Po koupání v přírodních nádržích se v létě 2023 na několika místech v České republice objevila u lidí, zejména u dětí, cerkáriová dermatitida. Jde o imunitní reakci na průnik larvy motolice – ptačí krevničky – do kůže nesprávného hostitele. Mezi hostiteli parazita jsou plicnatí vodní plži – plovatky a okružáci – a definitivní hostitelé vodní ptáci, zejména kachny. Hodiny až dny po koupání se vyvine svědivá vyrážka, následně s puchýřky. Hojení trvá dva týdny, symptomy lze tišit antihistaminiky. Čisté vodní nádrže bez plžů jsou bezpečné a v některých přírodních nádržích po nahlášení onemocnění přistoupila samospráva nebo provozovatel koupaliště k fyzické likvidaci plžů.
After swimming in natural reservoirs in the summer of 2023, cercarial dermatitis or Swimmer's itch appeared in several places in the Czech Republic in people, especially in children. It is an immune reaction to the penetration of a fluke larva – a bird blood fluke into the skin of the wrong host. The intermediate hosts of the parasite are pulmonate aquatic gas- tropods – pond snails and ramshorns – and the definitive hosts are waterfowl, especially ducks. An itchy rash develops hours to days after bathing, followed by blisters. Healing takes two weeks symptoms can be calmed by antihistamines. Clean water reservoirs without snails are safe, and in some natural ones, after the disease has been reported, the municipality or the operator of the swimming pool proceeded to physically dispose of the snails.
- MeSH
- Cercaria * pathogenicity MeSH
- Child MeSH
- Host-Parasite Interactions MeSH
- Humans MeSH
- Skin Diseases, Parasitic * diagnosis prevention & control therapy MeSH
- Ponds MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Geographicals
- Czech Republic MeSH
Cercarial dermatitis (swimmer's itch) is a common non-communicable water-borne disease. It is caused by penetration of the skin by larvae (cercariae) of schistosomatid flukes and develops as a maculopapular skin eruption after repeated contacts with the parasites. The number of outbreaks of the disease is increasing, and cercarial dermatitis can therefore be considered as an emerging problem. Swimmer's itch is mostly associated with larvae of the bird schistosomes of Trichobilharzia spp. Recent results have shown that mammalian infections (including man) manifest themselves as an allergic reaction which is able to trap and eliminate parasites in the skin. Studies on mammals experimentally infected by bird schistosome cercariae revealed, however, that during primary infection, parasites are able to escape from the skin to the lungs or central nervous system. This review covers basic information on detection of the infectious agents in the field and the clinical course of the disease, including other pathologies which may develop after infection by cercariae, and diagnosis of the disease.
- MeSH
- Central Nervous System microbiology MeSH
- Cercaria immunology MeSH
- Dermatitis diagnosis immunology parasitology MeSH
- Skin microbiology pathology MeSH
- Humans MeSH
- Disease Models, Animal MeSH
- Swimming MeSH
- Lung microbiology MeSH
- Schistosoma MeSH
- Schistosomiasis complications diagnosis immunology MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
- MeSH
- Dermatitis immunology parasitology pathology MeSH
- Epidemiology MeSH
- Ducks parasitology MeSH
- Lectins MeSH
- Humans MeSH
- Antibodies, Helminth analysis immunology MeSH
- Schistosomatidae immunology classification growth & development MeSH
- Life Cycle Stages MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Animals MeSH
- MeSH
- Dermatitis MeSH
- Prevalence MeSH
- Schistosomatidae parasitology MeSH
- Geographicals
- Czech Republic MeSH
The occurrence of a dermatitis was reported from 4 natural water reservoirs in Central Bohemia (Czechoslovakia) in June and August 1985 and 1986. The clinical course of the disease was suggestive of cercarial dermatitis. Exanthema occurred most frequently under the bathing suits of afflicted persons, and on unprotected parts of their skin as well. A total of 5,865 snails (Lymnaea auricularia) were collected at the localities Nový rybník in Príbram, Spálený mlýn at Lísnice and Uhonice. Nine individuals of L. stagnalis were collected at Grado, Celákovice. Biological examination indicated cercariae of bird schistosomes (Trichobilharzia szidati) only at one locality--Spálený mlýn, Lísnice. The question of cercarial dermatitis caused by species other than schistosome cercariae, especially by Diplostomum spathaceum which was abundant at Príbram, is discussed. Repeated outbreaks of cercarial dermatitis were stopped at one locality by chemical and mechanical snail control in a swimming pool. Chemical control by chlorinated lime and copper sulfate proved insufficient in the course of the season. The mechanical control (clearing of the mud and drying of the bottom of the pool) removed infected snails, reservoirs of the disease. Suggested changes in the composition of fish fauna should also reduce excessive reproduction of snails.
- MeSH
- Dermatitis epidemiology etiology prevention & control MeSH
- Disease Outbreaks * MeSH
- Trematode Infections epidemiology etiology prevention & control MeSH
- Pest Control MeSH
- Larva isolation & purification MeSH
- Humans MeSH
- Lymnaea parasitology MeSH
- Skin Diseases, Parasitic epidemiology etiology prevention & control MeSH
- Swimming MeSH
- Schistosomatidae isolation & purification MeSH
- Fresh Water * MeSH
- Water * MeSH
- Disease Reservoirs MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czechoslovakia MeSH
Cercarial dermatitis (CD) is an allergic skin disease that rises in consequence of infection by invasive stages (cercariae) of trematodes of the family Schistosomatidae. CD has been considered a re-emerging disease, human cases have been reported from all continents, and tourism-threatening outbreaks occur even in frequented recreational areas. Although the symptoms of CD are generally known, the data on immune response in human patients are sporadic and incomprehensive. In the present study, we attempted to correlate the symptoms, personal history, and time course of CD in human patients with differential cell counts, dynamics of selected cytokines, and dynamics and quality of antibody response. By a systematic follow-up, we obtained a uniquely complex dataset from ten persons accidentally and concurrently infected by the same parasite species in the same locality. The onset of CD was significantly faster, and the symptoms were heavier in participants with a history of CD if compared to naive ones, who, however, also developed some of the symptoms. The repeatedly infected persons had elevated proportion of eosinophils 1 week post exposure (p.e.) and a stronger specific IgG but not IgM response, whereas specific IgE response was not observed. Increased serum levels of IL-4 occurred 1 and 3 week(s) p.e. in all participants. There was high variability in individual immunoblot patterns of IgG response, and no antigen with a universal diagnostic potential was confirmed. The presented analyses suggested that a complex approach can improve the accuracy of the diagnosis of CD, but component data should be interpreted carefully.
- MeSH
- Dermatitis immunology parasitology MeSH
- Adult MeSH
- Disease Outbreaks MeSH
- Immunoglobulin E blood MeSH
- Immunoglobulin G blood MeSH
- Immunoglobulin M blood MeSH
- Trematode Infections diagnosis immunology parasitology MeSH
- Interleukin-4 blood MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Follow-Up Studies MeSH
- Antibodies, Protozoan blood MeSH
- Surveys and Questionnaires MeSH
- Ponds parasitology MeSH
- Schistosomatidae immunology MeSH
- Animals MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
Cercarial dermatitis (swimmer's itch) is a condition caused by infective larvae (cercariae) of a species-rich group of mammalian and avian schistosomes. Over the last decade, it has been reported in areas that previously had few or no cases of dermatitis and is thus considered an emerging disease. It is obvious that avian schistosomes are responsible for the majority of reported dermatitis outbreaks around the world, and thus they are the primary focus of this review. Although they infect humans, they do not mature and usually die in the skin. Experimental infections of avian schistosomes in mice show that in previously exposed hosts, there is a strong skin immune reaction that kills the schistosome. However, penetration of larvae into naive mice can result in temporary migration from the skin. This is of particular interest because the worms are able to migrate to different organs, for example, the lungs in the case of visceral schistosomes and the central nervous system in the case of nasal schistosomes. The risk of such migration and accompanying disorders needs to be clarified for humans and animals of interest (e.g., dogs). Herein we compiled the most comprehensive review of the diversity, immunology, and epidemiology of avian schistosomes causing cercarial dermatitis.
- MeSH
- Biodiversity MeSH
- Disease Outbreaks MeSH
- Host Specificity MeSH
- Humans MeSH
- Bird Diseases parasitology transmission MeSH
- Skin Diseases, Parasitic epidemiology immunology parasitology prevention & control MeSH
- Schistosomiasis epidemiology immunology parasitology prevention & control MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
- Research Support, N.I.H., Extramural MeSH
- Research Support, U.S. Gov't, Non-P.H.S. MeSH
The human infection known under the names cercarial dermatitis or swimmers' itch is generally associated with swimming in lakes all over the world, however, a number of outbreaks of cercarial dermatitis developing in salt or brackish waters are also reported. The disease presents as allergic reaction which is able to trap and eliminate the parasites in the skin. However, the infection can be linked to more than skin symptoms under certain circumstances. Recent studies on bird schistosomes have shown that during primary infections of noncompatible hosts (mice) the parasites may migrate through visceral and nervous tissues of mammals. Up to date, cercarial dermatitis has been mostly associated with the cercariae of bird schistosomes of the genus Trichobilharzia. Recent findings of new genera and species indicate, however, broader spectrum of causative agents of the disease with different life cycles, host specificity and pathogenicity.
- MeSH
- Dermatitis etiology immunology parasitology MeSH
- Host-Parasite Interactions genetics drug effects MeSH
- Larva immunology microbiology parasitology MeSH
- Humans MeSH
- Birds microbiology parasitology MeSH
- Mammals parasitology MeSH
- Schistosoma isolation & purification microbiology parasitology MeSH
- Schistosomatidae isolation & purification microbiology parasitology MeSH
- Check Tag
- Humans MeSH
Cercariae of bird schistosomes (genus Trichobilharzia) are able to penetrate the skin of mammals (noncompatible hosts), including humans, and cause a Th2-associated inflammatory cutaneous reaction termed cercarial dermatitis. The present study measured the antibody reactivity and antigen specificity of sera obtained after experimental infection of mice and natural infection of humans. Sera from mice re-infected with T. regenti showed a bias towards the development of antigen-specific IgM and IgG1 antibodies and elevated levels of total serum IgE, indicative of a Th2 polarized immune response. We also demonstrate that cercariae are a source of antigens triggering IL-4 release from basophils collected from healthy human volunteers. Analysis of sera from patients with a history of cercarial dermatitis revealed elevated levels of cercarial-specific IgG, particularly for samples collected from adults (> 14 years old) compared with children (8-14 years old), although elevated levels of antigen-specific IgE were not detected. In terms of antigen recognition, IgG and IgE antibodies in the sera of both mice and humans preferentially bound an antigen of 34 kDa. The 34 kDa molecule was present in both homogenate of cercariae, as well as cercarial excretory/secretory products, and we speculate it may represent a major immunogen initiating the Th2-immune response associated with cercarial dermatitis.
- MeSH
- Antigens, Helminth chemistry immunology MeSH
- Basophils immunology MeSH
- Dermatitis immunology parasitology MeSH
- Child MeSH
- Adult MeSH
- Financing, Organized MeSH
- Immunoglobulin E MeSH
- Immunoglobulin G blood MeSH
- Immunoglobulin M blood MeSH
- Interleukin-4 secretion MeSH
- Humans MeSH
- Adolescent MeSH
- Molecular Weight MeSH
- Mice MeSH
- Antibodies, Helminth blood MeSH
- Schistosomatidae immunology MeSH
- Age Factors MeSH
- Animals MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Humans MeSH
- Adolescent MeSH
- Mice MeSH
- Animals MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
