Warning: Can gnathostomiasis in Vietnam make patients blind, comatose and lead to death?
People with gnathostomiasis can go blind, even die?
Pursuant to Section 1 of the Guidelines issued together with Decision 1574/QD-BYT in 2022 of the Ministry of Health, there are warnings about gnathostomiasis as follows:
"first. OUTLINE
Pinworm disease in humans is caused by many species of parasitic roundworms like Gnathostoma, which belong to the class of roundworms but have spikes on their heads, so they are called "thornworms". The disease is found mainly in Southeast Asia, but it can also be found in other parts of Asia, Central and South America, and some parts of Africa. People get sick from eating raw or undercooked freshwater fish, eels, frogs, birds and reptiles...Cyclops contains larvae.
The most common symptoms in humans are episodic swelling of the skin and increased eosinophils in the blood. In rare cases, the parasites can enter organs such as the liver, eyes, brain, and spinal cord and cause related symptoms such as vision loss, blindness, neuralgia, paralysis, and kissing. coma and can lead to death.
1.1. Agent
There are at least five species of Gnathostoma spp. that have been shown to cause disease in humans include G. spinigerum, G. hispidum, G. doloresi, G. nipponicum and G. binucleatum. In Vietnam, the majority of cases were found to be caused by Gnathostoma spinigerum.
1.2. Inoculum
The main source of the disease is dogs and cats infected with the worm Gnathostoma spinigerum. In addition, some other animals such as eels, freshwater fish, frogs, birds, snakes can carry the larvae of this worm.
1.3. Infectiousness and immunity
All people, both sexes, are susceptible to this larva infection and are susceptible to reinfection if they live in an endemic area.
1.4. Mode of transmission
People get sick from eating Cyclops, fish, eels, frogs, snakes.. or undercooked meat of animals containing larvae."
Accordingly, people infected with gnathostomiasis will experience swelling on the skin that moves in waves and increases in blood eosinophils. In more severe cases, vision loss, blindness, coma and possibly death can result.
The gnathostomiasis in Vietnam is caused by humans eating raw or undercooked freshwater fish, eels, frogs, birds, and reptiles. In addition, gnathostomiasis on Vietnam can infect anyone, regardless of age or sex, and infected individuals can be reinfected if they live in endemic areas.
Warning: Can gnathostomiasis in Vietnam make patients blind, comatose and lead to death?
What symptoms will appear when infected with gnathostomiasis in Vietnam?
Pursuant to Section 2 of the Guidelines issued together with Decision 1574/QD-BYT in 2022 of the Ministry of Health, there are guidelines on symptoms of gnathostomiasis in Vietnam as follows:
"2. CLINICAL
After 2-4 weeks of infection with Gnathostoma spp., the patient may develop symptoms such as fever, fatigue, poor appetite, nausea and vomiting, diarrhea, and abdominal pain that is not clear. The larvae then migrate and cause the corresponding clinical form.
2.1. Skin and soft tissue
- Skin lesions can be seen in the form of a nodule, a small pimple, a limited edematous mass of unknown size; swelling, heat, redness, pain.
- Local edema: At the site of injury, there is movement under the skin, intermittent due to the movement of larvae.
- Itching, urticaria: Chronic nature, mainly at the lesion site.
- Migrating larvae can be found everywhere in the patient's body including upper extremities, lumbar region, lower extremities, face and neck, abdomen and chest, back and buttocks.
2.2. Nervous body
Depending on the number of larvae and the location of damage, the neurological form includes the degree of damage such as nerve root myelitis, encephalomyelitis, encephalitis-meningitis; Common symptoms are as follows:
- Meningeal syndrome: Stiff neck, photophobia, increased intracranial pressure.
- Encephalitis syndrome: Consciousness disturbance, weakness/hemiplegia.
- There are cases of prolonged coma.
2.3. Thể nội tạng và cơ quan khác hiếm gặp
When larvae migrate to internal organs such as liver and lungs, the corresponding clinical manifestations:
- Digestive system: When the larvae migrate to the gastrointestinal wall, the patient may experience discomfort, fever, urticaria, anorexia, nausea, vomiting, diarrhea, epigastric or lower costal pain. right if the larvae migrate to the liver;
- Pulmonary form: The patient presents with cough, chest pain due to pleurisy, shortness of breath, pneumothorax, effusion-pneumothorax, hemoptysis, coughing up larvae;
- Urogenital, genital: Blood in urine, sometimes larvae enter the uterus;
- In the eye: Very rare larva entering the eye, Gnathostoma spp. can penetrate directly into the eye causing uveitis, iritis, iris atrophy, hemorrhage, increased ocular pressure, retinal scarring, visual disturbances, decreased visual acuity, pain, photophobia and photophobia. blind;
- In the ear: Due to the larvae of Gnathostoma spp. moving into the ear cavity, nasal cavity, can damage the vestibular-cochlear organ, causing ear pain, hearing loss or tinnitus."
Thus, when a person is infected with gnathostomiasis in Vietnam larvae, they will begin to show symptoms according to the above guidance of the Ministry of Health.
What are the stages of gnathostomiasis in Vietnam infection cycle?
According to Section 1 of the Guidelines issued together with Decision 1574/QD-BYT in 2022 of the Ministry of Health, the cycle of infection with gnathostomiasis is described as follows:
(1) In the main host, the adult worms live in the stomach wall, laying eggs, and the eggs are excreted in the feces.
(2) Eggs form mating and release the first stage larvae (L1) in the aquatic environment.
(3) Ingested by the Cyclops crustacean (1st intermediate host), the larvae develop from L1 to early stage 3 (EL3).
(4) When crustaceans are swallowed by fish, frogs, snakes (2nd intermediate host), EL3 larvae migrate to muscle tissue and develop into complete 3rd stage (AL3).
(5) The second intermediate host is swallowed by the main host, AL3 larvae develop into adult worms in the stomach.
(6) In some carriers, the larvae retain the AL3 state and infectivity.
(7) People get sick from eating undercooked meat of animals containing stage 3 (AL3) larvae.
Accordingly, the infection cycle of gnathostomiasis in Vietnam will include 7 stages as described above.
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