Trematodes recovered in the small intestine of stray cats in the Republic of Korea

Co-occurrence of leptospirosis and Opisthorchis viverrini infection in cats and their risk factors

Leptospirosis is a waterborne disease with a worldwide distribution. In Northeast Thailand, its prevalence overlaps with the endemicity of Opisthorchis viverrini, (OV). This study aimed to investigate the prevalence and risk factors of leptospirosis in cats and its association with opisthorchiasis in endemic area of Thailand. 115 cats were sampled for blood and feces. We tested Leptospira antibodies in blood using the Lepto-latex test. For fecal analysis, we applied the formalin-ether concentration technique (FECT) for OV and identified Leptospira spp. through PCR targeting the 16S rRNA and LipL32. Non-spatial analyses included Pearson's Chi-square, Fisher's exact test, and logistic regression, while spatial analyses involved Inverse Distance Weighted (IDW), spatial autocorrelation, and Geographically Weighted Logistic Regression (GWLR). Serological analysis revealed 15.65 % of cats positive for Leptospira spp., whereas 44.35 % of fecal samples positive for OV. PCR analysis identified 1 L. interrogans with the 16S rRNA, while the LipL32 identified 2 samples related to L. interrogans and 1 to L. borgpetersenii. The spatial autocorrelation indicated clustering of leptospirosis cases. Logistic regression revealed 2 significant risk factors; OV infection (OR 3.44, 95 % CI 1.10-10.73; p 0.03) and proximity to flooded areas (OR 3.47, 95 % CI 1.12-10.74; p 0.03). Furthermore, GWLR showed median coefficients of 0.59 (-1.62-5.15) for OV infection and 2.15 (1.30-6.47) for proximity to flooded areas. This study demonstrates a significant association between cat leptospirosis with OV infection and proximity to flooded areas. These highlight the importance of monitoring environmental and biological risk factors to mitigate leptospirosis in endemic regions.

Metabarcoding of pathogenic parasites based on copro-DNA analysis of wild animals in South Korea

Four species of dominant wild animals, namely, Prionailurus bengalensis euptilurus, Nyctereutes procyonoides koreensis, Hydropotes inermis argyropus, and Sus scrofa coreanus, are hosts of potential infectious agents, including helminths and protozoa. Therefore, it is necessary to analyze the infectious agents present in these wild animals to monitor and control the spread of pathogens. In the present study, fecal samples from 51 wild animals were collected from the mountains of Yangpyeong, Hoengseong, and Cheongyang in South Korea and metabarcoding of the V9 region of the 18S rRNA gene was performed to identify various parasite species that infect these wild animals. Genes from nematodes, such as Metastrongylus sp., Strongyloides spp., Ancylostoma sp., and Toxocara sp., were detected in the fecal samples from wild animals. In addition, platyhelminthes, including Spirometra sp., Echinostomatidae gen. sp., Alaria sp., Neodiplostomum sp., and Clonorchis sp., and protozoa, including Entamoeba sp., Blastocystis sp., Isospora sp., Tritrichomonas sp., Pentatrichomonas sp., and Cryptosporidium sp., were detected. In the present study, various parasites infecting wild animals were successfully identified using metabarcoding. Our technique may play a crucial role in monitoring parasites within wild animals, especially those causing zoonoses.

Epidemiology and Geographical Distribution of Human Trematode Infections

Digenetic trematodes infecting humans are more than 109 species that belong to 49 genera all over the world. According to their habitat in the definitive hosts, they are classified as 6 blood flukes (Schistosoma japonicum. S. mekongi, S. malayensis, S. mansoni, S. intercalatum, and S. haematobium), 15 liver flukes (Fasciola hepatica, F. gigantica, Clonorchis sinensis, Opisthorchis viverrini, O. felineus, Dicrocoelium dendriticum, D. hospes, Metorchis bilis, M. conjunctus, M. orientalis, Amphimerus sp., A. noverca, A. pseudofelineus, Pseudamphistomum truncatum, and P. aethiopicum), nine lung flukes (Paragonimus westermani, P. heterotremus, P. skrjabini, P. skrjabini miyazakii, P. kellicotti, P. mexicanus, P. africanus, P. uterobilateralis, and P. gondwanensis), 30 heterophyid intestinal flukes (Metagonimus yokogawai, M. takahashii, M. miyatai, M. suifunensis, M. katsuradai, M. pusillus, M. minutus, Heterophyes heterophyes, H. nocens, H. dispar, Haplorchis taichui, H. pumilio, H. yokogawai, H. vanissinus, Centrocestus formosanus, C. armatus, C. cuspidatus, C. kurokawai, Procerovum calderoni, P. varium, Pygidiopsis genata, P. summa, Stictodora fuscata, S. lari, Stellantchasmus falcatus, Heterophyopsis continua, Acanthotrema felis, Apophallus donicus, Ascocotyle longa, and Cryptocotyle lingua), 24 echinostome intestinal flukes (Echinostoma revolutum, E. cinetorchis, E. mekongi, E. paraensei, E. ilocanum, E. lindoense, E. macrorchis, E. angustitestis, E. aegyptica, Isthmiophora hortensis, I. melis, Echinochasmus japonicus, E. perfoliatus, E. lilliputanus, E. caninus, E. jiufoensis, E. fujianensis, Artyfechinostomum malayanum, A. sufrartyfex, A. oraoni, Acanthoparyphium tyosenense, Echinoparymphium recurvatum, Himasthla muehlensi, and Hypoderaeum conoideum), 23 miscellaneous intestinal flukes (Brachylaima cribbi, Caprimolgorchis molenkampi, Phaneropsolus bonnei, P. spinicirrus, Cotylurus japonicus, Fasciolopsis buski, Gastrodiscoides hominis, Fischoederius elongatus, Watsonius watsoni, Gymnophalloides seoi, Gynaecotyla squatarolae, Microphallus brevicaeca, Isoparorchis hypselobagri, Nanophyetus salmincola, N. schikobalowi, Neodiplostomum seoulense, Fibricola cratera, Plagiorchis muris, P. vespertilionis, P. harinasutai, P. javensis, P. philippinensis, and Prohemistomum vivax), one throat fluke (Clinostomum complanatum), and one pancreatic fluke (Eurytrema pancreaticum). The mode of transmission to humans includes contact with cercariae contaminated in water (schistosomes) or ingestion of raw or improperly cooked food, including fish (liver flukes, heterophyid flukes, echinostomes, and throat flukes), snails (echinostomes, brachylaimids, and gymnophallid flukes), amphibia, reptiles (neodiplostomes), aquatic vegetables (fasciolids and amphistomes), and insect larvae or adults (lecithodendriids, plagiorchiids, and pancreatic flukes). Praziquantel has been proven to be highly effective against almost all kinds of trematode infections except Fasciola spp. Epidemiological surveys and detection of human infections are required for a better understanding of the prevalence, intensity of infection, and geographical distribution of each trematode species.

Cryptocotyle lata (Trematoda: Heterophyidae) Adult from a Korean Raccoon Dog, Nyctereutes procyonoides koreensis

Total 513 heterophyid flukes were collected from a carcass of wild Korean raccoon dog, Nyctereutes procyonoides koreensis, in Korea. With morphological and molecular characteristics, the flukes were identified to Cryptocotyle lata. The adult C. lata were minute, transparent, pentagonal, 522 μm long by 425 μm wide. Ceca extended into post-testicular region. Ventrogenital sac elliptical, 79 μm by 87 μm with genital pore and ventral sucker. Two testes semielliptical and slightly lobed, located in the posterior region, right testis 173 μm by 155 μm, left testis 130 μm by 134 μm. In a phylogenetic tree, the fluke specimen of this study was grouped with C. lata divergent from Cryptocotyle lingua. We report here N. procyonoides koreensis first as a natural definitive host of C. lata.

Euryhelmis squamula (Digenea: Heterophyidae) Recovered from Korean Raccoon Dog, Nyctereutes procyonoides koreensis, in Korea

In this study, we intended to describe an unrecorded species of heterophyid trematode recovered from the small intestine of a Korean raccoon dog, Nyctereutes procyonoides koreensis, in Korea. A total of 13 small flukes were collected from a deceased Korean raccoon dog which was found in Chuncheon-si, Gangwon-do, Korea in May 2017. The trematode body were covered with many small spines, rectangular, broader than long, 807–1,103 μm long and 1,270–1,550 μm wide. Oral sucker in the anterior end slightly smaller than acetabulum. Pharynx muscular and well developed. Esophagus relatively long and sigmoid. Acetabulum small and located at median in anterior 2/5 portion. Ceca bifurcated at the anterior of genital pore and acetabulum and terminated at testis level. Testes larger, deeply lobed and located at the near of posterior end of body. Ovary small, triangular and located at the slight left of median and the anterior of left testis. Vitelline follicles dendritic and extend from the middle level of esophagus to the posterior portion of body. Eggs embryonated, operculated, small and 33–35×15–16 μm in size. Based on the morphological characteristics, the small heterophyid flukes recovered from the small intestines of Korean raccoon dog, N. procyonoides koreensis, were identified as Euryhelmis squamula (Digenea: Heterophyidae). Accordingly, this species of heterophyid flukes is to be a new trematode fauna in Korea by this study.

Intestinal Flukes Recovered from a Herring Gull, Larus argentatus, in the Republic of Korea

Trematode specimens were collected from the intestine of a herring gull, Larus argentatus, which was found in a critical condition on the shore of a small island (Yubu-do, Seocheon-gun, Chungcheongnam-do) located at the western coast of the Korean peninsula. Total 11 specimens of intestinal flukes, including 3 Cryptocotyle lingua (Heterophyidae), 1 Himasthla alincia (Echinostomatidae), 5 Cardiocephaloides medioconiger (Strigeidae), and 2 Diplostomum spathaceum (Diplostomidae), were recovered. C. lingua was morphologically characterized by the presence of a large ventrogenital apparatus and 2 obliquely tandem testes. H. alincia had an elongated body and a head collar equipped with 31 collar spines. C. medioconiger had a bisegmented body and a voluminous copulatory bursa containing the seminal vesicle and ejaculatory duct. D. spathaceum also had a bisegmented body and its vitellaria extended up to the anterior border of the tribocytic organ. It is of note that C. lingua is potentially zoonotic that can occur in birds and humans. Three of them, i.e., C. lingua, C. medioconiger, and D. spathaceum, are new trematode fauna in Korea. Studies on trematode fauna of migratory birds should be continued in Korea.

Foodborne intestinal flukes: A brief review of epidemiology and geographical distribution

Foodborne intestinal flukes are highly diverse consisting of at least 74 species with a diverse global distribution. Taxonomically they include 28 species of heterophyids, 23 species of echinostomes, and 23 species of miscellaneous groups (amphistomes, brachylaimids, cyathocotylids, diplostomes, fasciolids, gymnophallids, isoparorchiids, lecithodendriid-like group, microphallids, nanophyetids, plagiorchiids, and strigeids). The important heterophyid species (15 species) include Metagonimus yokogawai, M. takahashii, M. miyatai, Heterophyes heterophyes, H. nocens, Haplorchis taichui, H. pumilio, H. yokogawai, Heterophyopsis continua, Centrocestus formosanus, Pygidiopsis genata, P. summa, Stellantchasmus falcatus, Stictodora fuscata, and S. lari. The echinostome species of public health significance (15 species) include Echinostoma revolutum, E. cinetorchis, E. lindoense, E. ilocanum, Isthmiophora hortensis, Echinochasmus japonicus, E. perfoliatus, E. liliputanus, E. fujianensis, E. caninus, Acanthoparyphium tyosenense, Artyfechinostomum malayanum, A. sufrartyfex, A. oraoni, and Hypoderaeum conoideum. Among the other zoonotic intestinal flukes, Gastrodiscoides hominis, Brachylaima cribbi, Neodiplostomum seoulense, Fasciolopsis buski, Gymnophalloides seoi, Caprimolgorchis molenkampi, Phaneropsolus bonnei, Microphallus brevicaeca, Nanophyetus salmincola, and N. schikhobalowi (10 species) have drawn considerable medical attention causing quite a fair number of human infection cases. The principal mode of human infections include ingestion of raw or improperly cooked fish (heterophyids and echinostomes), snails including oysters (echinostomes and G. seoi), amphibians and reptiles (N. seoulense), aquatic vegetables (amphistomes and F. buski), and insect larvae or adults (C. molenkampi and P. bonnei). Epidemiological characteristics such as the prevalence, geographical distribution, and clinical and public health significance are poorly known in many of these species. Praziquantel has been proved to be highly effective against most species of intestinal fluke infections. Surveys and detection of human infection cases are urgently required for better understanding of the global status and public health significance of each species.

Paraphyly of Conodiplostomum Dubois, 1937

Adult trematodes of the genera Conodiplostomum Dubois, 1937 and Neodiplostomum Railliet, 1919 (Trematoda: Diplostomidae) parasitize the intestines of birds of prey, owls and, rarely, passeriform birds. Although the family is taxonomically unsettled, molecular phylogenetics have not been applied to analyze Conodiplostomum and Neodiplostomum and the reference DNA sequences from adult Diplostomidae are scarce and limit studies of their indistinct larval forms. We analyze the Conodiplostomum and Neodiplostomum spp. found during the examination of Czech birds performed from 1962 to 2017, and we provide comparative measurements and host spectra, including prevalence and intensity; we also provide and analyze the sequences of four DNA loci from eight diplostomid species. Molecular phylogenetic analysis suggested that Conodiplostomum spathula (Creplin, 1829), the type species of this genus, is nested in Neodiplostomum. Thus, we suggest the rejection of Conodiplostomum spathula (Creplin, 1829) and the resurrection of Neodiplostomum spathula (Creplin, 1829) La Rue, 1926 and reclassification of all species of Conodiplostomum with the neodiplostomulum type of metacercariae to Neodiplostomum as well. Conodiplostomum canaliculatum (Nicoll, 1914) is reclassified as Neodiplostomum spathulaeforme (Brandes, 1888). The molecular analysis suggested that Conodiplostomum perlatum (Ciurea, 1911), the species with the neascus type of metacercariae, belongs to Crassiphialinae Sudarikov, 1960. We erect the genus Ciureatrema gen. nov. Heneberg & Sitko and reclassify Conodiplostomum perlatum (Ciurea, 1911) as Ciureatrema perlatum (Ciurea, 1911) and establish it as a type species of Ciureatrema gen. nov. Further research should focus on the evolution of the neascus and neodiplostomulum types of metacercariae, as well as the evolution of the genital cone and pseudosuckers in Diplostomidae.

Necrotizing Enteritis Caused by Pharyngostomum cordatum Infection in a Stray Cat

A stray female cat of unknown age, presenting bright red watery diarrhea, was submitted to the Animal and Plant Quarantine Agency for diagnosis. In the small intestines extracted from the necropsied cat, numerous white oval-shaped organisms were firmly embedded in the mucosa and there was thickening of intestinal wall. Histopathological analysis revealed severe necrotizing enteritis, together with atrophied intestinal villi, exfoliated enterocytes, and parasitic worms. Recovered worms were identified as Pharyngostomum cordatum by morphological observation and genetic analysis. Although P. cordatum is known to occur widely in Korea, this is the first clinical description of an infection by P. cordatum causing severe feline enteritis.

Epidemiology of Trematode Infections: An Update

Digenetic trematodes infecting humans are more than 91 species which belong to 46 genera all over the world. According to their habitat in definitive hosts, they are classified as blood flukes (Schistosoma japonicum. S. mekongi, S. mansoni, S. haematobium, and S. intercalatum), liver flukes (Clonorchis sinensis, Opisthorchis viverrini, O. felineus, Metorchis conjunctus, M. bilis, M. orientalis, Fasciola hepatica, F. gigantica, Dicrocoelium dendriticum, and D. hospes), lung flukes (Paragonimus westermani, P. heterotremus, P. skrjabini, P. miyazakii, P. kellicoti, P. mexicanus, P. africanus, and P. uterobilateralis), throat fluke (Clinostomum complanatum), pancreatic fluke (Eurytrema pancreaticum), and intestinal flukes (Metagonimus yokogawai, M. miyatai, M. takahashii, Heterophyes nocens, H. heterophyes, Haplorchis taichui, H. pumilio, H. yokogawai, Centrocestus formosanus, Echinostoma revolutum, E. ilocanum, Isthmiophora hortensis, Echinochasmus japonicus, E. lilliputanus, Artyfechinostomum malayanum, A. sufrartyfex, A. oraoni, Fasciolopsis buski, Gymnophalloides seoi, Neodiplostomum seoulense, Caprimolgorchis molenkampi, Phaneropsolus bonnei, and Plagiorchis muris). The mode of transmission to humans includes contact with cercariae contaminated in water (schistosomes) and ingestion of raw or improperly cooked fish (liver and throat flukes, heterophyids, and echinostomes), snails (echinostomes and gymnophallids), amphibia, reptiles (neodiplostomes), aquatic vegetables (amphistomes), or insect larvae or adults (plagiorchiids, lecithodendriids, and pancreatic fluke). Praziquantel has been proved to be highly effective against most species of trematode infections except fascioliasis. Epidemiological surveys and detection of human infections are required for better understanding of the geographical distribution and endemicity of each trematode species.

A case report on the gallbladder fluke, Euparadistomum herpestesi (Trematoda: Dicrocoeliidae), in stray cats (Felis catus) in Beni-Suef, Egypt

Scarce literature studying parasites, particularly helminths, of gallbladder of cats in Egypt are available. Stray cats (Felis catus) are widespread in Beni-Suef, Egypt. Therefore, a total of 62 stray cats were necropsied and parasitologically examined. Three (4.84%) cats harboured an ovoid yellowish to brown flukes in the gallbladder. Infected cats were females and aged more than 3 years. The worm burden ranged 1-3 (one cat harboured 3 flukes and the other 2 cats were infected by one fluke each). Moreover, Mixed infections with intestinal cestodes and/or nematodes were detected. The fluke is quite discoid measuring 7.75 × 3.25 mm. The oral sucker measured 1 mm in diameter. The acetabulum was nearly central, rounded and measured 0.75 mm in diameter. Short pharynx (no prepharynx). Two broad intestinal ceca extending short distance from the posterior extremity of the fluke. Testes are ovoid, opposite to each other occupying the anterior half, each measured 0.25 mm in diameter. The ratio of testes to the acetabulum is characteristically 1:2. Ovary was somewhat ovoid, measured 0.3 × 0.45 mm, and attached to it a large dorsal chamber of receptaculum seminis measuring 0.58 × 0.52 mm. Vitellaria extended from the level of testes along the length of intestinal caeca or somewhat shorter than length of them. Uterus consisted of several coils occupying the entire area behind the oral sucker. Based on those criteria, the recovered flukes might be identified as Euparadistomum herpestesi. To the best of authors' knowledge and based on the microscopic identification, it is the first preliminary report denoting the existence of the gallbladder flukes, E. herpestesi, from stray cats in Beni-Suef, Egypt.

Molecular Genetic Findings of Spirometra decipiens and S. ranarum in Korea

The taxonomy of Spirometra species has been controversial despite the medical and veterinary importance. Currently, only a few Spirometra species are considered valid species in the genus Spirometra. In the present study, the distribution of Spirometra species obtained from animals in Korea were identified by molecular analysis of the mitochondrial cytochrome c oxidase I (cox1) gene. A total of 28 Spirometra species specimens were analyzed. These were all collected between 1973 and 2008 in the Republic of Korea. Mitochondrial cox1 sequences were examined for a total of 28 specimens comprising 14 S. decipiens and 14 S. ranarum. The difference in partial cox1 sequences (316 bp) between S. erinaceieuropaei (KJ599680) and S. ranarum (this study) was 9.3%, while that between S. decipiens (KJ599679) and S. ranarum (this study) was 2.2%. Genetic analyses identified 2 Spirometra species in animals such as cat, leopard cat, dog, duck and snake in Korea as S. decipiens and S. ranarum. S. decipiens and S. ranarum were present in Gyeongnam Province (P), Jeonnam P, Gangwon P, Chungbuk P, and Seoul. S. decipiens was found in tadpoles, snakes, ducks, cats, leopard cats and dogs, while S. ranarum was found in cats and dogs. The ratio of S. decipiens:S. ranarum calculated from the molecular data was 14:14 (or 1:1). These results indicate that S. decipiens and S. ranarum are sympatrically distributed in Korea.

Infections with Centrocestus armatus Metacercariae in Fishes from Water Systems of Major Rivers in Republic of Korea

The infection status of Centrocestus armatus metacercariae (CaMc) was broadly surveyed in freshwater fishes from major river systems in the Republic of Korea (Korea) during 2008–2017. A total of 14,977 fishes was caught and examined by the artificial digestion method. CaMc were detected in 3,818 (97.1%) (2,114 Z. platypus: 96.1% and 1,704 Z. temminckii: 98.4%) out of 3,932 Zacco spp. examined and their density was 1,867 (2,109 in Z. platypus and 1,567 in Z. temminckii) per fish infected. The prevalences with CaMc were high, 93.7–100%, in Zacco spp. from all surveyed areas. However, their densities were more or less different by the surveyed areas and fish species. They were most high in Nakdong-gang in Gyeongsangnam-do (4,201 in average), and followed by Geum-gang (2,343), Nakdong-gang in Gyeongsangbuk-do (1,623), Han-gang (1,564), Tamjin-gang and Yeongsan-gang (1,540), streams in the east coast (1,028), Seomjin-gang (488) and Mangyeong-gang (170). In another species of rasborinid fish, Opsariichthys uncirostris amurensis, CaMc were detected in 222 (74.8%) out of 297 ones examined and their density was 278 (1–4,480) per fish infected. CaMc were also detected in total 41 fish species except for the rasborinid fish, Z. platypus, Z. temminckii and O. uncirostris amurensis. Conclusively, it was confirmed that among the 3 species of rasborinid fish, Z. platypus and Z. temminckii are highly prevalent and O. uncirostris amurensis is moderately prevalent with CaMc. Additionally, we could know that variety of fish species act as the second intermediate hosts of C. armatus in Korea.

Spirometra decipiens (Cestoda: Diphyllobothriidae) Collected in A Heavily Infected Stray Cat from the Republic of Korea

Morphological and molecular characteristics of spirometrid tapeworms, Spirometra decipiens, were studied, which were recovered from a heavily infected stray cat road-killed in Eumseong-gun, Chungcheongbuk-do (Province), the Republic of Korea (=Korea). A total of 134 scolices and many broken immature and mature proglottids of Spirometra tapeworms were collected from the small intestine of the cat. Morphological observations were based on 116 specimens. The scolex was 22.8–32.6 mm (27.4 mm in average) in length and small spoon-shape with 2 distinct bothria. The uterus was coiled 3–4 times, the end of the uterus was ball-shaped, and the vaginal aperture shaped as a crescent moon was closer to the cirrus aperture than to the uterine aperture. PCR amplification and direct sequencing of the cox1 target fragment (377 bp in length and corresponding to positions 769–1,146 bp of the cox1 gene) were performed using total genomic DNA extracted from 134 specimens. The cox1 sequences (377 bp) of the specimens showed 99.0% similarity to the reference sequence of S. decipiens and 89.3% similarity to the reference sequence of S. erinaceieuropaei. In the present study, we report a stray cat heavily infected with S. decipiens identified by mitochondrial cox1 sequence analysis and morphological examinations of the adult worms.

Reservoir Animals and Their Roles in Transmission of Opisthorchis viverrini

Although any fish-eating mammals could be potential definitive hosts of Opisthorchis viverrini, only a few, especially cats and dogs, are actually known reservoir hosts for this parasite. Both animals usually get infected via consuming raw or undercooked contaminated fish, fish dishes or food remains from households. The infected animals sustain parasite egg spread via open environment defecation. Cats are the most important reservoir with higher prevalence rates of O. viverrini infection than dogs in endemic areas. Usually Opisthorchis-infected animals do not exhibit apparent clinical symptoms or specific abnormalities in laboratory examinations. Pathological findings in these animal reservoirs are basically similar to those seen in humans and experimental animals, namely periductal inflammation, biliary hyperplasia and periductal fibrosis. However, O. viverrini-associated cholangiocarcinoma has not yet been reported in the reservoir animals at present. Praziquantel is a treatment of choice not only for humans but also for animal reservoirs. Integrated control of opisthorchiasis in animal reservoirs is based on holistic approaches such as EcoHealth/One Health concepts. In fact integrated control of opisthorchiasis in humans in ecosystem has also proved successful, for example, the Lawa model for opisthorchiasis control in the endemic area of Khon Kaen, Thailand. Other feral and wild animals in endemic areas might also be potential reservoirs, and this requires more investigation. In addition, genetic diversity and evolution of the flukes might also influence zoonotic capability.

Fishborne zoonotic heterophyid infections: An update

Fishborne heterophyid trematodes infecting humans are at least 29 species worldwide and belong to 13 genera. Its global burden is much more than 7 million infected people. They include Metagonimus (M. yokogawai, M. takahashii, M. miyatai, M. minutus, and M. katsuradai), Heterophyes (H. heterophyes, H. nocens, H. dispar, and H. aequalis), Haplorchis (H. taichui, H. pumilio, H. yokogawai, and H. vanissimus), Pygidiopsis (P. summa and P. genata), Heterophyopsis (H. continua), Stellantchasmus (S. falcatus), Centrocestus (C. formosanus, C. armatus, C. cuspidatus, and C. kurokawai), Stictodora (S. fuscata and S. lari), Procerovum (P. varium and P. calderoni), Acanthotrema (A. felis), Apophallus (A. donicus), Ascocotyle (A. longa), and Cryptocotyle (C. lingua). Human infections are scattered around the world but the major endemic areas are located in Southeast Asia. The source of human infection is ingestion of raw or improperly cooked fish. The pathogenicity, host-parasite relationships, and clinical manifestations in each species infection are poorly understood; these should be elucidated particularly in immunocompromised hosts. Problems exist in the differential diagnosis of these parasitic infections because of close morphological similarity of eggs in feces and unavailability of alternative methods such as serology. Molecular diagnostic techniques are promising but they are still at an infant stage. Praziquantel has been proved to be highly effective against most of the patients infected with heterophyid flukes. Epidemiological surveys and detection of human infections are required for better understanding of the geographical distribution and global burden of each heterophyid species. In this review, the most updated knowledge on the morphology, biology, epidemiology, pathogenesis and pathology, immunology, clinical manifestations, diagnosis and treatment, and prevention and control of fishborne zoonotic heterophyid infections is provided.

Complete Mitochondrial Genome of Echinostoma hortense (Digenea: Echinostomatidae)

Echinostoma hortense (Digenea: Echinostomatidae) is one of the intestinal flukes with medical importance in humans. However, the mitochondrial (mt) genome of this fluke has not been known yet. The present study has determined the complete mt genome sequences of E. hortense and assessed the phylogenetic relationships with other digenean species for which the complete mt genome sequences are available in GenBank using concatenated amino acid sequences inferred from 12 protein-coding genes. The mt genome of E. hortense contained 12 protein-coding genes, 22 transfer RNA genes, 2 ribosomal RNA genes, and 1 non-coding region. The length of the mt genome of E. hortense was 14,994 bp, which was somewhat smaller than those of other trematode species. Phylogenetic analyses based on concatenated nucleotide sequence datasets for all 12 protein-coding genes using maximum parsimony (MP) method showed that E. hortense and Hypoderaeum conoideum gathered together, and they were closer to each other than to Fasciolidae and other echinostomatid trematodes. The availability of the complete mt genome sequences of E. hortense provides important genetic markers for diagnostics, population genetics, and evolutionary studies of digeneans.

Trematode Metacercariae in Freshwater Fish from Water Systems of Hantangang and Imjingang in Republic of Korea

The infection status of freshwater fish with digenetic trematode metacercariae was examined in water systems of Hantangang and Imjingang (River), the Republic of Korea. A total of 877 (594 from Hantangang and 283 from Imjingang) fishes were examined by the artificial digestion methods. Clonorchis sinensis metacercariae were detected in 7 (1.2%) fishes (in 3 spp.) from Hantangang in Cheorwon-gun, Gangwon-do, and 40 (14.1%) fishes (in 7 spp.) from Munsancheon in Paju-si, Gyeonggi-do. The average densities were 1.9 and 35.6 per fish infected, respectively. Metagonimus spp. metacercariae were detected in 312 (52.5%) and 113 (39.9%) fishes from Hantangang and Imjingang, and their average densities were 47.5 and 9.6 per fish infected, respectively. Centrocestus armatus metacercariae were found in 161 (27.1%) and 70 (24.7%) fishes from Hantangang and Imjingang, and their average number per fish infected was 694 and 82, respectively. Echinostoma spp. metacercariae were detected in 50 (8.4%) and 94 (33.2%) fishes from Hantangang and Imjingang, and their average densities were 9.6 and 23.1 per fish infected, respectively. The infection status of fishes with metacercariae of Stephanoprora spp., Diplostomum spp., Clinostomum complanatum, Metorchis orientalis, and Metorchis taiwanensis were analyzed by surveyed regions. Conclusively, it was confirmed that C. sinensis metacercariae were quite commonly detected in fishes from Munsancheon but rarely from other localities, whereas the metacercariae of other digenetic trematodes were relatively prevalent in fishes from water systems of Hantangang and Imjingang in Korea.

Potential Zoonotic Trematodes Recovered in Stray Cats from Kuwait Municipality, Kuwait

Stray cats are a common feature roaming the streets and alleys of Kuwait; they could be a source of parasites, including trematodes, that affect humans. A survey was conducted to identify feline trematodes and throw the light on their public health significance in Kuwait. Out of 240 stray cats trapped from different localities of Kuwait from June 2011 to May 2012, 59 (24.6%) were found to be infected with 14 species of trematodes. The most common were trematodes of the genus Heterophyes, particularly H. heterophyes and H. dispar that were found in respectively 15.8% and 10.8% of the cats examined. Other trematodes recorded, with lower prevalences, were Heterophyes nocens (2.9%), Haplorchis taichui (3.8%), Stictodora sawakinensis (2.1%), Stellantchasmus falcatus (1.6%), Echinochasmus japonicus (1.6%), and Mesostephanus dottrensi (1.3%). Centrocestus cuspidatus, Galactosomum fregatae, Ascocotyle sp., Mesostephanus appendiculatus, Haplorchis yokogawai, and Pygidiopsis genata showed the lowest prevalence (0.4%) and intensity. The majority of the trematodes are recorded for the first time in Kuwait and even in the Gulf region. The study reveals that stray cats are good indicators of fish-borne trematodes in the environment. As all trematodes recovered are zoonotic, their significance to public health should be considred.

Zoonotic Intestinal Trematodes in Stray Cats (Felis catus) from Riverside Areas of the Republic of Korea

The present study was performed to survey the infection status of zoonotic intestinal trematode (ZIT) in stray cats from 5 major riverside areas in the Republic of Korea. Total 400 stray cats were captured with live-traps in riverside areas of Seomjingang ('gang' means river) (203 cats) from June to October 2010, and of Yeongsangang (41), Nakdonggang (57), Geumgang (38), and Hangang (61 cats) from June to October 2011, respectively. Small intestines resected from cats were opened with a pair of scissors in a beaker with 0.85% saline and examined with naked eyes and under a stereomicroscope. More than 16 ZIT species were detected in 188 (92.6%) cats from Seomjingang areas, and the number of worms recovered was 111 per cat infected. In cats from riverside areas of Yeongsangang, Nakdonggang, Geumgang, and Hangang, more than 9, 8, 3, and 5 ZIT species were recovered, and the worm burdens were 13, 42, 11, and 56 specimens per infected cat, respectively. As the members of family Heterophyidae, more than 10 species, i.e., Metagonimus spp., Pygidiopsis summa, Heterophyes nocens, Stellantchasmus falcatus, Heterophyopsis continua, Acanthotrema felis, Centrocestus armatus, Procerovum varium, Cryptocotyle concava, and Stictodora lari, were recovered. More than 5 species of echinostomes, i.e., Echinostoma hortense, Echinochasmus japonicus, Echinochasmus sp., Echinoparyphium sp., and unidentified larval echinostomes, were collected. Plagiorchis spp. were detected in cats from areas of Seomjin-gang and Yeongsangang. From the above results, it has been confirmed that stray cats in 5 major riverside areas of Korea are highly infected with various species of ZITs.