Schistosoma japonicum

Schistosoma japonicum is an important parasite and one of the major infectious agents of schistosomiasis.This parasite has a very wide host range, infecting at least 31 species of wild mammals, including 9 carnivores, 16 rodents, one primate, two insectivores and three artiodactyls and therefore it can be considered a true zoonosis.

Morphology
The S. japonicum worms are yellow or yellow-brown. The males of this species are slightly larger than the other Schistosomes and they measure ~ 1.2cm by 0.5 mm. The females measure 2cm by 0.4 mm. The adult worms are longer and narrower than the related S. mansoni worms.

By electron microscopy there are no bosses or spines on the dorsal surface of the male, which is ridged and presents a spongy appearance. Many spines cover the inner surface of the oral sucker and extend to the pharyngeal opening. The oral sucker shows a rim with spines of variable size and sharpness inward and outward from the rim. The ventral sucker possesses many spines which are smaller than in the oral sucker. The lining of the gynecophoric canal is roughened by minute spines. The integument of the female is ridged and pitted and possesses fewer spines than in the oral sucker, the ventral sucker, and the gynecophoric canal of the male. Anterior to the acetabulum, the integumental surfaces are devoid of spines. However, in the other areas, spines are equally distributed except for the vicinity of the excretory pore.

The ova are about 55 - 85 mm by 40 - 60 mm, oval with a minute lateral spine or knob.

Life Cycle
The life cycles of S. japonicum and S. mansoni are very similar. In brief, eggs of the parasite are released in the feces and if they come in contact with water they hatch into free-swimming larva, called miracidia. The larva then has to infect a snail of the species Oncomelaria hupensis within one or two days. Inside the snail, the larva undergo asexual reproduction through a series of stages called sporocysts. After the asexual reproduction stage cercaria (another free-swimming larva) are generated in large quantities, which then leave (shed into the environment) the snail and must infect a suitable vertebrate host. Once the cercaria penetrates the skin of the host it loses its tail and becomes a schistosomule. The worms then migrate through the circulation ending at the mesenteric veins where they mate and start laying eggs. Each pair desposits around 1500 – 3500 eggs per day in the vessels of the intestinal wall. The eggs infiltrate through the tissues and are passed in the feces.

Diagnosis
Microscopic identification of eggs in stool or urine is the most practical method for diagnosis. Stool examination should be performed when infection with S. mansoni or S. japonicum is suspected, and urine examination should be performed if S. haematobium is suspected.

Eggs can be present in the stool in infections with all Schistosoma species. The examination can be performed on a simple smear (1 to 2 mg of fecal material). Since eggs may be passed intermittently or in small amounts, their detection will be enhanced by repeated examinations and/or concentration procedures (such as the formalin - ethyl acetate technique). In addition, for field surveys and investigational purposes, the egg output can be quantified by using the Kato-Katz technique (20 to 50 mg of fecal material) or the Ritchie technique.

Eggs can be found in the urine in infections with S. haematobium (recommended time for collection: between noon and 3 PM) and with S. japonicum. Detection will be enhanced by centrifugation and examination of the sediment. Quantification is possible by using filtration through a Nucleopore membrane of a standard volume of urine followed by egg counts on the membrane. Tissue biopsy (rectal biopsy for all species and biopsy of the bladder for S. haematobium) may demonstrate eggs when stool or urine examinations are negative.

Treatment
The chemotherapy of choice is praziquantel, a quinolone derivative. Praziquantel is generally administered in an oral form in one or two doses from 40-60 mg/kg body weight.