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Stafar mönnum hætta af lirfum fuglablóðagða?

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Authors
Karl Skírnisson
Kolarova, Libusa
Issue Date
2002-10-01

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Other Titles
Are nasal Trichobilharzia cercariae potential threath to human health?
Citation
Læknablaðið 2002, 88(10):739-44
Abstract
During late summer in 1995 to 1997, repeated outbreaks of maculopapular skin eruptions were observed on legs of children after wading in the pond of the Family Park in Reykjavík, Iceland. Investigation, starting in autumn 1997, revealed that the causative agent was a previously undescribed schistosome cercaria of the genus Trichobilharzia, shed by Radix peregra, the only snail occurring in the pond. This was the first report of swimmer's itch in Iceland. Infection experiments with cercariae from the pond have revealed adult worms and eggs of a Trichobilharzia in the nasal area of ducklings (Anas platyrhynchos f.dom.) 18-23 days p.i., and schistosomula in the spinal cord of BALB/c mice 3, 6 and 10 days p.i. Moreover, a mouse killed 3 days p.i. also had schistosomula in the lungs. During the prepatent period the infected ducklings had neuromotoric symptoms and gross pathology revealed petechiae in the nasal cavity. The results indicate that the cercaria responsible for swimmer's itch in Iceland is a nasal schistosome. Furthermore, adults of two visceral Trichobilharzia species have been found in Icelandic whooper swans Cygnus cygnus. As schistosomula of both nasal and visceral Trichobilharzia species are able to develop and migrate for several days in a non-specific mammalian host, humans are warned to expose themselves to Trichobilharzia cercariae in Iceland.
Síðsumars árin 1995 til 1997 fundust þráfaldlega kláðabólur á fótum barna eftir að þau höfðu verið að vaða í tjörn í Fjölskyldugarðinum í Laugardal í Reykjavík. Rannsóknir sem hófust haustið 1997 leiddu í ljós að útbrotin voru eftir sundlirfur áður óþekktrar tegundar fuglablóðögðu af ættkvíslinni Trichobilharzia. Kláðabóla myndast eftir hverja lirfu sem nær að smjúga í gegnum húðina. Sundlirfurnar fjölga sér kynlaust í vatnasniglinum Radix peregra sem er algengur í tjörninni. Á ensku eru útbrot sem þessi nefnd sundmannakláði (swimmer's itch) en sjúkdómurinn gengur undir nafninu cercarial dermatitis. Í sýkingartilraunum hefur þessum sundlirfum verið gefinn kostur á því að smjúga í gegnum húð fugla, einkum andfugla. Nýverið báru tilraunirnar árangur því fullorðnar blóðögður og egg fundust í slímhimnu í nefholi andarunga (Anas platyrhynchos f. dom.). Endurteknar smittilraunir hafa leitt til sömu niðurstöðu. Ormar nasablóðagða ferðast upp í nefhol á um þremur vikum eftir að sundlirfurnar hafa borað sig inn í gegnum húðina á fótum. Ferðalagið þangað er sérstakt því ormarnir fikra sig eftir úttaugum upp í mænu, eftir mænunni upp í heila og í gegnum hann á áfangastaðinn í nefholi. Á leiðinni stækka ormarnir og þroskast en þeir lifa á taugavef hýsilsins. Taugaskemmdir virðast standa í réttu hlutfalli við fjölda lirfa sem smita fuglinn. Tilraunamýs hafa einnig verið smitaðar með sundlirfunni úr vaðtjörn Fjölskyldugarðsins og hefur komið í ljós að hluti þeirra lifir og þroskast að ákveðnu marki í þeim í að minnsta kosti tíu daga. Þegar eftir þrjá daga eru ormarnir komnir upp í mænu. Einnig hafa lirfur fundist í lungum þremur dögum eftir sýkingu. Þar sem sundlirfur fuglablóðagða virðast í einhverjum tilfellum geta náð þroska í spendýrum, þótt aldrei hafi verið sýnt fram á að þær nái fullum þroska í þeim, er fólki ráðlagt að forðast Trichobilharzia sundlirfur á Íslandi.
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Icelandic Journal Articles (Peer Reviewed)

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