Elimination of Simulium neavei-Transmitted Onchocerciasis in Wambabya-Rwamarongo Focus of Western Uganda.

Wambabya-Rwamarongo onchocerciasis focus is one of the eight foci Uganda verified using the WHO verification guidelines. The approach for elimination was twice yearly treatment with ivermectin for every round, treating at least 90% of all the eligible population. This was in combination with vector elimination using Abate® (BASF SE, Limburgerhof, Germany) since elimination nationwide policy was launched. From 2008 to 2013, the program distributed ivermectin with a mean treatment coverage of the ultimate treatment goal (UTG) or eligible population of 91.2%, with a range of 85-96%. In 2009, vector elimination based on ground larviciding had a dramatic impact on the Simulium vectors, as the last fly was observed in October 2009. No more Simulium vectors were observed during a period of at least 7 years, including the 3-year posttreatment surveillance (PTS) until the focus was reclassified as eliminated in August 2017. During the PTS period, none of the 10,578 trapped crabs were found infested with the aquatic stages of the vector. The last infested crab was observed in March 2010, and for at least 7 years, no infested crabs were observed. Serological surveys showed that of 2,978 young children examined in 2013, only one was OV16 positive (0.0%; 95% CI: 0-0.21). In 2017, after the PTS period, all 3,079 young children examined were negative for OV16 (95% CI: 0-0.16). Therefore, entomological and serological results provided evidence that resulted in the reclassification of Wambabya-Rwamarongo focus from "transmission interrupted" to "transmission eliminated" with no possibility of recrudescence.

Neoandracantha peruensis n. gen. n. sp. (Acanthocephala, Polymorphidae) described from cystacanths infecting the ghost crab Ocypode gaudichaudii on the Peruvian coast.

The cystacanths of Neoandracantha peruensis n. gen. n. sp. are described from the ghost crab Ocypode gaudichaudii collected from the Pacific coast of Peru. While it is uncommon to describe acanthocephalan taxa from immature stages, the presence of clear-cut distinguishing features separating the present material from its nearest congeneric taxa, and the absence of adults, justifies the erection N. peruensis. The new genus is distinguished by having three separate fields of trunk spines. Specimens of N. peruensis have a slender trunk with two anterior swellings, 3 separate fields of spines on the foretrunk swelling, and no genital spines on the hindtrunk. The proboscis of the new species is heavily armored with 21-22 longitudinal rows of 22 hooks each. Hook no. 14 is more robust ventrally than dorsally. Cystacanths of N. peruensis also have a long tubular hindtrunk and the males have diagonal testes in the midtrunk swelling. Specimens of the closely related Andracantha Schmidt, 1975 have anteriorly enlarged pear-shaped Corynosoma-like trunks, only two fields of anterior trunk spines with occasional genital spines, and bilateral or tandem testes. Proboscides of species of Andracantha have considerably fewer hooks that gradually decrease in size posteriorly. The taxonomic component of this work is amplified by metal analysis of hooks and spines that shows a marked amount of magnesium (Mg) in hooks but not in spines. The highest level of sulfur (S) was found in the outer layer of hooks and anterior spines. The metal footprint of hooks and spines varies in different species of acanthocephalans and has an interspecific diagnostic value.

Impact of disease on the survival of three commercially fished species.

Recent increases in emergent infectious diseases have raised concerns about the sustainability of some marine species. The complexity and expense of studying diseases in marine systems often dictate that conservation and management decisions are made without quantitative data on population-level impacts of disease. Mark-recapture is a powerful, underutilized, tool for calculating impacts of disease on population size and structure, even in the absence of etiological information. We applied logistic regression models to mark-recapture data to obtain estimates of disease-associated mortality rates in three commercially important marine species: snow crab (Chionoecetes opilio) in Newfoundland, Canada, that experience sporadic epizootics of bitter crab disease; striped bass (Morone saxatilis) in the Chesapeake Bay, USA, that experience chronic dermal and visceral mycobacteriosis; and American lobster (Homarus americanus) in the Southern New England stock, that experience chronic epizootic shell disease. All three diseases decreased survival of diseased hosts. Survival of diseased adult male crabs was 1% (0.003-0.022, 95% CI) that of uninfected crabs indicating nearly complete mortality of infected crabs in this life stage. Survival of moderately and severely diseased striped bass (which comprised 15% and 11% of the population, respectively) was 84% (70-100%, 95% CI), and 54% (42-68%, 95% CI) that of healthy striped bass. The disease-adjusted yearly natural mortality rate for striped bass was 0.29, nearly double the previously accepted value, which did not include disease. Survival of moderately and severely diseased lobsters was 30% (15-60%, 95% CI) that of healthy lobsters and survival of mildly diseased lobsters was 45% (27-75%, 95% CI) that of healthy lobsters. High disease mortality in ovigerous females may explain the poor recruitment and rapid declines observed in this population. Stock assessments should account for disease-related mortality when resource management options are evaluated.

A rare case of paragonimiasis miyazakii with lung involvement diagnosed 7 years after infection: A case report and literature review.

We report a rare case of pulmonary paragonimiasis caused by Paragonimus miyazakii that showed pulmonary manifestations and a long-term clinical course after infection. A 45-year-old Japanese male developed cough and dyspnea in 2004 and was diagnosed with eosinophilic pneumonia. He had been treated with low-dose oral corticosteroid for 7 years. He recalled that he had consumed a large amount of raw freshwater crab (Geothelphusa dehaani) several weeks before he had been admitted for the first time, and that had been the only occasion when he had eaten this meat. The patient was referred to our hospital due to persistent hemoptysis, and his chest computed tomography scan showed pulmonary nodules and cavities, and his serum total IgE level was elevated. Bronchoscopy was performed, and ova were detected in the bronchoalveolar lavage fluid. The morphological examination of the ova and immunoserological examination yielded typical findings of P. miyazakii. Treatment with praziquantel improved his chest radiographic findings and a decrease of serum total IgE, as well as the values of immunoserological examination for P. miyazakii. The clinical course of this patient indicated that he had been infected with P. miyazakii for 7 years at least, which is unusual for paragonimiasis miyazakii.

Transmission of Onchocerca volvulus continues in Nyagak-Bondo focus of northwestern Uganda after 18 years of a single dose of annual treatment with ivermectin.

The objective of the study was to determine whether annual ivermectin treatment in the Nyagak-Bondo onchocerciasis focus could safely be withdrawn. Baseline skin snip microfilariae (mf) and nodule prevalence data from six communities were compared with data collected in the 2011 follow-up in seven communities. Follow-up mf data in 607 adults and 145 children were compared with baseline (300 adults and 58 children). Flies collected in 2011 were dissected, and poolscreen analysis was applied to ascertain transmission. Nodule prevalence in adults dropped from 81.7% to 11.0% (P < 0.0001), and mf prevalence dropped from 97.0% to 23.2% (P < 0.0001). In children, mf prevalence decreased from 79.3% to 14.1% (P < 0.0001). Parous and infection rates of 401 flies that were dissected were 52.9% and 1.5%, respectively, whereas the infective rate on flies examination by polymerase chain reaction (PCR) was 1.92% and annual transmission potential was 26.9. Stopping ivermectin treatment may result in onchocerciasis recrudescence.

A Case of Pulmonary Paragonimiasis with Involvement of the Abdominal Muscle in a 9-Year-Old Girl

In Korea, many people enjoy eating raw or underkooked freshwater crayfish and crabs which unfortunately may cause paragonimiasis. Here, we describe a case of pulmonary and abdominal paragonimiasis in a 9-year-old girl, who presented with a 1-month history of abdominal pain, especially in the right flank and the right inguinal area, with anorexia. A chest radiograph revealed pleural effusion in both lungs, and her abdominal sonography indicated an inflammatory lesion in the right psoas muscle. Peripheral blood analysis of the patient showed hypereosinophilia (66.0%) and an elevated total serum IgE level (>2,500 IU/ml). The pleural effusion tested by ELISA were also positive for antibodies against paragonimiasis. Her dietary history stated that she had ingested raw freshwater crab, 4 months previously. The diagnosis was pulmonary paragonimiasis accompanied by abdominal muscle involvement. She was improved after 5 cycles of praziquantel treatment and 2 times of pleural effusion drainage. In conclusion, herein, we report a case of pulmonary and abdominal paragonimiasis in a girl who presented with abdominal pain and tenderness in the inguinal area.

Differences in enzyme activities between two species of Hematodinium, parasitic dinoflagellates of crustaceans.

Parasitic dinoflagellates of the genus Hematodinium infect several commercially important decapod crustaceans. Different species of Hematodinium have different levels of virulence in their respective hosts. Enzyme activities were studied from two species of Hematodinium, one isolated from the Norway lobster (Nephrops norvegicus) and the other from the American blue crab (Callinectes sapidus). We report the identification of differences in secretion of acid phosphatase (AP) and leucine arylamidase from two parasite species. Leucine arylamidase was only contained and secreted by the species infecting the blue crab. Both parasite species contained AP, but only the species infecting the Norway lobster secreted this enzyme. In this species, AP activity was predominantly in the soluble fraction (69.5%). AP activity was localized to cytoplasmic granules and on the membranes surrounding the cell nucleus. In addition to providing information on the cellular metabolism of the parasite, the pattern of activities of these enzymes may also be useful in distinguishing among different species of Hematodinium.

Molecular detection of Hematodinium spp. in Norway lobster Nephrops norvegicus and other crustaceans.

The Norway lobster Nephrops norvegicus (L.) from the coastal waters of Scotland is seasonally infected by a parasitic dinoflagellate of the genus Hematodinium. Methods used to detect infection include a morphological index (pleopod diagnosis) and several immunoassays. The present study describes the development and application of a set of Hematodinium-specific polymerase chain reaction (PCR) primers and DNA probes based on Hematodinium ribosomal DNA (rDNA). In the PCR assay, a diagnostic band of 380 bp was consistently amplified from total genomic DNA isolated from Hematodinium-infected N. norvegicus. The sensitivity of the assay was 1 ng DNA, which is equivalent to 0.6 parasites. The primer pair also detected Hematodinium DNA in preparations of the amphipod Orchomene nanus, indicating that the amphipod may be infected with the same Hematodinium sp. infecting N. norvegicus. DNA probes detected Hematodinium parasites in heart, hepatopancreas and gill tissues from N. norvegicus, and hepatopancreas and gill tissues from Carcinus maenas, confirming Hematodinium infection in the latter.

A histopathological survey of shore crab (Carcinus maenas) and brown shrimp (Crangon crangon) from six estuaries in the United Kingdom.

Invertebrates show considerable potential as sentinel organisms for the monitoring of the health status of aquatic systems. They are generally small, abundant, relatively sessile, and may readily bioaccumulate toxins. Cascade-like stress responses can occur following acute or chronic exposures to contaminated environments and as such, the overall health status of individuals within those environments, both in terms of histopathological lesions and the presence of infecting organisms, may ultimately reflect the general health status of these sites. The current study provides baseline multi-organ histopathological data for two common crustacean species, the shore crab (Carcinus maenas) and the brown shrimp (Crangon crangon) collected from six UK estuarine sites. Changes in the metabolic condition of crustaceans from these sites (measured in terms of connective tissue storage cell status) were interpreted in relation to other health measures (including parasite load and the presence of microbial pathogens). The relative ease at which a holistic assessment of health can be made using histopathology and the suitability of these species as environmental sentinels provide support for the inclusion of crustaceans as indicators of aquatic environmental health. Studies linking disease status to burdens of industrial contamination in these environments are now required.

Epidemiology, symptoms and treatment of paragonimiasis in Sin Ho district, Lai Chau province, Vietnam.

Sin Ho is a district of the northern mountainous province of Lai Chau, Vietnam, where the people have the habit of eating undercooked crabs. A study on paragoniamiasis carried out from 1994 to 1995 with 1,642 persons in this endemic area, showed that the rate of eating raw-crab was 72.5%. Crab examination (Ranguna kimboiensis) showed an infection rate of Paragonimus metacercaria of 98.1%. With 624 stool samples examined by Kato technique, the infection rate of Paragonimus in humans was 6.4%. With 338 sputum samples examined by direct and centrifuge methods, the infection rate of Paragonimus was 7.4%. Most of the patients were children (63.2%). The infection rate of Paragonimus in dogs was 18.2 - 33.3%. Adult worms, collected from the dogs in the field and from the cats in laboratory, were identified as Paragonimus heterotremus. The main symptoms of Paragonimus patients were cough and hemoptysis (92%), discontinuously developed (96%), without fever (94%), chest pain (70%), pleural effusion (26%), neurogical symptoms (8%), eosinophilia (88.9%), nodular ring shadows in the lungs, as shown by chest X-ray examination and more in lower lobe, (76.2%). Paragonimiasis patients were treated by (a) Praziquantel 25 mg/kg/day x 3 days; the cure rate was 68.8%. (b) Praziquantel 50 mg/kg/day x 3 days; the cure rate was 75%.

Pulmonary paragonimiasis: clinical features, diagnosis and treatment of 39 cases in Manipur.

Thirty-nine cases of pulmonary paragonimiasis due to Paragonimus westermani were identified in Manipur, India. Recurrent haemoptysis, often increased on exertion, was the most common symptom. The clinical features and radiological appearances simulated pulmonary tuberculosis and 23 cases were treated for tuberculosis for varying periods before the final diagnosis. Young males aged 11 to 30 years comprised two-thirds of the cases. The disease was acquired by eating raw or improperly cooked crabs (Potamon deham). Intradermal tests (IDT) employing a saline extract of adult Paragonimus were a simple and reliable method of detecting present or past infection. Erythema of large size even without wheal and pseudopodia may indicate a positive IDT. Charcot-Leyden crystals (CLC) were detected in all sputum samples positive for Paragonimus ova. In patients (four) presenting with pleural effusion, Paragonimus ova were not present in the sputum, stool or pleural fluid. Bithionol (2,2'-thiobis [4,6-dichlorophenol]) orally, 40 mg/kg body-weight/day, 10 to 25 doses, cured all cases and, except in one, side effects were minimal. Relapse in one patient after six months' treatment was apparently cured by a second course of Bithionol.

Successful treatment with praziquantel of six patients infected with the African lung fluke, Paragonimus uterobilateralis.

Six cases of human paragonimiasis (Paragonimus uterobilateralis) are documented from Liberia and Guinea. These are the first cases reported from these countries. Paragonimiasis should be considered in the differential diagnosis of any West African patient who presents with hemoptysis. Praziquantel was used successfully to treat these patients, and may be the drug of choice for P. uterobilateralis infections.