Metagonimus Yokogawai Small Intestinal Fluke Disease

Metagonimus yokogawai is the smallest intestinal flukes parasitic in humans and fish-eating mammals such as pigs, dogs, cats and fish-eating birds. M. yokogawai is found mainly in the Far East, Taiwan, Korea, China, Siberia, Japan, Indonesia, Philippines, Balkans, Spain, Israel and Egypt. In Korea, M. yokogawai infection is the most common disease among intestinal trematodes identified in humans

. There are also intestinal flukes Echinostoma Sp.
ABOUT THE BODY
Adult flukes are shaped like leaves, from 1.0 to 2 5mm long, 04 to 0.75mm across, the outer epidermis has thorns, flat, symmetrical body on both sides, has 2 suction senses , belly and mouth suction.



. The oral cavity attaches to the esophagus, then branched into two cecum which goes parallel to the anus. M. yokogawai is hermaphrodite, having one ovary and two testes, the uterus being the largest organ, facing the genital holes (where the eggs are laid).
Eggs of M. yokogawai are difficult to distinguish from eggs of other small tapeworms, especially eggs from the family Heterophyidea and also closely related to the liver fluke eggs of the genera Opisthorchis and Clonorchis Eggs have a length of about 265 - 30μm, width from 15 - 17μm, with a lid, yellow or brown.
Epidemiological characteristics
Intermediate host
M. yokogawai has a complex life cycle involving two intermediate hosts. The first intermediate host is the snail of the genus semisulcospira and the second intermediate host is some species of freshwater and brackish water species such as: Pecoglossus altevelis is one of the most common fish species infected, yellow carp (Carassius) auratus), common carp (Cyprinus carpio), Zacco temminckii, Protimus steindachneri, Acheilognathus lancedata and Pseudorashora parva.



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DEVELOPMENT PROCESS
Adult flukes parasitize in the small intestine of humans and mammals eat fish and then lay eggs and eggs in the faeces. Eggs meet the water environment, snails (belonging to semisulcospira) eat tapeworm eggs, hatched eggs and develop into the larvae of feathers in the intestine. In snails, the hairy larvae then undergo several stages from sporocysts, rediae, and develop into many tail larvae. The caudal larvae then leave the snails that swim in the water and enter the appropriate fish and then form the larval cysts in the flesh Humans and other fish-eaters eat raw fish containing uncooked larval cysts or fish containing uncooked larval cysts. The tapeworm larvae develop into adult flukes and live parasites in the small intestine.
Clinical manifestations
The most common symptom is diarrhea and abdominal pain, most mild symptoms can be easily overlooked but are important for diagnosis. Flukes attach to the walls of the small intestine but usually do not cause symptoms, when infected with large numbers can cause chronic diarrhea, abdominal pain, nausea, peripheral eosinophilia may increase early in the stage. infected segment. The disease is caused by acute M.



. yokogawai, with clinical manifestations detected 5-7 days after infection. Severe illness is often associated with epigastric pain, irritability, anorexia and fatigue
Sometimes, the worms get into the mucosa and lay eggs, the eggs can migrate and circulate in the body, they can invade the brain, heart, or spinal cord, causing embolism, which is life-threatening. The formation of granulomas around the egg can cause heart failure, seizures and abnormal neurological manifestations.
DIAGNOSE
The diagnosis is mainly done by looking for faecal samples for eggs, the diagnosis may be difficult because M. yokogawai's ability to lay eggs is limited, so the method of focusing eggs in feces to prove cases of tapeworm infection Lightweight is essential. Accurate identification of species is also difficult because the eggs of the flukes are very similar in size and morphology, especially the flukes of the Heterophyidea family and the small liver fluke species of the genera Opisthorchis and Clonorchis. It is important for the person to be infected, to find out if they have been to M. yokogawai endemic areas, to check for signs and symptoms that can lead to M. yokogawai disease.




PREVENTION
To prevent disease, it is necessary to propagate by health education communication, kill intermediate snails, transmit diseases, not defecate into ponds, not eat raw or undercooked fish salad, detect and treat patients early.
DS. Cao Chí Công.

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