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Intestinal trematodes of humans in Korea: Metagonimus, heterophyids and echinostomes
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Korean J Parasito > Volume 28(Suppl):1990 > Article

Original Article
Korean J Parasitol. 1990 Dec;28(Suppl):103-122. English.
Published online Mar 20, 1994.  http://dx.doi.org/10.3347/kjp.1990.28.Suppl.103
Copyright © 1990 by The Korean Society for Parasitology
Intestinal trematodes of humans in Korea: Metagonimus, heterophyids and echinostomes
J Y Chai and S H Lee
Department of Parasitology and Institute of Endemic Diseases, Seoul National University College of Medicine, Seoul 110-460, Korea.
Abstract

Ten species of the trematode family Heterophyidae (Metagonimus yokogawai, M. takahashii, Heterophyes nocens, H. heterophyes, H. dispar, Heterophyopsis continua, Pygidiopsis summa, Stellantchasmus falcatus, Centrocestus armatus and Stictodora fuscatum), and 3 species of the family Echinostomatidae (Echinostoma hortense, E. cinetorchis and Echinochasmus japonicus) have been found to infect humans in Korea. Biological and epidemiological studies on the above species have shown that Metagonimus, heterophyids and echinostomes are all prevalent indigenously in Korea except H. heterophyes and H. dispar, of which the human cases were infected when they came to the Middle East. Various kinds of fish have been proven to be the source of human infection with these flukes. For example, fresh water fish such as the sweetfish, carp, loach, etc., were found to carry the metacercarial stage of M. yokogawai, M. takahashii, C. armatus, E. hortense, E. cinetorchis and/or E. japonicus. Brackish water fish such as the mullet, perch and goby, were verified to be the second intermediate host of H. nocens, H. continua, P. summa, S. falcatus and/or S. fuscatum. Among the intestinal flukes, M. yokogawai is the most prevalent species in Korea.

Figures


Fig. 1
Metagonimus yoiogawai, bentral view, acetocarmine stained, recovered from a man. Note the location of the ventral sucker(VS) and two tests (T).


Fig. 2
Map of the geographical distribution of M. yokogawai in Korea, based of the metacercarial infection in the sweetfish (Redrawn from Seo et al., 1982 & Song et al., 1985).

Area Code (1-61)

  • Gangwon-do: 1-2. Kosung-gun, 3. Sokcho-city, 4-6. Yangyang-gun, 7. Myongju-gun, 8. Kangnung-city, 9. Myoungju-gun, 10-15. Samcheok-gun.

  • Kyongsangbuk-do: 16-19. Uljin-gun, 20-23. Yongduk-gun, 24. Yongil-gun, 25. Wolsung-gun, 26. Koryung-gun.

  • Kyongsangnam-do: 27. Ulsan-city, 28. Ulju-gun, 29-30. Yangsan-gun, 31. Milyang-gun, 32. Euichang-gun, 33. Keoje-gun, 34. Kosung-gun, 35. Euiryung-gun, 36. Chinju-city, 37-39. Hadong-gun, 40-41. Namhae-gun.

  • Chollanam-do: 42-43. Kwangyang-gun, 44. Soonchun-city, 45. Kosung-gun, 46-47. Koorye-gun, 48. Seungju-gun, 49. Koheung-gun, 50. Bosung-gun, 51-54. Changhung-gun, 55. Bosung-gun, 56-57. Kangjin-gun, 58-59. Haenam-gun.

  • Chollabuk-do: 60. Kochang-gun.

  • Cheju-do: 61. Seogwipo-city.



Fig. 3
Section of M. yokogawai in the jejunum, (A) at an early stage (3-day) of infection in d dog (X200), and(B) at a later stage (2-week) of infection in a rat (×100) (Chai, 1979). Note villous atrophy (B) and crypt hyperplasia (A&B) of the host's jejunal mucosa. H-E stain.


Fig. 4
Eggs of M. yokogawai, obtained from the uterus of several adult worms.


Fig. 5
Metagonimus takahashii, ventral view, fresh preparation from a man. Note the ventral sucker (VS), two separately located testes (T), uterine tubule crossing over the two testes, and posteriormost extension of vitellaria.


Figs. 6-7
Heterophyes nocens (Fig. 6) and H. heterophyes (Fig. 7), ventral view, fresh preparations from a man (Chai et al., 1985b) and another (Chai et al., 1986a). Note the ventral sucker (VS) and other organs, that show no special difference between the two species, except in the morphology of the genital sucker (GS) (for detail see Fig. 8-9).


Figs. 8-9
Close-up view of the ventral sucker (VS) and genital sucker (GS) of H. nocens (Fig. 8) and H. heterophyes (Fig. 9). The number of rodlets on the gonotyl (GS) is about 53 from the former (Fig. 8) and about 76 from the latter (Fig. 9).


Figs. 10-11
Heterophyes dispar, ventral view of a whole worm (Fig. 10) and a close-up view (Fig. 11) of the vental sucker (VS) and genital sucker (GS), fresh preparation from a man (Chai et al., 1986a). Note the small size of the genital sucker (GS) (Fig. 10) compared with th large ventral one (VS) and small number (about 30) of rodlets on the gonotyl (Fig. 11).


Fig. 12
Heterophyopsis continua, ventral view, acetocarmine stained, recovered from a man (Seo et al., 1984b). Note the elongated body shape, ventral sucker (VS), genital sucker (GS), and two obliquely tandem testes (T).


Fig. 13
Pygidiopsis summa, ventral view, fresh preparation from an experimentally infected rat (10-day old worm) (Chai et al., 1986b). Note the slightly submedian ventral sucker (VS) and associated genital apparatus, forming together a ventrogenital apparatus (VGA). Also see the two side-by-side testes (T).


Fig. 14
Stellantchasmus falcatus, ventral view, fresh preparation from a patient (Seo et al., 1984a). Note th submedian ventral sucker (VS), elongated sac-like seminal vesicle (SV), and two side-by-side testes (T).


Fig. 15
Centrocestus armatus, ventral view, drawing from a specimen recovered from a man (Hong et al., 1988). Note the circumoral spines characteristic of this genus.


Fig. 16
Stictodora fuscatum, ventral view, fresh specimen from a patient in a southwestern coastal area (Chai et al., to be published). Note the characteristic features of the ventrogenital sac (VGS), metraterm (MT) containing an egg, two obliquely located testes (T), and distribution of the vitellaria.


Fig. 17
Echinostama hortense, 28-day (A), 42-day (B) and 150-day worm (C) grown in experimental rats, acetocarmine stained (Seo et al., 1985a). Note the large ventral sucker (VS), submedian location of the ovary (Ov), and two slightly lobulated tandem testes (T).


Fig. 18
Section of the duodenum of a rat 22 days after experimental infection with E. hortense (Lee et al., 1990). Note a worm sucking at a villus with its oral sucker armed with collar spines (arrows). The host mucosa shows villous atrophy and crypt hyperplasia, with inflammatory reactions. H-E stain. ×100.


Fig. 19
Echinostoma cinetorchis, ventral view of two adult worms, grown in experimental rats 16 days after infection, acetocarmine stained (Seo et al., 1984c). Note a worm (A) that has two testes (T) one of which moved to an abnormal location and another that has only one testis (T).


Fig. 20
Echinochasmus japonicus, ventral view of a fresh specimen (A) recovered from a naturally infected chicken and dorsal view of an acetocarmine stained specimen (B) from an experimentally infected chick. Note the arrangement of 24 collar spines (arrows) which is discontinued dorsally, large ventral sucker (VS), two tandem tested (T) and small uterus with only one egg (E) each.

Tables


Table 1
Human intestinal flukes which belong to the family Heterophyidae or Echinostomatidae in Korea

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