Foodborne parasitic infections PARAGONIMIASIS (Lung fluke) Paragonimiasis, or lung fluke The most common species Paragonimus spp. is a common disease, is caused by infection in Asia are P. westermani, parasite of crustacean-eating with several species of trematodes P. heterotremus and mammals such as dogs, cats, ? belonging to the genus P. philippinensis. tigers, mongooses and monkeys. Introduction Paragonimus. (reservoir definitive hosts). The adult flukes live in the lungs of infected mammals and lay eggs that are coughed up through the airways and either expectorated in the sputum or swallowed and Transmission defecated. and risk When the eggs reach freshwater, they develop Eating into miracidia that will inhabit various species undercooked factors infected of aquatic snails where they will asexually freshwater reproduce and eventually give rise to more crustaceans Lack of developed larvae called cercariae. Definitive host sanitation (Fluke) and open The cercariae will then further inhabit various defecation freshwater crustaceans, which act as second intermediate hosts, such as crabs and nd 2 intermediate Free living crayfish but also shrimp and even frogs. host When the crustaceans are eaten raw or undercooked, the metacercariae that is the infective stage for several mammals will excyst 1st intermediate in the intestine and penetrate their way through the intestinal wall, peritoneum, diaphragm Free living host and pleura - eventually reaching the lungs and completing the cycle. The incubation period is 65 to 90 days. When worms reach the lungs, symptoms Triclabendazole and praziquantel are both in humans may include chronic cough with WHO-recommended medicines for treatment of blood-stained sputum, chest pain with difficult paragonimiasis in humans. breathing and fever; pleural effusion and Triclabendazole is preferred for the simplicity of pneumothorax are possible complications. Signs and Treatment its regimen, which ensures higher compliance symptoms Symptoms and signs mimic those with treatment. of tuberculosis or lung cancer, and Praziquantel can be used in animals. paragonimiasis should always be suspected in patients with tuberculosis who are non- responsive to treatment. 1. Preventive chemotherapy with a single Usually, parasites in the lungs of cats and oral dose of triclabendazole in communities dogs are not of great importance and where cases of paragonimiasis appear to be respiratory signs are comparatively rare. significantly clustered Some parasites might lodge in the brain or Public health 2. Prevention and control in animals other organs causing more severe damage. prevention Treatment of domestic animals, such as pigs, and control cats and dogs Individual diagnosis is made based on the 3. Water, sanitation and hygiene clinical picture, on the recall of consuming raw (WASH) crustaceans, on the detection of eosinophilia Reduce contamination of freshwater streams and on the typical findings of ultrasound, with faeces and sputum by improving X-ray, computed tomography or magnetic Detection sanitation and promoting toilet use in endemic resonance imaging scans. Tests to rule out areas and tuberculosis should always be conducted. diagnosis 4. Risk communication proper cooking of Confirmation of diagnosis and monitoring crustaceans and food handling of interventions rely on parasitological, immunological, and molecular techniques. Diagnosis in animals is mainly based on www.who.int/health-topics/foodborne-trematode-infections microscopy. i.