Belizario V Y, de Leon W U, Esparar D G, Galang J M, Fantone J, Verdadero C
Department of Parasitology, College of Public Health, University of the Philippines Manila.
Southeast Asian J Trop Med Public Health. 2000 Sep;31(3):478-81.
A 20 year old female from Compostela Valley Province in the Philippines, presenting with chronic diarrhea, borborygmi, bipedal edema, anorexia and weight loss was seen at Davao Regional Hospital. Her stool specimen, suspected by a local medical technologist to have Capillaria philippinensis ova, was forwarded to the Diagnostic Parasitology Laboratory of the College of Public Health, University of the Philippines Manila. It was examined and found to contain Capillaria philippinensis adults, larvae and eggs. Twelve deaths among people coming from the same barangay, affected by a similar illness with no definite diagnosis except "gastroenteritis" were also reported. These prompted health officials to send a team that would investigate the etiology of the disease outbreak labeled as a "Mystery Disease". Seventy-two stool samples from symptomatic patients were examined. Fifty-three (73.6%) individuals were proven to harbor at least one parasite with 16 (22.2%) individuals positive for Capillaria philippinensis infection. Ocular inspection, interviews and focus group discussions revealed that the people's eating habits are not much different from the habits of those from the Ilocos provinces where capillariasis was initially described. In both areas, people are fond of eating kinilaw or raw fish. They also eat raw shrimps, crabs and snails. Furthermore, the people defecate in the field or in the same body of water where they get the fishes, shrimps, crabs and snails that they eat, thus completing the life cycle of Capillaria philippinensis. Fish-eating birds were likely to have spread this parasite to the area. This is the first report of a capillariasis outbreak in Compostela Valley Province, and this should alert health authorities to consider embarking on serious efforts for developing proficiency of laboratory and clinical diagnosis especially in government health facilities where the poor and marginalized sectors of society are likely to consult.
一名来自菲律宾康波斯特拉山谷省的20岁女性，因慢性腹泻、腹鸣、双下肢水肿、厌食和体重减轻，前往达沃地区医院就诊。当地医学技术人员怀疑其粪便样本含有菲律宾毛细线虫卵，遂将样本送至菲律宾大学马尼拉分校公共卫生学院诊断寄生虫学实验室。经检查，发现样本中含有菲律宾毛细线虫成虫、幼虫和虫卵。据报告，来自同一巴朗盖的12人死于类似疾病，除“肠胃炎”外，没有明确诊断。这些情况促使卫生官员派出一个小组，对这场被称为“神秘疾病”的疾病爆发的病因进行调查。对72名有症状患者的粪便样本进行了检查。53人（73.6%）被证实至少感染一种寄生虫，其中16人（22.2%）菲律宾毛细线虫感染呈阳性。通过目视检查、访谈和焦点小组讨论发现，这些人的饮食习惯与最初描述有毛细线虫病的伊洛科斯省居民的饮食习惯没有太大差异。在这两个地区，人们都喜欢吃生腌鱼或生鱼。他们还吃生虾、螃蟹和蜗牛。此外，人们在田间或他们获取食用的鱼、虾、螃蟹和蜗牛的同一水体中排便，从而完成了菲律宾毛细线虫的生命周期。食鱼鸟类可能将这种寄生虫传播到了该地区。这是康波斯特拉山谷省首次报告毛细线虫病疫情，这应提醒卫生当局认真努力提高实验室和临床诊断水平，特别是在社会贫困和边缘化群体可能就诊的政府卫生设施中。
