RESUMO
Gnathostomiasis is an important food-borne parasitic zoonosis that is endemic mainly in Asian countries where some people prefer to eat raw freshwater fish. In North America, the first recorded case of gnathostomiasis was in Mexico in 1970, and the numbers of gnathostomiasis patients in Mexico seems to be increasing dramatically with time. However, the epidemiology of this disease in Mexico has never been described in detail. Here we review the current status of gnathostomiasis in Mexico.
Assuntos
Gnathostoma , Dermatopatias Parasitárias/epidemiologia , Infecções por Spirurida/epidemiologia , Adulto , Animais , Anticorpos Anti-Helmínticos/sangue , Ensaio de Imunoadsorção Enzimática , Feminino , Peixes/parasitologia , Parasitologia de Alimentos , Água Doce , Gnathostoma/imunologia , Gnathostoma/isolamento & purificação , Humanos , México/epidemiologia , Pessoa de Meia-Idade , Dermatopatias Parasitárias/diagnóstico , Dermatopatias Parasitárias/etiologia , Infecções por Spirurida/diagnóstico , Infecções por Spirurida/etiologia , Tilápia/parasitologiaRESUMO
Gnathostomiasis was first described in Mexico in 1970, and endemic areas have been spreading in six states of this country. In Culiacan, Sinaloa, 300 cases of cutaneous larva migrans were recorded between January 1992 and December 1995. In addition, a Gnathostoma larva was surgically removed from the eye of one patient. Cutaneous lesions were observed mainly on the face, neck, arms, and legs. About 70% of the patients showed eosinophilia. A skin biopsy was carried out on 35 patients and the parasite was identified in histopathologic sections of 12 of these patients. In four patients, the larva migrated out spontaneously from the skin. An enzyme-linked immunosorbent assay using a crude somatic extract of adult Gnathostoma doloresi worms showed that 93% of the patients were seropositive, confirming the reliability of clinical diagnosis. A total of 14 advanced third-stage Gnathostoma larvae were found in four species of ichthyophagous birds captured on dams and dikes near the city of Culiacan. Scanning electron micrographs of human and bird larvae showed that they were morphologically indistinguishable from G. spinigerm. We conclude that the life cycle of Gnathostoma has been established in Sinaloa, and has become a serious public health issue for residents.