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 Echinostomiasis: a common but forgotten food-borne disease Graczyk TK; Fried BAm J Trop Med Hyg  1998[Apr]; 58 (4): 501-4Human echinostomiasis, endemic to southeast Asia and the Far East, is a  food-borne, intestinal, zoonotic parasitosis attributed to at least 16 species of  digenean trematodes transmitted by snails. Two separate life cycles of  echinostomes, human and sylvatic, efficiently operate in endemic areas. Clinical  symptoms of echinostomiasis include abdominal pain, violent watery diarrhea, and  anorexia. The disease occurs focally and transmission is linked to fresh or  brackish water habitats. Infections are associated with common sociocultural  practices of eating raw or insufficiently cooked mollusks, fish, crustaceans, and  amphibians, promiscuous defecation, and the use of night soil (human excrement  collected from latrines) for fertilization of fish ponds. The prevalence of  infection ranges from 44% in the Philippines to 5% in mainland China, and from  50% in northern Thailand to 9% in Korea. Although the patterns of other  food-borne trematodiases have changed in Asia following changes in habits,  cultural practices, health education, industrialization, and environmental  alteration, human echinostomiasis remains a health problem. The disease is most  prevalent in remote rural places among low-wage earners and in women of child  bearing age. Echinostomiasis is aggravated by socioeconomic factors such as  poverty, malnutrition, an explosively growing free-food market, a lack of  supervised food inspection, poor or insufficient sanitation, other helminthiases,  and declining economic conditions. Furthermore, World Health Organization control  programs implemented for other food-borne helminthiases and sustained in endemic  areas are not fully successful for echinostomiasis because these parasites  display extremely broad specificity for the second intermediate host and are  capable of completing the life cycle without involvement of the human host.|*Food Parasitology[MESH]|*Zoonoses[MESH]|Amphibians[MESH]|Animals[MESH]|Asia, Eastern/epidemiology[MESH]|Asia, Southeastern/epidemiology[MESH]|Crustacea[MESH]|Echinostomiasis/epidemiology/prevention & control/*transmission[MESH]|Fishes[MESH]|Humans[MESH]|Mollusca[MESH]|Shellfish[MESH]|Snails[MESH]
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