Paragonimus westermani

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Paragonimus westermani

• Reba Cunningham

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History

• Most discoveries
• made between
• 1874-1918
• Discovered in Brazil
• in 1850 by Diesing
• First described in Bengal tigers housed in zoos
  in Hamburg and Amsterdam in 1877
• Coenraad Kerbert named the parasite after the
  manager of the zoo G.F Westerman

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Continued

• Sidney Ringer discovered the parasite in a human
  in a Portuguese man during an autopsy in 1879
• Rudolf Luekart found that the parasite found in
  the tiger is the same as the parasite that caused
  haemoptysis in Formosa and Japan
• 1916-1922 Japanese workers discovered the life
  cycle in the snail
• Nine cases of paragonimiasis have been
  encountered in Laotian Hmong immigrants from Camp
  Ban Vinai in Thailand
• 12 Human infestations were described later in Asia

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Transmission

• Eating raw, undercooked or pickled crustaceans
  such as crab or crayfish
• Spitting, a habit in asian countries
• Cultures that eat raw crustaceans
• Drunken Crab in China
• Raw Crab or Crayfish and alcohol in The
  Philippines
• Gye Muchim in Korea
• Sushi crab, ama ebi and odori in Japan

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Distribution

• It is estimated that 20 million are infected with
  Paragonimus westermani
• It is endemic in China, Korea, Japan, the
  Philippines, and Taiwan
• Japan, Korea, Formosa, China, Manchuria, the
  Philippine Islands and India
• Infection is also found in parts of tropical West
  Africa, from the Congo and Nigeria, especially
  from Southern Cameron
• Rare in the US but it is found in Missouri

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Treatment

• Praziquantel-Oral, causes severe spasms and
  paralysis of the worms' muscles
• Not for pregnant women
• Stomach pains, dizziness, fever, nausea,
  vomiting, headache
• Better tolerated than Bithionel
• Bithionol
• Diarrhea, use is limited due to side effects
• Triclabendazole
• Can cure cases other drugs failed

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Prevention

• Fully cook shellfish
• Heat water to 55oC for 5 minutes
• Freeze Fish
• -20 C for 7 days
• -35 C for 15 hours
• Make spitting illegal
• Use molluscicides to control snail population

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Resources

• http//www.patient.co.uk/showdoc/40000491/
• http//tmcr.usuhs.mil/tmcr/chapter22/intro.htm
• http//www.nlm.nih.gov/medlineplus/druginfo/uspdi/
  202474.html
• http//mywebpages.comcast.net/fredarfaa/lungtrmt.h
  tm