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Although fish tapeworm infections in arctic and subarctic residents are often attributed to the cestode Diphyllobothrium latum, other Diphyllobothrium species are frequently responsible. D. dendriticum, for example, occurs throughout the circumpolar area at high latitudes beyond the range of D. latum. Several additional species are also implicated in human infections in northern communities bordering the Pacific: D. ursi from northern Canada and Alaska, D. dalliae from Alaska and Siberia, and D. klebanovskii from Siberia. Routine diagnosis of diphyllobothriasis by coprology does not allow designation of the Diphyllobothrium species involved as their eggs cannot be differentiated and identification of the proglottids from adult worms requires a taxonomic specialist. On the other hand, relevant information on the Diphyllobothrium species most likely to infect the inhabitants of a particular region can be derived from a knowledge of the fish consumed. Larvae of D. dendriticum occur predominantly in salmonid fishes (e.g. arctic char, salmon, trout, whitefish), and this parasite has never been found in pike and perch, the usual intermediate hosts of D. latum. Conversely, D. latum is rarely found in salmonids. D. ursi and D. klebanovskii predominantly occur in Pacific salmon, and D. dalliae in Alaskan blackfish. Species other than D. latum probably constitute transitory intestinal infections in humans, usually lasting for only a few months. Although many carriers are asymptomatic, overt clinical manifestations of diphyllobothriasis can include diarrhea, epigastric pain, nausea and vomiting. There are no reports of anaemia associated with any of the northern species except D. latum. Effective control for diphyllobothriasis originating from D. latum has been achieved in many areas by a combination of selective drug therapy and improved sewage treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
A retrospective laboratory survey on 10758 patients at the Hospital of Panguipulli showed the existence of 11 cases of diphyllobothriasis during a ten year (1979-1988) period. Age and sex as well as data of biannual prevalence of diphyllobothriasis are given. Some factors that determine the existence of diphyllobothriasis focus at lakes from Valdivia River Basin are briefly reviewed.
Diphyllobothriasis latum is an intestinal parasitosis caused by the ingestion of mostly raw fresh-water fish containing plerocercoids of Diphyllobothrium latum. We report an 8-year-old boy who came to our hospital with the complaint of a tapeworm hanging from the anus after defecation. The other symptom was mild abdominal cramping for a period of 1 year. The laboratory examination did not reveal anemia or vitamin B12 deficiency. Examination of gravid proglottids with rosette-like central uterus and typically operculated eggs of D. latum confirmed the diagnosis. The morphologic characters of proglottids and eggs size are compatible with D. latum. The patient had a history of eating uncooked fish for 1 year. Salmonids may be the infection source. He was treated with two doses of praziquantel and passed about 183 cm in length of all proglottids. There is a high prevalence of diphyllobothriasis latum in the northern temperate areas, but it is very rare in children. This patient is the first child case reported in Taiwan.
Diphyllobothriasis is a disease caused by infection with adult tapeworms of the genus Diphyllobothrium. Humans acquire the infection by consuming the raw or inadequately cooked flesh, roe, liver, or other organs of infected fish. Diphyllobothrium latum infection has not been reported in Malaysia; we are reporting the first case. The patient was a 62 year old Chinese male seen at the outpatient clinic with complaints of watery stools and slight abdominal discomfort for four days. Physical examination was normal. He was treated for diarrhea. Two days after treatment, he passed out intact off-white proglottids in his stool. Diphyllobothriasis was confirmed by examination of these gravid proglottids; typical operculated eggs were seen after rupturing the gravid proglottids. The patient had a history of eating sashimi (Japanese raw fish). He was treated with a single dose of praziquantel and had been well since.
We described a Saudi patient infected with Diphyllobothrium latum D. latum. A 38-year-old male presented, complaining of passing worms. He had a history of recent travel to Europe and South East Asia. Stools examination revealed typical D. latum eggs. He was treated with praziquantel followed by saline purge, after which he discharged an intact tapeworm. Macroscopic and microscopic examinations of the worm confirmed the diagnosis of D. latum. This is the first case of diphyllobothriasis to be reported in Saudi Arabia. The epidemiology and methods of prevention of diphyllobothriasis are discussed.
A considerable decrease in lysozime activity has been detected in the serum of patients with diphyllobothriasis especially in the early period of invasion. A 13-20-fold increase in enzyme activity has been found in the urine of patients, which disappeared 1 month after treatment, indicating the normalization of the immune status after the recovery from diphyllobothriasis. The index of lysozyme activity may be used in combination with other tests for the evaluation of the treatment efficacy.
Plerocercoids of D. ditremum were obtained from the Japanese surfsmelt (Hypomesus pretiosus) and administered to Golden hamsters. The animals were treated with paromomycin sulfate on the 16th day of infection. Anthelmintic effect was imperfection after administration of 530 mg/kg in 4 divided doses. Kamala and bithionol, however, successfully expelled the worm at the doses of 80 and 160 mg/kg and 12.5--70 mg/kg, respectively. The balloon-like structures and the other morphological changes of the tegument such as exfoliation of microtriches were remarkably observed on the worms immersed in 2% solution of paromomycin sulfate. Four human cases of diphyllobothriasis were treated with paromomycin sulfate at the doses of 46--56 mg/kg. No side effects were observed. Stool examination made 1 month after treatment were negative to the eggs. From these results, an anthelmintic effect of paromomycin sulfate was shown in the concentration of 2% on D. ditremum in vitro and in the dosage of 46--56 mg/kg in diphyllobothriasis lata patients.
There are conditions for forming a diphyllobothriasis focus in the basin of the lower Don. In terms of the population affliction, low risk for its infection and the size of copepods, the focus is differentiated as an Oligocopepoda one of low epidemiological intensity. Its formation is favoured by the activation of the population's migration, favourable ecological and biological conditions for the existence of intermediate and supplementary hosts, the population's habit of having ill-disinfected fish, the pathways of infected material delivery into the reservoirs, the survival periods for broad tape-worm eggs, which are sufficient for diphyllobothriasis pathogens to develop their biological cycle under the conditions of Rostov Province.
BACKGROUND: Very few sporadic cases of autochthonous diphyllobothriasis have been reported in Italy during the past 20 years, probably due to the drastic decrease or disappearance of some fish species, mainly Perca fluviatilis L., known as the intermediate host of the infective larval stage of this tapeworm. However, increasing consumption of raw or undercooked fish during the last years as influenced by Oriental cuisine, played an important role in a number of new single cases of the infection or microepidemics. PATIENTS: We describe six cases which were diagnosed within a period of 4 months, which all originated from the area of Lake Como (Lombardy region). All subjects had previously eaten raw perch fillets. Four individuals complained of gastrointestinal signs and symptoms, whereas two were asymptomatic. DISCUSSION: Parasitological diagnosis was achieved in four cases by recovery of typical operculated eggs in stool specimens; in two others by morphological features of proglottids recovered from feces. Treatment with niclosamide, as a single oral dose, cured the infection in all subjects. This is the first report of this infection in Italy in the last 10 years.
Eight cases of diphyllobothriasis have been experienced in the Juntendo University Hospital. Seven of the 8 patients excreted tapeworm fragments. Eggs of Diphyllobothrium latum were found in the feces in 5 cases. One patient had a history of ingestion of raw trout (Sushi), and 2 raw salmon. One might have been infected in foreign countries, and 3 could not tell the source of infection. Bithoinol was administered orally to 7 patients. Four of the 7 excreted the worm and the scolex was recognized in three of the four. Neither recurrence nor abnormal findings have been recognized so far.
In the Valdivia (Chile) river basin 1,295 inhabitants of 6 riverside districts were examined between March and October 1987 and showed a 1.2% of prevalence by Diphyllobothrium in the districts of Riñihue and Las Huellas. Prevalence of 5.3% and 9.8% respectively were registered in dogs of the districts of Riñihue and Malihue. No cat or pig infection was observed in the different districts. The parasites recovered after the treatment were identified as Diphyllobothrium latum. Human infection by D. latum in the districts affected results from the consumption of smoked or insufficiently cooked fish. The investigation of 1,450 fish (4 exotic species and 11 autochthonous ones), caught in the Valdivia river basin in 1986 and 1987, showed the existence of plerocercoids of D. latum and/or Diphyllobothrium dendriticum in Salmo gairdneri and Salmo trutta among exotic fish and in some autochthonous species. Prevalence and mean intensity in the infection of fish as well as the degree of aggregation in the infrapopulations varied in the different districts. Some species of fish would act as intermediary hosts and others as paratenic hosts in the life cycles of Diphyllobothrium spp. in the Valdivia river basin. An improvement in the conditions of basic sanitation, in sanitary education and in the treatment of infected persons is proposed as a means for the control of diphyllobothriasis in the districts affected.
OBJECTIVE: In view of the amateur fishing practices and the importance of salmonids in the region the study sets out to detect human hosts in the Andean-Patagonian zone. MATERIAL AND METHOD: Information campaigns were carried out by Clinical Analysis Laboratories of Andean Patagonia between 1986 and 1995 to detect diphyllobothriasis more efficiently by means of coproparasitological analysis. RESULTS: Further, forms were prepared for the collection of information about infection, treatment and the characteristics of the human host. During this period 13 new cases were registered either through direct identification of the parasite or through the presence of eggs in the faeces. The characteristics of infection are similar to those described for the genus Diphyllobothrium. CONCLUSIONS: The favourite game fish in Andean Patagonia are salmonids. This fish, often infected with plerocercoids, when eaten insufficiently cooked or cold smoked, constitutes the main source of human infection.
The purpose of the paper is to describe 4 new cases of human diphyllobothriasis in Patagonia, Argentine. Adult parasites recovered were submitted to morphological and histological analyses for taxonomic identification. The etiological agent found was always Diphyllobothrium latum and all the cases were autochthonous. These data combined with previous information make the number of autochthonous human cases of diphyllobothriosis registered in Argentina increase to 18.
Cases of human diphyllobothriasis have been reported worldwide. Only 1 case in Brazil was diagnosed by our institution from January 1998 to December 2003. By comparison, 18 cases were diagnosed from March 2004 to January 2005. All patients who became infected ate raw fish in sushi or sashimi.
A review of requests for niclosamide ( Niclocide or Yomesan ) made to the Centers for Disease Control Parasitic Diseases Drug Service indicated that an outbreak of diphyllobothriasis occurred in west coast states in 1980, and in the Los Angeles area in 1981. Our investigation of 52 infections that occurred in 1980 implicates fresh salmon (Oncorhynchus spp.) as the host for the Diphyllobothrium parasite in 82% of the persons interviewed. We describe here common symptoms of the infection, methods of fish preparation employed by infected individuals, and epidemiologic data. We suggest that changes in fish marketing practices and the popularity of uncooked or slightly cooked fresh salmon were responsible for this epidemic. We recommend that salmon be either cooked or frozen before it is eaten.