EID Journal Home > Volume 17, Number 1–January 2011
Volume 17, Number 1–January 2011
Echinostoma revolutum Infection in Children, Pursat Province, Cambodia
Woon-Mok Sohn, Jong-Yil Chai, Comments to Author Tai-Soon Yong, Keeseon S. Eom, Cheong-Ha Yoon, Muth Sinuon, Duong Socheat, and Soon-Hyung Lee
Author affiliations: Gyeongsang National University School of Medicine, Jinju, South Korea (W.-M. Sohn); Seoul National University College of Medicine, Seoul, South Korea (J.-Y. Chai, S.-H. Lee); Korea Association of Health Promotion, Seoul (J.-Y. Chai, C.-H. Yoon); Yonsei University College of Medicine, Seoul (T.-S. Yong); Chungbuk National University College of Medicine, Cheongju, South Korea (K.S. Eom); and Center for National Malaria Control, Phnom Penh, Cambodia (M. Sinuon, D. Socheat)
Suggested citation for this article
To determine the prevalence of helminthic infections in Pursat Province, Cambodia, we tested fecal specimens from 471 children, 10–14 years of age, in June 2007. The prevalence of infection with echinostome flukes ranged from 7.5% to 22.4% in 4 schools surveyed. Adult worms were identified as Echinostoma revolutum.
Echinostomes (family Echinostomatidae) are intestinal trematodes of birds and mammals, including humans. Echinostomiasis can result in severe epigastric or abdominal pain accompanied by diarrhea, easy fatigue, and malnutrition (1). Heavy worm loads may lead to death due to intestinal perforation or marked malnutrition and anemia, as has been reported for infection caused by an echinostome species, Artyfechinostomum malayanum (under the name Artyfechinostomum mehrai), in India (1).
A total of 20 species of echinostomes that belong to 8 genera (Echinostoma, Echinochasmus, Acanthoparyphium, Artyfechinostomum, Episthmium, Himasthla, Hypoderaeum, and Isthmiophora) infect humans worldwide (1). Echinostoma revolutum, the most widely distributed species, is found from Asia and Oceania to Europe and the Americas (1). The first reported human infection was in Taiwan in 1929 (2). The prevalence of E. revolutum flukes in Taiwan during 1929–1979 varied from 0.11% to 0.65% (3). Small E. revolutum–endemic foci or a few cases of human infection were discovered in the People's Republic of China, Indonesia, and Thailand until 1994 (4,5). However, no information is available about human E. revolutum infection after 1994, even in areas where the parasite was previously endemic.
In Cambodia, humans are commonly infected with intestinal nematodes and protozoa, including hookworms, Strongyloides stercoralis, Ascaris lumbricoides, Trichuris trichiura, and Giardia lamblia (6,7). However, with the exception of the blood fluke Schistosoma mekongi, infection with trematodes or cestodes has seldom been reported (8). Echinostomatid eggs have been detected in schoolchildren in 2 provinces, Battambang and Kampongcham (9,10), but adult worms were not collected for identification. The Korea Association of Health Promotion, South Korea, and The National Institute of Malaria, Entomology, and Parasitology, Ministry of Health, Cambodia, have been conducting an international collaboration to control intestinal helminthiases in schoolchildren in Cambodia (2006–2011). In June 2007, we conducted a fecal survey in 4 primary schools in Pursat Province, Cambodia, and found that an average of 11.9% of schoolchildren had positive test results for echinostome eggs. Adult worms recovered after the children received treatment with praziquantel and underwent purgation with magnesium salts were identified as E. revolutum. We report echinostomiasis as an endemic trematode infection among schoolchildren in Pursat.
Sohn W-M, Chai J-Y, Yong T-S, Eom KS, Yoon C-H, Sinuon M, et al. Echinostoma revolutum infection in children, Pursat Province, Cambodia. Emerg Infect Dis [serial on the Internet]. 2011 Jan [date cited]. http://www.cdc.gov/EID/content/17/1/117.htm
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Jong-Yil Chai, Department of Parasitology and Tropical Medicine, Seoul National University College of Medicine, Seoul 110-799, South Korea; email: firstname.lastname@example.org
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