Update on the human broad tapeworm (genus diphyllobothrium), including clinical relevance

Diphyllobothriasis Caused by the Sanada Tapeworm: A Case Report

The incidence of human diphyllobothriasis is expected to rise amidst the current global popularity of Japanese cuisine, such as sushi, which contains raw fish. We report a case of a 10-year-old boy with a diphyllobothriasis infection acquired via sushi consumption. The patient was otherwise healthy, exhibited no symptoms, and was successfully treated with a single dose of 10 mg/kg praziquantel. In Japan, this parasite is known as "Sanada-mushi" because it resembles a Sanada cord. Prompt recognition of this parasite by evoking the Sanada cord's appearance may facilitate early diagnosis and treatment and increase public awareness to prevent diphyllobothriasis.

Diphyllobothrium sp. and Other Parasites of Migrating and Rare Fish Species in the Southern Baltic Sea and Coastal Waters, Poland

The present study is the first to analyse the parasite fauna of sole Solea solea, dab Limanda limanda, hake Merluccius merluccius, whiting Merlangius merlangus, and plaice Pleuronectes platessa in the Pomeranian Bay, as well as saithe Pollachius virens from the Szczecin Lagoon (Poland). The aim of this study was to determine the occurrence of parasites in migrating and rare fish in the Pomeranian Bay and the Szczecin Lagoon and to determine the composition of the diet of these fish. The fish for analysis were obtained in the years 2010-2019. The typical marine nematode Capillaria (Procapillaria) gracilis, rarely recorded in Poland, was found, in addition to the following parasites: Ichthyophonus hoferi, Trichodina jadranica, Diphyllobothrium sp., Dichelyne (Cucullanellus) minutus, Raphidascaris acus, Anisakis simplex, Contracaecum osculatum, Hysterothylacium aduncum, Pseudoterranova decipiens, and Echinorhynchus gadi. Because the fish species analysed in the study are not typically present in the Baltic (with the exception of plaice), and because we do not know how long they feed while they are in the Baltic, we cannot be certain which parasites they acquired in the water bodies analysed in the study and which were introduced during the migration of fish. Although these fish are outside of their normal geographic range (except for plaice), in the new environment, there were enough suitable intermediate hosts for the parasites of these fish to complete their life cycle and survive.

Female Germline Cysts in Animals: Evolution and Function

Germline cysts are syncytia formed by incomplete cytokinesis of mitotic germline precursors (cystoblasts) in which the cystocytes are interconnected by cytoplasmic bridges, permitting the sharing of molecules and organelles. Among animals, such cysts are a nearly universal feature of spermatogenesis and are also often involved in oogenesis. Recent, elegant studies have demonstrated remarkable similarities in the oogenic cysts of mammals and insects, leading to proposals of widespread conservation of these features among animals. Unfortunately, such claims obscure the well-described diversity of female germline cysts in animals and ignore major taxa in which female germline cysts appear to be absent. In this review, I explore the phylogenetic patterns of oogenic cysts in the animal kingdom, with a focus on the hexapods as an informative example of a clade in which such cysts have been lost, regained, and modified in various ways. My aim is to build on the fascinating insights of recent comparative studies, by calling for a more nuanced view of evolutionary conservation. Female germline cysts in the Metazoa are an example of a phenomenon that-though essential for the continuance of many, diverse animal lineages-nevertheless exhibits intriguing patterns of evolutionary innovation, loss, and convergence.

The Occurrence of Freshwater Fish-Borne Zoonotic Helminths in Italy and Neighbouring Countries: A Systematic Review

In recent years, the consumption of fish products has surged in European countries, being an essential part of a healthy diet. Despite representing a small part of EU production, freshwater fisheries hold considerable significance for lake-dwelling populations and tourists seeking traditional dishes. This increased fish consumption has brought to light potential health risks associated with fish-borne zoonotic helminths (FBZHs), now acknowledged as global food-borne parasites. Fish-borne zoonotic helminths belong to various taxonomic groups, including nematodes (Anisakidae), trematodes (Opisthorchiidae and Heterophyidae), and cestodes (Diphyllobothriidae). More than 50 species of FBZH are known to cause human infections, derived from eating raw or undercooked aquatic foods containing viable parasites. Despite increased attention, FBZHs remain relatively neglected compared to other food-borne pathogens due to factors like chronic disease progression and under-diagnosis. This systematic review concentrates on the prevalence of six freshwater FBZHs (Clinostomum complanatum, Contracaecum rudolphii, Dibothriocephalus latus, Eustrongylides excisus, Opisthorchis felineus, and Pseudamphistomum truncatum) in Italy and neighbouring countries. The study explores the expansion of these parasites, analysing their biological and epidemiological aspects, and the factors that influence their proliferation, such as the increased cormorant population and the lake eutrophication phenomena. In summary, this research highlights the necessity for further research, the development of spatial databases, and the establishment of a unified European policy to effectively manage these multifaceted health concerns. It strongly advocates adopting a One-Health approach to address the growing incidence of parasitic zoonoses within the context of food safety in EU countries.

Correlates of Iron, Cobalamin, Folate, and Vitamin A Status among Stunted Children: A Cross-Sectional Study in Uganda

Micronutrient deficiencies and stunting are prevalent. We assessed correlates of iron, cobalamin, folate, and vitamin A biomarkers in a cross-sectional study of stunted children aged 12-59 months in eastern Uganda. The biomarkers measured were serum ferritin (S-FE), soluble transferrin receptor (S-TfR), retinol binding protein (S-RBP), plasma cobalamin (P-Cob), methylmalonic acid (P-MMA), and folate (P-Fol). Using linear regression, we assessed socio-demography, stunting severity, malaria rapid test, and inflammation as correlates of micronutrient biomarkers. Of the 750 children, the mean (SD) age was 32.0 (11.7) months, and 45% were girls. Iron stores were depleted (inflammation-corrected S-FE < 12 µg/L) in 43%, and 62% had tissue iron deficiency (S-TfR > 8.3 mg/L). P-Cob was low (<148 pmol/L) and marginal (148-221 pmol/L) in 3% and 20%, and 16% had high P-MMA (>0.75 µmol/L). Inflammation-corrected S-RBP was low (<0.7 µmol/L) in 21% and P-Fol (<14 nmol/L) in 1%. Age 24-59 months was associated with higher S-FE and P-Fol and lower S-TfR. Breastfeeding beyond infancy was associated with lower iron status and cobalamin status, and malaria was associated with lower cobalamin status and tissue iron deficiency (higher S-TfR) despite iron sequestration in stores (higher S-FE). In conclusion, stunted children have iron, cobalamin, and vitamin A deficiencies. Interventions addressing stunting should target co-existing micronutrient deficiencies.

The Landscape of Parasitic Infections in the United States

The landscape of parasitic infections in the United States has shifted dramatically over the past century. Although infections such as malaria have been successfully eliminated, others remain endemic and pose a significant public health risk. Numerous parasitic infections are also imported each year. This article focuses on endemic parasitic infections that may be commonly seen in anatomical pathology preparations and discusses their biology, diagnostic histopathological features, and epidemiology.

Comparative transcriptomic analysis of the larval and adult stages of Dibothriocephalus dendriticus (Cestoda: Diphyllobothriidea)

Tapeworms of the genus Dibothriocephalus are widely distributed throughout the world, some of which are agents of human diphyllobothriasis, one of the most important fish-borne zoonoses caused by a cestode parasite. Genomic and transcriptomic data can be used to develop future diagnostic tools and epidemiological studies. The present work focuses on a comparative analysis of the transcriptomes of adult and plerocercoid D. dendriticus and the identification of their differentially expressed genes (DEGs). Transcriptome assembly and analysis yielded and annotated 35,129 unigenes, noting that 16,568 (47%) unigenes were not annotated in known databases, which may indicate a unique set of expressed transcripts for D. dendriticus. A total of 8022 differentially expressed transcripts were identified, including 3225 upregulated and 4797 downregulated differentially expressed transcripts from the plerocercoid and adult animals. The analysis of DEGs has shown that among the most differentially expressed genes, there are important genes characteristic of each stage. Thus, several genes are characteristic of D. dendriticus plerocercoids, including fatty acid-binding protein and ferritin. Among the most highly expressed DEGs of the adult stage of D. dendriticus is the Kunitz-type serine protease inhibitor, in two putative isoforms. The analyses of GO and KEGG metabolic pathways revealed that a large number of the DEGs of D. dendriticus are associated with the biosynthesis of various substances such as arginine and folate, as well as with various metabolic pathways such as galactose metabolism, selenocompound metabolism, and phosphonate and phosphinate metabolism. This will contribute to further research aimed at identifying targets for new generation drugs and the development of specific vaccines.

Intestinal parasites in the Neolithic population who built Stonehenge (Durrington Walls, 2500 BCE)

Durrington Walls was a large Neolithic settlement in Britain dating around 2500 BCE, located very close to Stonehenge and likely to be the campsite where its builders lived during its main stage of construction. Nineteen coprolites recovered from a midden and associated pits at Durrington Walls were analysed for intestinal parasite eggs using digital light microscopy. Five (26%) contained helminth eggs, 1 with those of fish tapeworm (likely Dibothriocephalus dendriticus) and 4 with those of capillariid nematodes. Analyses of bile acid and sterol from these 5 coprolites show 1 to be of likely human origin and the other 4 to likely derive from dogs. The presence of fish tapeworm reveals that the Neolithic people who gathered to feast at Durrington Walls were at risk of infection from eating raw or undercooked freshwater fish. When the eggs of capillariids are found in the feces of humans or dogs it normally indicates that the internal organs (liver, lung or intestines) of animals with capillariasis have been eaten, and eggs passed through the gut without causing disease. Their presence in multiple coprolites provides new evidence that internal organs of animals were consumed. These novel findings improve our understanding of both parasitic infection and dietary habits associated with this key Neolithic ceremonial site.

Population genetic structure of diphyllobothriid tapeworms (Cestoda: Diphyllobothriidea) parasitising fish in the Baikal Rift Zone

Tapeworms of the genus Dibothriocephalus are widely distributed throughout the world, and some are agents of human diphyllobothriasis, one of the most important fish-borne zoonoses caused by a cestode parasite. Until now, the population genetic structure of diphyllobothriid tapeworms in the Baikal Rift Zone (BRZ) has remained unexplored. The major aim of this study was to analyse the population genetic structure of D. dendriticus and D. ditremus parasitising fish in the BRZ based on internal transcribed spacer 1 (ITS1) and mitochondrial gene cytochrome oxidase subunit I (cox1) sequences. We found that both species had complex population genetic structures. Each species formed 2 clades (D. dendriticus: Clade 1 & 2; D. ditremus Clade A & B) that differed in genetic diversity. D. dendriticus haplotypes in Clade 1 formed a star-like sub-network with a main haplotype, whereas the haplotypes in Clade 2 formed a diffuse network. We assumed that the complex population genetic structure of D. dendriticus was a consequence of populations evolving under different palaeoecological conditions during the Last Glacial Maximum. In contrast to D. dendriticus, both clades in the D. ditremus samples formed a diffuse network. Our findings revealed hypothetical pathways in the formation of the population genetic structure of diphyllobothriids in the BRZ. On one hand, isolation by distance played an important role; on the other hand, lake recolonisation from refugia and a genetic bottleneck after the end of the Last Glacial Maximum had a possible influence.

Serum cobalamin in children with moderate acute malnutrition in Burkina Faso: Secondary analysis of a randomized trial

BACKGROUND

Among children with moderate acute malnutrition (MAM) the level of serum cobalamin (SC) and effect of food supplements are unknown. We aimed to assess prevalence and correlates of low SC in children with MAM, associations with hemoglobin and development, and effects of food supplements on SC.

METHODS AND FINDINGS

A randomized 2 × 2 × 3 factorial trial was conducted in Burkina Faso. Children aged 6 to 23 months with MAM received 500 kcal/d as lipid-based nutrient supplement (LNS) or corn-soy blend (CSB), containing dehulled soy (DS) or soy isolate (SI) and 0%, 20%, or 50% of total protein from milk for 3 months. Randomization resulted in baseline equivalence between intervention groups. Data on hemoglobin and development were available at baseline. SC was available at baseline and after 3 and 6 months. SC was available from 1,192 (74.1%) of 1,609 children at baseline. The mean (±SD) age was 12.6 (±5.0) months, and 54% were females. Low mid-upper arm circumference (MUAC; <125 mm) was found in 80.4% (958) of the children and low weight-for-length z-score (WLZ; <-2) in 70.6% (841). Stunting was seen in 38.2% (456). Only 5.9% were not breastfed. Median (IQR) SC was 188 (137; 259) pmol/L. Two-thirds had SC ≤222 pmol/L, which was associated with lower hemoglobin. After age and sex adjustments, very low SC (<112 pmol/L) was associated with 0.21 (95% CI: 0.01; 0.41, p = 0.04) and 0.24 (95% CI: 0.06; 0.42, p = 0.01) z-score lower fine and gross motor development, respectively. SC data were available from 1,330 (85.9%) of 1,548 children followed up after 3 months and 398 (26.5%) of the 1,503 children after 6 months. Based on tobit regression, accounting for left censored data, and adjustments for correlates of missing data, the mean (95% CI) increments in SC from baseline to the 3- and 6-month follow-up were 72 (65; 79, p < 0.001) and 26 (16; 37, p < 0.001) pmol/L, respectively. The changes were similar among the 310 children with SC data at all 3 time points. Yet, the increase was 39 (20; 57, p < 0.001) pmol/L larger in children given LNS compared to CSB if based on SI (interaction, p < 0.001). No effect of milk was found. Four children died, and no child developed an allergic reaction to supplements. The main limitation of this study was that only SC was available as a marker of status and was missing from a quarter of the children.

CONCLUSIONS

Low SC is prevalent among children with MAM and may contribute to impaired erythropoiesis and child development. The SC increase during supplementation was inadequate. The bioavailability and adequacy of cobalamin in food supplements should be reconsidered.

TRIAL REGISTRATION

ISRCTN Registry ISRCTN42569496.

Intestinal Perforation Due to Adult Tapeworm of Taenia: A Case Report and Review of the Literature

Taeniasis is an intestinal helminth infection due to adult tapeworms belonging to the genus Taenia. Taeniasis remains a major burden in low-income countries in Asia. We present a case of intestinal perforation caused by adult tapeworm of Taenia in a 50-year-old Nepali male. The patients presented to the hospital with severe abdominal pain and intermittent vomiting. Following clinical presentations and imaging features, gastrointestinal perforation was suspected. Surgical removal of adult tapeworm of Taenia, suspected to be T. saginata or T. asiatica, was carried out during exploratory laparotomy, which was followed by an uneventful postoperative period. In addition to case presentation, we systematically review published case reports on taeniasis-related intestinal perforation. A learning point from this case is clinician should maintain a clinical suspicion of taeniasis as a possible cause of intestinal perforation in endemic areas.

An annotated checklist of the eukaryotic parasites of humans, exclusive of fungi and algae

The classification of "parasites" in the medical field is a challenging notion, a group which historically has included all eukaryotes exclusive of fungi that invade and derive resources from the human host. Since antiquity, humans have been identifying and documenting parasitic infections, and this collective catalog of parasitic agents has expanded considerably with technology. As our understanding of species boundaries and the use of molecular tools has evolved, so has our concept of the taxonomy of human parasites. Consequently, new species have been recognized while others have been relegated to synonyms. On the other hand, the decline of expertise in classical parasitology and limited curricula have led to a loss of awareness of many rarely encountered species. Here, we provide a comprehensive checklist of all reported eukaryotic organisms (excluding fungi and allied taxa) parasitizing humans resulting in 274 genus-group taxa and 848 species-group taxa. For each species, or genus where indicated, a concise summary of geographic distribution, natural hosts, route of transmission and site within human host, and vectored pathogens are presented. Ubiquitous, human-adapted species as well as very rare, incidental zoonotic organisms are discussed in this annotated checklist. We also provide a list of 79 excluded genera and species that have been previously reported as human parasites but are not believed to be true human parasites or represent misidentifications or taxonomic changes.

Diphyllobothrium stemmacephalum (Cestoda: Diphyllobothriidae) found from a harbor porpoise in northern Japan, with comments on a geographical gap with human infection cases in southern Japan

Even though the cetacean tapeworm Diphyllobothrium stemmacephalum occurs in both cold and warm waters, human infections and final host occurrences have been confined to temperate areas in and near Japan. We recently obtained a strobila of this cestode that was excreted from a harbor porpoise accidentally caught offshore of Hokkaido of northern Japan. Genetic analysis of 28S rDNA and cox1 genes confirmed that the cestode was D. stemmacephalum. Our finding sets the northernmost record of D. stemmacephalum in the western Pacific, suggesting that the risk of human infections by this parasite in northern Japan deserves further attention.

"Stranger things" in the gut: uncommon items in gastrointestinal specimens

Organic (such as parasites or vegetable remnants) and inorganic substances may be encountered during routine pathology diagnostic work up of endoscopic gastrointestinal biopsy samples and major resections, causing possible diagnostic conundrums for the young and not so young pathologists. The main aim of this review is the description of the most frequent oddities one can encounter as foreign bodies, in gastrointestinal pathology, on the basis of the current literature and personal experience. The types of encountered substances are divided into four principal categories: parasites (helminths such as Enterobius vermicularis, Strongyloides, Schistosoma, and Anisakis, and protozoa such as Entamoeba, Giardia and some intestinal coccidia); drugs and pharmaceutical fillers (found as deposits and as bystanders, innocent or not); seeds (possibly confused with worms) and plant remnants; pollutants (secondary to post-resection or post-biopsy contamination of the sample). An ample library of images is provided in order to consent easy referencing for diagnostic routine.

Relationship between the prevalence of Dibothriocephalus latus (Cestoda: Diphyllobothriidea) and the load of Escherichia coli: New findings in a neglected fish-borne parasitic zoonosis

The sub-Alpine lakes of Switzerland, Italy and France have long been reported as an endemic area of diphyllobothriosis, a parasitic zoonosis caused by Dibothriocephalus latus. With this study, we explored the hypothesis for a relationship between the prevalence of D. latus in Perca fluviatilis and the Escherichia coli load in lake water. To do this, we identified eleven sampling sites in three areas (north, centre and south) of Lake Iseo (north Italy) to determine E. coli load and the prevalence of D. latus in P. fluviatilis. Prevalence and 95% confidence interval (CI) of D. latus infestation ranged from 0% (95% CI: 0.71-0.0) in Sarnico (southern area) to 20% (95% CI: 33.0-11.2) in Pisogne (northern area). There were significant differences in prevalence between the sites (χ²  = 31.12; p-value = .0006) and in E. coli load (Kruskal-Wallis test; p-value = .0005). There was decreasing gradient of E. coli load and prevalence of D. latus infestation from north to south. A significant positive correlation (r = .881; p-value = .003) was found between E. coli load and prevalence of D. latus. Also, linear regression showed a significant relationship between E. coli load and prevalence of infestation (R²  = .775). Our findings offer an explanation for the link between E. coli load in water and D. latus prevalence. The potential factors in this link are the efficiency of the local wastewater treatment plant, the bathymetric profile of the lake and the life cycle of D. latus, which is mainly affected by light and water temperature.

Biology, Epidemiology, Clinical Features, Diagnosis, and Treatment of Selected Fish-borne Parasitic Zoonoses

Fish-borne parasites have been part of the global landscape of food-borne zoonotic diseases for many decades and are often endemic in certain regions of the world. The past 20 years or so have seen the expansion of the range of fish-borne parasitic zoonoses to new geographic regions leading to a substantial public health burden. In this article, we summarize current knowledge about the biology, epidemiology, clinical characteristics, diagnosis, treatment and control of selected fish-borne helminthic diseases caused by parasitic roundworm (Anisakis), tapeworm (Dibothriocephalus), and fluke (Metagonimus). Humans acquire infection via consumption of raw or improperly cooked fish or fish products. The burden from these diseases is caused by morbidity rather than mortality. Infected patients may present with mild to severe gastrointestinal (eg, abdominal pain, diarrhea, and indigestion) or allergic manifestations. Patients are often admitted to the hospital or clinic with acute symptoms and no prior health problems and no travel history. Diagnosis is often established based on the detection of the diagnostic parasite stages (eg, eggs or tapeworm segments) in the patient's feces. Sometimes imaging is required to exclude other causes and avoid unnecessary surgery. Dibothriocephalus and Metagonimus are mainly treated with praziquantel. Extraction of adult Dibothriocephalus or Anisakis larvae from the bowel ensures complete elimination of the parasites and prevents a relapse of infection. The development and implementation of more efficient food safety and public health strategies to reduce the burden of zoonotic diseases attributable to fish-borne parasites is highly desirable.

Anti-parasitic drugs modulate the non-selective channels formed by connexins or pannexins

The proteins connexins, innexins, and pannexins are the subunits of non-selective channels present in the cell membrane in vertebrates (connexins and pannexins) and invertebrates (innexins). These channels allow the transfer of ions and molecules across the cell membrane or, and in many cases, between the cytoplasm of neighboring cells. These channels participate in various physiological processes, particularly under pathophysiological conditions, such as bacterial, viral, and parasitic infections. Interestingly, some anti-parasitic drugs also block connexin- or pannexin-formed channels. Their effects on host channels permeable to molecules that favor parasitic infection can further explain the anti-parasitic effects of some of these compounds. In this review, the effects of drugs with known anti-parasitic activity that modulate non-selective channels formed by connexins or pannexins are discussed. Previous studies that have reported the presence of these proteins in worms, ectoparasites, and protozoa that cause parasitic infections have also been reviewed.

Parasitic Infections of the Gastrointestinal Track and Liver

Parasites have coevolved with humans. Several of them colonize the human body and establish a symbiotic relationship. Other parasites cause severe and lethal diseases. Prevalence of parasitic infections is decreased in highly industrialized countries, largely due to enforced hygienic practices. In contrast, parasites cause significant morbidity and mortality in parts of the world with barriers to effective public hygiene. Some parasites have emerged as potent pathogens in specific patient populations, such as immune suppressed individuals, regardless of sanitation. This article reviews common parasites encountered in clinical practice and, in the setting of host-parasite symbiosis, discusses their immune regulatory role.

Molecular cytogenetic analysis of a triploid population of the human broad tapeworm, Dibothriocephalus latus (Diphyllobothriidea)

The large-sized tapeworm Dibothriocephalus latus is known as the broad or fish-borne cestode of mammals that is capable to infect humans and cause diphyllobothriosis. Recently, molecular data on D. latus has been accumulating in the literature and a complete genome sequence has been published; however, little is known about the karyotype and chromosome architecture. In this study, an in-depth karyological analysis of 2 D. latus specimens was carried out. The plerocercoids originated from a perch caught in subalpine Lake Iseo (Italy) and the tapeworms were reared in hamsters. Both specimens contained cells with a highly variable number of chromosomes ranging from18 to 27. Nevertheless, the largest portion of mitotic figures (47%) showed a number corresponding to the triploid set, 3n = 27. Accordingly, the karyotype of the analyzed specimens consisted of 9 triplets of metacentric chromosomes. Fluorescence in situ hybridization (FISH) with the 18S rDNA probe clearly demonstrated the presence of 3 clusters of hybridization signals on the triplet of chromosome 7, thus confirming the triploid status of the specimens. FISH with a telomeric (TTAGGG)n probe confined hybridization signals exclusively to the terminal chromosomal regions, supporting the earlier findings that this repetitive motif is a conserved feature of tapeworm telomeres.

Diphyllobothrium sprakeri n. sp. (Cestoda: Diphyllobothriidae): a hidden broad tapeworm from sea lions off North and South America

BACKGROUND

The systematic of several marine diphyllobothriid tapeworms of pinnipeds has been revised in recent years. However, 20 species of Diphyllobothrium from phocids and otariids are still recognized as incertae sedis. We describe a new species of Diphyllobothrium from the intestine of California sea lions Zalophus californianus (Lesson) (type-host) and South American sea lions Otaria flavescens (Shaw).

METHODS

Zalophus californianus from the Pacific coast of the USA and O. flavescens from Peru and Argentina were screened for parasites. Partial fragments of the large ribosomal subunit gene (lsrDNA) and the cytochrome c oxidase subunit 1 (cox1) mitochondrial gene were amplified for 22 isolates. Properly fixed material from California sea lions was examined using light and scanning electron microscopy.

RESULTS

A total of four lsrDNA and 21 cox1 sequences were generated and aligned with published sequences of other diphyllobothriid taxa. Based on cox1 sequences, four diphyllobothriid tapeworms from O. flavescens in Peru were found to be conspecific with Adenocephalus pacificus Nybelin, 1931. The other newly generated sequences fall into a well-supported clade with sequences of a putative new species previously identified as Diphyllobothrium sp. 1. from Z. californianus and O. flavescens. A new species, Diphyllobothrium sprakeri n. sp., is proposed for tapeworms of this clade.

CONCLUSIONS

Diphyllobothrium sprakeri n. sp. is the first diphyllobothriid species described from Z. californianus from the Pacific coast of North America, but O. flavescens from Argentina, Chile and Peru was confirmed as an additional host. The present study molecularly confirmed the first coinfection of two diphyllobothriid species in sea lions from the Southern Hemisphere.

A regional study of the zoonotic broad tapeworm Dibothriocephalus spp. in Northwestern Patagonia (Argentina): origin of fishes and coastal cities as factors affecting infection in fishes

Diphyllobothriosis was first recorded in humans in Argentina in 1892 and in introduced salmonids in 1952. The aim of this work is to assess factors influencing the values of prevalence and abundance of plerocercoids in fishes that could increase the risk of transmission of Dibothriocephalus spp. in Andean Patagonian lakes. We analysed two key issues potentially related to the occurrence of tapeworms in fish: the presence of cities on coastlines (as potential sources of eggs to nearby lakes) and the difference between native and exotic fishes in susceptibility to infection. We investigated the probability of finding parasites in fish, the variation in parasite abundance in different environments and the relationship between host length and occurrence of plerocercoids. A total of 3226 fishes (belonging to six autochthonous and four introduced species) were analysed between 2010 and 2019 in eight environments. Plerocercoids were counted, and a subset was determined molecularly to species level. Two species, Dibothriocephalus latus and Dibothriocephalus dendriticus, were identified from both salmonids and native fishes, this being the first molecular confirmation of these tapeworm species parasitizing native South American fishes. Salmonids had higher levels of infection than native fishes, and these levels were higher in aquatic environments with a city on their coastline. Transmission to humans seems to occur mainly through Oncorhynchus mykiss, which showed the highest infection values and is the species most captured by fishers. Based on previous data and the present results, eggs shed by humans, dogs and gulls in cities could be the principal factors in maintaining the life cycle of this parasite in surrounding aquatic environments.

Proteomic Insights into the Biology of the Most Important Foodborne Parasites in Europe

Foodborne parasitoses compared with bacterial and viral-caused diseases seem to be neglected, and their unrecognition is a serious issue. Parasitic diseases transmitted by food are currently becoming more common. Constantly changing eating habits, new culinary trends, and easier access to food make foodborne parasites' transmission effortless, and the increase in the diagnosis of foodborne parasitic diseases in noted worldwide. This work presents the applications of numerous proteomic methods into the studies on foodborne parasites and their possible use in targeted diagnostics. Potential directions for the future are also provided.

Intestinal parasitic infections in pregnancy - A review

Intestinal parasitic infections are widespread worldwide and with increased global travel and transport of food, these are not entirely limited to traditionally endemic areas. The prevalence of parasitic infections in endemic areas among pregnant women ranges from 24 to 70 % with approximately 10 % of women having multiple parasites. Pregnancy with its increased nutritional demands and altered immunological defenses is an especially vulnerable time for acquiring parasitic infections, which may be associated with adverse outcomes such as anaemia, which in some cases may even contribute to mortality. The presence of a helminthic infections during pregnancy may also cause immunological effects that can contribute to maternal morbidity and mortality as well as affecting the maternal immune response and immune system function in the baby after birth. Mass administration of anthelminthic drug therapy has been applied in endemic areas but there is inconclusive evidence of its benefit in improving pregnancy outcomes, however, no safety concerns have been highlighted with the use of the recommended drugs for parasitic infections.

Occurrence and Spatial Distribution of Dibothriocephalus Latus (Cestoda: Diphyllobothriidea) in Lake Iseo (Northern Italy): An Update

Dibothriocephalus latus (Linnaeus, 1758) (Cestoda: Diphyllobothriidea; syn. Diphyllobothrium latum), is a fish-borne zoonotic parasite responsible for diphyllobothriasis in humans. Although D. latus has long been studied, many aspects of its epidemiology and distribution remain unknown. The aim of this study was to investigate the prevalence, mean intensity of infestation, and mean abundance of plerocercoid larvae of D. latus in European perch (Perca fluviatilis) and its spatial distribution in three commercial fishing areas in Lake Iseo (Northern Italy). A total of 598 specimens of P. fluviatilis were caught in 2019. The total prevalence of D. latus was 6.5%. However, there were significant differences between areas (10.2% North; 7.3% Center; 1.5% South) (Chi-square test, p = 0.0018). The mean intensity of infestation ranged from 1 larva in southern area to 1.2 larvae in both the central and northern (Pisogne) areas. In addition, the mean abundance ranged from 0.02 in the southern area to 0.26 in the northern area (Pisogne). The total number of larvae (anterior dorsal—AD = 21; anterior ventral—AV = 1; posterior dorsal—PD = 15; posterior ventral—PV = 5) differed significantly between the four anatomical quadrants (Kruskal–Wallis test; p = 0.0001). The prevalence of D. latus plerocercoid larvae in European perch from Lake Iseo has long been investigated, but without an appropriate sampling design. With the present study, a broader analysis in spatial distribution has been added to the existing literature, revealing new information about D. latus distribution and occurrence in Lake Iseo, with new data that will be useful for health authorities and future studies.

The parasite that came in from the cold

We describe the case of a Russian child with persistent mild eosinophilia in whom intestinal parasitism by Dibothriocephalus latus is finally diagnosed. This cestode is prevalent in circumpolar regions and, therefore, an uncommon finding in International Health units, where care for patients from tropical and subtropical areas is usually provided.

Pre-Columbian zoonotic enteric parasites: An insight into Puerto Rican indigenous culture diets and life styles

The pre-Columbian Huecoid and Saladoid cultures were agricultural ethnic groups that supplemented their diets by fishing, hunting and scavenging. Archaeological deposits associated to these cultures contained a variety of faunal osseous remains that hinted at the cultures' diets. The present study identified zoonotic parasites that may have infected these two cultures as a result of their diets. We used metagenomic sequencing and microscopy data from 540-1,400 year old coprolites as well as the zooarchaeological data to recreate the possible interactions between zoonotic parasites and their hosts. Microscopy revealed Diphyllobothrium spp. and Dipylidium caninum eggs along with unidentified cestode and trematode eggs. DNA sequencing together with functional prediction and phylogenetic inference identified reads of Cryptosporidium spp., Giardia intestinalis and Schistosoma spp. The complimentary nature of the molecular, microscopy and zooarchaeology data provided additional insight into the detected zoonotic parasites' potential host range. Network modeling revealed that rodents and canids living in close proximity to these cultures were most likely the main source of these zoonotic parasite infections.

Zoonotic transmission of intestinal helminths in southeast Asia: Implications for control and elimination

Intestinal helminths are extremely widespread and highly prevalent infections of humans, particularly in rural and poor urban areas of low and middle-income countries. These parasites have chronic and often insidious effects on human health and child development including abdominal problems, anaemia, stunting and wasting. Certain animals play a fundamental role in the transmission of many intestinal helminths to humans. However, the contribution of zoonotic transmission to the overall burden of human intestinal helminth infection and the relative importance of different animal reservoirs remains incomplete. Moreover, control programmes and transmission models for intestinal helminths often do not consider the role of zoonotic reservoirs of infection. Such reservoirs will become increasingly important as control is scaled up and there is a move towards interruption and even elimination of parasite transmission. With a focus on southeast Asia, and the Philippines in particular, this review summarises the major zoonotic intestinal helminths, risk factors for infection and highlights knowledge gaps related to their epidemiology and transmission. Various methodologies are discussed, including parasite genomics, mathematical modelling and socio-economic analysis, that could be employed to improve understanding of intestinal helminth spread, reservoir attribution and the burden associated with infection, as well as assess effectiveness of interventions. For sustainable control and ultimately elimination of intestinal helminths, there is a need to move beyond scheduled mass deworming and to consider animal and environmental reservoirs. A One Health approach to control of intestinal helminths is proposed, integrating interventions targeting humans, animals and the environment, including improved access to water, hygiene and sanitation. This will require coordination and collaboration across different sectors to achieve best health outcomes for all.

Locally acquired infection with Dibothriocephalus nihonkaiense (=Diphyllobothrium nihonkaiense) in France: the importance of molecular diagnosis

Diphyllobothriasis is a parasitic fish-borne disease caused by tapeworms of the genus Dibothriocephalus (=Diphyllobothrium). The majority of reported cases are attributed to D. latum, based on morphological identification of eggs or proglottids. However, numerous reports in recent years suggested that other Dibothriocephalus species could be involved in human infections, mainly after consumption of salmonid fish. Among these, D. nihonkaiense has been predominantly reported from Eastern Asia and probably underestimated in the rest of the world. We report here a clinical case of D. nihonkaiense in a French patient (without history of travel abroad) after consumption of salmon. Suspected on morphological characteristics, the final identification of D. nihonkaiense was performed using molecular methods by sequencing nad1, cox1, and 5.8S rRNA (containing ITS1 and 2) genes sequences. The patient was successfully treated by a single dose of praziquantel. Reports of diphyllobothriasis due to D. nihonkaiense are rare outside Asia, but worldwide demand of seafood could lead to the globalization of cases and reflect the need to monitor the distribution of Dibothriocephalus species. Thus, clinical parasitologists should be aware of this risk and able to raise the possibility of infections by non-endemic Dibothriocephalus species in order to use the proper molecular tools.

Zoonoses and potential zoonoses of bears

Captive and free-ranging wild bears can carry and transmit several zoonotic pathogens. A review of nearly 90 years of scientific publications concerning confirmed and potential zoonotic diseases that can be present in any of the eight species of bears in the world was conducted. The findings were organized amongst the following disease sections: bacterial, viral, protozoal, mycotic, helminth and arthropod-borne. The most commonly reported pathogens of concern were of parasitic (Trichinella, Toxoplasma) and bacterial (Francisella, Brucella) origin.

Comparison of Four Parasitological Techniques for Laboratory Diagnosis of Eggs from Spirometra spp. in Wild Mammal Fecal Samples

PURPOSE

This study aimed to compare the performance of four different microscopic coproparasitological techniques in relation to egg recovering and the frequency of alterations in the eggs observed through each technique.

METHODS

A total of 213 fecal samples from free-living carnivorous mammals were collected between 2017 and 2018 in Itatiaia National Park, RJ, Brazil. Faust and modified Sheather floatation techniques as well as Lutz and modified Ritchie sedimentation techniques were applied.

RESULTS

The total positivity rate for Spirometra spp. eggs was 24.4%, and these were detected mainly through Lutz and modified Ritchie sedimentation techniques, with substantial agreement (kappa = 0.73; p = 0.00 < 0.05; McNemar p value = 1.0; Fisher's exact test p = 0.616). Faust and modified Sheather flotation techniques did not present good egg recovery, with frequencies of 6.6% and 7.5%, respectively. Eggs with morphological alterations were mostly observed through Faust (17.3%) and modified Sheather (13.5%). Both flotation techniques presented statistically significant frequencies of deformed eggs, in comparison with the sedimentation techniques (p = 0.00). Low frequencies of deformed eggs were observed when the samples were analyzed through modified Ritchie and Lutz sedimentation techniques.

CONCLUSIONS

From these results, sedimentation techniques such as modified Ritchie and Lutz methods were more efficient for diagnosing the eggs of this helminth in fecal material from free-living carnivores and should always be used when analyzing fecal samples from hosts of different species.

Characteristics related to fish consumption and the risk of ichthyozoonosis in a Colombian population

Objective This study aimed to determine the dietary habits related to fish consumption and the risk factors associated with acquiring an ichthyo-zoonotic disease.Materials and Methods A descriptive, cross-sectional study was carried out by means of a structured survey administered to 150 individuals in the city of Cali, Colombia.Results Epidemiological variables regarding fish consumption and preparation were contrasted with the medical records of the respondents. The median fish consumption in the surveyed population was three times a month, with raw or salted/marinated fish once a month. A positive correlation between fish consumption and allergic conditions was confirmed. There was no infectious or parasitic history associated with the data on fish consumption.Conclusions A relationship between fish consumption and allergies was confirmed. Further research is necessary to establish the possible pathogens associated with hypersensitivity, such as parasites of the Anisakidae family.

The ABCs of Nutrient Deficiencies and Toxicities

Vitamins and minerals are part of a well-balanced diet. They are essential for normal growth and development, which is especially crucial for the pediatric population. Vitamins are divided based on their solubility into fat-soluble vitamins, which include vitamins A, D, E, and K and water-soluble vitamins, which include the B vitamins and vitamin C. Minerals include calcium, magnesium, and phosphorus. Trace minerals are micronutrients and include copper, zinc, selenium, chromium and manganese. The pediatrician is often the first health care provider to interface with patients, allowing them to pick up on nutritional derangements. This article reviews the basic sources, absorption, metabolism as well as the signs and symptoms that arise in deficient and toxic states of fat-soluble vitamins, water-soluble vitamins, minerals, and trace elements. [Pediatr Ann. 2019;48(11):e434-e440.].

Endohelminths of European Perch (Perca fluviatilis) from Selected Localities in Poland with an Emphasis on Search of the Broad Fish Tapeworm Dibothriocephalus latus

INTRODUCTION

A piscivorous fish European perch (Perca fluviatilis) is present in all types of lakes and brackish waters in Poland. Previous ichthyoparasitological surveys revealed broad spectrum of endohelminths in perch from different aquatic environments. Among them, detection of Diphyllobothrium sp. and Dibothriocephalus latus (syn. Diphyllobothrium latum) in the Pomeranian Bay is of particular interest, since D. latus is one of the causative agents of diphyllobothriasis, fish-borne parasitic zoonosis. Besides, D. latus eggs were previously detected in coprological samples of otter, wolf and lynx from the Białowieża Primeval Forest.

AIM

To conduct parasitological examinations of European perch from the Pomeranian Bay in order to detect the spectrum of its endohelminths and to provide a pilot study on helminths of perch from different water bodies in the Białowieża Primeval Forest. Due to zoonotic character of D. latus, we have focused our attention to this tapeworm.

RESULTS

The larvae of tapeworm Triaenophorus nodulosus and thorny-headed worm Acanthocephalus lucii were detected in perch from the Pomeranian Bay. In perch from different localities in the Białowieża Primeval Forest, T. nodulosus, A. lucii and tapeworm Proteocephalus percae were detected. D. latus plerocercoids were found neither in musculature nor in peritoneal cavity and other internal organs of any of the fish examined from both studied localities in Poland.

CONCLUSION

Future screening implementing morphological and molecular markers is needed in order to understand the current distribution of D. latus in Europe.

Complex insight on microanatomy of larval "human broad tapeworm" Dibothriocephalus latus (Cestoda: Diphyllobothriidea)

BACKGROUND

In Europe, the tapeworm Dibothriocephalus latus (syn. Diphyllobothrium latum) is a well-known etiological agent of human diphyllobothriosis, which spreads by the consumption of raw fish flesh infected by plerocercoids (tapeworm's larval stage). However, the process of parasite establishment in both intermediate and definitive hosts is poorly understood. This study was targeted mainly on the scolex (anterior part) of the plerocercoid of this species, which facilitates penetration of the parasite in intermediate paratenic fish hosts, and subsequently its attachment to the intestine of the definitive host.

METHODS

Plerocercoids were isolated from the musculature of European perch (Perca fluviatilis) caught in Italian alpine lakes. Parasites were examined using confocal microscopy, scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Immunofluorescence tagging was held on whole mount larvae.

RESULTS

The organisation of the central and peripheral nervous system was captured in D. latus plerocercoids, including the ultrastructure of the nerve cells possessing large dense neurosecretory granules. Two types of nerve fibres run from the body surface toward the nerve plexus located in the parenchyma on each side of bothria. One type of these fibres was found to be serotoninergic and possessed large subtegumental nerve cell bodies. A well-developed gland apparatus, found throughout the plerocercoid parenchyma, produced heterogeneous granules with lucent core packed in a dense layer. Three different types of microtriches occurred on the scolex and body surface of plerocercoids of D. latus: (i) uncinate spinitriches; (ii) coniform spinitriches; and (iii) capilliform filitriches. Non-ciliated sensory receptors were observed between the distal cytoplasm of the tegument and the underlying musculature.

CONCLUSIONS

Confocal laser scanning microscopy and electron microscopy (SEM and TEM) showed the detailed microanatomy of the nervous system in the scolex of plerocercoids, and also several differences in the larval stages compared with adult D. latus. These features, i.e. well-developed glandular system and massive hook-shaped uncinate spinitriches, are thus probably required for plerocercoids inhabiting fish hosts and also for their post-infection attachment in the human intestine.

Intestinal parasites at the Late Bronze Age settlement of Must Farm, in the fens of East Anglia, UK (9th century B.C.E.)

Little is known about the types of intestinal parasites that infected people living in prehistoric Britain. The Late Bronze Age archaeological site of Must Farm was a pile-dwelling settlement located in a wetland, consisting of stilted timber structures constructed over a slow-moving freshwater channel. At excavation, sediment samples were collected from occupation deposits around the timber structures. Fifteen coprolites were also hand-recovered from the occupation deposits; four were identified as human and seven as canine, using fecal lipid biomarkers. Digital light microscopy was used to identify preserved helminth eggs in the sediment and coprolites. Eggs of fish tapeworm (Diphyllobothrium latum and Diphyllobothrium dendriticum), Echinostoma sp., giant kidney worm (Dioctophyma renale), probable pig whipworm (Trichuris suis) and Capillaria sp. were found. This is the earliest evidence for fish tapeworm, Echinostoma worm, Capillaria worm and the giant kidney worm so far identified in Britain. It appears that the wetland environment of the settlement contributed to establishing parasite diversity and put the inhabitants at risk of infection by helminth species spread by eating raw fish, frogs or molluscs that flourish in freshwater aquatic environments, conversely the wetland may also have protected them from infection by certain geohelminths.

Broad tapeworms (Diphyllobothriidae), parasites of wildlife and humans: Recent progress and future challenges

Tapeworms of the family Diphyllobothriidae, commonly known as broad tapeworms, are predominantly large-bodied parasites of wildlife capable of infecting humans as their natural or accidental host. Diphyllobothriosis caused by adults of the genera Dibothriocephalus, Adenocephalus and Diphyllobothrium is usually not a life-threatening disease. Sparganosis, in contrast, is caused by larvae (plerocercoids) of species of Spirometra and can have serious health consequences, exceptionally leading to host's death in the case of generalised sparganosis caused by 'Sparganum proliferum'. While most of the definitive wildlife hosts of broad tapeworms are recruited from marine and terrestrial mammal taxa (mainly carnivores and cetaceans), only a few diphyllobothriideans mature in fish-eating birds. In this review, we provide an overview the recent progress in our understanding of the diversity, phylogenetic relationships and distribution of broad tapeworms achieved over the last decade and outline the prospects of future research. The multigene family-wide phylogeny of the order published in 2017 allowed to propose an updated classification of the group, including new generic assignment of the most important causative agents of human diphyllobothriosis, i.e., Dibothriocephalus latus and D. nihonkaiensis. Genomic data of selected representatives have also begun to accumulate, promising future developments in understanding the biology of this particular group of parasites. The list of nominal species of taxonomically most complicated genus Spirometra as well as host-parasite list of 37 species of broad tapeworms parasitising marine mammals (pinnipeds and cetaceans) are also provided.

Dibothriocephalus nihonkaiensis: an emerging foodborne parasite in Brittany (France)?

BACKGROUND

Diphyllobothriosis is an intestinal cestodosis caused by tapeworms of the family Diphyllobothriidae. In France, endemic cases are limited to south-east and due to Dibothriocephalus latus. In this paper, we investigate a series of seven cases of diphyllobothriosis in the non-endemic French region of Brittany. All have been diagnosed between 2016 and 2018 at the University Hospital of Rennes.

METHODS

Parasites were identified by their morphological features and by phylogenetic analysis of the cox1 gene. Phylogenetic tree was built using maximum likelihood criterion under the GTR+G+I model and 2000 bootstrap replicates. A form was sent to all patients to collect data concerning clinical signs and possible sources of infection.

RESULTS

All cases were due to Dibothriocephalus nihonkaiensis, a species strictly distributed in the North Pacific. Epidemiological investigation showed that the parasite was probably acquired in France, after consumption of Japanese food containing raw salmon. All patients presented with at least abdominal pain and fatigue except for one patient who had no symptoms.

CONCLUSIONS

To our knowledge, this case series is the most important cohort of allochthonous diphyllobothriosis described in Europe. This sudden emergence raises concern about foodborne infections, highlighting (i) risky food habits in absence of adequate sanitary control; and (ii) the breaking of the rule of geographical restriction due to globalization and worldwide trades.

Epidemiology of Diphyllobothrium nihonkaiense Diphyllobothriasis, Japan, 2001-2016

The threat from this disease, the most common cestodiasis in Japan, is increasing because of globalization and lack of awareness.

We report 958 cases of cestodiasis occurring in Japan during 2001–2016. The predominant pathogen was Diphyllobothrium nihonkaiense tapeworm (n = 825), which caused 86.1% of all cases. The other cestode species involved were Taenia spp. (10.3%), Diplogonoporus balaenopterae (3.3%), and Spirometra spp. (0.2%). We estimated D. nihonkaiense diphyllobothriasis incidence as 52 cases/year. We observed a predominance of cases during March–July, coinciding with the cherry salmon and immature chum salmon fishing season, but cases were present year-round, suggesting that other fish could be involved in transmission to humans. Because of increased salmon trade, increased tourism in Japan, and lack of awareness of the risks associated with eating raw fish, cases of D. nihonkaiense diphyllobothriasis are expected to rise. Therefore, information regarding these concerning parasitic infections and warnings of the potential risks associated with these infections must be disseminated to consumers, food producers, restaurant owners, physicians, and travelers.

A Systematic Overview of Zoonotic Helminth Infections in North America

Zoonotic helminths are frequent human parasites that generally complete their natural life cycle in the absence of humans. This review encompasses 30 common or clinically relevant zoonotic helminth infections that are endemic to North America. For each organism or disease, the following information is briefly reviewed: taxonomy, biology, and life cycle, epidemiology, route of transmission for the human host, clinical manifestations, pathologic features, treatment, and laboratory diagnosis. Illustrations are provided for select parasites.