Adults should not eat it, and children should not touch it.
Contents
Encephalitis is caused by parasites!
2006 Beijing "Fushouluo Incident"
History of the discovery and development of the Tubeworm in Guangzhou
It is also possible to get infected without eating Fushou snails!
What are the symptoms of infection with Guangzhou Tube Roundworm?
How to treat infection with Guangzhou tube roundworm? Seriously?
Which areas are there cantonese roundworms?
How to prevent Guangzhou roundworm infection?
1 Encephalitis is caused by parasites!
Aaron is a 7-year-old boy who has had frequent headaches in the past 1 month, which is unbearable, accompanied by vomiting, and it is difficult to alleviate headache medicine. After 3 days of pain, the headache became more and more severe, and there was a high fever, so I had no choice but to go to the local people's hospital.
After lumbar puncture examination, the white blood cells in the cerebrospinal fluid test were significantly elevated, and the intracranial pressure was also very high, and the doctor considered Aaron to be an intracranial infection. The local people's hospital gave active anti-infection treatment, and the headache improved from before, which was still tolerable, but it was still repeated, so the headache lasted for nearly a month. For further treatment, Aaron's parents brought their children to the Guangzhou Women's and Children's Center.
Because the pathogen is not known at the beginning and bacterial infections cannot be excluded, doctors give the strongest anti-infective regimen and try to determine whether it is common purulent meningitis through treatment. However, given such a good anti-infection regimen, Aaron's fever and headache relief was not noticeable.
Doctors quickly arranged for magnetic resonance imaging and found multiple lesions in Aaron's skull: abnormal signals in the right temporal lobe and bilateral occipital lobes, considering changes in encephalitis; and abnormal white matter signals around the anterior angle of the bilateral ventricles. Imaging physicians believe that this condition is more common intracranial infections.
The main pathogens of intracranial infection include viruses, bacteria, fungi, tuberculosis, and parasites. Doctors have screened for viruses, bacteria, fungi, and tuberculosis through a variety of tests, but have not been able to find evidence of infection. Aaron's blood routine eosinophils are elevated, and doctors believe that whether it is a parasitic infection needs to be considered.
Image courtesy of wikiwand
For parasitic infections, Aaron did not eat raw fish or unclean food, nor did he eat food such as wild game that was dangerous for parasite infection. In the winter, Aaron did not play in the waters with parasites, so it seems that it is unlikely to be a parasitic infection.
However, Aaron's clinical presentation, cerebrospinal fluid test, and skull MR test all support intracranial infection. Doctors believe that it may be some rare pathogen. Therefore, it was decided to perform high-throughput sequencing of Aaron's cerebrospinal fluid.
This pathogenic high-throughput sequencing can cover hundreds of pathogens, including viruses, bacteria, fungi, and parasites. Surprisingly, Aaron turned out to be a parasitic infection called "Guangzhou Tube Roundworm"!!
The figure below is an Angiostrongylus cantonensis, with two mature females on the left and stage 3 on the right.
Image from CD
So, what is The Guangzhou Tube Roundworm? How do people get infected? And how to prevent infection?
2 2006 Beijing "Fushouluo Incident"
On May 22, 2006, a 34-year-old male in Beijing ate "cold snail meat" with his colleagues at a restaurant in Beijing. On 30 May, he developed shoulder pain and neck stiffness, followed by skin paresthesia and tingling sensations, and on 10 June, he developed headache and nausea, and was diagnosed with eosinophilia meningitis at Beijing Friendship Hospital. Colleagues who ate on the same day also experienced the same symptoms.
On June 25 of the same year, the doctor went to the restaurant involved to investigate and found that the cold snail sold by the restaurant was "Fushou snail". Doctors tested fushou snail and found that there were Spikyloidium larvae in the snail, so the man and his colleagues were considered eosinophilic meningitis caused by Guangzhou Strongyloides infection.
The incident became a major public health emergency in Beijing, causing a total of 160 cases of infection, all caused by the consumption of cold mixed Fushou snail.
Pictured above is a snail with its pink egg
3 History of the discovery and development of Tubeworm in Guangzhou
In order to better prevent this disease, let's first pick up the "history" of Guangzhou pipe nematode:
In 1933, Professor Chen Xintao, a famous parasitologist in China, was found in the body of Guangdong house rat and brown family mouse;
In 1935, it was identified as a newly discovered parasite and named Guangzhou lung nematode;
In 1945, the larvae of the worm were first found in the cerebrospinal fluid of a 15-year-old boy in Taiwan;
In 1946, Dougherty revised it to Canton tube roundworm;
In 1984, the mainland reported the first case of Guangzhou tube strongiasis infection;
In 1997, 47 people in Wenzhou, Zhejiang Province, were infected with Guangzhou Roundworm;
In 2001, the WHO called it an "emerging global threat" of foodborne parasitic diseases;
In 2004, our Ministry of Health called it an "emerging infectious disease";
In 2006, there was an outbreak of mass infection in Beijing, affecting 160 people.
4 You can also get infected without eating Fushou snails!
How does Guangzhou Tube Roundworm infect people? Let's first understand its "life history.".
Adults parasitize the pulmonary arteries of rodents, and after spawning, they migrate with blood to the mirrel capillaries and develop into stage 1 larvae in the alveoli. Stage 1 larvae travel through the trachea to the pharynx, reach the intestines of mice after swallowing, and are excreted with feces.
Infected with snails such as Fushou snails and slugs (intermediate hosts), it enters the internal organs of snails and develops into stage 3 larvae; it may also turn into frogs, snails, fish, shrimp (freshwater shrimp), crabs and centipedes and other hosts, and develop into stage 3 and stage 4 larvae.
Humans are infected primarily through intermediate and transitive hosts. Therefore, do not eat such things as Fushou snails, and try to avoid eating fish, shrimp and crabs produced in the waters polluted by Fushou snails.
If a person eats or is exposed to the above-mentioned snails, slugs, frogs, snails, fish, shrimp and crabs, or infected water containing more larvae, they may become infected with Spunculia cambodia.
In this case, Aaron did not have clear contact with Fushou snail, why was he also infected with Guangzhou tube roundworm? After repeated medical history, it turned out that Aaron had eaten many freshwater shrimp in the first month before the onset of the disease!
And Aaron's area has more Fushou snails. And if this freshwater shrimp comes from waters containing Fushou snails, or from waters containing parasites, it may lead to shrimp with insects!
The infection method of Guangzhou tube roundworm is through oral infection, and it may be infected by eating a contaminated intermediate host or a transitive host. In addition, if you drink contaminated raw water, or if you come into contact with raw water and do not pay attention to washing your hands, you may become infected with Roundworm.
Clinically, there have also been cases of children who like to play Fushou snails and are infected, which should also be paid attention to.
5 What are the symptoms of infection with Guangzhou tube roundworm?
When uncooked snails, slugs, frogs, snails, fish, shrimp and crabs are eaten, if infected larvae are present, the bugs penetrate the intestinal wall and follow the blood flow to the brain, causing infection of the central nervous system and causing eosinophilic meningoencephalitis. As insects migrate through the body, they can damage the intestinal wall, liver, lungs and brain, and most seriously intracranial infections.
Larval invasion does not occur immediately, with a minimum incubation period of 1 day and a maximum of 35 days. It is mainly manifested as fever and acute severe headache, followed by neck rigidity, nausea, vomiting and neck mobility pain or stiffness, and a few even cause blindness and hemiplegia.
Of these, headaches are the most characteristic. About 90% of patients experience pain, manifested as severe swelling pain, unbearable, intermittent attacks at first, gradually frequent or prolonged, and painkillers are effective in less than half of patients. Headaches are mainly on the forehead, the back of the head, or both sides.
Doctors may examine the blood and may find elevated blood white blood cells, mild to moderate increases in eosinophils; increased cerebrospinal fluid pressure, increased eosinophils, mildly elevated or normal proteins, slightly decreased or normal sugar, and rarely can find worms directly in the cerebrospinal fluid. Therefore, immunological methods are needed to detect the presence of parasite antibodies in blood and cerebrospinal fluid, or by pathogenIC PCR or high-throughput sequencing.
6 How to treat infection with Guangzhou tube strong nematode? Seriously?
In humans, adults migrate to the brain (and rarely to the lungs) but do not lay eggs. Therefore, if there is no re-infection, the migrating larvae will gradually die and the accompanying inflammation will subside. Therefore, studies have shown that most brain tubes are self-limiting in the course of infection and can be fully recovered.
However, there have also been reports of deaths from child infections that require attention. If the infection can be treated in time, it is expected to achieve a good recovery effect.
It has been suggested that analgesics, glucocorticoids, and regular discharge of cerebrospinal fluid are used to relieve symptoms caused by increased intracranial pressure.
In addition, it is worth reminding that there is currently controversy over whether to give deworming drugs.
Because the parasite cannot lay eggs and reproduce in the human body, it will die naturally after a certain period of time, mainly causing eosinophilic meningitis and mechanical damage. If the body is killed with anthelmintics, the antigens released by the body may induce a body reaction, leading to increased inflammation.
7 Which areas are there cantonese roundworms?
Eosinophilic meningitis caused by Roundworm Guangzhou occurs mainly in Southeast Asia (especially Thailand, Malaysia, and southern Vietnam), as well as throughout the Pacific Ocean basin, including Indonesia, the Philippines, Taiwan, Chinese mainland, Japan, Papua New Guinea, Hawaii, and several smaller Pacific islands.
Partly due to the spread of infected rats by ship, the parasite is also found in Africa, South America, Australia, Cuba, Puerto Rico and Jamaica outside this vast region, and has spread from New Orleans to other parts of Louisiana. A wider range of sporadic cases have been detected in Europe and the United States, only partly due to travel-related exposures.
On the mainland, Guangzhou tube nematode is not only in the Guangzhou area, the distribution range is very wide, the provinces and regions with more reports include: Guangdong, Guangxi, Hainan, Yunnan, Zhejiang and Fujian, Heilongjiang, Liaoning, Tianjin and Beijing also have a small number of cases reported.
In short, Guangzhou tube roundworm is mainly distributed in the southern region, and with the increase of population mobility in the northern region, the difference between the north and the south of the goods transported from the south to the north and the difference in eating habits (especially snails, seafood and other foods) may also spread to the northern region.
8 How to prevent Guangzhou roundworm infection?
Guangzhou tube roundworm infection is not so terrible, and prevention can be avoided. It is mainly transmitted through the intermediate host and the relay host, the intermediate host found in China is mainly brown cloud agate snail and Fushou snail transmission, do not eat these snails.
These snails are also often found in wet places such as front and back of houses, courtyards, rivers, canals, and even kitchens and bathrooms, and the larvae may remain everywhere with the mucus they secrete as they move. Children should not be allowed to play with these snails, so as not to be infected by the hands.
In addition, seafood in the infected water contaminated with these snails may also become a source of infection, including slugs, frogs, snails, fish, shrimp and crabs. For fish, shrimp and crabs of unclear origin, they must be fully cooked to eat, and do not use fast cooking methods such as stir-frying, hot pot or boiling water.
In addition, there is a hidden way of infection, when snails or snails crawl through vegetables, larval secretions may stick to the vegetables, at this time may be transmitted through vegetables. This situation is mainly seen in areas with many fushou snails and brown cloud agate snails.
In short, do not eat raw or semi-raw snails, do not eat lettuce, do not drink raw water, and wash your hands fully after contact with snails.
Finally, use these pictures to understand the difference between Pomacea canaliculata and field snail.
The picture above is Fushou snail ↑↑
The picture above is a field snail ↑↑
The difference between Fushou snail and field snail:
Fushou snail is larger, much larger than the field snail (1-1.5cm);
The vertebral tail of the Fushou snail is short and flat, while the vertebral tail of the field snail is long and pointed;
The shell mouth of the Fushou snail is flat, and the shell mouth of the field snail is round;
The eggs of the Fushou snail are pink, and the field snails are transparent.
Can you tell the difference?
bibliography:
1. Jinzhong Municipal Center for Disease Control and Prevention Department of Infectious Disease Prevention and Control Yan Yirang's courseware "Guangzhou Tube Roundworm Disease", link: https://wenku.baidu.com/view/7f4ed8fda36925c52cc58bd63186bceb18e8ed20.html?from=search
2.up to date, 2019-12-28 UPDATE, Eosinophilic meningitis.
Source of this article: Pediatrician Kong Lingkai
This article is written by Xiaoxin Detective
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