CASES/YEAR
0 (US); 1,000 (Global)
OTHER NAMES
Intestinal capillariasis; Paracapillaria philippinensis; Paracapillariasis;
INCUBATION
Unknown; [CCDM]
INITIAL SYMPTOMS
Abdominal pain, diarrhea, protein-losing enteropathy;
PRECAUTIONS
". . . not transmitted directly from person to person." [CCDM, p. 93]
COMMENTS
Birds (natural hosts) or humans (accidental hosts) acquire the infection by eating freshwater fish infected with larvae. These zoonotic intestinal nematode worms develop in the intestines in 1-2 months. Patients have muscle wasting from the protein-losing enteropathy. The disease can be fatal in 4-6 months without treatment. [ID, p. 2365] Capillariasis caused by C. philippinensis is associated with eosinophilia. [Guerrant, p. 946] Patients have diarrhea and malabsorption with abdominal pain, vomiting, weight loss, and edema. Autoinfection can produce very heavy infections. Fever and eosinophilia are not common. A 33% mortality rate has been reported in untreated patients. [PPID, p. 3477-8] Sources of infection are raw or undercooked shrimp or fish. [Cecil, p. 2133]
DIAGNOSTIC
Stool examination: Eggs resemble those of T. trichiura; Identify worms in jejunal biopsy; [CCDM, p. 92] Serology; [PPID, p. 3477]
SCOPE
Mainly in Philippines and Thailand; Cases reported in Japan, Korea, Taiwan, and Egypt; Isolated cases in Iran, India, Indonesia, and Columbia; [CCDM]
SIGNS & SYMPTOMS
-
>fever
-
G abdominal pain
-
G diarrhea
-
G nausea, vomiting
-
H eosinophilia
-
H leukocytosis
-
N muscle weakness
-
X pleural effusions
-
*weight loss
SOURCE
Animal Tissue, Eating Contaminated Food, Eating Infected or Toxin-Containing Fish, Eating Contaminated Mollusks or Crustacean
RESERVOIR
Birds and Poultry, Fish and Shellfish
RISK FACTORS
- Eat undercooked meat or fish
- Travel to endemic area
TREATMENT
Treat with mebendazole or albendazole. [CCDM]
REFERENCES FOR CASES/YEAR
1.
2. (Global) Described in coastal regions of the Philippines and Thailand; [ID, p. 2365] "It is endemic in restricted areas of the Philippines and Thailand. Sporadic cases have been reported in Japan, Korea, Taiwan, India, and Iran. Recently, this disease was reported to be emerging in Egypt. One Italian and 1 Korean traveler have acquired this parasite in Indonesia, and 1 case has been discovered in Indonesia." [PMID 16206105] Guesstimate: 1000 cases/year;