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Assessment of morbidity due to Schistosoma japonicum infection in China.

Chen MG - Infect Dis Poverty (2014)

Bottom Line: Due to the socio-economic situation, which did not allow for a control program to be implemented until the early 1950s, morbidity was serious and mortality was high before this.Comparatively higher morbidity is seen in the acute and advanced phases of the disease.The problem of mammalian reservoir hosts of S. japonicum makes the epidemiology and control of schistosomiasis in China even more complicated and arduous, and the control progress in animal reservoirs is briefly presented.

View Article: PubMed Central - HTML - PubMed

Affiliation: National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China. mgchen51@hotmail.com.

ABSTRACT
This paper presents a historical assessment of morbidity due to the Schistosoma japonicum infection in China. Due to the socio-economic situation, which did not allow for a control program to be implemented until the early 1950s, morbidity was serious and mortality was high before this. Based on a few investigations and published papers, it can be said that the disease caused millions of deaths, and destroyed numerous families and villages. Since the 1950s, there has been a national control program, intensive control and prevention work has been carried out, and consequently the disease is being controlled. At present, both the prevalence and the morbidity of the disease have been decreasing substantially. The morbidity of the three phases of the disease is outlined in this paper. Comparatively higher morbidity is seen in the acute and advanced phases of the disease. The four major forms of advanced schistosomiasis i.e., ascites, megalosplenia, dwarfism, and colonic tumoroid proliferation, are outlined with their characteristic clinical presentations; their proportions are different during various periods of the national control program. Ectopic schistosomiasis and the relationship between the S. japonicum infection and colorectal cancer are also discussed. Post-transmission schistosomiasis is briefly discussed (which can happen even if the disease reaches the criteria of elimination, and the infection and transmission have stopped, but yet it still develops). The problem of mammalian reservoir hosts of S. japonicum makes the epidemiology and control of schistosomiasis in China even more complicated and arduous, and the control progress in animal reservoirs is briefly presented.

No MeSH data available.


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Excavation site of an ancient female corpse with schistosomiasis in Changsha City, Hunan Province, in 1971 [8].
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Figure 1: Excavation site of an ancient female corpse with schistosomiasis in Changsha City, Hunan Province, in 1971 [8].

Mentions: The eggs of S. japonicum identified in two ancient corpses from the Hunan and Hubei provinces excavated in 1971 and 1975, respectively, have shown that the prevalence of schistosomiasis in China has a history dating more than 2,100 years [8-10] (see Figures 1, 2, 3, and 4). In old volumes about traditional Chinese medicine, a description of clinical symptoms resembling Katayama fever (acute schistosomiasis) can be traced back to 400 B.C. [11], and symptoms resembling the late stage of schistosomiasis, such as ascites and splenomegaly, can be traced back to as early as 2697 B.C., as evident in the text “Ling-Su”, claimed to be written by Huang-Di (the King) [12,13]. Great suffering and premature death due to schistosomiasis existed for centuries [11]. The first clinical case was discovered in 1905 in a missionary hospital in Changde County, Hunan Province, by Dr. Logan, an American physician, confirmed by typical S. japonicum eggs found in the patient’s feces [14]. The patient was an 18-year-old fisherman. His major complaints were bloody diarrhea and loss of working ability. A physical examination showed an underdeveloped young man with a short statue (137 cm in height). In 1924, Dr. Totell, also an American physician and director of the aforementioned missionary hospital, examined 63 residents in two villages in the same county using the direct fecal smear technique (a technique with low sensitivity for the discovery of the S. japonicum infection). Eggs were found in 38 of the fecal specimens with a high prevalence of 60.3%, showing that both prevalence and intensity of the infection in the area were very high [15]. Faust and Meleney, professors at the Peking Union Medical College, were the first to make a survey on the infection in the Jiangsu, Zhejiang, and Guangdong provinces, and to discover the molluscan host of the parasite in China. They published a monograph “Studies on schistosomiasis japonica” in 1924, which was the first systemic report related to the prevalence and morbidity of the S. japonicum infection published in the country [16]. Clinical cases and valuable observations on the morphology and lifecycle of the causative agent and pathological anatomy of the disease were provided.


Assessment of morbidity due to Schistosoma japonicum infection in China.

Chen MG - Infect Dis Poverty (2014)

Excavation site of an ancient female corpse with schistosomiasis in Changsha City, Hunan Province, in 1971 [8].
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3928580&req=5

Figure 1: Excavation site of an ancient female corpse with schistosomiasis in Changsha City, Hunan Province, in 1971 [8].
Mentions: The eggs of S. japonicum identified in two ancient corpses from the Hunan and Hubei provinces excavated in 1971 and 1975, respectively, have shown that the prevalence of schistosomiasis in China has a history dating more than 2,100 years [8-10] (see Figures 1, 2, 3, and 4). In old volumes about traditional Chinese medicine, a description of clinical symptoms resembling Katayama fever (acute schistosomiasis) can be traced back to 400 B.C. [11], and symptoms resembling the late stage of schistosomiasis, such as ascites and splenomegaly, can be traced back to as early as 2697 B.C., as evident in the text “Ling-Su”, claimed to be written by Huang-Di (the King) [12,13]. Great suffering and premature death due to schistosomiasis existed for centuries [11]. The first clinical case was discovered in 1905 in a missionary hospital in Changde County, Hunan Province, by Dr. Logan, an American physician, confirmed by typical S. japonicum eggs found in the patient’s feces [14]. The patient was an 18-year-old fisherman. His major complaints were bloody diarrhea and loss of working ability. A physical examination showed an underdeveloped young man with a short statue (137 cm in height). In 1924, Dr. Totell, also an American physician and director of the aforementioned missionary hospital, examined 63 residents in two villages in the same county using the direct fecal smear technique (a technique with low sensitivity for the discovery of the S. japonicum infection). Eggs were found in 38 of the fecal specimens with a high prevalence of 60.3%, showing that both prevalence and intensity of the infection in the area were very high [15]. Faust and Meleney, professors at the Peking Union Medical College, were the first to make a survey on the infection in the Jiangsu, Zhejiang, and Guangdong provinces, and to discover the molluscan host of the parasite in China. They published a monograph “Studies on schistosomiasis japonica” in 1924, which was the first systemic report related to the prevalence and morbidity of the S. japonicum infection published in the country [16]. Clinical cases and valuable observations on the morphology and lifecycle of the causative agent and pathological anatomy of the disease were provided.

Bottom Line: Due to the socio-economic situation, which did not allow for a control program to be implemented until the early 1950s, morbidity was serious and mortality was high before this.Comparatively higher morbidity is seen in the acute and advanced phases of the disease.The problem of mammalian reservoir hosts of S. japonicum makes the epidemiology and control of schistosomiasis in China even more complicated and arduous, and the control progress in animal reservoirs is briefly presented.

View Article: PubMed Central - HTML - PubMed

Affiliation: National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China. mgchen51@hotmail.com.

ABSTRACT
This paper presents a historical assessment of morbidity due to the Schistosoma japonicum infection in China. Due to the socio-economic situation, which did not allow for a control program to be implemented until the early 1950s, morbidity was serious and mortality was high before this. Based on a few investigations and published papers, it can be said that the disease caused millions of deaths, and destroyed numerous families and villages. Since the 1950s, there has been a national control program, intensive control and prevention work has been carried out, and consequently the disease is being controlled. At present, both the prevalence and the morbidity of the disease have been decreasing substantially. The morbidity of the three phases of the disease is outlined in this paper. Comparatively higher morbidity is seen in the acute and advanced phases of the disease. The four major forms of advanced schistosomiasis i.e., ascites, megalosplenia, dwarfism, and colonic tumoroid proliferation, are outlined with their characteristic clinical presentations; their proportions are different during various periods of the national control program. Ectopic schistosomiasis and the relationship between the S. japonicum infection and colorectal cancer are also discussed. Post-transmission schistosomiasis is briefly discussed (which can happen even if the disease reaches the criteria of elimination, and the infection and transmission have stopped, but yet it still develops). The problem of mammalian reservoir hosts of S. japonicum makes the epidemiology and control of schistosomiasis in China even more complicated and arduous, and the control progress in animal reservoirs is briefly presented.

No MeSH data available.


Related in: MedlinePlus