In vitro study of antimicrobial activity of some plant seeds against bacterial strains causing food poisoning diseases / Estudo in vitro da atividade antimicrobiana de algumas sementes de plantas contra cepas bacterianas que causam doenças de intoxicação alimentar

In this research, some plant seeds powder was evaluated to find their potential effect to rule diseases of food poisoning. Antimicrobial effect of five plant seeds was examined contra Bacillus cereus, Staphylococcus aureus, Escherichia coli, Klebsiella. pneumonia and Candida albicans by using well diffusion method. Antimicrobial activity studies revealed high potential activity of plant seeds powder of Nigella sativa L., cucurbita pepo, Sesamum radiatum, Trigonella foenum-graecum, Linum usitatissimum with variable efficiency contra tested microbial strains with concentration of 100 mg/ml, except Sesamum radiatum scored no effect. The T. foenum and N. sativa seed powder showed the largest inhibition zone (24-20 mm) contra K. pneumonia, followed by S. aureus (20-18 mm) and C. albicans (15mm) respectively. The five plant seeds powder exhibited bacteriostatic and bactericidal effects with MIC's 20 and MBC 40 mg/ml against K. pneumonia, and MIC's 40 and MBC 60 mg/ml against S. aureus. The results of this study indicated that plants seeds powder have promising antimicrobial activities and their potential applications in food process. It could be utilized as a natural medicinal alternative instead of chemical substance.

Nesta pesquisa, o pó de sementes de plantas foi avaliado para encontrar seu efeito potencial no controle de doenças de intoxicação alimentar. O efeito antimicrobiano de cinco sementes de plantas foi examinado contra Bacillus cereus, Staphylococcus aureus, Escherichia coli, Klebsiella pneumonia e Candida albicans usando o método de difusão bem. Estudos de atividade antimicrobiana revelaram alto potencial de atividade de sementes de plantas em pó de Nigella sativa L., Cucurbita pepo, Sesamum radiatum, Trigonella foenum-graecum, Linum usitatissimum com eficiência variável contra cepas microbianas testadas com concentração de 100 mg / ml, exceto Sesamum radiatum com pontuação não efeito. O pó de sementes de T. foenum e N. sativa apresentou a maior zona de inibição (24-20 mm) contra K. pneumonia, seguido por S. aureus (20-18 mm) e C. albicans (15 mm), respectivamente. O pó de cinco sementes de plantas exibiu efeitos bacteriostáticos e bactericidas com MIC's 20 e MBC 40 mg / ml contra K. pneumonia, enquanto MIC's 40 e MBC 60 mg / ml contra S. aureus. Os resultados deste estudo indicaram que os pós de sementes de plantas apresentam promissoras atividades antimicrobianas e suas potenciais aplicações em processos alimentícios. Ele poderia ser utilizado como alternativa medicinal natural em vez de substância química.

Evaluating uncertainty and variability associated with Toxoplasma gondii survival during cooking and low temperature storage of fresh cut meats.

Toxoplasmosis is an infection caused by the protozoan parasite, Toxoplasma gondii. It has been reported as the fourth leading cause of hospitalization and second leading cause of death among 31 major foodborne pathogens in the United States. Humans are infected through consumption of raw or undercooked meat containing T. gondii tissue cysts or ingestion of food, soil, or water contaminated by T. gondii oocysts. People often lack knowledge about how to prevent T. gondii infection, especially the risks associated with eating or handling raw or undercooked meat. Current available data on cooking or low temperature storage for whole cuts of meat are not sufficient to validate inactivation of T. gondii. The objectives of the present study were to estimate the relationship of time and temperature with the survival rate of T. gondii during cooking and low temperature storage of fresh cut meats. We used different statistical sampling techniques such as bootstrap resampling and Gibbs sampling to establish those relationships. Monte Carlo simulation was used to estimate the safe temperature for cooking and storing meats. The results showed no detection of T. gondii in fresh meats when the internal temperature reached above 64 °C (147.2 °F) and below -18 °C (0 °F). The tissue cysts can remain viable at least up to 30 days at 4 °C (39 °F) and about 3.3% cysts survived at 62.8 °C (145 °F). This study can provide helpful information in improving the risk models to further mitigate the public health burden of toxoplasmosis.

Foodborne zoonotic parasites of the family Opisthorchiidae.

Several foodborne zoonotic trematodes of the family Opisthorchiidae have been reported to infect people, specifically two genera, Clonorchis and Opisthorchis. Three species Clonorchis sinensis, Opisthorchis felineus and Opisthorchis viverrini are the most extensivley studied of the Opisthorchiidae. At least 680 million people worldwide are at risk of infection of these liver flukes through the consumption of raw or partially cooked freshwater cyprinid fish. An estimated 45 million people in Europe and Asia are currently infected with these liver flukes. Of these, the 35 million are infected with C. sinensis mainly in China, 10 million with O. viverrini in Southeast Asia, and 1.2 million with O. felineus in Eastern Europe and Russia. These liver flukes have been proven to be causative agents of bile duct cancer or cholangiocarcinoma (CCA). A multidisciplinary program should be implemented involving comprehensive research on molecular genetics, diagnosis, treatment, prevention, as well as educational and control programs should progressively be introduced and applied in endemic regions of O. viverrini, O. felineus and C. sinensis throughout their ranges, hence, opisthorchiasis and clonorchiasis free communities can be realised globally.

A smartphone microscopic method for simultaneous detection of (oo)cysts of Cryptosporidium and Giardia.

BACKGROUND: Food and water-borne illness caused by ingestion of (oo)cysts of Cryptosporidium and Giardia is one of the major health problems globally. Several methods are available to detect Giardia cyst and Cryptosporidium oocyst in food and water. Most of the available methods require a good laboratory facility and well-trained manpower and are therefore costly. There is a need of affordable and reliable method that can be easily implemented in resource limited settings. METHODOLOGY/PRINCIPLE FINDINGS: We developed a smartphone based microscopic assay method to screen (oo)cysts of Cryptosporidium and Giardia contamination of vegetable and water samples. The method consisting of a ball lens of 1 mm diameter, white LED as illumination source and Lugols's iodine staining provided magnification and contrast capable of distinguishing (oo)cysts of Cryptosporidium and Giardia. The analytical performance of the method was tested by spike recovery experiments. The spike recovery experiments performed on cabbage, carrot, cucumber, radish, tomatoes, and water resulted in 26.8±10.3, 40.1±8.5, 44.4±7.3, 47.6±11.3, 49.2 ±10.9, and 30.2±7.9% recovery for Cryptosporidium, respectively and 10.2±4.0, 14.1±7.3, 24.2±12.1, 23.2±13.7, 17.1±13.9, and 37.6±2.4% recovery for Giardia, respectively. The spike recovery results are comparable with data obtained using commercial brightfield and fluorescence microscope methods. Finally, we tested the smartphone microscope system for detecting (oo)cysts on 7 types of vegetable (n = 196) and river water (n = 18) samples. Forty-two percent vegetable and thirty-nine percent water samples were found to be contaminated with Cryptosporidium oocyst. Similarly, thirty-one percent vegetable and thirty-three percent water samples were contaminated with Giardia cyst. CONCLUSIONS: The newly developed smartphone microscopic method showed comparable performance to commercial microscopic methods. The new method can be a low-cost and easy to implement alternative method for simultaneous detection of (oo)cysts in vegetable and water samples in resource limited settings.

Estimating deaths from foodborne disease in the UK for 11 key pathogens.

OBJECTIVE: To estimate the number of deaths from foodborne disease in the UK from 11 key pathogens. DESIGN: Four different models were developed using data from a range of sources. These included enhanced surveillance, outbreaks, death certificates and hospital episode statistics data. For each model, median estimates were produced with 95% credible intervals (CrI). The results from the different models were compared. RESULTS: The estimates for foodborne deaths for each pathogen from the different models were consistent, with CrIs largely overlapping. Based on the preferred model for each pathogen, foodborne norovirus is estimated to cause 56 deaths per year (95% CrI 32 to 92), foodborne Salmonella 33 deaths (95% CrI 7 to 159), foodborne Listeria monocytogenes 26 deaths (95% CrI 24 to 28), foodborne Clostridium perfringens 25 deaths (95% CrI 1 to 163) and foodborne Campylobacter 21 deaths (95% CrI 8 to 47). The considerable overlap in the CrIs means it is not possible to make any firm conclusions on ranking. Most of these deaths occur in those aged over 75 years. Foodborne deaths from Shigella, Cryptosporidium, Giardia, adenovirus, astrovirus and rotavirus are all rare. CONCLUSIONS: We estimate that there are 180 deaths per year in the UK (95% CrI 113 to 359) caused by foodborne disease based on these 11 pathogens. While this is a small fraction of the estimated 2.4 million cases of foodborne illness per year it still illustrates the potential severity of these illnesses demonstrating the importance in continuing efforts to reduce these infections.

Human infection with Pseudoterranova cattani by ingestion of "ceviche" in Buenos Aires, Argentina / Infección humana con Pseudoterranova cattani por ingesta de ceviche en Buenos Aires, Argentina

Abstract Anisakidosis is an infection caused by larval nematodes that belong to several genera within the family Anisakidae. Anisakidosis has about 20000 cases reported to date, the vast majority (90%) in Japan. Usually, human anisakiosis is more common than human pseudoterranovosis in Japan and Europe, although in North America Pseudoterranova spp. is the more frequent. Cases of human pseudoterranovosis have been reported from Chile and Peru. We here report one of the few cases of human infection by Pseudoterranova cattani by consumption of ``ceviche'' in Buenos Aires, Argentina.

Resumen La anisakidosis es una infección por larvas de nematodos que pertenecen a varios géneros dentro de la familia Anisakidae. Se han registrado aproximadamente 20.000 casos hasta la fecha, la mayoría (90%) en Japón. En Europa y Japón la anisakidosis es más frecuente en el humano que la pseudoterranovosis. En cambio, en América del Norte es más frecuente la infección humana por Pseudoterranova spp. También se han informado casos de pseudoterranovosis humana en Chile y en Perú. Informamos uno de los pocos casos de infección humana por Pseudoterranova cattani por consumo de ceviche en Buenos Aires, Argentina.

In vivo and in vitro studies using Clonorchis sinensis adult-derived total protein (CsTP) on cellular function and inflammatory effect in mouse and cell model.

Clonorchis sinensis (C. sinensis) can induce a food-borne parasitic disease (clonorchiasis). Numerous studies have analyzed functional proteins, immunologic factors, pro-inflammatory cytokines, and cell signaling transduction that promote the development of clonorchiasis. In a previous study, it was shown that C. sinensis adult-derived total protein (CsTP) might be involved in the pathogenesis and development of liver fibrosis via bringing about Th2 immune response. In the present study, further investigation of CsTP on cellular function and inflammatory effect in vitro and in vivo has been elicited. CsTP induced inflammation and autophagy as evidenced by upregulation of TNF-α, IFN-γ, and autophagic markers LC3B and P62. Exposed to CsTP upregulated the antiapoptotic gene Bcl-2 expression, diminished the apoptosis induced by H2O2, but promoted the proliferation and migration of LX-2 cells in proper concentration range. Additionally, the protein levels of p-AKT and p-mTOR were repressed in response to CsTP, suggesting a correlation of blocking the activation of mTOR/AKT signaling pathway. These results revealed that CsTP might exacerbate hepatic pathological changes by regulating cell proliferation, apoptosis, autophagy, and inflammation in the liver and LX-2 cells. Some effects might be partially involved in the mTOR and AKT pathways.

Oxysterols of helminth parasites and pathogenesis of foodborne hepatic trematodiasis caused by Opisthorchis and Fasciola species.

The foodborne trematodiases refer to a cluster of zoonotic neglected tropical diseases caused by trematodes, with transmission involving ingestion of contaminated plants, fishes, and crustaceans. Over 40 million people are infected with foodborne trematodes and 750 million are at risk of infection. From a public health point of view, important species include Clonorchis sinensis, Opisthorchis viverrini, Opisthorchis felineus, Fasciola hepatica, and Fasciola gigantica. Infection with C. sinensis and O. viverrini is classified as a group 1 biological carcinogen and a major risk factor for cholangiocarcinoma. The carcinogenic potential of the infection with O. felineus is less clear but recent biochemical and histopathological findings revealed that opisthorchiasis felinea also fits this pattern. By contrast, evidence of carcinogenic potential of infection with F. hepatica or F. gigantica, close phylogenetics relatives of Opisthorchis, is less certain. Oxysterols have been essentially described in animal model of opisthorchiasis and associated cholangiocarcinoma. Several oxysterol-like metabolites have been detected not only on developmental stages of O. viverrini and O. felineus but also on biofluids from experimentally infected hamsters as products of the activities of the liver flukes. These sterol derivatives are metabolized to active quinones that can modify host DNA. We have postulated that helminth parasite-associated sterols might induce tumor-like phenotypes in biliary epithelia, the cells of origin of liver fluke infection-associated cholangiocarcinoma, through the formation of DNA adducts, dysregulation of apoptosis, and other homeostatic pathways. Here we review, interpret, and discuss findings of oxysterol-like metabolites detected in liver flukes and their role in carcinogenesis, aiming to enhance understanding the pathogenesis of foodborne trematodiasis caused by Opisthorchis and Fasciola species. In future, further investigations will be necessary in order to comprehend relationship between liver flukes' oxysterols and their role in infection-associated diseases in humans.

Investigations from Northern Greece on mussels cultivated in areas proximal to wastewaters discharges, as a potential source for human infection with Giardia and Cryptosporidium.

Marine bivalves are usually cultivated in shallow, estuarine waters where there is a high concentration of nutrients. Many micro-pollutants, including the protozoan parasites Giardia duodenalis and Cryptosporidium spp., which also occur in such environments, may be concentrated in shellfish tissues during their feeding process. Shellfish can thus be considered as vehicles for foodborne infections, as they are usually consumed lightly cooked or raw. Therefore, the main objective of this study was to investigate the presence of both parasites in Mediterranean mussels, Mytilus galloprovincialis that are cultivated in Thermaikos Gulf, North Greece, which is fed by four rivers that are contaminated with both protozoa. Moreover, the occurrence of these protozoa was monitored in treated wastewaters from 3 treatment plants that discharge into the gulf. In order to identify potential sources of contamination and to estimate the risk for human infection, an attempt was made to genotype Giardia and Cryptosporidium in positive samples. Immunofluorescence was used for detection and molecular techniques were used for both detection and genotyping of the parasites. In total, 120 mussel samples, coming from 10 farms, were examined for the presence of both protozoa over the 6-month farming period. None of them were found positive by immunofluorescence microscopy for the presence of parasites. Only in 3 mussel samples, PCR targeting the GP60 gene detected Cryptosporidium spp. DNA, but sequencing was not successful. Thirteen out of 18 monthly samples collected from the 3 wastewater treatment plants, revealed the presence of Giardia duodenalis cysts belonging to sub-assemblage AII, at relatively low counts (up to 11.2 cysts/L). Cryptosporidium oocysts (up to 0.9 oocysts/L) were also detected in 4 out of 8 samples, although sequencing was not successful at any of the target genes. At the studied location and under the sampling conditions described, mussels tested were not found to be harboring Giardia cysts and the presence of Cryptosporidium was found only in few cases (by PCR detection only). Our results suggest that the likelihood that mussels from these locations act as vehicles of human infection for Giardia and Cryptosporidium seems low.

Consumer knowledge and practices to pork safety in two Taenia solium cysticercosis endemic districts in Eastern Cape Province of South Africa.

BACKGROUND: Globally, Taenia solium can cause cysticercosis in humans (including neurocysticercosis) and in pigs through ingestion of eggs and taeniasis in humans through ingestion of raw/undercooked pork contaminated with mature cysts. It is now recognised globally as one of the most prevalent food-borne parasitic diseases. The majority of cases have been reported in developing countries where consumption of food produced under unhygienic conditions is prevalent, exacerbated by lack of food safety education. The aim of this study was to determine the knowledge and practices of consumers towards pork safety in two districts of the Eastern Cape Province of South Africa, where T. solium cysticercosis is endemic in pigs and humans. METHODS: Three-hundred-and-sixty-one (361) participants were conveniently interviewed on consumer knowledge (harmfulness of T. solium cysticercosis, ability to identify cysts, trustworthiness of registered butcheries and legal requirements) and practices (storage of pork and method(s) of cooking pork safely) through a structured questionnaire. Chi-square for association of variables was used to compare differences in the districts. RESULTS: Overall, 73.1% of the study group from both districts agreed that pork forms an important part of their diet. Consumers (54.2%: 189/349) agreed that pork infected with T. solium cysts could be harmful, and 57.3% (188/328) indicated their inability to identify T. solium cysts in pork when slaughtered at home. Although 69.5% (234/352) trusted pork bought from butcheries, only 52.2% (187/358) were aware that butcheries must present a registration certificate in order to operate. This coincides with the fact that very few (< 10%) were aware of the legal requirements in terms of disease control, slaughter and food preparation. Most consumers (88.7%: 268/302) kept pork in the fridge and only 11.3% (34/302) kept it in a freezer (p = 0.02). Although not significantly different between the districts (p = 0.15), consumers in Alfred Nzo (71.4%: 152/213) and OR Tambo (61.2%: 74/12) mostly cooked pork as a stew, followed by braai/barbeque and frying or baking. This was in line with the fact that consumers in Alfred Nzo (79%: 147/186) and OR Tambo (80.8%: 120) preferred well-cooked pork; the main reason for this was the belief that cooking kills germs (43.6%: 121/277) followed by rendering the meat tasty (26.4%: 73/277). CONCLUSIONS: Consumers surveyed in the two districts were somewhat aware that T. solium cysticercosis could be harmful, although some were not able to identify T. solium cysts in pork. They also lacked sufficient knowledge regarding butchery certification and other legal requirements related to disease control, slaughter and food preparation. Practices related to cooking have the potential to promote the transmission of human taeniasis and the fact that most respondents preferred stewed pork could be a positive sign, as the cysts are destroyed during the cooking process. Results from this study are useful for the development of a control and prevention strategy targeted towards consumers, and the creation of awareness of food safety, with special emphasis on T, solium cysticercosis.

Effects of Kudoa septempunctata infections in a human intestinal epithelial model (Caco-2): a DNA microarray study.

Kudoa septempunctata, a myxosporean parasite infecting the trunk muscles of olive flounder (Paralichthys olivaceus), is reported to cause food poisoning in humans. The molecular mechanisms underlying the toxicity of K. septempunctata spores remain largely unknown. In the present study, we examine the molecular basis of such toxicity using DNA microarray analysis of K. septempunctata-inoculated human colon adenocarcinoma cells (Caco-2). We observed that the transepithelial resistance of the K. septempunctata-inoculated Caco-2 cell monolayers decreased markedly. DNA microarray analysis revealed that the mRNA expression profiles of control and inoculated cells clearly differed. Inflammatory and bacteria-related pathways, such as interleukin-8 (IL-8) production and MAPK/NF-kappa B pathway, were enriched. The concentrations of IL-8 and serotonin (5-HT) were higher in inoculated cells than in controls. K. septempunctata invasion damages the human intestinal epithelium, causing increased production of IL-8 and 5-HT, which likely results in the vomiting associated with K. septempunctata invasion.Abbreviations: AP-1: activator protein 1; DAVID: Database for Annotation, Visualization and Integrated Discovery; ENS: enteric nervous system; FARMS: Factor Analysis for Robust Microarray Summarization; FDR: false discovery rate; GO: Gene Ontology; 5-HT: 5-hydroxytryptamine; IL-8: Interleukin-8; KEGG: Kyoto Encyclopedia of Genes and Genomes; K. septempunctata: Kudoa septempunctata; NF-kappa B: nuclear factor-kappa B; TJ: tight junction; TER: transepithelial electrical resistance.

Comparative evaluation of loop-mediated isothermal amplification (LAMP) vs qPCR for detection of Toxoplasma gondii oocysts DNA in mussels.

The apicomplexan parasite Toxoplasma gondii can infect humans and cause toxoplasmosis. T. gondii has been highly prioritized among the foodborne parasites regarding its global impact on public health. Human infection can occur through multiple routes, including the ingestion of raw or undercooked food contaminated with T. gondii oocysts, such as fresh produce and bivalves. As filter-feeders, bivalves can accumulate and concentrate contaminants, including protozoan (oo)cysts. Although detection of T. gondii in different bivalves by molecular techniques (PCR and qPCR) has been achieved, routine application is currently limited by lack of sensitivity or equipment costs. Here, we describe the assessment of a loop-mediated isothermal amplification (LAMP)-based assay to detect T. gondii oocysts in spiked mussels. Detection limit was down to 5 oocysts/g in tissue and 5 oocyst/ml in hemolymph, and, under the experimental conditions tested, LAMP was found to provide a promising alternative to qPCR.

Multiple food-borne trematodiases with profound systemic involvement: a case report and literature review.

BACKGROUND: Food-borne trematodiases are an important group of neglected global diseases. Affected patients in regions with low prevalence usually experience delayed diagnosis, especially when presenting with atypical clinical symptoms. Here, we presented a rare case of a Chinese patient infected with three food-borne trematodiases. CASE PRESENTATION: A 42-year-old man presented with diarrhea, lower extremity edema, and symptoms of cardiac dysfunction. He had a history of intermittent consumption of raw freshwater fishes for 6-7 years. Upon evaluation, he had eosinophilia, anemia, intrahepatic bile duct dilatation and a growing space-occupying lesion in the left atrium. The patient underwent a cardiac surgery which revealed an endocardial hematoma due to mechanical injuries. Imaging investigations also revealed intracranial and pulmonary lesions. A total of three trematodiases were diagnosed based upon microscopic stool examination, from which eggs of Clonorchis sinensis, Heterophyidae and Echinostomatidae were identified. Deposition of Clonorchis sinensis eggs was also observed from ileocecal squash slides. The patient was successfully treated with three cycles of praziquantel. CONCLUSIONS: Food-borne trematodiases may present with systemic involvement. Patients with dietary history of high risk or atypical ingestions should be evaluated for parasitic infection, even in non-endemic areas.

Differential Cleaving of Specific Substrates for Cathepsin-Like Activity Shows Cysteine and Serine Protease Activities and a Differential Profile Between Anisakis simplex s.s. and Anisakis pegreffii, Sibling Species Major Etiologic Agents of Anisakiasis.

Humans can contract anisakiasis by eating fish or squid containing live larvae of the third stage (L3) of the parasitic nematodes of the genus Anisakis, majorly from Anisakis simplex s.s. and Anisakis pegreffii, sibling species of the A. simplex s.l. complex. Most cases diagnosed molecularly are due to A. simplex s.s., although A. pegreffii has also been identified in human cases. Cathepsins are mostly lysosomal multifunctional cysteine proteases and can participate in the pathogenicity of parasites. Cathepsin B and L activities were investigated in the two sibling species of Anisakis mentioned. L3 and L4 of both species were collected during their in vitro development, and cathepsin activity was determined in the range of pH 4.0-8.5, using specific fluorogenic substrates. The activity detected with the substrate Z-FR-AMC (N-α-benzyloxycarbonyl-L-phenylalanyl-L-arginine-7-amido-4-methyl-coumarin) was identified as cathepsin L (optimum pH = 5.0, range 4.0-6.0, p < 0.001). Activity was highest in L3 freshly collected from fish, especially in A. simplex s.s., and decreased during development, which could be related to virulence, invasion of host tissues, and/or intracellular digestion. Cathepsin B-like activity was not identified with either of the substrates used (Z-RR-AMC [N-α-benzyloxycarbonyl-L-arginyl-L-arginine-7-amido-4-methyl-coumarin] and Z-FR-AMC). With Z-RR-AMC, cleaving activity was detected almost exclusively in L4 of A. simplex s.s. (p < 0.05) with optimum pH = 8.0 (range 7.0-8.5). Assays with class-specific protease inhibitors showed that this activity was mainly due to serine proteases [up to 90% inhibition with 4-(2-aminoethyl) benzenesulfonyl fluoride hydrochloride (AEBSF)], although metalloproteases (up to 40-45% inhibition with 1,10 phenanthroline) and slight cysteine protease activity (<15% inhibition with E64 [L-trans-epoxysuccinyl-leucylamido-(4-guanidino)-butane]; putative cathepsin B-like) were also detected. These results show differential serine protease activity between sibling Anisakis species, regulated by larval development, at least in A. simplex s.s. The higher cathepsin L and serine protease activities detected in this species could be related to its greater pathogenicity, reported in experimental animals, compared to that of A. pegreffii.

First Case Report of Possible Sarcocystis truncata-induced Food Poisoning in Venison.

Along with the increase in consumption of raw animal meat, the prevalence of food poisoning is increasing. A 67-year-old Japanese man had eaten raw venison 4 hours prior to the beginning of vomiting. Many white cysts were discovered in the venison, with numerous bradyzoites being detected after the cysts were punctured. The presence of the Sarcocystis spp. 18S rRNA gene was detected by polymerase chain reaction, and Sarcocystis truncata was isolated from the venison. Sarcocystis truncata has not previously been identified in sika deer (Cervus nippon) in Japan. This is the first report of possible Sarcocystis truncata-induced food poisoning following consumption of venison.

Sparganosis: an under-recognised zoonosis in Australia?

Sparganosis is a rare zoonotic parasitosis that is sporadically reported worldwide. In Australia, the causative tapeworms are considered endemic in wildlife animals, however, there have been only five reported human infections. We present three additional cases of sparganosis, involving two Australian born gentlemen who have never travelled overseas and a woman who emigrated from Ethiopia. The first man presented with two unusual subcutaneous lumps that migrated along the anterior abdominal wall connected by a tunnel. The second man presented with two separate lumps, one on the thigh and the other on the left upper abdomen over a 4-week interval. The woman presented with 6 weeks of intermittent fevers, night sweats, abdominal pain and passing intestinal worms. This series of patients suggests that sparganosis is under-recognised in Australia and serves as a reminder for clinicians to the varied presentations that can be characteristic of this lesser known zoonosis.

Follow-up study of high-dose praziquantel therapy for cerebral sparganosis.

BACKGROUND: Cerebral sparganosis is the most serious complication of human sparganosis. Currently, there is no standard for the treatment of inoperable patients. Conventional-dose praziquantel therapy is the most reported treatment. However, the therapeutic outcomes are not very effective. High-dose praziquantel therapy is a useful therapeutic choice for many parasitic diseases that is well tolerated by patients, but it has not been sufficiently evaluated for cerebral sparganosis. This study aims to observe the prognoses following high-dose praziquantel therapy in inoperable patients and the roles of MRI and peripheral eosinophil absolute counts during follow-up. METHODOLOGY: Baseline and follow-up epidemiological, clinical, radiological and therapeutic data related to 10 inoperable patients with cerebral sparganosis that were treated with repeated courses of high-dose praziquantel therapy, with each course consisting of 25 mg/kg thrice daily for 10 days were assessed, followed by analyses of the prognoses, MRI findings and peripheral eosinophil absolute counts. PRINCIPAL FINDINGS: Baseline clinical data: the clinical symptoms recorded included seizures, hemiparesis, headache, vomiting and altered mental status. Peripheral blood eosinophilia was found in 3 patients. The baseline radiological findings were as follows. Motile lesions were observed in 10 patients, including aggregated ring-like enhancements, tunnel signs, serpiginous and irregular enhancements. Nine of the 10 patients had varying degrees of white matter degeneration, cortical atrophy and ipsilateral ventricle dilation. The follow-up clinical data were as follows. Clinical symptom relief was found in 8 patients, symptoms were eliminated in 1 patient, and symptoms showed no change from baseline in 1 patient. Peripheral blood eosinophilia was found in 2 patients. The follow-up radiological findings were as follows. Motile lesions that were transformed into stable, chronic lesions were found in 8 patients, and motile lesions that were eliminated completely were found in 2 patients. CONCLUSIONS: High-dose praziquantel therapy for cerebral sparganosis is effective. The radiological outcomes of motile lesions are an important indicator during the treatment process, especially during follow-ups after clinical symptoms have improved. Peripheral eosinophil absolute counts cannot be used as an effective prognostic indicator.

Nasopharyngeal linguatulosis or halzoun syndrome: clinical diagnosis and treatment

SUMMARY Halzoun syndrome, also known as nasopharyngeal linguatulosis, is a rare entity that is mostly prevalent in Eastern Mediterranean countries. The consumption of raw ovine liver and lymph nodes infested with Linguatula serrata nymphs remains a major cause of the nasopharyngeal symptoms and discomfort associated with the disease. Halzoun syndrome is a clinical diagnosis based on history and presentation. Treatment of this disease is still debated; however, our experience reveals that alcohol gargle can be a good option. Proper counselling on the hazards of eating raw liver in endemic areas is needed. Moreover, physicians should be aware of the sequence of events in the disease in order not to delay or miss the diagnosis. This communication presents a rare Lebanese case of Halzoun syndrome that offers medical implications in the clinical diagnosis and treatment of the nasopharyngeal symptoms of this syndrome, with a review of the literature.

RESUMO Esta comunicação apresenta um caso libanês raro de síndrome de Halzoun que oferece implicações médicas no diagnóstico clínico e no tratamento dos sintomas nasofaríngeos desta síndrome, com uma revisão da literatura. A síndrome de Halzoun, também conhecida como linguatulose nasofaríngea, é uma entidade rara predominante nos países do Mediterrâneo Oriental. O consumo de linfonodos ovinos e linfáticos ovinos infestados com ninfas Linguatula serrata continua a ser uma das principais causas dos sintomas nasofaríngeos e do desconforto associado à doença. A síndrome de Halzoun é um diagnóstico clínico baseado na história e na apresentação. O tratamento dessa doença ainda é debatido; no entanto, nossos resultados revelam que o gargarismo de álcool pode ser uma boa opção. É necessário um aconselhamento adequado sobre os perigos de comer fígado cru em áreas endêmicas. Além disso, os médicos devem estar cientes da sequência de eventos na doença, a fim de não atrasar ou perder o diagnóstico.