This survey was undertaken to determine the recent prevalence of lung fluke, Paragonimus westermani, in the three localities of Wiseong county, Kyungpook Province, Korea and to compare the prevalence among the residents in the same areas between 1924 and 1980. The three localities, Ku-seong, Sam-chun, and Um-ji villages (dong) have been known as the endemic areas of Paragonimus westermani. The surveys were made on the general population. They were examined using intradermal test with Paragonimus westermani antigen, and the diagnosis of paragonimiasis was made depending on the positive intradermal reaction. The sputum examination could not be performed beacause the residents were inaccessible. The prevalence of Paragonimus westermani among the residents in the three communities varied from 1.4 percent to 7.9 per cent, with an average of 4.0 per cent. Whereas, the average reported by Ichinomiya in 1924 was 4.7 percent. There are no significant differences in the sex and age specific rates of infection between 1924 and 1980. With the abundant density of Semisulcospira snails and crayfish in Sam-chun stream and the high rate of infection with Paragonimus westermani among the residents in the village, it is found that Sam-chun village, one of the three localitied in Wiseong county, where Ichinomiya (1924) surveyed, was still the endemic focus of Paragonimus westermani.
parasitology-helminth-trematoda ; Paragonimus westermani ; paragonimiasis ; epidemiology

This study was undertaken to evaluate the status of human paragonimiasis in Kang Hwa Gun, Kyunggi Do, Korea from March 1973 to October 1975 by the use of intradermal screening test with Veronal buffered saline antigen. A total number of 7,352 (male 3,936; female 3,4l6) consisting of 3,447 primary school children, 2,689 middle school students, l,008 high school students of 9 Myuns out of 13 Myuns of this County and 208 residents of all age group in Kilgeong-Ri, Yangdo Myun were examined by the intradermal test with Paragonimus antigen. In order to detect Paragonimus egg, the sputum and the stool examinations were undertaken on the residents in Kilgeong-Ri. The infestation rate of crayfish with Paragonimus metacercaria was also examined in Konneung and Jeongha village in Kilgeong-Ri. The following results were obtained in this survey: As a whole, 16.6 per cent of the examiners showed positive reaction with sexual difference of 16.1% in male and 14.8 per cent in female. In age groups, the highest positive rate showed in middle school age group (17.1 per cent) than primary school (14.0 per cent) and high school age group (11.4 per cent). In regional differences of positive rates, the highest rate (28.4 per cent) showed at Yangdo Myun followed by Kilsang Myun (27.0 per cent), Hwado Myun (25.0 per cent), and Naega Myun(20.8 per cent). In the result of 208 residents Kilgeong-Ri, the positive of 36.1 per cent in male and 20.2 per cent in female. The highest positive rate showed in 10 to 19 age group (41.5 per cent). Among the residents in Kilgeong-Ri, Paragonimus eggs were detected in 11 residents by the sputum and the stool examinations. The infestation rate of crayfsh with Paragonimus metacercariae was 100 per cent (41 out of 41 crayfishes) in Konneung village, and 84.6 per cent (9 out of 13 crayfishes) in Jeongha village, Kilgeong-Ri The fluctuation of the infection rate of crayfish with Paragonimus metacercariae was decreased in Konneung village in 2 years after the treatment with Bilevon against 10 paragonimiasis patients.
parasitology-helminth-trematoda ; epidemiology-paragonimiasis ; Paragonimus westermani ; crayfish-Cambaroides similis

parasitology-helminth-trematoda ; Paragonimus westermani ; paragonimiasis ; ELISA ; immunology

As epidemiological parameters of human paragonimiasis, the positive rates of intradermal test and the sputum/stool examination have long been employed in population surveys. However, both the specificity of the intradermal test and the sensitivity of sputum/stool examination have been gradually declined as the endemicity was lowered; thus the gap between above two parameters widened. In such context, the development of a new epidemiological parameter or tool which makes it possible to accurately discriminate the active paragonimiasis cases was necessary. In the present study, the detection rate of Paragonimus-specific IgG antibody by micro-ELISA was evaluated as an indicator of epidemiologic status of human paragonimiasis in a population. A total of 4,285 students and inhabitants living in Bukpyeong Myeon and Bukil Myeon, Haenam Gun, Jeonlanam Do was surveyed in October 1983 by intradermal test first. Out of them, 244 case (5.7 percent) were found positively reacted to VBS antigen of P. wetermani. Out of 168 positive reactors, 7 cases (4.2 percent) were egg positive either by two times of sputum examination or by one stool examination. That indicated that only 0.16 percent of total surveyed were confirmed as active paragonimiasis by egg detection. When sera collected from 239 positive reactors of intradermal test were tested by micro-ELISA for their specific IgG antibody, 40 cases (16.7 percent) were found to be positive. All of 7 eggs positive cases were again positive for specific IgG antibody. Among remaining 232 intradermal test positive cases, 33 cases were positive for IgG antibody. In contrast to those, none of 42 positive reactors to intradermal test for Clonorchis and of 128 intradermal test negative cases showed positive for Paragonimus- specific IgG antibody. The rate of specific IgG antibody as detected by micro-ELISA appeared to be increased with the wheal size of the intradermal test. When the wheal size was over 13 mm in diameter, about 50 percent of them were positive for specific IgG antibody. Thirty-one specific antibody positive cases were clinically evaluated by laboratory examinations (repeated sputum examination, peripheral eosinophil count and chest roentgenogram) and by history taking. Out of them 24 cases were associated with one or more positive laboratory findings; thus considered as active paragonimiasis cases. Out of 7 lab. finding-free cases 3 revealed past history of typical paragonimiasis symptoms, suggesting that they were in chronic or in convalescent stages. The remaining 4 cases were considered as either mild or ectopic infection cases; the possibility of cross-reaction with other helminthiases could not be ruled out. From the above results, it was inferred that the detection of Paragonimus-specific IgG antibogy by micro-ELISA was very much helpful in detecting the active cases as well as in proper evaluation of the endemicity of human paragonimiasis in a population. The convenience of mass handling of sera in micro-ELISA was considered another superiority as an epidemiologic tool.
parasitology-helminth-trematoda ; Paragonimus westermani ; paragonimiasis ; ELISA ; immunology ; diagnosis ; IgG

A case of Paragonimus westermani cysts found deep inside the spleen is described. This spleen was from a dog that was experimentally infected via oral route with a hundred metacercariae and was killed 3 months after. At autopsy, beside the usual lesions due to Paragonimus in the lungs, the spleen was the site of multiple parasitic cysts. The involved spleen was slightly enlarged and showed an area of hemorrhagic dome on the capsular surface. There found a total of 8 adult worms in four well demarcated parasitic cysts containing a pair of worms each. All of them were found deep into the splenic parenchyme and were surrounded by a well formed connective tissue wall, thus resembling the features of the pulmonary paragonimiasis. The route of infection was assumed to be a direct transcapsular invasion during the phase of larval migration.
parasitology-helminth-trematoda ; paragonimiasis ; Paragonimus westermani ; dog ; case report ; spleen

A total of 52 paragonimiasis patients was treated with praziquantel at three dose levels: 21 patients received 3 x 25.0 mg/kg bwt on a single day, 21 patients were treated with 3 x 25.0 mg/kg for 2 consecutive days and 10 patients were treated with the same dose for 3 consecutive days. Follow-up examination were carried out at monthly up to 4 months (120 days) after treatment. Fifteen (71.4%) out of 21 patients who received the drug 3 x 25.0 mg/kg bwt on a single day were parasitologically cured. Eighteen (85.7%) out of 21 patients who received 3 x 25.0 mg/kg bwt for 2 consecutive days were also cured. Six and 3 of uncured cases in each above groups were treated again with doses of 3 x 25.0 mg/kg bwt for 2 or 3 consecutive days. Two (consisting each one in each group ) of nine retreated cases were failed in parasitological cure. Therefore the overall cure rates of 95.2 % (20 out of 21 cases) in each group were finally obtained. On the other hand, in 10 patients who received 3 x 25.0 mg/kg bwt for 3 consecutive days, complete cure was obtained at 4 months follow-up examinations. Praziquantel is well tolerated and side effects consist particularly of mild and transient headache and dizziness. There was no great difference between the three dosage groups. Extended hematological and biochemical tests, and urinalysis, revealed no abnormal findings which could be related to the compound after therapy. The disappearance of precipitating bands of immunoelectrophoresis together with the disappearance of abnormal shawdows in chest X-ray after treatment gave a potent proof on assuring the cure of paragonimiasis.
parasitology-helminth-trematoda ; chemotherapy ; praziquantel ; paragonimiasis ; Paragonimus westermani

In order to understand the effect of prednisolone injection on the immune responses of albino rat against Paragonimus iloktsuenensis infection, the differential leucocyte counts, appearance of immunoblast (large pyroninophilic cell, LPC) in the spleen and lungs in various experimental groups were observed in relation with the growth, maturation and migration sites of this rodent lungfluke. Rats of 3 experimental groups (A series), each group consisted of 5 rats, were infected with 20 metacercariae of P. iloktsuenensis, and they were kept for 3 days(Group I), 3 weeks(Group II), and 4 weeks (Group III) of infection period. The same number of experimental groups, each group of rats received 10 mg/kg dose of prednisolone injection every other day, were also kept and examined in comparison with the former groups. Preparation of peripheral blood smear and collection of worms were completed immediately after the end of infection period, and they were stained with Giemsa or Semichon's acetocarmine. Paraffin sections of the spleen and the lung tissues were stained with hematoxylin-eosin and methyl green pyronin (MGP). Those materials from A and B series of experimental groups were examined under the light microscope, and the results obtained were as follows: On observing differential leucocyte counts of peripheral blood smear, lymphocyte counts were consistently higher than those of uninfected controls in A series of infected groups, while those of B series were consistently low. On the other hand, neutrophil counts of A series showed lower counts than those of B series. In general, fluctuation patterns of both A and B series of experimental groups were almost the same, although lymphocyte and neutrophil counts showed reciprocal relation. The eosinophil counts of both series were negligible, especially in the groups of B series. The counts of LPC in the periarterial lymphatic sheath of the spleen were rapidly increased in the groups of A series, while those of B series were much less than those of A series, and the appearance of considerable LPC in the spleen was also delayed in B series. Furthermore, LPC of peribronchial lymphatic tissue in A series started to increase after the invasion of lungflukes into the lungs, while those of B series were much less due to the inhibited migration of lymphocytes into the lesions. Number, size and maturity of collected worms showed no significant differences between the groups of A and B series, but migration speed of the lungflukes was somewhat accelerated in B series than in A series. In this connection, it was considered that the immune responses of albino rats did not contribute for the complete protection against P. iloktsuenensis, but inhibited the migration of this lungfluke to some extent.
parasitology-helminth-trematoda ; Paragonimus iloktsuenensis ; paragonimiasis ; immunology ; prednisolone

The present study investigated the infection status of Paragonimus westermani metacercariae in freshwater crabs (n = 363) and crayfish (n = 31) from October 2007 to October 2008 using the crush method. All of the freshwater crabs, Eriocheir japonicus, were negative for P. westermani metacercariae while 10 (32.3%) of the 31 examined crayfish were positive. The 10 positive crayfish were caught in Haenam, Jeollanam-do, and there were 8-59 (mean 28.4) metacrcariae per infected crayfish. These results suggest that P. westermani metacerariae are still transmitted by crayfish enzootically in southern Korea, and that freshwater crabs may transmit metacercariae only on rare occasions.
Animals ; Astacoidea/*parasitology ; Brachyura/*parasitology ; Humans ; Korea/epidemiology ; Paragonimiasis/epidemiology/parasitology/*veterinary ; Paragonimus westermani/*isolation & purification ; Prevalence

Paragonimus harinasutai metacercariae were found in a species of freshwater crab, Indochinamon ou, collected in a small stream of Namback District, Luang Prabang Province, Lao PDR. Adult flukes were recovered after experimental infection of the metacercariae to dogs. Metacercariae were round or slightly elliptical, 0.666 x 0.626 mm in average size, and had a thin cyst wall of about 20 microm in thickness, a black excretory bladder, convoluted ceca, and some pinkish materials in the body. Adults were somewhat elongated, 95.2 x 36.5 mm in average size, covered with single-tipped tegumental spines, had a smaller oral sucker than the ventral sucker, a moderately branched ovary, and 5-6 lobulated testes. Eggs were ovoid and bilaterally symmetrical in shape, 79 x 45 microm in average size, and had a uniformly thickened shell. By the present study, it has been confirmed that I. ou is a new second intermediate host for P. harinasutai.
Animals ; Crustacea/*parasitology ; Disease Reservoirs/*parasitology ; Dogs ; Female ; *Host-Parasite Interactions ; Humans ; Laos ; Male ; Paragonimiasis/*parasitology ; Paragonimus/anatomy & histology/*isolation & purification/ultrastructure ; Shellfish/*parasitology

Human paragonimiasis was endemic in Korea until the 1960's, and nowadays, the prevalence is decreasing. However, it is still one of the important helminthic diseases. Though it is essentially a pulmonary disorder, it may involve brain, muscle, mesentery, genital tract, pleura, peritoneum, spinal cord, spleen, and liver. We experienced two cases of paragonimiasis in a family who had ingested raw crabs together for 7 months. A 57-year-old female patient was admitted due to abdominal pain, diarrhea and tenesmus for 6 months. And, her 35-year-old son complained of cough, chest discomfort and dyspnea. The definite diagnosis for paragonimiasis could be made by the detection of the egg and adult worm from stool, sputum and involved lesion. Neither an egg or worm was detected. However, they were diagnosed based on the food history, laboratory data including serum eosinophilia, ELISA for specific IgG, pleural and peritoneal fluid examination, radiological findings, and intradermal tests. They were treated with praziquantel and their symptoms improved rapidly over 2 days. Both patients were asympromatic at a follow-up visit 2 months later.
Adult ; Animals ; Crustacea/parasitology ; Family Health ; Humans ; Male ; Paragonimiasis/complications/*diagnosis/transmission ; *Paragonimus westermani ; Peritonitis/*complications/diagnosis/parasitology ; Pleurisy/*complications/diagnosis/parasitology ; Shellfish/parasitology