Tracking the existence of Dioctophyma renale in Parthian Empire of Iran (247 BC-224 AD).

Paleoparasitological investigation in the archeological site of the Caspian Sea littoral revealed the presence of human Dioctophyma renale infection, a ubiquitous kidney-residing helminth of mammals, during the Parthian Empire of Iran (247 BC-224 AD). This study reports the oldest human infection with giant kidney worm in the Middle East, mainly in an area where the infection is reported nowadays. The paucity of records throughout the literature suggests that the same species of parasite occurred with low frequency in the past, as well. The cemetery in the archeological site of Kiasar represented a unique opportunity of studying human and animal parasites of the Parthian Empire in Iran.

Dual-Source Dual-Energy CT-Scan Confirms the Diagnosis of Ancient Hydatid Cysts Recovered from a Late Roman Burial in Amiens, France.

Background: Two calcified objects recovered from an adolescent in a burial site in Amiens, France, have been previously identified as hydatid cysts using thin-section petrography. The importance of ancient hydatidosis besides the value of these unique archeological excavated materials encouraged the authors to look at this attractive subject more interdisciplinary by implementing medical radiology. Methods: In the current experiment, which has been carried out in the Radiology Department, Tehran Heart Center (THC), Tehran, Iran, the conventional and dual-energy dual-source Tomography, X-Ray Computed-scan was used in studying the remaining structures of the two calcified masses. The imaging procedure was carried out based on X-Ray attenuation by two different tube voltages. Results: A high concentration of calcium sediment in the cyst walls was revealed in Hounsfield units, the measuring of the elements in CT. Taking advantage of implementing this imaging technique the oxalate calcium was also shown as the dominant component of the samples. The results were all in favor of diagnosing hydatid cysts. Conclusion: The achieved pictorial results in the present paper have highlighted the important role of CT scan as a noninvasive confirming technique in paleopathological investigations. Using Dual-source dual-energy CT-scan in reconfirming these previously identified hydatid cysts, is an encouraging message towards the necessity of sequential studies on invaluable biological excavated pieces.

Celebrating the 60th Anniversary of the International Commission on Trichinellosis: An early example of Franco-German collaboration to study the Trichinellosis outbreak of Emersleben (1883).

Two prominent physicians, Grancher and Brouardel, were sent by the French Health authorities to study the severe ongoing outbreak of trichinellosis in Emersleben, Germany (1883). They produced a highly accurate description of the outbreak and confirmed that they had never observed such cases in France. Grancher performed two necropsies and very precisely described the histological lesions provoked by the larvae entering and transforming muscular fibers. They also had the opportunity to meet Virchow in Berlin and they emphasized his extreme kindness. This French medical mission and cooperation with famous German scientists such as Virchow is probably one of the first examples of international collaboration on trichinellosis. It prefigured the international collaborative efforts made by the International Commission on Trichinellosis which was created in 1958 and is still active.

A common source for a trichinellosis outbreak reported in France and Serbia in 2017.

Trichinellosis is a rare parasitic zoonosis in the European Union. Meat from backyard pigs was the common source for a trichinellosis outbreak caused by Trichinella spiralis, which occurred in France and Serbia in the beginning of 2017. An epidemiological study was conducted in France and Serbia to determine the extent of the outbreak, to identify its source and to implement control measures. Three cases were exposed in Serbia and brought back to France pork delicatessen which they shared with relatives and friends. Around 47 individuals were exposed to the parasitised meat in France and Serbia and 20 cases of trichinellosis were reported (nine in France and 11 in Serbia). Nine of them were female. The diagnosis was delayed, in part because the parasitosis was not known by most physicians, which led to complications in the French cases such as facial paralysis and pulmonary embolism. Health alerts and survey networks are indispensable at a European level to control the disease.

Early days of the International Commission on Trichinellosis (1958-1972).

Herein we describe the origin of the International Commission on Trichinellosis more than 60 years after its foundation. We attempt to clarify previous debate over the founding presidents and particularly the role of Polish parasitologist, Zbigniew Kozar. Seminal and core proceedings of the Commission published in Wiadomosci Parazytologiczne and other records were used to advance this goal. An early regional commission initially held in Budapest, Hungary at the Hungarian Meeting of Parasitologists was devoted to trichinellosis and was presided over by Kozar from 1958 to 1960. However, the official formation of the Commission did not occur until 1960 during the 1st International Conference on Trichinellosis held in Warsaw, Poland, where Witold Stefanski was elected president. During the 2nd International Conference on Trichinellosis, which was held in 1969 in Wroclaw, Poland, Samuel E. Gould was elected president until his untimely death in 1970. Zbigniew Kozar was secretary general from 1960 to 1972. Beginning with the 3rd International Conference held in Miami, Florida, USA in 1972, the activities of the Commission and the Conference became better documented.

Confusing a Pollen Grain with a Parasite Egg: Infection or Traditional Medicine?

Camacho & Reinhard stated in the December 2019 issue of the KJP (57: 621-625) that we confused a pollen grain with an Enterobius egg found in the grave of a female adolescent residing in ancient Tehran 7,000 years ago. We want here to clarify and answer to the outlined points in their article.

Coalition: Advocacy for prospective clinical trials to test the post-exposure potential of hydroxychloroquine against COVID-19.

Our coalition of public health experts, doctors, and scientists worldwide want to draw attention to the need for high-quality evaluation protocols of the potential beneficial effect of hydroxychloroquine (HCQ) as a post-exposure drug for exposed people. In the absence of an approved, recognized effective pre or post-exposure prophylactic drug or vaccine for COVID-19, nor of any approved and validated therapeutic drug, coupled with social and political pressure raised by publicity both regarding the potential beneficial effect of hydroxychloroquine (HCQ) as well as potential risks from HCQ, we urge the immediate proper clinical trials. Specifically, we mean using HCQ for post-exposure of people with close contact with patients with positive COVID19 rtPCR, including home and medical caregivers. We have reviewed the mechanisms of antiviral effect of HCQ, the risk-benefit ratio taking into consideration the PK/PD of HCQ and the thresholds of efficacy. We have studied its use as an antimalarial, an antiviral, and an immunomodulating drug and concluded that the use of HCQ at doses matching that of the standard treatment of Systemic Lupus erythematous, which has proven safety and efficacy in terms of HCQ blood and tissue concentration adapted to bodyweight (2,3), at 6 mg/kg/day 1 (loading dose) followed by 5 mg/kg/ day, with a maximum limit of 600 mg/day in all cases should swiftly be clinically evaluated as a post-exposure drug for exposed people.

Imported loiasis in France: a retrospective analysis of 167 cases with comparison between sub-Saharan and non sub-Saharan African patients.

BACKGROUND: Imported loiasis is a rare cause of consultation at the return of stay in central Africa, which often poses difficult diagnostic and therapeutic questions to practitioners especially those who are unaccustomed to tropical medicine. These difficulties can lead to risks for the patients especially if inappropriate treatment is given. Large series of imported loiasis are scarce. METHODS: We retrospectively studied the data including outcome in patients diagnosed with imported loiasis between 1993 and 2013 in the Paris area on the basis of a parasitological diagnosis (microfilaremia > 1/ml and/or serologic tests). We compared sub-Saharan and non sub-Saharan African patients. RESULTS: Of the 177 identified cases, 167 could be analysed. Sex ratio was 1, mean age 41 years and 83% were sub-Saharan Africans. Cameroon was the main country of exposure (62%). Incubation time may be long (up to 18 months). Of the 167 cases, 57% presented with characteristic symptoms (Calabar swellings, creeping dermatitis, eyeworm) whereas 43% were diagnosed fortuitously. Microfilaremia was evidenced in 105 patients (63%), and specific antibodies in 53%. Compared to sub-Saharan Africans, other patients were presenting less frequently with eyeworm migration and microfilaremia whereas they had higher eosinophilia and positive serology. Prevalence of Calabar swellings was not significantly different between the two groups. Cure rates were 52% with ivermectin alone, and 77% with ivermectin followed by diethylcarbamazine. No severe adverse event was reported. CONCLUSIONS: Presentation of imported loiasis varies according to ethnicity. A systematic screening should be recommended in patients with potential exposure in endemic country. Treatment with ivermectin followed by diethylcarbamazine could be a valuable option.

Toxoplasmosis: Overview from a One Health perspective.

Toxoplasmosis is paradigmatic of the One Health approach, as the causative parasite Toxoplasma gondii infects virtually all warm-blooded animals, including humans. This makes T. gondii one of the most successful parasites on earth, infecting up to a third of the global human population. Moreover, the T. gondii disease burden has been ranked among the highest of all parasitic diseases. To reduce the disease burden of toxoplasmosis in humans, interventions are needed in the animal reservoirs, necessitating close collaboration between both the human and veterinary medical sectors. In the present special issue of FAWPAR, several of the most pertinent topics related to the impact and control of toxoplasmosis are addressed by leading experts in the field. This collection of papers highlights state-of-the-art knowledge, gaps in knowledge and future perspectives, as well as the benefits of current and proposed future activities to tackle toxoplasmosis within the One Health context.

A national retrospective survey of anisakidosis in France (2010-2014): decreasing incidence, female predominance, and emerging allergic potential.

A retrospective survey was carried out over the years 2010-2014 among all Parasitology laboratories of University hospitals in France (ANOFEL network). The objective was to estimate the incidence of anisakidosis in France as new culinary habits such as the consumption of raw fish (sushi) or undercooked fish are increasing. A total of 37 cases of anisakidosis were notified by all French laboratories: 7 proven cases with evidence of a worm, 12 possible cases with abdominal pain after consumption of raw fish with detection of anti-Anisakis precipitins, and 18 allergic cases defined as acute manifestations after consumption of fish, associated with specific IgE for Anisakis. The median age of affected individuals was 42 years (11-69) and there was a significant predominance of women (67%). Compared with previous surveys in France, this study indicates a decrease in clinical cases of anisakidosis and illustrates the emerging allergic potential of anisakids.

TITLE: Étude nationale rétrospective de l'anisakidose en France (2010-2014) : diminution de l'incidence, prédominance féminine et augmentation des allergies. ABSTRACT: Une enquête rétrospective a été réalisée au cours des années 2010-2014 auprès des laboratoires de parasitologie des hôpitaux universitaires de France (réseau ANOFEL). L'objectif était d'estimer l'incidence de l'anisakidose en France depuis l'émergence de nouvelles habitudes culinaires comme la consommation de poissons crus (sushi) ou insuffisamment cuits. Les laboratoires français de Parasitologie ont ainsi notifié 37 cas d'anisakidose: 7 cas certains avec présence du ver, 12 cas possibles se caractérisant par des douleurs abdominales après consommation de poisson cru et la présence de précipitines anti-Anisakis et 18 cas allergiques définis comme des manifestations aiguës après consommation de poisson associées à des IgE spécifiques anti-Anisakis. L'âge médian des cas était de 42 ans (11-69) et il y avait une prédominance féminine significative (67 %). Par rapport aux enquêtes précédentes en France, cette étude indique une diminution des cas cliniques d'anisakidose mais illustre le potentiel allergique émergent des anisakidés.

Dicrocoelium Egg Identified in an Ancient Cemetery in Kiasar Archeological Site, Northern Iran, Dated Back 247 BC-224 AD.

BACKGROUND: Along with the newly emergence of paleoparasitology research in Iran, findings of parasites from Northern part of the county have not been reported so far. In this study tracking for the lancet liver fluke dates back 250 BC is addressed. METHODS: Samples were taken from grave crypts of the soil layers attached to the pelvic bones from above-mentioned site in 2015. The laboratory examinations were conducted in the Dept. of Medial Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Current rehydration technique using TSP 0.5% was utilized for examining the samples. RESULTS: Out of 10 burial soil samples examined, one individual was seen parasitized with a Dicrocoelium egg. The burial belonged to an adolescent male 20-22 yr old. The egg was in brown color and the length/width parameters of 36×22/5 µm. Parthian coins found in nearby the burials in Kiasar Cemetery, declared the time of the skeleton about 247 BC - 224 AD confidently. CONCLUSION: Although the possibility of transit infection with D. dendriticum is high, yet the environmental and geographical conditions in that time are in favor of a normal human transmission in northern Iran.

Human spiruridiasis due to Physaloptera spp. (Nematoda: Physalopteridae) in a grave of the Shahr-e Sukhteh archeological site of the Bronze Age (2800-2500 BC) in Iran.

Evidence of rare human helminthiasis in paleoparasitological records is scarce. we report here the finding of Physaloptera spp. eggs in a soil sample collected in the pelvic and sacrum bones area of a skeleton excavated from a grave of Shahr-e Sukhteh archeological site dating back to the Bronze Age. The site is located in southeastern Iran and has attracted the attention of numerous archeological teams owing to its vast expanse and diverse archeological findings since 1997. The spirurid nematodes Physaloptera spp. are rarely the cause of human helminthiasis nowadays, but this infection might not have been so rare in ancient populations such as those in the Shahr-e Sukhteh. Out of 320 skeletons analyzed in this study, only one parasitized individual was detected. This surprising result led us to suspect the role of nematophagous fungi and other taphonomic processes in possible false-negative results. This is the first paleoparasitological study on human remains in this archeological site and the first record of ancient human physalopterosis in the Middle East.

Molecular diagnosis of Pseudoterranova decipiens s.s in human, France.

BACKGROUND: Anisakis and Pseudoterranova are the main genera involved in human infections caused by nematodes of the Anisakidae family. Species identification is complicated due to the lack of differential morphological characteristics at the larval stage, thus requiring molecular differentiation. Pseudoterranova larvae ingested through raw fish are spontaneously eliminated in most cases, but mechanical removal by means of endoscopy might be required. To date, only very few cases of Pseudoterranova infection have been reported in France. CASE PRESENTATION: A 19-year-old woman from Northeastern France detected, while brushing her teeth, a larva exiting through her mouth. The patient who presented with headache, diarrhea, and abdominal cramps reported having eaten baked cod. The worm was a fourth-stage larva with a size of 22 × 0.9 mm, and molecular biology identified it as Pseudoterranova decipiens sensu stricto (s. s.). In a second P. decipiens infection case, occurring a few months later, a worm exited through the patient's nose after she had eaten raw sea bream. CONCLUSION: These two cases demonstrate that Pseudoterranova infection is not uncommon among French patients. Therefore, molecular techniques should be more widely applied for a better characterization of anisakidosis epidemiology in France.

First Paleoparasitological Report on the Animal Feces of Bronze Age Excavated from Shahr-e Sukhteh, Iran.

Shahr-e Sukhteh (meaning burnt city in Persian) in Iran is an archeological site dated back to around 3,200-1,800 BC. It is located in Sistan and Baluchistan Province of Iran and known as the junction of Bronze Age trade routes crossing the Iranian plateau. It was appointed as current study area for paleoparasitological investigations. Excavations at this site have revealed various archeological materials since 1967. In the present study, sheep and carnivore coprolites excavated from this site were analyzed by means of rehydration technique using TSP solution for finding helminth eggs. Dicrocoelium dendriticum, Capillaria sp., and Taenia sp. eggs were identified, while some other objects similar to Anoplocephalidae and Toxocara spp. eggs were also retrieved from the samples but their measured parameters did not match those of these species. The present paper illustrates the first paleoparasitological findings of Bronze Age in eastern Iran supporting the economic activities, peopling, and communication as well as the appropriate condition for zoonotic helminthiasis life cycle in Shahr-e Sukhteh archeological site.