PubMed2002
Over the past few years, the cercarial dermatitis has become a new problem of public health, obviously linked to the prolonged stay of migrant birds on our territory. This is a skin affection characterized by pruriginous and papulous eruptions caused by penetration of avian bilharzian larvae under the skin. These larvae are emitted by molluscs, mostly limneids. In aquatic birds, especially in migrating Anatidae, these larvae reach the visceral vessels, become adults in a few weeks, lay eggs, then degenerate. Corresponding miracidia contaminate new limneids. Since 1993, the total number of annual cases of cercarial dermatitis has increased from only ten to thousands in France and the affection rages in pools where limneids, migrating water birds and swimmers gather together. Fever, respiratory and/or digestive allergic symptoms appear in some cases. This clinical pattern has encouraged to undertake research on the future of these bilharzian larvae in mammals organism. A preliminary investigation on a rodent model showed that, once the skin barrier had been crossed, the schistosomulae migrated into the lungs of the host; there they survived a week and induced lesions. The goal of this study is to carry on the research, over a longer period, after exposure to cercariae, simultaneously in mammals and birds, with two species of bilharziae present in France. The selected models are the gerbil Meriones unguiculatus for mammals, and the ducks Anas platyrhynchos and Cairina moschata, for birds. 5 M. unguiculatus and 2 A. platyrhynchos were exposed to cercariae emitted by Radix auricularia; 2 gerbils and 5 A. platyryhnchos to larvae of R. peregra, 3 C. moschata to larvae emitted by two species of molluscs: 70-230 from R. auricularia and 330-585 from R. peregra. 5 gerbils died between 2 and 5 weeks after exposure, 2 gerbils sacrificed early, served as control animals for skin manifestations. Eight ducks were sacrificed between 2 and 4 weeks after; the 2 last ones, exposed several times, were sacrificed respectively 7 and 13 weeks after the first exposure. Visceral and skin samples were submitted to histological study. The control gerbils developed skin dermatitis. In ducks, R. auricularia was the vector of Trichobilharzia franki, whose selective dwelling site was the mesentery; R. peregra was the vector of an indeterminate species found in the lungs and nose. This species is called Bilharzia sp. in this study. The ducks, exposed to two kinds of larvae, displayed worms in these two main locations. In gerbils, T. franki induced lesions in the mesenteric veins and the peritoneum. Bilharzia sp. gave rise to lesions in lung arteries, pleura and liver veins. Vascular changes encompassed endothelitis and lymphocytic vasculitis, while serosa displayed mesothelial hyperplasia. The types of lesions observed in gerbils were noticed in ducks, and, according to the species of bilharzia, in the homologous viscera. Additional foreign body granulomas centred on worm's debris or their eggs, and vascular thromboses were present, too. In addition, ducks displayed lesions involving several other viscera including the intestine, the kidneys and the peripheral nerves. These changes were multiple and diffuse in C. moschata exposed to two species of bilharziae. They were observed mainly in mesenteric and intestinal vessels, pulmonary arteries and hepatic veins. In gerbils, the lesions persisted 2 to 5 weeks after exposure, but worms were not identified in the neighbouring tissues near the damaged vessels. In ducks, lesions were important between 2 and 7 weeks after exposure; they co-existed with live or dead worms, sometimes paired, with or without eggs. The hepatic lesions regressed 13 weeks, after exposure. In mammals and birds, young worms could migrate into the same visceral vessels, and stimulating formation of persistent lesions. In individuals exposed to the same cercariae, development of similar lesions would be probable.