Background & Objective: Symptomatic sarcocystosis has been said to be rare until recent years, when there were reports of outbreaks of febrile myositis for travellers returning from the Malaysian island resorts. In 2012, an outbreak of Sarcocystis nesbitti infection involving 92 college students and staff occurred after returning from Pangkor Island, Malaysia. A few months after recovering from the febrile illness, some patients complained of hair loss. This study aimed to determine the prevalence, clinical features and outcome of this disorder. Methods: All patients who became sick in the outbreak were asked whether they had the hair loss. For those who had, they were interviewed with standard questionnaires, examined and investigated. Patients were followed-up via an online survey 2 years later. Results: Out of 89 patients who were ill, 19 patients (21.4%) complained of alopecia. The mean peak onset was 4 months after the initial illness. Eleven patients (57.9%) reported the hair fall of more than 100 per day. The other symptoms were itch 10 (52.6%), scaling 10 (52.6%), erythema 4 (21.1%), none had scarring. Eleven patients (57.8%) had positive antinuclear factor with high titre (speckled or nucleolar pattern). Two years after the event, 10 had complete or near complete spontaneous recovery, 1 had partial response and 1 had no improvement. Conclusions: A delayed transient diffuse alopecia is seen in close to half of patients with Sarcocystis nesbittiinfection. This high frequency of positive ANF suggested an immune-mediated mechanism.
Sarcocystosis

Sarcocystis spp is a causative agent of sarcocystosis. They have a characteristic life cycle infecting both prey and predator. Sarcocystis can cause myositis, atrophy of the adjacent cells and abortion in cattle. In mice, sarcocystosis causes mild cellular reactions without clinical disease. Severe haemorrhage and abortion were also reported. For monitoring the disease in wild rodents of the Korean peninsula, we captured Apodemus agrarius chejuensis on Jeju island and examined the specimen histopathologically. Intramuscular cysts were found and diagnosed as Sarcocystis. Sarcocystic infection has been reported in worldwide. There have been many reported infections in cattle and pigs in Korea. To our knowledge, this is the first report of Sarcocystis in Apodemus agrarius chejuensis captured in Korea.
Animals ; Atrophy ; Cattle ; Korea ; Life Cycle Stages ; Mice ; Murinae ; Myositis ; Rodentia ; Sarcocystis ; Sarcocystosis ; Swine

The prevalence of Sarcocystis spp. was investigated by gross and histopathological examinations in 250 camels (Camelus dromedarius) slaughtered from 2002 to 2005 in the Mashhad Slaughterhouse, eastern Iran. Samples were taken from the diaphragm, heart, tongue, esophagus and masseter muscles for histopathological studies. No macroscopic sarcocysts were found in the samples at gross inspection. Sarcocysts were detected in 209 of 250 (83.6%) examined camels at histopathological level. The infection rate of the esophagus, heart, masseter muscles, diaphragm, and tongue was 58.8%, 48.0%, 46.8%, 41.6%, and 28.0%, respectively. There was no significant difference in the rate of infection between male (85.8%) and female (81.0%) camels. The tissue response to vital cysts was minimal; however, reaction to the degenerating cysts was severe and caused tissue damages resulting in hyperemia, hemorrhages, mononuclear cell infiltration, necrotic changes, and fibrosis. The wild and domestic carnivores especially dogs may be the final hosts of Sarcocystis spp. in this area.
Animals ; *Camels ; Esophagus/parasitology ; Female ; Heart/parasitology ; Iran/epidemiology ; Male ; Muscle, Skeletal/parasitology ; Prevalence ; Sarcocystis ; Sarcocystosis/complications/epidemiology/*veterinary

Eight dogs were experimentally infected with Sarcocystis by oral inoculation of cardiac muscle from naturally infected cattle. The infected dogs commenced discharging of sporocysts in the feces after 10 to 12 days of inoculation, and continued until 20 and 35 days after inoculation. Three dogs were reinfected with cardiac muscle from the naturally infected cattle. Sporocysts reappeared in the feces on 12 to 13 days after reinfection. Sarcocystis sporocysts collected from the experimentally infected dogs were fed to each of the two 30-day-old Korean native calves. The infected calves remained clinically normal, except for the high fever (> or = 40 degrees C) and decreased hematocrit values on day 30 to 40 post inoculation. Muscular cysts of Sarcocystis were found from infected calves on day 40 post inoculation. Proliferative forms of Sarcocystis were also observed in the muscle of infected calves. These results suggest that the Sarcocystis cruzi found in Korean native cattle has a 2-host life cycle with dogs as the definitive host and Korean native calves as the intermediate host.
Animals ; Cattle ; Cattle Diseases/*parasitology ; Dog Diseases/*parasitology ; Dogs/*parasitology ; Host-Parasite Relations ; Korea ; *Life Cycle Stages ; Sarcocystis/*growth & development/isolation & purification ; Sarcocystosis/*parasitology/*veterinary

Sarcocystis sp. infection was investigated in 20 necropsied captive wild mammals and 20 birds in 2 petting zoos in Malaysia. The gross post-mortem lesions in mammals showed marbling of the liver with uniform congestion of the intestine, and for birds, there was atrophy of the sternal muscles with hemorrhage and edema of the lungs in 2 birds. Naked eye examination was used for detection of macroscopic sarcocysts, and muscle squash for microscopic type. Only microscopically visible cysts were detected in 8 animals and species identification was not possible. Histological examination of the sections of infected skeletal muscles showed more than 5 sarcocysts in each specimen. No leukocytic infiltration was seen in affected organs. The shape of the cysts was elongated or circular, and the mean size reached 254 x 24.5 micrometer and the thickness of the wall up to 2.5 micrometer. Two stages were recognized in the cysts, the peripheral metrocytes and large numbers of crescent shaped merozoites. Out of 40 animals examined, 3 mammals and 5 birds were positive (20%). The infection rate was 15% and 25% in mammals and birds, respectively. Regarding the organs, the infection rate was 50% in the skeletal muscles followed by tongue and heart (37.5%), diaphragm (25%), and esophagus (12.5%). Further ultrastructural studies are required to identify the species of Sarcocystis that infect captive wild animals and their possible role in zoonosis.
Animals ; Animals, Wild/*parasitology ; Animals, Zoo/*parasitology ; Cell Size ; Malaysia/epidemiology ; Muscle, Skeletal/pathology ; Sarcocystis/cytology/growth & development/*isolation & purification ; Sarcocystosis/epidemiology/parasitology/*veterinary

The present study surveyed the prevalence of natural infection of the sheep esphagus muscle with sarcocysts of Sarcocystis ovicanis and examined induction of protective immunity using UV-attenuated sporocysts. The overall prevalence of natural infection of the sheep was 95%. Infectivity of the collected sarcocysts was confirmed by shedding of sporulated oocysts after feeding infected esophageal tissues to dogs. To induce protective immunity, lambs were immunized 3 times (once a week) with 1.5 x 10(4) sporocysts exposed to UV-light for 30 min (UV-30 group) or 60 (UV-60 group) min and then challenged with 1.5 x 10(4) normal sporocysts at the 3rd week post the 1st vaccination. These lambs showed high survival and less clinical signs of sarcocystosis than normal infected lambs. The attenuated sporocysts produced abnormal cysts; small in size and detached from the muscle fiber. These abnormalities were more obvious in UV-60 group than UV-30 group. Also, the IFN-gamma level and lymphocyte percentage were increased while the total leukocyte count was decreased in the UV-60 group compared with other groups. The high level of IFN-gamma may be an evidence for the induction of Th1 responses which may have protective effect against a challenge infection.
Animals ; Dogs ; Esophagus/parasitology ; Feces/parasitology ; Interferon-gamma/secretion ; Lymphocytes/immunology ; Oocysts/*immunology ; Peptide Fragments/secretion ; Prevalence ; Protozoan Vaccines/immunology ; Sarcocystis/cytology/*immunology/*radiation effects ; Sarcocystosis/epidemiology/immunology/prevention & control/*veterinary ; Severity of Illness Index ; Sheep/immunology/parasitology ; Sheep Diseases/immunology/*prevention & control ; Survival Analysis ; *Ultraviolet Rays ; Vaccines, Attenuated/immunology