Cho Seung Yull, Bae Jong Hoa, Seo Byong Seol
Department of Parasitology and Institute of Endemic Diseases, College of Medicine, Seoul National University, Korea.
Kisaengchunghak Chapchi. 1975 Jun;13(1):60-77. doi: 10.3347/kjp.1975.13.1.60.
Human sparganosis in Korea was discussed on the bases of five human cases experienced by the present authors and 58 case records already reported by many previous authors, in aspects of epidemiology and clinical features. Sparganosis is not infrequent tissue helminthiasis now in Korea and the incidence has been evidently increased during past 10 years. It might be interpreted that improved medical delivery system and health care exposed the hidden but prevalent disease. The distribution of sparganosis in Korea is apparently subdivided into three major endemic areas; Kyunggi Do, Kyungsang Do and Hamkyung Nam Do. Although scanty in other areas of Korea, the distribution of this disease is presumably throughout the whole peninsula of Korea except Cheju Do. The majority of human cases of sparganosis in Korea has revealed raw consuming of snakes for treatment of tuberculosis, syphilis and joint pain, for tonics and for the belief of special nutrition among very limited group of Korean population. Because of this kinds of mode of infection, comprising four fifths of all cases, the majority of cases detected were male adult consisting of about 70% of total cases. And drinking of untreated water in rural area where no protective, sanitary measures for water sources were provided in the past, seems another important causes of infection especially in women and children in Korea. Thus it may be concluded that sparganosis in Korea is concluded by eating of infective stages per os voluntarily or involuntarily, but not through the direct invasion. Clinically, subcutaneous mass or lump was the most frequent problem in those patients and those masses were associated with inflammatory signs. By the anatomical location of the lesion, some peculiar manifestations could be developed as in orbital, abdominal, urethral, ureteral and vertebral cases. And the lesions could be complicated by haemorrhage or abscess formations. The larval worms hitherto collected in Korea has been identified tentatively as Sparganum mansoni because neither branched larvae nor Sparganum proliferum were ever reported.
基于作者自身经历的5例人体病例以及许多前人已报道的58例病例记录，从流行病学和临床特征方面对韩国的人体裂头蚴病进行了讨论。裂头蚴病在韩国如今已并非罕见的组织寄生虫病，且在过去10年中发病率明显上升。这可能是由于医疗服务体系和卫生保健的改善使这种隐匿但普遍存在的疾病得以显现。韩国裂头蚴病的分布明显分为三个主要流行区：京畿道、庆尚道和咸镜南道。尽管在韩国其他地区病例较少，但据推测除济州道外，该病在朝鲜半岛全境均有分布。韩国大多数人体裂头蚴病病例显示，在非常有限的一部分韩国人群中，存在生吃蛇来治疗肺结核、梅毒和关节疼痛、作为滋补品以及出于特殊营养观念的情况。由于这种感染方式占所有病例的五分之四，所以检测到的大多数病例为成年男性，约占总病例数的70%。过去在农村地区，水源没有防护和卫生措施，饮用未处理的水似乎是另一个重要的感染原因，尤其是对韩国的妇女和儿童而言。因此可以得出结论，韩国的裂头蚴病是通过自愿或非自愿经口摄入感染阶段而感染的，而非通过直接侵入感染。临床上，皮下肿块或硬结是这些患者最常见的问题，且这些肿块伴有炎症体征。根据病变的解剖位置，在眼眶、腹部、尿道、输尿管和脊椎病例中会出现一些特殊表现。病变还可能并发出血或脓肿形成。迄今在韩国采集到的幼虫初步鉴定为曼氏裂头蚴，因为从未有过分支幼虫或增殖裂头蚴的报道。
