomics: implications for human health

    PLoS Negl. Trop. Dis.

    (2009)
  • D. Bunnag et al.

    Field trial on the treatment of fasciolopsiasis with praziquantel

    Southeast Asian J. Trop. Med. Public Health

    (1983)
  • W.P. Carney

    Echinostomiasis: a snail-borne intestinal trematode zoonosis

    Southeast Asian J. Trop. Med. Public Health

    (1991)
  • J.Y. Chai et al.

    A new endemic focus of Heterophyes nocens, Pygidiopsis summa, and other intestinal flukes in a coastal area of Muan-gun, Chollanam-do

    Korean J. Parasitol.

    (1997)
  • J.Y. Chai et al.

    High endemicity of Metagonimus yokogawai infection among residents of Samchok-shi, Kangwon-do

    Korean J. Parasitol.

    (2000)
  • J.Y. Chai et al.

    High prevalence of Haplorchis taichui, Phaneropsolus molenkampi, and other helminth infections among people in Khammouane province, Lao PDR

    Korean J. Parasitol.

    (2009)
  • M.G. Chen et al.

    Progress in assessment of morbidity due to Fasciola hepatica infection: a review of recent literature

    Trop. Dis. Bull.

    (1990)
  • M.G. Chen et al.

    DNA sequences of Paragonimus skrjabini populations from five provinces in China

    Chin. Med. J.

    (2004)
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