Shistosoma japonicum

Shistosoma japonicum lives in blood

vessels of man, and is also called blood
fluke.
This worm commonly live in mesenteric
vein, the eggs reach to human liver and
cause cirrhosis.
Shistosomiasis
Morphology
1. Adult
Male:10~20mm
Grayish
white,having a
gynecophoral
canal
Female:12~28mm
Cylindrical,
Darker,slender
and longer
Suckers and testes
2. Egg
•Oval, slightly
yellow
•No operculum,
having a spine on
the egg shell
•Miracidium
Life cycle
Adult lives in
mesenteric
vein,
The eggs cause
abscess in
intestinal wall
 Adult

Egg

cercaria

miracidium

Daughter sporocyst Mother sporocyst

 Snail
(Oncomelania genus)
Adults in
mesenteric
vein
Miracidium
Cercaria
 Important points
Where the adults live?
How do the eggs get into the lumen of
cecum ?
Intermediate host:
Infective host:
By which way the worm get into human
body ?
The migration routine:
Pathogenesis
Cercaria ： cercarial dermatitis
Adolescent ： inflammation of blood vessels
Adult ： inflammation of mesenteric vein
Egg ： cause human tissue become
necrotic,and form abscess, and then the
abscess become fibrotic, at last cause
cirrhosis. As result, portal hypertension will
take place.
Eggs in human liver
Eggs in the cecum of man
 Symptom
1. Acute shistosomiasis
2. Chronic shistosomiasis
3. Terminal shistosomiasis
 1. Acute shistosomiasis
The patients are infected with a large
number of cercariae,and also infected for
the first time.
Manifestations: fever, cough,diarrhea,
hepatic pain, enlarged lymph nodes,
hepatomegaly,etc.
 2. Chronic shistosomiasis
The patients have been infected with few
cercariae, but for many times in a long
time.
Manifestations ： chronic diarrhea,
dysentery,hepatomegaly, splenomegaly,
weight loss, anemia, emaciation, etc.
 3. Terminal shistosomiasis
Hepatic Cirrhosis, portal hypertension,
retarded growth
All symptoms and signs of cirrhosis
Most of the patients have serious
emaciation, anemia, having a great deal
of ascites.
Nutritional exhaustion, hepatic coma,
secondary infection, and upper digestive
tract bleeding.
Terminal shistosomiasis
Terminal shistosomiasis
Diagnosis
Epidemiology
 1. Distribution
Shistosomiasis is mainly prevalent in China,
Japan, Philippines and Indonesia
In China, this disease is found in 13
provinces along the Yangtze River valley
and to the south of the Yangtze
760 000 patients in China
 2. Factors for epidemic
Sources of infection
Water contaminated with feces
Snail existence
Human come into contact with polluted
water
Easily infected masses (paddy planter)
Treatment and prevention
1. Eradicate the sources of infection
Treat patients (Praziquantel)
Control of cattle,dog,pig,et al.
2. Break the transmission routine
Kill snails
Manage feces
Improve water supply
3. Protect the easily infected masses
Promote health education
Avoid touching the polluted water directly
(rubber boots)
Realize modernization of agriculture
Vaccine development
The end