Current Status and Perspectives of Cysticercosis and Taeniasis in Japan

Hiroshi Yamasaki

doi:10.3347/kjp.2013.51.1.19

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Articles from Symposium on Asian Taenia (October 2011, Osong, Korea)

Current Status and Perspectives of Cysticercosis and Taeniasis in Japan

Hiroshi Yamasaki

The Korean Journal of Parasitology 2013;51(1):19-29.
Published online: February 18, 2013

DOI: https://doi.org/10.3347/kjp.2013.51.1.19

Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan.

Corresponding author (hyamasak@nih.go.jp)

• Received: February 20, 2012 • Revised: December 18, 2012 • Accepted: December 18, 2012

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
INTRODUCTION
CLINICAL CASES
CURRENT STATUS OF T. ASIATICA INFECTION IN JAPAN
CONCLUSIONS
ACKNOWLEDGMENTS
References

Abstract

This mini-review describes recent epidemiological trends in cysticercosis and taeniasis in Japan. Some of the topics discussed herein were presented at the first symposium on "Current perspectives of Taenia asiatica researches", that was held in Osong in Chungbuk Province, South Korea, in October 2011 and organized by Prof. K. S. Eom, Chungbuk National University School of Medicine. To better understand the trends in the occurrence of cysticercosis and taeniasis in Japan, clinical cases reported in 2005 have been updated. In addition, the current status of Taenia asiatica infections successively occurring in Japan since 2010 is also discussed.
Key words: Taenia solium, Taenia asiatica, Taenia saginata, taeniasis, cysticercosis, Japan

INTRODUCTION

Cysticercosis, a parasitic disease caused by Taenia solium cysticercus, is one of the important parasitic diseases. Neurocysticercosis (NCC) is accepted to refer to cysts in the central nerve system, including the parenchyma and ventricles of the brain and the spinal cord. Subcutaneous cysticercosis (SCC) is used for the cysticercosis presenting the form of firm, mobile nodules, mainly in the soft tissues and muscles of on the trunk and extremities. NCC is clinically more serious than SCC because of the severity of the neurologic symptoms, such as epileptic seizures and paralysis that can result from infection. The disease constitutes a major public health problem in many parts of the world, including China, Southeast Asia, India, sub-Saharan Africa, and Latin America [1]. Cysticercosis has also become an important parasitic disease in developed countries, such as the United States, particularly in California and other states with a large immigrant population [2]. In Japan, although T. solium cysticercosis/taeniasis was endemic to the Okinawa region in southern Japan 50-60 years ago [3,4], the disease is no longer endemic in the area. Nonetheless, sporadic cases of cysticercosis have been reported in Japan, primarily among Japanese returning from abroad and foreigners coming to Japan (Table 1) [5].

Conversely, taeniasis, which is caused by infection with the adult tapeworm of T. solium or Taenia saginata, occurs worldwide, except in countries where people do not eat pork and beef for religious reasons [1]. Taeniasis caused by Taenia asiatica is restricted to countries in Asia, including South Korea, China, Taiwan, the Philippines, Vietnam, Thailand, Indonesia, and Japan [6]. In Japan, sporadic cases of taeniasis have been reported and most of them were caused by infection with T. saginata and were imported cases until T. asiatica infections were confirmed in 2010 (Table 2). Compared to cysticercosis, taeniasis is innocuous or asymptomatic, with most patients presenting with slight intestinal illness and mental discomfort due to persistent expulsion of the proglottids.

In Japan, the "Ordinance for Enforcement of the Food Sanitation Act" based on the Food Sanitation Law stipulates that food-borne parasitic diseases such as cysticercosis and taeniasis be treated as cases of food poisoning and that authorities be notified of their occurrence immediately. However, because parasitic diseases have never reported based on the law, it is not possible to accurately estimate the incidence of cysticercosis/taeniasis in Japan. Therefore, the author previously examined the epidemiological trends in cysticercosis and taeniasis based on clinical cases in Japan published in scientific journals [5]. Since then, new cases of cysticercosis and taeniasis have been reported and several cases of cysticercosis have been newly diagnosed in our department. The Department of Parasitology at the National Institute of Infectious Diseases, Tokyo routinely performs diagnostic tests requested for parasitic diseases from domestic and foreign medical institutions, and cysticercosis and taeniasis also are acceptable for diagnosis.

The purpose of this article is to overview the current status of cysticercosis/taeniasis in Japan and to update the data that was reported in 2005 [5] based on the cases cited in PubMed (National Library of Medicine) and Japana Centra Revuo Medicina as well as cases diagnosed in our department over the last 5 years (2007-2011).

CLINICAL CASES

Cysticercosis

According to Nishiyama and Araki [4], as many as 389 cases of cysticercosis were reported in Japan from 1908 to 1997. However, 24 cases reported between 1943 and 1979 were not included in the study. Furthermore, 41 cases, including 10 cases diagnosed by our department, have been newly confirmed between 1997 and 2011 (cases 26-66 in Table 1) [7-40]. Taken together, this gives a total of 454 cysticercosis cases that have been reported in Japan between 1908 and 2011. Table 1 shows 66 of the cysticercosis cases that have been reported over the last 22 years (1990-2011) along with cases confirmed by our department between 2007 and 2011.

Of these 66 cases, 54 (66.7%) were NCC; NCC with multiple cysts (28/54, 51.9%; Fig. 1E) was more frequent than NCC with a solitary cyst (13/54, 33.5%; Fig. 1A, B and Fig. 2A, B, E). Between 1990 and 2011, total 17 cases of SCC were reported as cases 4 [41], 16-17 [42], 24 [43], 26 [7], 28 [9], 29 [10], 34 [16], 35 [17], 44 [27,28], 45 [29], 52 [36], 56, 63, 64, 65, and 66. Two of them were systemic intramuscular cysticercosis with numerous calcified cysts; cases 44 [27,28] and 52 [36] (Fig. 1F, G; Fig. 2D, F). Very rarely, intramedullary cysticercosis in case 5 [44] and ocular cysticercosis in cases 11 [45], 36 [18], 43 [26], and 58 [38] have also been reported. Ten cases of NCC with either SCC or ocular cysticercosis were reported in cases 16-17 [42], 26 [7], 29 [10], 35 [17], 43 [26], 45 [29], 56 , 64, and 65 (Table 1). More interestingly, dual infection of cysticercosis and taeniasis was observed in 4 cases; 29 [17], 58 [51], 60, and 65 (Table 1). Furthermore, the adult tapeworm in case 41 was observed in the small intestine using capsule endoscopy to confirm the presence of the adult worm (Table 2).

Cysticercosis diagnosis is generally performed by imaging, serologic, and histopathologic examinations. In our department, molecular identification of the etiologic agents is routinely performed, if surgically removed materials are available [46-48]. Indeed, the usefulness of molecular methods for diagnosing the causative agents has successfully been demonstrated by the identification of 2 genotypes of T. solium cysticercus as well as confirmation of the agents in paraffin-embedded sections [24,25,28,31,33-35,37,40]. In addition, the localities where the patients were infected can also be inferred based on the DNA sequences of the causative agents [32,49].

In SCC, X-ray examinations have revealed the presence of rod-like, scattered, calcified lesions in the soft tissues of the extremities (Fig. 1F, G; Fig. 2D, F). These calcified cysts have histopathologically been confirmed to be T. solium in cases 16-17 [42], 26 [7], 52 [36], and 44 [27,28] (Fig. 2A, C, E).

Two types of T. solium cysticercus, cellulose- and racemose-types, are known to exist. The cellulose-type cysticercus is characterized by a single bladder measuring 3 to 18 mm in diameter with an invaginated scolex and primarily found in the cerebral parenchyma and musculature. The racemose-type presents as large multilobulated cystic lesions lacking a scolex and appears to prefer the cisternal and ventricular systems or subarachnoid space [2]. Indeed, the racemose-type cysticercus is frequently found in the subarachnoidal spaces as multilobulated lesions (Fig. 1C, D). Although cysticercosis due to racemose-type T. solium cysticercus is relatively rare, 8 cases have been documented in Japan in cases 8 [50,51], 15 [52], 18 [53], 19 [54], 39 [21], 50 [34], 61, and 62 [40] (Table 1; Fig. 1C, D; Fig. 2C). Of these, mitochondrial DNA analysis using histopathologic sections revealed that etiologic T. solium was the Asian genotype in 3 cases, 50 [32], 61, and 62 [40], and American/African genotype in case 50 [34] (Table 1). The racemose-type cysticercus is considered to be an aberrant, multilobular, non-viable T. solium cysticercus, possibly the degenerated form of a cysticercus in the basal subarachnoid space. Molecular analysis using formalin-fixed and paraffin-embedded histopathologic specimens has proved that the racemose-type cysticercus is T. solium in cases 50 [34], 61, and 62 [40].

Most of the cysticercosis cases in Japan are imported cases, meaning that the patients either lived in or visited countries where cysticercosis and taeniasis are still endemic, and where they are presumed to have been exposed to T. solium eggs. However, 13 cases have suggested that infection occurred within Japan (cases 1 [55], 8 [50,51], 10 [56], 12 [57], 20 [54], 21 [58], 22 [59], 23 [60], 28 [9], 40 [22], 52 [36], 53, and 62 [40]. NCC was diagnosed by imaging findings (Fig. 1), serology, histopathology (Fig. 2A, C, D, E), and molecular analysis.

Taeniasis

Table 2 shows 73 clinical taeniasis case reports that have been published in journals between 1990 and 2011 and diagnosed by our department between 2007 and 2011. In addition to these, 26 cases have been reported [61,62]. The most commonly encountered taeniasis cases were T. saginata infections and 48 cases (65.8%) have been confirmed to date (Table 2). Of these 48 cases, 45 were imported cases [63-78]. Although the route of infection is unknown, the possibility also exists that 4 of these cases may be attributable to domestic infections; cases 4 [65], 6 [66], 19 [73], and 22 [73]. T. solium taeniasis is extremely rare in Japan and only 1 case was reported in Okinawa in 1988 [79]. However, taeniasis solium cases with either NCC, SCC, or ocular cysticercosis have been confirmed, and all these were imported in cases 29 [10], 58 [38], 60, and 65 (Table 1) and cases 17 [10], 41, 53, and 64 (Table 2). Taeniasis caused by T. asiatica has been also recently successively confirmed in Japan and this will be discussed in the following chapter.

Taeniasis is usually diagnosed based on proglottid morphology. However, since T. saginata, T. solium, and T. asiatica are all morphologically similar, it is not always possible to accurately differentiate them. As a result, more reliable molecular diagnoses are currently employed to differentiate between taeniasis infections in our department [46-48]. Most recently, T. solium tapeworms have been observed in the small intestine using capsule endoscopy in cases 41 [23] and 53.

CURRENT STATUS OF T. ASIATICA INFECTION IN JAPAN

Although T. asiatica was not previously considered to occur in Japan [5], retrospective molecular analyses of proglottids revealed that 2 T. asiatica infections occurred in Tottori Prefecture on Honshu Island, Japan, in 1968 and 1996 [6]. Unfortunately, it is unknown whether the 2 Japanese cases were domestic infections or imported cases. As the number of Japanese travelers visiting Asian countries has increased, so too has the number of people from other Asian countries visiting Japan. This may mean that the likelihood of encountering cases of imported T. asiatica is increasing. Surprisingly, from June 2010 to December 2011, an increasing number of human cases with taeniasis have been diagnosed in the Kanto region, including Tokyo and the neighboring 5 prefectures (Gumma, Tochigi, Saitama, Chiba, and Kanagawa) in central Honshu [80-84]. Of 31 taeniasis cases, 20 were attributed to T. asiatica. Taenia asiatica tapeworms were identified based on nucleotide sequence analysis of the mitochondrial cytochrome c oxidase subunit 1 gene [25] and allelic analysis of the 2 nuclear genes for elongation factor 1-α and ezrin-radixin-moesin-like protein genes [85].

Nineteen out of 20 patients infected with T. asiatica were Japanese nationals residing in the Kanto area and 1 was a Filipino woman living in same area (Tochigi). Fifteen patients stated that they frequently ate raw pig liver (sashimi). Sixteen had never been overseas or, if they had undertaken any international travel, they traveled to countries where T. asiatica is not endemic. The infection in the Filipino woman who has returned to the Philippines several times was also considered to have been occurred in Japan.

The occurrence of taeniasis due to T. asiatica infection is thus considered to have occurred within Japan by the following reasons: i) most of the patients had never been overseas or traveled to areas where T. asiatica is not endemic, ii) most patients had histories of eating raw pig liver, iii) based on interviews with patients and meat inspectors, pigs that had been produced and slaughtered in the Kanto region were strongly suspected to be possible sources of infection, iv) although Japan imports pork from Canada, Mexico, and Europe, no raw pig liver is imported from these countries. At present, the reasons why T. asiatica infections successively occurred in the Kanto region, a region within which the disease was not reported previously, have not yet been satisfactorily clarified. Considering that patients have occurred now, it is possible that the workers and pigs on farms in the Kanto region currently constitute the T. asiatica reservoirs responsible for these infections. We have been investigating the prevalence of T. asiatica metacestodes in pigs from these farms in collaboration with local meat inspection centers. In addition, we have also disseminated information describing precautions against T. asiatica infections in Infectious Agents Surveillance Reports (http://idsc.nih.go.jp/iasr/32/374/kj3741.html) published by the Infectious Diseases Information Center at the National Institute of Infectious Diseases [80-84].

CONCLUSIONS

It is expected that cysticercosis and taeniasis will primarily be detected as imported cases with the increasing numbers of Japanese travelers to foreign countries where these diseases are endemic or visitors from these areas increase. The occurrence of human infections due to T. asiatica is currently restricted to the Kanto region in Japan, and the origins of infection have not yet been clarified. Thus, further occurrence of the disease is likely to occur, medical practitioners should be aware of the importance accurately identifying the causative agent responsible for infection.

ACKNOWLEDGMENTS

The author thanks Prof. Keeseon S. Eom and Prof. Jong-Yil Chai for their initiation to submit a review paper. The author also thanks Prof. H. Matsuoka, Prof. A. Chiba, Drs. T. Oda, S. Shiiki, T. Nagase, M. Tsuda, and S. Matsunaga, for providing imaging pictures and pathology specimens. Drs. Y. Morishima and H. Sugiyama are thanked for their valuable discussions of clinical cases, and M. Muto is also acknowledged for her technical assistance with molecular and serologic examinations of cysticercosis and taeniasis cases. The study was supported in part by Grants-in-Aid for Scientific Research from the Ministry of Health, Labour and Welfare, Japan (H20-22-Shinko-Ippan-016 and H23-Shinko-Ippan-014) and from the Japan Society for the Promotion of Science (23650602).

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Fig. 1

Imaging findings of selected cysticercosis cases. (A) plain CT image showing a solitary lesion at the left occipitoparietal area (case 48 [32], courtesy of Prof. H. Matsuoka). (B) MRI showing one of multiple cystic lesions in the left frontal and temporal lobes (case 49 [33]). (C) MRI showing a rasemose-type lesion at the basal cistern (case 50 [34], courtesy of Dr. T. Oda). (D) MRI FLAIR findings showing a giant and multilobulated mass in the subarachnoidal spaces of the right frontal lobe (case 62 [40], courtesy of Dr. S. Shiiki). (E) Cisterography showing multiple cysts in the brain (case 60, courtesy of Prof. A. Chiba). (F) X-ray findings showing typical rice grain calcifications in the muscles of buttocks and lower extremity (case 44 [27, 28], courtesy of Dr. T. Nagase). (G) CT findings showing numerous calcified cysts in muscles of the of the buttocks (case 52 [36], courtesy of Dr. M. Tsuda).

Fig. 2

Histopathologic findings of cystic lesions from cysticercosis patients. (A) A cellulose-type cysticercus characterized by rabyrinth-like structure (case 40 [22], courtesy of Dr. S. Matsunaga). (B) and (E) A resected lesion and a cellulose-type cysticercus (case 48 [32], courtesy of Prof. H. Matsuoka). (C) Racemose-type cysticercus characterized by complicated cystic walls (case 62 [40], courtesy of Dr. S. Shiiki). (D) SCC showing typical rice grain calcifications in the muscles of buttocks and lower extremity and the section of the calcified lesion (case 44 [27, 28], courtesy of Dr. T. Nagase). (F) Surgically removed calcified lesions (case 52 [36], courtesy of Dr. Tsuda). Sections (A, C , D, and E) were stained with hematoxylin and eosin.

Table 1.

Demographic and clinical data for cysticercosis cases reported in Japan (1990-2011)

Table 1.
Case No.	Year	Patient (Nationality/Age/Sex)	Type of cysticercosis	Diagnostic criteria	Presumed locality of infection	References
1	1990	Japanese/40/F	NCC (multiple)	CT/Pathology	Japan (Tokunoshima, Kagoshima)	55
2	1991	Korean/73/M	NCC (multiple)	CT/MRI/Pathology	Korea	86
3	1991	Japanese/33 /M	NCC (solitary)	CT/MRI/Serology	Honduras	87
4	1991	Japanese/29/F	SCC (solitary)	Pathology/Serology	Thailand	41
5	1991	Japanese/48/M	Intramedullary spinal (solitary)	CT/MRI/Pathology	Thailand	44
6	1992	Chinese/20/M	NCC (multiple)	CT/MRI/Pathology	China (Heilongjiang province)	88
7	1992	Japanese/41/F	NCC (multiple)	CT/MRI/Serology/Pathology	Hong Kong, Korea or Japan	89
8	1992	Japanese/30/M	NCC (multiple, racemose-type)	CT/MRI/Pathology	Japan (Ginowan, Okinawa)	50, 51
9	1992	Korean/42/M	NCC (multiple)	CT/MRI/Serology	Korea	90
10	1993	Japanese/44/F	NCC (solitary)	CT/Pathology	Japan	56
11	1993	Japanese/46/M	Ocular (solitary)	Funduscope/Pathology	Vietnam or Cambodia	45
12	1993	Japanese/41/F	NCC (solitary)	CT/MRI/Pathology	Japan	57
13	1993	Brazilian/26/F	NCC (multiple)	CT/Pathology	Brazil	91
14	1993	Japanese/49/F	NCC (multiple)	CT/MRI/Pathology	China	92
15	1993	Japanese/53/M	NCC (multiple, racemose-type ?)	CT/MRI/Pathology	Taiwan	55
16	1994	Korean/48/M	NCC (multiple) and SCC (systemic)	CT/MRI/X ray/Pathology	Korea	42
17	1994	Korean/43/F	NCC (multiple) and SCC (systemic)	CT/MRI/X ray/Pathology	Korea	42
18	1994	Japanese/72/F	NCC (racemose-type)	CT/MRI/Serology/Pathology	China	53
19	1994	Chinese/24/M	NCC (racemose-type)	CT/MRI/Pathology	China	54
20	1994	Japanese/44/M	NCC (solitary)	CT/MRI/Pathology	Japan	54
21	1994	Japanese/52/F	NCC (solitary)	CT/MRI/Serology	Japan	58
22	1995	Japanese/21/F	NCC (multiple)	MRI/PET	Japan	59
23	1996	Japanese/39/M	NCC (solitary)	MRI/Pathology	Japan	60
24	1996	Japanese/39/M	SCC (solitary)	Pathology	China	43
25	1996	Korean/70/F	NCC (multiple)	CT/MRI/Serology/Pathology	Korea	93
26	1997	Chinese/68/M	NCC (multiple) and SCC (multiple)	CT/MRI/X ray/Serology	China (Heilongjiang province)	7
27	1998	Chinese/48/M	NCC (multiple)	CT/MRI	China	8
28	1998	Japanese/37/M	SCC (solitary)	Pathology	Japan	9
29	1998	Japanese/34/M	NCC (multiple), SCC (multiple) and taeniasis	CT/MRI/Serology	China (Jiujiang, Jiangxi Province)	10
30	1998	Japanese/59/M	NCC (multiple)	CT/Pathology	China	11
31	1999	Japanese/19/F	NCC (solitary)	MRI/Pathology	India	12
32	1999	Chinese/55/M	NCC (multiple)	CT/MRI/Endoscopy/Pathology	China	13
33	1999	Japanese/46/M	NCC (solitary)	CT/MRI/Pathology	Indonesia, Nigeria, or Nepal	14, 15
34	2000	Japanese/45/F	SCC (multiple)	CT/Pathology	Thailand	16
35	2000	Cambodian/29/M	NCC (multiple) and SCC (multiple)	CT/MRI/X ray/Pathology	Cambodia	17
36	2001	Japanese/53/F	Ocular (solitary)	Funduscope/US	No information	18
37	2001	Japanese/43/F	NCC (solitary)	CT/MRI/Pathology	Thailand	19
38	2001	Unknown/73/M	NCC (multiple)	CT/MRI	No information	20
39	2001	Japanese/70/M	NCC (racemose type)	CT/MRI/Serology	Philippines	21
40	2002	Japanese/26/M	NCC (solitary)	CT/MRI/Pathology/Serology	Japan	22
41	2003	Japanese/22/F	NCC (solitary)	CT/MRI// US/Pathology	India	23
42	2004	Japanese/53/F	NCC (solitary)	CT/MRI/Pathology/DNA	India, Vietnam, Thailand or Myanmar	24, 25
43	2004	Chinese/50/M	Ocular (solitary) and NCC (solitary)	Funduscope/CT/Serology/Pathology	China (Heilongjiang province)	26
44	2004	Japanese/83/M	SCC (systemic)	CT/X ray/Pathology/DNA	China	27, 28
45	2005	Chinese/44/F	NCC (multiple) and SCC (multiple)	CT/MRI/X ray	China	29
46	2005	Chinese/21/F	NCC (solitary)	CT/MRI/PET/Serology	China (Harbin, Heilongjiang province)	30
47	2005	Filipino/9/F	NCC (solitary)	CT/MRI/Pathology/DNA	Philippines	31
48	2006	Japanese/24/F	NCC (solitary)	MRI/Pathology/DNA	Indonesia or Korea	32
49	2006	Indian/28/F	NCC (multiple)	CT/MRI/DNA	India	33
50	2006	Brazilian/42/F	NCC (racemose-type)	CT/MRI/Pathology/DNA	Brazil	34
51	2007	Japanese/38/F	NCC (solitary)	CT/MRI/Pathology/DNA	Nepal	35
52	2007	Japanese/84/M	SCC (systemic)	CT/X ray/DNA	Japan (Okinawa)	36
53	2007	Japanese/51/F	NCC (multiple)	CT/MRI	Japan (Okinawa)	This study
54	2007	Japanese/31/F	NCC (multiple)	CT/MRI	India	This study
55	2008	Indian/44 /F	NCC (multiple)	MRI/Serology/DNA	India	37
56	2008	Chinese/30/M	NCC (multiple ) and SCC (multiple)	CT/MRI/X ray/Serology	China	This study
57	2008	Japanese/39/F	NCC (multiple)	CT/MRI/PET/Serology	Asian or African countries	This study
58	2009	Japanese/24/M	Ocular and taeniasis	Funduscope/US/Serology	Malawi	38
59	2009	Korean/38/M	NCC (multiple)	CT/MRI/SEM/Pathology	Korea	39
60	2009	Japanese/20/F	NCC (multiple) and taeniasis	CT/MRI/Serology/Capsule endoscopy/DNA	India	This study
61	2009	Japanese/61 /M	NCC (multiple, racemose-type)	CT/MRI/US/Serology/Pathology/DNA	India, Thailand, China or Vietnam	This study
62	2010	Japanese/53/M	NCC (racemose-type)	CT/MRI/Pathology/Serology/DNA	Japan (Uruma, Okinawa)	40
63	2010	Japanese/58/F	SCC (multiple)	CT/MRI/X ray/DNA	Japan (Akita or Okinawa)	This study
64	2010	Chinese/46/F	NCC (multiple) and SCC (multiple)	CT/MRI/US/Serology	China (Harbin, Heilongjiang province)	This study
65	2010	Japanese/31/M	NCC (multiple), SCC(multiple) and taeniasis	CT/MRI/Serology/DNA	India	This study
66	2011	Nepalese/35/M	SCC (solitary)	CT/US/Serology/Pathology/DNA	Nepal	This study

Table 2.

Demographic and clinical data for taeniasis reported in Japan (1990-2011)

Table 2.
Case No.	Year	Patient (Nationality /Age/Sex)	Etiologic agent (diagnostic criteria)	Presumed locality of infection	References
1	1990	Japanese/72/M	T. saginata (/Morphology)	?	63
2	1990	Korean/52/M	T. saginata (Serology/Morphology)	?	64
3	1990	Japanese/34/M	T. saginata (Morphology)	Ethiopia	65
4	1990	Japanese/32/M	T. saginata (Morphology)	Japan	65
5	1990	Japanese/26/M	T. saginata (Morphology)	Ethiopia or Somalia	65
6	1992	Japanese/10/F	T. saginata (Morphology)	Japan	66
7	1994	Japanese	T. saginata (Morphology)	Iran	53
8	1994	Japanese	T. saginata (Morphology)	?	53
9	1994	Japanese	T. saginata (Morphology)	?	53
10	1994	Japanese	T. saginata (Morphology)	France or Germany	53
11	1994	Japanese	T. saginata (Morphology)	Germany	53
12	1996	Japanese/53/F	T. saginata (Morphology)	?	67
13	1996	Japanese/26/M	T. saginata (Morphology)	Bolivia	68
14	1996	Japanese/47/M	T. saginata (Morphology)	Cote D’lvoire	69
15	1997	Japanese/23/F	T. saginata (Morphology)	Europe	70
16	1998	Brazilian/45/M	T. saginata (Colonoscope/Morphology)	Brazil	71
17	1998	Japanese/34/M	Probably T. solium with NCC	China (Jiujiang, Jiangxi Province)	10
18	2001	Filipino/32/F	T. saginata (Morphology)	Philippines	72
19	2001	Japanese/26/M	T. saginata (Morphology)	Japan or India	73
20	2001	Japanese/47/M	T. saginata (Morphology)	Indonesia	73
21	2001	Japanese/30/M	T. saginata (Morphology)	Ethiopia	73
22	2001	Japanese/60/M	T. saginata (Morphology)	Japan	73
23	2002	Japanese/30/M	T. saginata (Morphology)	Ethiopia	74
24	2002	Japanese/51/M	T. saginata (Morphology)	Thailand	74
25	2002	Japanese/46/M	T. saginata (Morphology)	Africa	75
26	2003	Japanese/24/F	T. saginata (Morphology)	Vietnam	77
27	2007	Japanese/45/M	T. saginata (DNA)	Thailand or Indonesia	76
28	2007	Cambodian/16/M	T. saginata (DNA)	Cambodia	94
29	2007	Japanese/58/M	T. saginata (DNA)	Korea	94
30	2007	Japanese/32/M	T. saginata (DNA)	Ethiopia	94
31	2007	Japanese/33/M	T. saginata (DNA)	Cambodia or Ethiopia	94
32	2007	Japanese/40/F	T. saginata (DNA)	China, Kenya, Monaco or Croatia	This study
33	2007	Japanese/25/M	T. saginata (Endoscope/Morphology)	Laos	78
34	2008	Japanese/26/F	T. saginata (DNA)	Nicaragua, Laos or Indonesia	This study
35	2008	Japanese/26/M	T. saginata (DNA)	Indonesia	This study
36	2008	Japanese/45/M	T. saginata (DNA)	Vietnam or China	This study
37	2009	Japanese/24/M	Taenia sp. (Morphology) with ocular type	Malawi	38
38	2009	Japanese/63/M	T. saginata (DNA)	Thailand	This study
39	2009	Japanese/57/M	T. saginata (DNA)	Thailand	This study
40	2009	Japanese/49/M	T. saginata (DNA)	Thailand	This study
41	2009	Japanese/20/F	T. solium (Capsule endoscope/DNA) with NCC	India	This study
42	2010	Japanese/58/M	T. asiatica (DNA)	Japan	81, 84
43	2010	Japanese/41/F	T. asiatica (DNA)	Japan	81, 84
44	2010	Japanese/55/M	T. asiatica (DNA)	Japan	81, 84
45	2010	Japanese/40/M	T. asiatica (DNA)	Japan	81, 84
46	2010	Japanese/31/M	T. asiatica (DNA)	Japan	82, 84
47	2010	Japanese/41/M	T. asiatica (DNA)	Japan	83
48	2010	Japanese/28/M	T. asiatica (DNA)	Japan	83
49	2010	Japanese/30/M	T. asiatica (DNA)	Japan	83, 84
50	2010	Japanese/60/M	T. asiatica (DNA)	Japan	83
51	2010	Japanese/39/F	T. asiatica (DNA)	Japan	83, 84
52	2010	Japanese/24/F	T. asiatica (DNA)	Japan	83
53	2010	Japanese/31/M	T. solium (endoscopy/DNA) with NCC	India	This study
54	2010	Japanese/39/M	T. asiatica (DNA)	Japan	84
55	2010	Japanese/56/M	T. saginata (DNA)	Thailand	This study
56	2010	Japanese/26/F	T. asiatica (DNA)	Japan	84
57	2010	Japanese/43/F	T. asiatica (DNA)	Japan	84
58	2010	Filipino/31/F	T. asiatica (DNA)	Philippines	This study
59	2011	Japanese/46/M	T. saginata (DNA)	Malaysia	This study
60	2011	Japanese/35/M	T. saginata (DNA)	Mali	This study
61	2011	Japanese/52/M	T. saginata (DNA)	Thailand	This study
62	2011	Japanese/24/F	T. saginata (DNA)	Indonesia (Bali)	This study
63	2011	Japanese/41/M	T. saginata (DNA)	Senegal	This study
64	2011	Thai/21/M	T. solium (DNA)	Thailand	This study
65	2011	Japanese/33/M	T. saginata (DNA)	Sudan	This study
66	2011	Japanese/54/M	T. asiatica (DNA)	Japan	This study
67	2011	Japanese/38/M	T. asiatica (DNA)	Japan	This study
68	2011	Ethiopian/24/F	T. saginata (DNA)	Ethiopia	This study
69	2011	Japanese/12/M	T. asiatica (DNA)	Japan	This study
70	2011	Japanese/54/M	T. asiatica (DNA)	Japan	This study
71	2011	Japanese/42/F	T. saginata (DNA)	France	This study
72	2011	Ethiopian/26/F	T. saginata (DNA)	Ethiopia	This study
73	2011	Japanese/41/F	T. asiatica (DNA)	Japan	This study

Figure & Data

References

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Current Status and Perspectives of Cysticercosis and Taeniasis in Japan

Korean J Parasitol. 2013;51(1):19-29. Published online February 18, 2013

DOI: https://doi.org/10.3347/kjp.2013.51.1.19

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Current Status and Perspectives of Cysticercosis and Taeniasis in Japan

Korean J Parasitol. 2013;51(1):19-29. Published online February 18, 2013

DOI: https://doi.org/10.3347/kjp.2013.51.1.19

Figure

Current Status and Perspectives of Cysticercosis and Taeniasis in Japan

Fig. 1 Imaging findings of selected cysticercosis cases. (A) plain CT image showing a solitary lesion at the left occipitoparietal area (case 48 [32], courtesy of Prof. H. Matsuoka). (B) MRI showing one of multiple cystic lesions in the left frontal and temporal lobes (case 49 [33]). (C) MRI showing a rasemose-type lesion at the basal cistern (case 50 [34], courtesy of Dr. T. Oda). (D) MRI FLAIR findings showing a giant and multilobulated mass in the subarachnoidal spaces of the right frontal lobe (case 62 [40], courtesy of Dr. S. Shiiki). (E) Cisterography showing multiple cysts in the brain (case 60, courtesy of Prof. A. Chiba). (F) X-ray findings showing typical rice grain calcifications in the muscles of buttocks and lower extremity (case 44 [27, 28], courtesy of Dr. T. Nagase). (G) CT findings showing numerous calcified cysts in muscles of the of the buttocks (case 52 [36], courtesy of Dr. M. Tsuda).

Fig. 2 Histopathologic findings of cystic lesions from cysticercosis patients. (A) A cellulose-type cysticercus characterized by rabyrinth-like structure (case 40 [22], courtesy of Dr. S. Matsunaga). (B) and (E) A resected lesion and a cellulose-type cysticercus (case 48 [32], courtesy of Prof. H. Matsuoka). (C) Racemose-type cysticercus characterized by complicated cystic walls (case 62 [40], courtesy of Dr. S. Shiiki). (D) SCC showing typical rice grain calcifications in the muscles of buttocks and lower extremity and the section of the calcified lesion (case 44 [27, 28], courtesy of Dr. T. Nagase). (F) Surgically removed calcified lesions (case 52 [36], courtesy of Dr. Tsuda). Sections (A, C , D, and E) were stained with hematoxylin and eosin.

Fig. 1

Fig. 2

Current Status and Perspectives of Cysticercosis and Taeniasis in Japan

Case No. Year Patient (Nationality/Age/Sex) Type of cysticercosis Diagnostic criteria Presumed locality of infection References 1 1990 Japanese/40/F NCC (multiple) CT/Pathology Japan (Tokunoshima, Kagoshima) 55 2 1991 Korean/73/M NCC (multiple) CT/MRI/Pathology Korea 86 3 1991 Japanese/33 /M NCC (solitary) CT/MRI/Serology Honduras 87 4 1991 Japanese/29/F SCC (solitary) Pathology/Serology Thailand 41 5 1991 Japanese/48/M Intramedullary spinal (solitary) CT/MRI/Pathology Thailand 44 6 1992 Chinese/20/M NCC (multiple) CT/MRI/Pathology China (Heilongjiang province) 88 7 1992 Japanese/41/F NCC (multiple) CT/MRI/Serology/Pathology Hong Kong, Korea or Japan 89 8 1992 Japanese/30/M NCC (multiple, racemose-type) CT/MRI/Pathology Japan (Ginowan, Okinawa) 50, 51 9 1992 Korean/42/M NCC (multiple) CT/MRI/Serology Korea 90 10 1993 Japanese/44/F NCC (solitary) CT/Pathology Japan 56 11 1993 Japanese/46/M Ocular (solitary) Funduscope/Pathology Vietnam or Cambodia 45 12 1993 Japanese/41/F NCC (solitary) CT/MRI/Pathology Japan 57 13 1993 Brazilian/26/F NCC (multiple) CT/Pathology Brazil 91 14 1993 Japanese/49/F NCC (multiple) CT/MRI/Pathology China 92 15 1993 Japanese/53/M NCC (multiple, racemose-type ?) CT/MRI/Pathology Taiwan 55 16 1994 Korean/48/M NCC (multiple) and SCC (systemic) CT/MRI/X ray/Pathology Korea 42 17 1994 Korean/43/F NCC (multiple) and SCC (systemic) CT/MRI/X ray/Pathology Korea 42 18 1994 Japanese/72/F NCC (racemose-type) CT/MRI/Serology/Pathology China 53 19 1994 Chinese/24/M NCC (racemose-type) CT/MRI/Pathology China 54 20 1994 Japanese/44/M NCC (solitary) CT/MRI/Pathology Japan 54 21 1994 Japanese/52/F NCC (solitary) CT/MRI/Serology Japan 58 22 1995 Japanese/21/F NCC (multiple) MRI/PET Japan 59 23 1996 Japanese/39/M NCC (solitary) MRI/Pathology Japan 60 24 1996 Japanese/39/M SCC (solitary) Pathology China 43 25 1996 Korean/70/F NCC (multiple) CT/MRI/Serology/Pathology Korea 93 26 1997 Chinese/68/M NCC (multiple) and SCC (multiple) CT/MRI/X ray/Serology China (Heilongjiang province) 7 27 1998 Chinese/48/M NCC (multiple) CT/MRI China 8 28 1998 Japanese/37/M SCC (solitary) Pathology Japan 9 29 1998 Japanese/34/M NCC (multiple), SCC (multiple) and taeniasis CT/MRI/Serology China (Jiujiang, Jiangxi Province) 10 30 1998 Japanese/59/M NCC (multiple) CT/Pathology China 11 31 1999 Japanese/19/F NCC (solitary) MRI/Pathology India 12 32 1999 Chinese/55/M NCC (multiple) CT/MRI/Endoscopy/Pathology China 13 33 1999 Japanese/46/M NCC (solitary) CT/MRI/Pathology Indonesia, Nigeria, or Nepal 14, 15 34 2000 Japanese/45/F SCC (multiple) CT/Pathology Thailand 16 35 2000 Cambodian/29/M NCC (multiple) and SCC (multiple) CT/MRI/X ray/Pathology Cambodia 17 36 2001 Japanese/53/F Ocular (solitary) Funduscope/US No information 18 37 2001 Japanese/43/F NCC (solitary) CT/MRI/Pathology Thailand 19 38 2001 Unknown/73/M NCC (multiple) CT/MRI No information 20 39 2001 Japanese/70/M NCC (racemose type) CT/MRI/Serology Philippines 21 40 2002 Japanese/26/M NCC (solitary) CT/MRI/Pathology/Serology Japan 22 41 2003 Japanese/22/F NCC (solitary) CT/MRI// US/Pathology India 23 42 2004 Japanese/53/F NCC (solitary) CT/MRI/Pathology/DNA India, Vietnam, Thailand or Myanmar 24, 25 43 2004 Chinese/50/M Ocular (solitary) and NCC (solitary) Funduscope/CT/Serology/Pathology China (Heilongjiang province) 26 44 2004 Japanese/83/M SCC (systemic) CT/X ray/Pathology/DNA China 27, 28 45 2005 Chinese/44/F NCC (multiple) and SCC (multiple) CT/MRI/X ray China 29 46 2005 Chinese/21/F NCC (solitary) CT/MRI/PET/Serology China (Harbin, Heilongjiang province) 30 47 2005 Filipino/9/F NCC (solitary) CT/MRI/Pathology/DNA Philippines 31 48 2006 Japanese/24/F NCC (solitary) MRI/Pathology/DNA Indonesia or Korea 32 49 2006 Indian/28/F NCC (multiple) CT/MRI/DNA India 33 50 2006 Brazilian/42/F NCC (racemose-type) CT/MRI/Pathology/DNA Brazil 34 51 2007 Japanese/38/F NCC (solitary) CT/MRI/Pathology/DNA Nepal 35 52 2007 Japanese/84/M SCC (systemic) CT/X ray/DNA Japan (Okinawa) 36 53 2007 Japanese/51/F NCC (multiple) CT/MRI Japan (Okinawa) This study 54 2007 Japanese/31/F NCC (multiple) CT/MRI India This study 55 2008 Indian/44 /F NCC (multiple) MRI/Serology/DNA India 37 56 2008 Chinese/30/M NCC (multiple ) and SCC (multiple) CT/MRI/X ray/Serology China This study 57 2008 Japanese/39/F NCC (multiple) CT/MRI/PET/Serology Asian or African countries This study 58 2009 Japanese/24/M Ocular and taeniasis Funduscope/US/Serology Malawi 38 59 2009 Korean/38/M NCC (multiple) CT/MRI/SEM/Pathology Korea 39 60 2009 Japanese/20/F NCC (multiple) and taeniasis CT/MRI/Serology/Capsule endoscopy/DNA India This study 61 2009 Japanese/61 /M NCC (multiple, racemose-type) CT/MRI/US/Serology/Pathology/DNA India, Thailand, China or Vietnam This study 62 2010 Japanese/53/M NCC (racemose-type) CT/MRI/Pathology/Serology/DNA Japan (Uruma, Okinawa) 40 63 2010 Japanese/58/F SCC (multiple) CT/MRI/X ray/DNA Japan (Akita or Okinawa) This study 64 2010 Chinese/46/F NCC (multiple) and SCC (multiple) CT/MRI/US/Serology China (Harbin, Heilongjiang province) This study 65 2010 Japanese/31/M NCC (multiple), SCC(multiple) and taeniasis CT/MRI/Serology/DNA India This study 66 2011 Nepalese/35/M SCC (solitary) CT/US/Serology/Pathology/DNA Nepal This study Case No. Year Patient (Nationality /Age/Sex) Etiologic agent (diagnostic criteria) Presumed locality of infection References 1 1990 Japanese/72/M T. saginata (/Morphology) ? 63 2 1990 Korean/52/M T. saginata (Serology/Morphology) ? 64 3 1990 Japanese/34/M T. saginata (Morphology) Ethiopia 65 4 1990 Japanese/32/M T. saginata (Morphology) Japan 65 5 1990 Japanese/26/M T. saginata (Morphology) Ethiopia or Somalia 65 6 1992 Japanese/10/F T. saginata (Morphology) Japan 66 7 1994 Japanese T. saginata (Morphology) Iran 53 8 1994 Japanese T. saginata (Morphology) ? 53 9 1994 Japanese T. saginata (Morphology) ? 53 10 1994 Japanese T. saginata (Morphology) France or Germany 53 11 1994 Japanese T. saginata (Morphology) Germany 53 12 1996 Japanese/53/F T. saginata (Morphology) ? 67 13 1996 Japanese/26/M T. saginata (Morphology) Bolivia 68 14 1996 Japanese/47/M T. saginata (Morphology) Cote D’lvoire 69 15 1997 Japanese/23/F T. saginata (Morphology) Europe 70 16 1998 Brazilian/45/M T. saginata (Colonoscope/Morphology) Brazil 71 17 1998 Japanese/34/M Probably T. solium with NCC China (Jiujiang, Jiangxi Province) 10 18 2001 Filipino/32/F T. saginata (Morphology) Philippines 72 19 2001 Japanese/26/M T. saginata (Morphology) Japan or India 73 20 2001 Japanese/47/M T. saginata (Morphology) Indonesia 73 21 2001 Japanese/30/M T. saginata (Morphology) Ethiopia 73 22 2001 Japanese/60/M T. saginata (Morphology) Japan 73 23 2002 Japanese/30/M T. saginata (Morphology) Ethiopia 74 24 2002 Japanese/51/M T. saginata (Morphology) Thailand 74 25 2002 Japanese/46/M T. saginata (Morphology) Africa 75 26 2003 Japanese/24/F T. saginata (Morphology) Vietnam 77 27 2007 Japanese/45/M T. saginata (DNA) Thailand or Indonesia 76 28 2007 Cambodian/16/M T. saginata (DNA) Cambodia 94 29 2007 Japanese/58/M T. saginata (DNA) Korea 94 30 2007 Japanese/32/M T. saginata (DNA) Ethiopia 94 31 2007 Japanese/33/M T. saginata (DNA) Cambodia or Ethiopia 94 32 2007 Japanese/40/F T. saginata (DNA) China, Kenya, Monaco or Croatia This study 33 2007 Japanese/25/M T. saginata (Endoscope/Morphology) Laos 78 34 2008 Japanese/26/F T. saginata (DNA) Nicaragua, Laos or Indonesia This study 35 2008 Japanese/26/M T. saginata (DNA) Indonesia This study 36 2008 Japanese/45/M T. saginata (DNA) Vietnam or China This study 37 2009 Japanese/24/M Taenia sp. (Morphology) with ocular type Malawi 38 38 2009 Japanese/63/M T. saginata (DNA) Thailand This study 39 2009 Japanese/57/M T. saginata (DNA) Thailand This study 40 2009 Japanese/49/M T. saginata (DNA) Thailand This study 41 2009 Japanese/20/F T. solium (Capsule endoscope/DNA) with NCC India This study 42 2010 Japanese/58/M T. asiatica (DNA) Japan 81, 84 43 2010 Japanese/41/F T. asiatica (DNA) Japan 81, 84 44 2010 Japanese/55/M T. asiatica (DNA) Japan 81, 84 45 2010 Japanese/40/M T. asiatica (DNA) Japan 81, 84 46 2010 Japanese/31/M T. asiatica (DNA) Japan 82, 84 47 2010 Japanese/41/M T. asiatica (DNA) Japan 83 48 2010 Japanese/28/M T. asiatica (DNA) Japan 83 49 2010 Japanese/30/M T. asiatica (DNA) Japan 83, 84 50 2010 Japanese/60/M T. asiatica (DNA) Japan 83 51 2010 Japanese/39/F T. asiatica (DNA) Japan 83, 84 52 2010 Japanese/24/F T. asiatica (DNA) Japan 83 53 2010 Japanese/31/M T. solium (endoscopy/DNA) with NCC India This study 54 2010 Japanese/39/M T. asiatica (DNA) Japan 84 55 2010 Japanese/56/M T. saginata (DNA) Thailand This study 56 2010 Japanese/26/F T. asiatica (DNA) Japan 84 57 2010 Japanese/43/F T. asiatica (DNA) Japan 84 58 2010 Filipino/31/F T. asiatica (DNA) Philippines This study 59 2011 Japanese/46/M T. saginata (DNA) Malaysia This study 60 2011 Japanese/35/M T. saginata (DNA) Mali This study 61 2011 Japanese/52/M T. saginata (DNA) Thailand This study 62 2011 Japanese/24/F T. saginata (DNA) Indonesia (Bali) This study 63 2011 Japanese/41/M T. saginata (DNA) Senegal This study 64 2011 Thai/21/M T. solium (DNA) Thailand This study 65 2011 Japanese/33/M T. saginata (DNA) Sudan This study 66 2011 Japanese/54/M T. asiatica (DNA) Japan This study 67 2011 Japanese/38/M T. asiatica (DNA) Japan This study 68 2011 Ethiopian/24/F T. saginata (DNA) Ethiopia This study 69 2011 Japanese/12/M T. asiatica (DNA) Japan This study 70 2011 Japanese/54/M T. asiatica (DNA) Japan This study 71 2011 Japanese/42/F T. saginata (DNA) France This study 72 2011 Ethiopian/26/F T. saginata (DNA) Ethiopia This study 73 2011 Japanese/41/F T. asiatica (DNA) Japan This study

Table 1. Demographic and clinical data for cysticercosis cases reported in Japan (1990-2011)

Table 2. Demographic and clinical data for taeniasis reported in Japan (1990-2011)

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Current Status and Perspectives of Cysticercosis and Taeniasis in Japan

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CURRENT STATUS OF T. ASIATICA INFECTION IN JAPAN

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