Macpherson Calum N L
St George's University, P.O. Box 7, Grenada, West Indies.
Int J Parasitol. 2005 Oct;35(11-12):1319-31. doi: 10.1016/j.ijpara.2005.06.004. Epub 2005 Jul 20.
The behaviour of Homo sapiens has a pivotal role to play in the macro and microepidemiology of emerging or re-emerging parasitic zoonoses. Changing demographics and the concomitant alterations to the environment, climate, technology, land use and changes in human behavior, converge to favour the emergence and spread of parasitic zoonoses. The recent unprecedented movements of people, their animals and their parasites around the world, introduce and mix genes, cultural preferences, customs, and behavioral patterns. The increasing proclivity for eating meat, fish, crabs, shrimp, molluscs raw, undercooked, smoked, pickled or dried facilitates a number of protozoan (Toxoplasma), trematode (Fasciola sp., Paragonimus spp., Clonorchis sp., Opisthorchis spp., Heterophyes sp., Metagonimus sp., Echinostoma spp., Nanophyetus sp.) cestode (Taenia spp, Diphyllobothrum sp.) and nematode (Trichinella spp., Capillaria spp., Gnathostoma spp., Anisakis sp., Parastrongylus spp.) caused zoonoses. The increasing world population and the inability to keep pace with the provision of adequate sanitation and clean, safe drinking water, has led to an increased importance of waterborne zoonoses, such as those caused by Giardia, Cryptosporidium and Toxoplasma. Our close relationship with and the numerous uses to which we put companion animals and their ubiquitous distribution has resulted in dogs and cats unwitting participation in sharing over 60 parasite species including: Giardia, Cryptosporidium, Toxoplasma, most foodborne trematode species, Diphyllobothrum, Echinococcus spp., Ancylostoma and Toxocara. Changing human behaviour through education, to encourage the proper cooking of food, which may have cultural and social significance, will remain as challenging as controlling stray and feral pet populations, improving hygiene levels and the provision of safe drinking water and the proper use of sanctuary facilities. Long pre-patent periods and the normally insidious sub-clinical nature of most zoonoses makes advice requiring behavioural change for their control a difficult task. Our clearer understanding of the heterogeneity of susceptibility to infection, the complex genetic variations of people and parasite species and the development of molecular epidemiological tools is shedding more light on transmission routes and the spectrum of disease that is observed. Improved and new serological, molecular and imaging diagnostic tests and the development of broad spectrum chemotherapeutic agents has led to the attenuation of morbidity and mortality due to parasitic zoonoses in economically advantaged regions. Such advancements, in partnership with supportive behavioural change, has the potential for a sustainable global reduction in the burden of ill health due to parasitic zoonoses. Whether this will materialise is a challenge for us all.
人类行为在新出现或再次出现的寄生性人畜共患病的宏观和微观流行病学中起着关键作用。人口结构的变化以及随之而来的环境、气候、技术、土地利用的改变和人类行为的变化，共同促成了寄生性人畜共患病的出现和传播。最近，人们、他们的动物及其寄生虫在全球范围内前所未有的流动，带来并混合了基因、文化偏好、习俗和行为模式。越来越多的人倾向于食用生的、未煮熟的、烟熏的、腌制的或干制的肉类、鱼类、螃蟹、虾、软体动物，这助长了许多由原生动物（弓形虫）、吸虫（肝片吸虫属、并殖吸虫属、华支睾吸虫属、后睾吸虫属、异形吸虫属、后圆吸虫属、棘口吸虫属、新并殖吸虫属）、绦虫（带绦虫属、阔节裂头绦虫属）和线虫（旋毛虫属、毛细线虫属、颚口线虫属、异尖线虫属、类圆线虫属）引起的人畜共患病。世界人口的不断增加以及无法跟上提供充足卫生设施和清洁、安全饮用水的步伐，导致了水源性人畜共患病（如由贾第虫、隐孢子虫和弓形虫引起的疾病）的重要性日益增加。我们与伴侣动物的密切关系以及我们对它们的众多用途和它们无处不在的分布，导致狗和猫不知不觉地参与传播60多种寄生虫，包括：贾第虫、隐孢子虫、弓形虫、大多数食源性吸虫种类、阔节裂头绦虫、棘球绦虫属、钩虫和弓首蛔虫。通过教育改变人类行为，鼓励正确烹饪食物（这可能具有文化和社会意义），将与控制流浪和野生宠物数量、提高卫生水平、提供安全饮用水以及正确使用庇护设施一样具有挑战性。大多数人畜共患病的长潜伏期和通常隐匿的亚临床性质使得要求改变行为以控制它们的建议成为一项艰巨的任务。我们对感染易感性的异质性、人和寄生虫物种复杂的基因变异以及分子流行病学工具的发展有了更清晰的认识，这为传播途径和所观察到的疾病谱提供了更多的线索。改进的和新的血清学、分子和影像学诊断测试以及广谱化疗药物的开发，已导致经济发达地区寄生性人畜共患病所致的发病率和死亡率有所下降。这些进展与支持性的行为改变相结合，有可能在全球范围内可持续地减轻寄生性人畜共患病造成的健康负担。这是否会成为现实对我们所有人来说都是一个挑战。
