Overgaauw P A
Virbac Nederland B.V., Barneveld, The Netherlands.
Crit Rev Microbiol. 1997;23(3):215-31. doi: 10.3109/10408419709115137.
Toxocarosis is the clinical disease in man caused by infection of zoonotic roundworms of dogs and cats, Toxocara canis and T. cati. In this review the mode of transmission to the human by oral ingestion of Toxocara eggs from the environment is discussed. T. cati seems to play a more important role than generally suggested. Direct contact with animals is not considered a potential risk because embryonation of excreted Toxocara ova requires a minimum of 2 weeks. For the same reason there is no relationship expected between infection and exposure to dogs and cats in the household. Children more frequently have clinical symptoms because of the closer contact with contaminated soil in yards and sandpits, the lack of hygiene, and because of eating dirt. Toxocara larval migration in the body can cause various clinical syndromes. Visceral larva migrans, ocular larva migrans, and covert toxocarosis are described. Serodiagnostic techniques are reliable tools to detect antibodies or antigens. Systemic treatment with anthelmintics is described but can result in hypersensitivity reactions caused by dying larvae. For ocular lesions, laser photocoagulation and corticosteroid therapy are described. Preventive measures consist of preventing contamination of the environment with Toxocara eggs and for education of pet owners and non-pet owners to increase awareness about potential zoonotic hazards. Veterinary practitioners, general practitioners, and public health agencies should therefore provide sufficient information and advice.
弓首蛔虫病是由犬猫的人兽共患蛔虫——犬弓首蛔虫和猫弓首蛔虫感染人类引起的临床疾病。在这篇综述中，讨论了通过经口摄入环境中的弓首蛔虫卵而传播给人类的方式。猫弓首蛔虫似乎比通常认为的发挥着更重要的作用。直接接触动物不被视为潜在风险，因为排出的弓首蛔虫卵的胚胎发育至少需要2周时间。出于同样的原因，预计感染与家庭中接触犬猫之间没有关联。儿童更频繁地出现临床症状，原因是他们与庭院和沙坑中受污染土壤的接触更密切、卫生习惯差以及有吃泥土的行为。弓首蛔虫幼虫在体内移行可导致各种临床综合征。文中描述了内脏幼虫移行症、眼幼虫移行症和隐匿性弓首蛔虫病。血清诊断技术是检测抗体或抗原的可靠工具。文中描述了使用驱虫药进行全身治疗，但这可能会导致由死亡幼虫引起的过敏反应。对于眼部病变，描述了激光光凝和皮质类固醇治疗。预防措施包括防止环境被弓首蛔虫卵污染，以及对宠物主人和非宠物主人进行教育，以提高对潜在人兽共患病危害的认识。因此，兽医从业者、全科医生和公共卫生机构应提供充分的信息和建议。
