Imported human Schistosoma japonicum: A report on two cases in Filipino migrants present in Italy and a systematic review of literature

Iacopo Vellere, Valentina Dianora Mangano, Maria Cristina Cagno, Federico Gobbi, Andrea Ragusa, Alessandro Bartoloni, Giandomenico Biancofiore, Paolo De Simone, Daniela Campani, Fabrizio Bruschi, Lorenzo Zammarchi

Research output: Contribution to journalReview article

Abstract

Background: Schistosoma japonicum is endemic in the Philippines, China, and Indonesia, and is the third-most common schistosoma species. The infection can be asymptomatic for years but, if left untreated, can lead to irreversible complications. Method: We report the results of a systematic review of the literature on imported S. japonicum infection and describe two previously unpublished cases diagnosed in Filipino migrants in Italy. Results: Twenty-five imported cases of S. japonicum schistosomiasis were retrieved. All patients but one were migrants. Most subjects acquired the infection in Philippines (n = 18, 72%). Median age at diagnosis was 46 years. Median period of residence in non-endemic countries before diagnosis was 14.5 years. Cases of prevalent hepatosplenic involvement were 10 (40%), those with prevalent intestinal involvement were 10 (40%), whereas five (20%) had overlapping manifestations. Ten patients suffered from cirrhosis; two underwent liver transplantation. Three patients presented with acute abdomen due to intestinal complications, leading to explorative laparotomy. In all cases, but one, the diagnosis was based on a histological examination of biopsy specimen, revealing S. japonicum ova. Seventeen patients were treated with praziquantel, and in three of them, possible treatment failures occurred. Conclusions: S. japonicum infection is uncommonly reported in non-endemic areas, but is probably underestimated because of a low threshold awareness of clinicians and unavailability of specific diagnostic tools. Viable S. japonicum adults may persist for decades, indicating that migrants or travellers previously exposed in areas with high-risk areas can harbour viable worms and deserve treatment.

Original languageEnglish
Article number101496
JournalTravel Medicine and Infectious Disease
Early online dateSep 24 2019
DOIs
Publication statusE-pub ahead of print - Sep 24 2019

Keywords

  • Europe
  • Migrant
  • Non endemic
  • Schistosoma japonicum
  • Schistosomiasis
  • Travellers

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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    Vellere, I., Mangano, V. D., Cagno, M. C., Gobbi, F., Ragusa, A., Bartoloni, A., Biancofiore, G., De Simone, P., Campani, D., Bruschi, F., & Zammarchi, L. (2019). Imported human Schistosoma japonicum: A report on two cases in Filipino migrants present in Italy and a systematic review of literature. Travel Medicine and Infectious Disease, [101496]. https://doi.org/10.1016/j.tmaid.2019.101496