| An epidemiological and clinical study on paragomimiasis in Korean children |
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Chong Moo Park, Chang Hwa Ann |
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Children’s Hospital and Dept, of Pediatrics, Presbyterean Hospital, Taegu, Korea |
| 韓國每童 에서의 肺吸史症에 對한 疫學的，臨床的 邸究
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朴 鍾 策, 宋 昌 華 |
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大邱東山基督病院 小兒科 및 小兒病院 |
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| Abstract |
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Paragonimiasis is a disease of man caused by the presence of oriental lung fluke, Paragonimus Westermani, encapsulated in the parenchyma of lung. The heavily infected area is confined primarily to the Far East, including Japan, Korea, Formosa, isolated foci in China, Indo-china, Philippines, Thailand and Malay* The infection is also recorded in some part of India, South America and Africa. It has been thought paragonimiasis is endemic in Korea* Both paragonimiasis and clonorchiasis are important fluke infections in Korea. All acquire the metacercariae through the ingestion of infected raw flesh water-crabs in streams or crayfishes in mountainside streams. Pollution of water by the eggs of the parasites specially those from reservoir hosts other than man，
serves as the principle source of infection for the snails which in turn produce the cercariaa that invade crustaeceans hosts. 179 cases of paragonimiasis at the Children’s Hospital and Presbyterean Hospital in Taegu,
Korea daring past 7 years(1953-1959) have been studied. Summary : 1) Yearly incidence of paragonimiasis in our hospital (Jan. 1953-Aug. 1959) ranged between 0.09-0.22% of the wholeout-patient by history and clinical findings(1953-1957) and 0.58-1.7% by including paragonimus skin test (1958-1959). (Table 1). 2) Age incidence were relatively even throughout infancy to childhood except low incindence under 1 year. There were three peaks on 3 years, 6-8 years, and 11-12 years, which seems closely related to the epidemic of measles as shown in Fig I. (Table 2, 3) Male incidence was found to be more than twice of female (69 : 31). 3) The most important source of paragonimus infection was from crayfish ingestion during measles infection for the mistaken idea that raw juice is effective in "bringing out” the rash (80%), and ingestion of uncooked crabs (soybean sauce pickle) (16%) 4% of the patients had no history of any ingestion of crayfish or crab 4) Paragonimus skin test was condueted on suspected patients and 97% of clinically approved piatents were positive. Of 179 tested for paragonimus ova in sputa and feces were positive in 77% and 40% each. While 46% of the tested patients were positve to paragonimus skin test who had taken raw crayfish or crab in the past(table 4). 287 cases out of 1,967 measles patients had history of crayfish ingestion and the number of ingested crayfish ranged from 1-19.
5) 1164 crayfishes from 5 mountainside streams, around Taegu area were gathered and studied for metacercariae in different season repeatedly. Positive mecereariae infestations were ranged between 29-96%, averaging 58% as shown in Table 6 and 7. 6) We have employed alternate combine treatment of Emetine Hcl (I.M. lmg./kg.) and Chloroquine (orajiy 13mg-/kg.) for 10days with 10days period of resting therefter for 40-100
days. 104 cases in 170 patients recieved the full course of treatment- Follow up study has shown 43% of complete cure (negative ovum in sputa and feces for 3 months) after completion of the treament. The remainder of 56 cases, including 30 cases who were symptomless with positive skin test, 14 cases are still on treament, 12 cases were failed to follow up. 7) 22unfavorable cases with.above regiipen were treated with PAA 2056(Park Davis Co.) 5 mg. /kg. for 15 days followed 10 days resting period. Examination of ova in sputa and feces
turned to be negative at the end of first treatment in 2 cases, 4 cases at the end of 2 nd treattmen and lease at the end of thM treatment 8) Extra-pulmpaary (ectopic) paragonimiasis infection were found in 7% of the patients(12cases), 7 cases of pleurisy with pleural thickning; 3cases of cerebral paragonimiasis; 2 casea
of skin and subcutapeus nodules. |
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