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Diphyllobothriosis humana por infección por Diphyllobotrhium pacificum en un niño de 3 años en Antofagasta, Chile: infection in a 3 year old boy in Antofagasta, Chile
Abstract
Diphyllobothriosis is a zoonosis related to the consumption of crude or inadequately cooked sea or freshwater fish. We report a case of diphyllobothriosis caused by D. pacificum diagnosed in a 3 year old boy in the city port of Antofagasta in the north of Chile. The patient expelled one strobile of 55cm from which a morphometric study of proglotids and eggs demonstrated that it was a specimen of D. pacificum. He was treated with praziquantel but neither new strobiles or eggs were expelled. Haematological studies did not show any abnormalities. None of the family group were infected. Our finding is interesting in that among 16 cases documented in Chile, 3 correspond to children between 3 and 7 years
... Other risk factors associated with infection are occupation, age and gender (Guttowa, 1970;Adams and Rausch, 1997;Sagua et al., 2000). Although infection rates are usually highest in adults, especially males, there are reports of high rates in children (Christian and Perret, 1974;Khodakova et al., 1996). ...
... Seemingly unrelated environmental changes may also have unexpected effects on the epidemiology of this zoonosis. It has been suggested that the increase in infections by D. pacificum during the 1975-2000 period in Northern Chile was related to the cyclic appearance of El Nino phenomena in the Eastern Pacific, which not only affect fish populations but also that of the primary definitive host, the sea lion (Sagua et al., 2000). Another example is the increased risk of diphyllobothriid infection of fish because of growing marine mammal populations in the Northwest Pacific, a result of the 1972 Marine Mammal Protection Act (Deardorff, 1991). ...
The fish-borne parasitic zoonoses have been limited for the most part to populations living in low- and middle-income countries, but the geographical limits and populations at risk are expanding because of growing international markets, improved transportation systems, and demographic changes such as population movements. While many in developed countries will recognize meat-borne zoonoses such as trichinellosis and cysticercosis, far fewer are acquainted with the fish-borne parasitic zoonoses which are mostly helminthic diseases caused by trematodes, cestodes and nematodes. Yet these zoonoses are responsible for large numbers of human infections around the world. The list of potential fish-borne parasitic zoonoses is quite large. However, in this review, emphasis has been placed on liver fluke diseases such as clonorchiasis, opisthorchiasis and metorchiasis, as well as on intestinal trematodiasis (the heterophyids and echinostomes), anisakiasis (due to Anisakis simplex larvae), and diphyllobothriasis. The life cycles, distributions, epidemiology, clinical aspects, and, importantly, the research needed for improved risk assessments, clinical management and prevention and control of these important parasitic diseases are reviewed.
... Respecto a estas condiciones, debe señalarse que los contagios de parásitos normalmente ocurren por consumo de alimentos infectados, agua y por el ciclo «ano-mano-boca, lo que facilita que una persona se contagie a si mismo» (Geosalud 2004); como también a su grupo, sin requerir otros vectores. Asimismo, aspectos culturales como el proceso de agriculturización y su concomitante sedentarismo (Larsen 1995: 198) produjo significativas modificaciones en los hábitos alimenticios (Sagua et al. 2000(Sagua et al. , 2001, sanitarios (Morales et al. 1999) y de higiene de las poblaciones prehispánicas, que facilitaron el desarrollo de las enfermedades parasitarias. ...
... Respecto a estas condiciones, debe señalarse que los contagios de parásitos normalmente ocurren por consumo de alimentos infectados, agua y por el ciclo «ano-mano-boca, lo que facilita que una persona se contagie a si mismo» (Geosalud 2004); como también a su grupo, sin requerir otros vectores. Asimismo, aspectos culturales como el proceso de agriculturización y su concomitante sedentarismo (Larsen 1995: 198) produjo significativas modificaciones en los hábitos alimenticios (Sagua et al. 2000(Sagua et al. , 2001, sanitarios (Morales et al. 1999) y de higiene de las poblaciones prehispánicas, que facilitaron el desarrollo de las enfermedades parasitarias. ...
Technical Appendix. Historical survey of records of adult Adenocephalus
pacificus, marine fish reported as second intermediate hosts of A. pacificus, and descriptions of clinical cases of diphyllobothriosis caused by A. pacificus.
The Pacific broad tapeworm Adenocephalus pacificus (syn. Diphyllobothrium pacificum) is the causative agent of the third most common fish-borne cestodosis among humans. Although most of the nearly 1,000 cases among humans have been reported in South America (Peru, Chile, and Ecuador), cases recently imported to Europe demonstrate the potential for spread of this tapeworm throughout the world as a result of global trade of fresh or chilled marine fish and travel or migration of humans. We provide a comprehensive survey of human cases of infection with this zoonotic parasite, summarize the history of this re-emerging disease, and identify marine fish species that may serve as a source of human infection when eaten raw or undercooked. © 2015, Centers for Disease Control and Prevention (CDC). All rights reserved.
Recent clinical and epidemiológica! information, an analysis of the literature, and study of the technical aspects of Chilean salmon aquaculture indicate that this activity has the ability to expand the range of diphyllobothriasis caused by the fish tapeworm Diphyllobothrium latum. Evidence for expansion of the range of the fish tapeworm includes the emergences of clinical cases in Brazil related to consumption of salmon produced in Chile. Expansion of the range of this parasite is also suggested by an increase of its geographical range in Chile, beyond its previously endemic foci in the lakes of Regions IX and X. Prevention of further dissemination of this parasitic disease rests on an improvement of sanitation and sewage disposal around the lakes of Regions IX, X and XI in Chile, improvement in aquaculture methods including curtailing the use offish tapeworm-contaminated lakes to grow juveniles forms ofsalmonids and more measures to decrease the number of salmonid escapees from marine pens to prevent their return to rivers and lakes carrying the infestation. Moreover, tracking the origin ofjuveniies in marketed salmon, determining the presence of plerocercoids in them, and increased education of the public regarding the potential dangers of eating raw fish should also be implemented. Only by stimulating the dialogue between the industry, consumers and state regulators will it be possible to implement appropriate measures to prevent further expansion of this parasitic disease by salmon aquaculture (Rev Méd Chile 2007; 135:1064-71)
The real incidence of infection by Diphyllobothrium latum in Chite is difficutt to establish. It seems to be quite low and megaloblastic anemia associated with it is rare. We present a case of such an association in which there was no deffect in the absorbtion of vitamin B12 or folate. The ineffective erythropoiesis is usually associated with vítamin B12 delficiency from whatever cause and it was clearly shown here. Megaloblastic anemia induced by D. latum is multi-factorial, leads to varying degrees of vitamin B12 defficiency and ineffective erythropoiesis. It is reversible after the elimination of the parasite.
Plerocercoids of Diphyllobothrium were studied from fish samples representing eight species of salmonids from British Columbia, Wyoming, Quebec, and Maine. Adults were studied mainly from experimental infections of golden hamsters, Mesocricetus auratus (Waterhouse). Using scanning electron microscopy and histological techniques, the plerocercoids and adults were identified as Diphyllobothrium dendriticum or Diphyllobothrium ditremum. Morphological comparisons were made with European specimens of these two species and those of Diphyllobothrium latum (Linnaeus, 1758). Among the nine freshwater species reviewed, Diphyllobothrium cordiceps (Leidy, 1872), Diphyllobothrium sebago (Ward, 1910), and Diphyllobothrium ursi Rausch, 1954, are considered synonyms of Diphyllobothrium dendriticum.
Applicable publications, involving five languages, have been reviewed to obtain information on El Niños that occurred over the past four and a half centuries. Since this information refers strictly to El Niño occurrences, a regional manifestation of the large-scale (El Niño-Southern Oscillation (ENSO)) event, it is based primarily on evidence obtained from the west coast region of northern South America and its adjacent Pacific Ocean waters. Authored lists of events were not acceptable without referenced valid information sources. It was desirable to have cross-correlated reports from independent sources. Relative strengths of events are based on such considerations as wind and current effects on travel times of ancient sailing ships, degree of physical damage and destruction, amounts of rainfall and flooding, mass mortality of endemic marine organisms and guano birds, extent of invasion by tropical nekton, rises in sea temperatures and sea levels, affects on coastal fisheries and fish meal production, etc. Emphasis is placed on strong and very strong events. For example, the 1940-1941, 1957-1958, and 1972-1973 events fall into the strong category, whereas the 1891, 1925-1926 and 1982-1983 events are considered very strong. Over our period of study, 47 El Niño events were placed in the strong or very strong categories. Over the period 1800-present, we noted 32 El Niño events of moderate or near moderate intensity. Weak events are not included here. The approach used here caused us to revise many of our earlier evaluations concerning event occurrences and intensities. Our tropical Pacific thickness analyses and cumulative plots of Southern Oscillation index anomalies over the southeast Pacific trade wind zone showed additional evidence as to the unusual strength of the 1982-1983 event. Also, in our investigation we noted several periods of long-term (near decadal or longer) climatic change.
Diphyllobothrium pacificum, a tapeworm from seals, is reported for the first time from man in Peru. Seven further cases are described from people living along the coast and whose food includes various species of sea fish. The very complicated history of the parasite which involves numerous synonyms has been established. This is also first report of human diphyllobothriasis other than D. latum from the Southern Hemisphere.
Primer caso humano de infección por Diphyllobothrium pacificum en Chile
- A Atías
- P Cattan
Morphological observation of Diphyllobothrium pacificum (Nybelin, 1931) Margolis, 1956 from fur seals, Callorhinus ursinus in Japan
- J Maejima
- S Yazaki
- M Fukumoto
Nuevos registros de parásitos en mamíferos marinos chilenos
- J Fernández
Diphyllobothrium pacificum: Hallazgo de larvas plerocercoides en peces marinos del Perú y desarrollo de de formas adultas del parásito en Canis familiaris
- H Escalante
- H Miranda
Difilobotriasis humana por Diphyllobothrium pacificum en Chile: Experiencia con 11 casos
- H Sagua
- A Fuentes
- J Soto
Hallazgo de huevos de Diphyllobothrium pacificum en coprolitos humanos del norte de Chile (4100 al 1950 a de C)
- L Núñez
- L Ferrando
- A De Araujo
Infección por Diphyllobothrium pacificum, probablemente adquirida en el sur de Chile, por un niño de tres años
- R Mercado
- P Torres
- A Lobos
Difilobotriasis humana por Diphyllobothrium pacificum: Un nuevo caso en Antofagasta, Norte de Chile
- A González
- H Sagua
- L Cortés
Larvas plerocercoides de Diphyllobothridae Lühe, 1910: Hallazgo en peces marinos de consumo humano en la costa peruana
- H Escalante