METAGONIMOSIS (metagonimosis) — the helminthosis proceeding with intestinal frustration.
It is for the first time described by S. Yokogawa in 1911. It is widespread in Japan, China; in the USSR meets in the Far East in the basin of the Amur River.
The activator M. — a trematode of Metagonimus yokogawai Katsurada, 1912. Length of helminth is 1 — 2,5 mm, width is 0,4 — 0,7 mm; the body is covered with small spinules (fig). Eggs of helminth oval, 0,026 in size — 0,028 X 0,015 — 0,017 mm, pinkish-orange color; cover of egg smooth, thin. On one of its poles there is flat, badly distinguishable lid, edges a cut act a little; the border of a lid has an appearance of an equal striola, on a pole of egg, opposite to a lid, the hillock is swept well up. In a stage of puberty of Metagonimus yokogawai parasitizes in a small bowel of the person, a cat and dog (final owners). Intermediate owners of helminth — fresh-water mollusks of Melania libertina, etc. Additional owners — fishes of different types.
the Source of an invasion are sick M. people, cats, dogs. With their excrements are allocated to the environment of egg of helminth. At hit of eggs in water they leave larvae-miratsidii, to-rye actively are implemented in mollusks — intermediate owners of a parasite. In a mollusk there is a development and reproduction of larval generations of helminth which is coming to an end with formation of the larvae possessing a tail, tserkariyev to-rye come out mollusks in water, get into fishes and intsistirutsya in them, turning in metatserkariyev. The last are localized in scales, hypodermic cellulose and muscles of fishes. Metacercarias represent spherical cysts to dia. 0,18 — 0,20 mm, inside to-rykh are located a mobile larva.
Infection of fishes (whitefish, ide, sazan, bream, crucian, etc.) there is a hl. obr. in creeks of the rivers, lakes contaminated by excrements of the person or animal and abounding with mollusks. The person catches M. at consumption of the crude and insufficiently thermally processed fish containing metacercarias of helminth and also at an accidental proglatyvaniye of its scales which stuck to ware, food stuffs and got to water in preparation time of fish dishes.
From cysts — metatserkariyev in intestines larvae hatch, to-rye get into a mucous membrane and move ahead in it, laying the narrow courses. In 2 weeks they reach puberty and leave in a gleam of a gut. As a result of mechanical and, perhaps, toksiko-allergic influence of helminths there is an endoenteritis.
The clinical picture
M. sometimes proceeds subclinically, but quite often there are nausea, hypersalivation, abdominal pains and persistent recurrent ponosa with a kashitseobrazny or liquid chair.
the Diagnosis is based on detection in Calais of the patient of eggs of a metagonimus, to-rye are similar to Clonorchis sinensis eggs — the causative agent of helminthosis of a liver and a pancreas — clonorchosis (see). The last, unlike eggs of a metagonimus, have the pear-shaped form and are covered with a thick rough cover; they possess a high lid, the border passes a cut with the case of egg in a view of the rough twisting line.
apply extract from a rhizome of a men's fern To removal of helminths. Extract is given in the conditions of a hospital on 2 — 2,5 g (in the morning on an empty stomach in two steps with an interval of 8 — 10 min.). Within 2 days before treatment of the patient receives the food poor in fats. In the morning in day of administration of drug appoint an enema, the night before and in 1,5 — 2 hours after reception of extract of a fern — salt laxative. In view of weak effect of anthelmintic drugs on the parasites who are in a wall of a gut at detection of eggs of helminths in Calais it is necessary to repeat treatment, but not earlier than, in 2 — 3 months after the first course.
Forecast and Prevention
Forecast favorable. Perhaps spontaneous release from helminths.
Prevention: consumption of only carefully fried thoroughly or boiled thoroughly fish; strict observance of rules of hygiene in the maintenance of kitchen and kitchen accessories; protection of reservoirs from fecal pollution.
Bibliography: Astafyev B. A. The differential diagnosis of a clonorchosis, metagonimosis and opisthorchosis on morphological features, eggs, Medical parazitol., t. 29, .Vo 5, page 607, i960; Podjyapol-s to and I am V. P. and To and p at with t and V. F N. Helminthic diseases of the person, page 268, M., 1958; With both N about in and the p L. I. K to a question of helminthic invasions of the population of the estuary of Amur River, Medical parazitol., t. 21, No. 1, page 79, 1952; Faust E. Page of Human helminthology, L., 1949, bibliogr.
H. H. Plotnikov.