Haplorchis taichui

Haplorchis taichui: Description, Causes and Risk Factors: Haplorchis taichuiHaplorchis taichui is a minute intestinal fluke (MIF) of the Heterophyidae family that parasitizes the small intestine of several kinds of birds and mammals including humans. In Thailand, it has been reported as the largest degree of trematode recovered in the gastrointestinal tract of humans living in the Northern region. Although there is no report of clinical importance caused by H. taichui, other MIF can elicit a mild inflammatory reaction at the site of contact with the intestine or burrow into the mucosa. The worms produce mild irritation, accompanied by colicky pain and mucus in the diarrhea. The intestinal trematode, Haplorchis taichui, is a medically important parasite infecting humans and livestock. Haplorchiasis has become one of the major public health concern in Asia. H. taichui is the most frequently reported species among the minute intestinal flukes from eastern Asia, including Thailand. This parasite has an aquatic life cycle, using freshwater snails as the first and cyprinid fish as the second intermediate hosts, with definitive hosts being fish-eating mammals. Previous reports showed that metacercariae of 2 heterophyids, H. taichui and Haplorchoides sp., had high prevalence of infection in cyprinid fish collected from Chiang Mai and Lamphun provinces of Thailand. This was also found in a later study where a high prevalence (83.9%) of these 2 heterophyid trematodes was also recorded from the same area. Many species of heterophyid trematodes have been reported from pleurolophocercous cercariae, such as H. taichui, Haplorchis pumilio, and Stellantchasmus falcatus. About 100 species of snails have been reported to act as intermediate hosts for the trematodes especially in thiarid snails which harbor the larvae of intestinal trematodes, including H. taichui. Human infection with H. taichui is caused by consumption of raw and/or undercooked fresh water fish harboring the viable infective stage or metacercariae, in which they grow to be adults in the small intestine. Some of the Thai traditional food prepared from raw fresh water fish can serve as the source of infection. Although information is available on the development of MIF in experimental animals, the H. taichui per se strain studied was from Formosa. No detailed information regarding the infectivity and development of this parasite was found. Since parasitic stains may differ biologically and/or physiologically. Symptoms: Most individual with mild-to-moderate infection will be asymptomatic. Symptoms of acute infection include fever, eosinophilia, myalgia, and lymphadenopathy. Patient with chronic disease may present with diarrhea, flatulence, fever, dyspepsia, and anorexia. Diagnosis: Diagnosis is usually by direct microscopic examination of the eggs in fecal samples. Serological tests detect antibodies to the trematodes, but active infection cannot be differentiated. An indirect immunofluorescent antibody technique for serology indicate 81% of patients had antibodies to the adult trematodes or eggs, and that about 5% of patients had a possible cross-reaction between the parasite antigen and self antigens. ELISA technique and DNA probes are very useful for extensive diagnosis. Traditional methods of detecting cercarial infections are usually performed by exposing the snails to light or dissection. It is difficult to determine the parasite stages to the species level since they appear morphologically very similar to other trematodes. In addition, only a very small percentage of snails can be found to be infected when testing shed cercariae. Specific identification of cercariae from field collected snails is difficult, but necessary for epidemiological studies. Treatment: Praziquantel divided in 3 doses in 1 day was a well-tolerated and effective treatment for infection by H. taichui. NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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