Tanaka H, Tsuji M
Department of Tropical Diseases and Parasitology, Kyorin University School of Medicine, Tokyo, Japan.
Int J Parasitol. 1997 Dec;27(12):1465-80. doi: 10.1016/s0020-7519(97)00183-5.
Among the areas in Japan where schistosome infections have occurred for many years, three major areas were Katayama District, Kofu Basin and Chikugo River Basin and three minor areas were Numazu District, Tone River Basin and Obitsu River Bank. The presence of the disease had long been recognised in the Katayama Memoir written by Fujii (1847, in the Chinese Classics). The cause of this endemic disease had been studied by many researchers, and finally a new trematode, Schistosoma japonicum, was discovered by Katsurada in 1904 [Tokyo Iji Shinshi, Vol. 1371, pp. 13-32]. The route of percutaneous infection was proven by Fujinami & Nakamura (1909) [Kyoto Medical Journal, Vol. 6, pp. 224-252] using 17 calves. Miyairi & Suzuki (1913) [Tokyo Iji Shinshi, Vol. 1836, pp. 1961-1965] determined a small snail, Oncomelania nosophora, as being the intermediate host, and clarified the development of the schistosome in the snail. To kill schistosome eggs, human faecal matter ('night soil') was stored for 2 weeks or more before using as fertiliser. Control of the parasite used caustic lime and calcium cyanamide to kill eggs, cercariae and Oncomelania snails. Susceptible cows were replaced with horses, which were more resistant to infection as the animal of burden for agriculture. Ditches around the rice fields were cemented for destruction of snail habitats. For snail control, sodium pentachlorophenate (NaPCP) was sprayed extensively. Some wetlands were drained and reclaimed and in selected localities, the river bottom was dredged. Such projects were undertaken with government support and aided by community participation. Epidemiological surveys began in 1910, first at Kofu, and infected people were treated with sodium tartar emetic (Stibnal) after 1921. The total number of cases detected in Japan in 1920 was about 8000. This figure was reduced annually down to 438 by 1970. The last human case of new infection found in Japan was at Kofu in 1977. Although snails were eradicated in most areas by 1983, a limited number of uninfected snails remain at Kofu and Obitsu.
在日本，血吸虫感染已存在多年的地区中，三大主要区域是片山地区、甲府盆地和筑后河流域，三个较小区域是沼津地区、利根川流域和小仏河岸。藤井（1847年，见于汉文典籍）所著的《片山备忘录》中早就记载了该病的存在。许多研究人员对这种地方病的病因进行了研究，最终，桂田于1904年发现了一种新的吸虫——日本血吸虫[《东京医学新闻》，第1371卷，第13 - 32页]。藤浪和中村（1909年）[《京都医学杂志》，第6卷，第224 - 252页]用17头小牛证明了经皮感染途径。宫入和铃木（1913年）[《东京医学新闻》，第1836卷，第1961 - 1965页]确定一种小型蜗牛——钉螺为中间宿主，并阐明了血吸虫在蜗牛体内的发育过程。为了杀死血吸虫卵，人粪便（“夜粪”）在用作肥料之前要储存两周或更长时间。寄生虫防治使用苛性石灰和氰氨化钙来杀死虫卵、尾蚴和钉螺。易感染的奶牛被马取代，马作为农业役畜对感染更具抵抗力。稻田周围的沟渠用水泥砌起来以破坏钉螺栖息地。为了控制钉螺，广泛喷洒五氯酚钠（NaPCP）。一些湿地被排水和开垦，在特定地区，河底被疏浚。这些项目在政府支持下开展，并得到社区参与的协助。流行病学调查始于1910年，首先在甲府进行，1921年后，感染人群用吐酒石（锑波芬）进行治疗。1920年日本检测到的病例总数约为8000例。到1970年，这个数字逐年降至438例。日本最后一例新感染的人类病例是1977年在甲府发现的。尽管到1983年大多数地区的钉螺已被消灭，但甲府和小仏仍有少量未感染的钉螺留存。
