Kuchta Roman, Brabec Jan, Kubáčková Petra, Scholz Tomáš
Institute of Parasitology, Biology Centre of the Academy of Sciences of the Czech Republic, České Budějovice, Czech Republic.
University Hospital Brno, Brno, Czech Republic.
PLoS Negl Trop Dis. 2013 Dec 26;7(12):e2535. doi: 10.1371/journal.pntd.0002535. eCollection 2013.
A total number of 14 valid species of Diphyllobothrium tapeworms have been described in literature to be capable of causing diphyllobothriosis, with D. latum being the major causative agent of all human infections. However, recent data indicate that some of these infections, especially when diagnosed solely on the basis of morphology, have been identified with this causative agent incorrectly, confusing other Diphyllobothrium species with D. latum. Another widely distributed species, D. dendriticum, has never been considered as a frequent parasite of man, even though it is found commonly throughout arctic and subarctic regions parasitizing piscivorous birds and mammals. Recent cases of Europeans infected with this cestode called into question the actual geographic distribution of this tapeworm, largely ignored by medical parasitologists.
On the basis of revision of more than 900 available references and a description and revision of recent European human cases using morphological and molecular (cox1) data supplemented by newly characterized D. dendriticum sequences, we updated the current knowledge of the life-cycle, geographic distribution, epidemiological status, and molecular diagnostics of this emerging causal agent of zoonotic disease of man.
The tapeworm D. dendriticum represents an example of a previously neglected, probably underdiagnosed parasite of man with a potential to spread globally. Recent cases of diphyllobothriosis caused by D. dendriticum in Europe (Netherlands, Switzerland and Czech Republic), where the parasite has not been reported previously, point out that causative agents of diphyllobothriosis and other zoonoses can be imported throughout the world. Molecular tools should be used for specific and reliable parasite diagnostics, and also rare or non-native species should be considered. This will considerably help improve our knowledge of the distribution and epidemiology of these human parasites.
文献中已描述共有14种有效的裂头绦虫物种能够引起裂头绦虫病，其中阔节裂头绦虫是所有人类感染的主要病原体。然而，最近的数据表明，其中一些感染，尤其是仅基于形态学诊断的感染，被错误地认定为此病原体，将其他裂头绦虫物种与阔节裂头绦虫混淆。另一个广泛分布的物种，枝双腔吸虫，从未被认为是人类的常见寄生虫，尽管它在北极和亚北极地区普遍存在，寄生于食鱼鸟类和哺乳动物。最近欧洲人感染这种绦虫的病例对这种绦虫的实际地理分布提出了质疑，而医学寄生虫学家基本上忽略了这一点。
在对900多篇现有参考文献进行修订的基础上，以及使用形态学和分子（细胞色素c氧化酶亚基1，cox1）数据对近期欧洲人类病例进行描述和修订，并补充新鉴定的枝双腔吸虫序列，我们更新了关于这种新出现的人类人畜共患病病原体的生命周期、地理分布、流行病学状况和分子诊断的现有知识。
绦虫枝双腔吸虫代表了一种以前被忽视、可能诊断不足的人类寄生虫，有在全球传播的潜力。最近在欧洲（荷兰、瑞士和捷克共和国）出现的由枝双腔吸虫引起的裂头绦虫病病例，这些地区以前未报告过该寄生虫，指出裂头绦虫病和其他人畜共患病的病原体可以在世界各地传入。应使用分子工具进行特异性和可靠的寄生虫诊断，同时也应考虑罕见或非本地物种。这将极大地有助于提高我们对这些人类寄生虫的分布和流行病学的认识。
