INTRODUCTION
Pygidiopsis summa (Digenea: Heterophyidae) is a very small intestinal trematode. This fluke was first found from dogs experimentally fed the metacercariae from mullets,
Mugil cephalus, in Japan [
1]. Human infections with this fluke were confirmed by detection of eggs in the feces and also adult flukes in Japan [
2,
3]. In the Republic of Korea (Korea), human cases have been sporadically reported from western and southern coastal areas, i.e., Okgu-gun and Buan-gun (Jeollabuk-do), Shinan-gun, Muan-gun, Gangjin-gun, Haenam-gun, and Yeoungam-gun (Jeollanam-do) [
4-
11]. Some species of brackish water fish, namely,
M. cephalus,
Liza haematocheila, and
Acanthogobius flavimanus, are known to be the source of human infections and second intermediate hosts of this fluke [
12-
17].
A total of 11 species in 8 genera have been reported as zoonotic heterophyid flukes (ZHF) in Korea. Among these, 7 including
P. summa are contracted by consumption of raw flesh of brackish water fish, including
M. cephalus,
L. haematocheila,
A. flavimanus,
Lateolabrax japonicus,
Konosirus punctatus,
Boleophthalmus pectinirostris, and
Scartelaos sp., in Korea [
12]. Studies on the source of human infections with ZHF were performed mainly in western and southern coastal areas of Korea. Most of the surveys were carried out in limited areas and examined a small number of fish hosts [
13-
18]. Especially, Seo et al. [
14] surveyed total 59 mullets (1-14; av. 4.2 per locality) from 14 localities, and Guk et al. [
17] examined a total of 139 mullets (5-20; av. 12.6) from 11 areas. However, the number of examined fish was not enough for evaluation of the metacercarial endemicity in each surveyed area. Therefore, we examined mullets broadly collected from 18 coastal areas in 3 Korean seas, Yellow Sea, South Sea, and East Sea, to know the infection status of zoonotic trematode metacercariae.
DISCUSSION
By the present study, it has been confirmed that
P. summa metacercariae are prevalent in mullets from lakes in eastern coastal areas as well as in mullets from western and southern coastal areas in Korea. Among 346 mullets collected from 18 surveyed areas, 236 (68.2%) from 15 areas, except for Boseong-gun (Jeollanam-do), Pohang-si, and Uljin-gun (Gyeongsangbuk-do), were infected with
P. summa metacercariae. Especially mullets from Taean-gun (Chungcheongnam-do) and Geoje-si (Gyeongsangnam-do) were infected with more than 1,000 metacercariae per infected fish. On the other hand, Seo et al. [
14] detected
P. summa metacercariae in 17 (28.8%) out of 59 mullets collected from 14 surveyed areas, and they found them in mullets from only 4 localities, i.e., Okgu-gun (Jellabuk-do), Mokpo-si, Yeocheon-gun (Jellanam-do), and Sacheon-si (Gyeongsangnam-do). Metacercarial burdens were relatively low except for mullets from Okgu-gun [
14]. Guk et al. [
17] reported that
P. summa metacercariae were infected in 88 (63.3%) out of 139 mullets collected from 11 surveyed areas, and their intensity per infected fish was not so high, i.e., 146 metacercariae in average. Moreover, the mullets from 3 localities, i.e., Masan-si (Gyeongsangnam-do), Yeongdeok-gun (Gyeongsangbuk-do), and Sokcho-si (Gangwon-do), were negative for
P. summa metacercariae [
17].
The prevalence and intensity of
P. summa metacercariae in mullets have been shown to vary by geographical localities of 3 different seas in the Korean peninsula. In the present study, the metacercariae of
P. summa were detected in 76 (93.8%) out of 81 mullets from 4 coastal areas of Yellow Sea, 122 (69.3%) of 176 mullets from 7 areas of South Sea, and in 38 (42.7%) out of 89 mullets from 7 sites of East Sea. The average intensities were 496, 369, and 291 metacercariae per fish infected, respectively. Whereas, in Guk et al. [
17], the prevalences were 87.0, 54.1, and 4.0% in mullets from the coastal areas of Yellow Sea, South Sea, and East Sea, and their average intensities were 177, 47, and 8 per fish infected, respectively. The trends of metacercarial infection in this study, the higher prevalence and higher intensity in mullets from the coastal areas in Yellow Sea than in other 2 Seas, were similar to those of Guk et al. [
17], although each data of this study was much higher. This endemic trend of
P. summa metacercariae in mullets coincided well with the trend that human cases with this fluke have been mainly reported in the western and southern coastal areas, i.e., Okgu-gun and Buan-gun (Jeollabuk-do), Shinan-gun, Muan-gun, Gangjin-gun, Haenam-gun, and Youngam-gun (Jeollanam-do), in Korea [
4-
11]. Among 18 surveyed areas, 5 areas, including Muan-gun, Shinan-gun, Gangjin-gun, Sacheon-si, and Yeongdeok-gun, were the same regions as in Guk et al. [
17]. The prevalence and metacercarial density in mullets from these 5 regions were somewhat different between the 2 studies. In the present study, the prevalences were 100, 90.5, 44.7, 94.1, and 37.5% in Muan-gun, Shinan-gun, Gangjin-gun, Sacheon-si, and Yeongdeok-gun, respectively, and intensities were 20, 168, 12, 25, and 8 metacercariae per fish infected, respectively. Whereas, in Guk et al. [
17], the prevalences were 100, 100, 70, 77, and 0%, and the metacercarial densities were 59, 483, 2, 71, and 0, respectively. These differences were probably due to the collection time and site of mullets.
In previous studies [
14,
17],
P. summa metacercariae were rarely detected in mullets from eastern coastal areas. Seo et al. [
14] could not find them at all in mullets from Ulsan Metropolitan City, Pohang-si, Yeongdeok-gun (Gyeongsangbuk-do), and Gangneung-si (Gangwon-do). Guk et al. [
17] detected total 8
P. summa metacercariae in only 1 mullet from Donghae-si (Gangwon-do). They could not detect them in mullets from Yeongdeok-gun (Gyeongsangbuk-do) and Sokcho-si (Gangwon-do) [
17]. In the present study, we detected total 11,058
P. summa metacercariae (291 in average) in 38 (63.3%) out of 60 mullets from 5 eastern coastal sites, i.e., Ulsan Metropolitan City, Yeongdeok-gun (Gyeongsangbuk-do), and Gangneung-si, Goseong-gun (Songjiho and Hwajinpoho, Gangwon-do). Especially in mullets from 3 coastal lakes, Gyeongpoho, Songjiho, and Hwajinpoho, in Gangwon-do, the prevalences were 100, 100, and 69.2%, and the intensities were 419, 147, and 672 metacercariae per fish infected, respectively. These interesting findings suggest that the life cycle of
P. summa is actively maintained in the coastal lakes and adjacent areas of East Sea. Accordingly, residents who habitually eat raw flesh of mullets in these areas should pay attention to infection with this fluke.
In the present study, the metacercariae of
H. nocens were detected in mullets from 7 localities, which included Muan-gun, Shinan-gun, Haenam-gun, Gangjin-gun, and Boseong-gun (Jeollanam-do), Hadong-gun, and Geoje-si (Gyeongsangnam-do), in western and southern coasts of Korea. Their prevalences were 66.7, 100, 28.6, 81.6, 3.9, 61.5, and 27.3%, and the intensities were 64, 84, 119, 99, 1, 24, and 24 metacercariae per fish infected, respectively. In Guk et al. [
17],
H. nocens metacercariae were found in mullets from 7 surveyed areas, i.e., Ganghwa-gun (Gyeonggi-do), Seocheon-gun (Chungcheongnam-do), Buan-gun (Jeollabuk-do), Muan-gun, Shinan-gun, Gangjin-gun (Jeollanam-do), and Sacheon-si (Gyeongsangnam-do), in western and southern coasts of Korea. Their prevalences were 42-100%, and the intensities were 4-271 metacercariae per fish infected [
17]. On the other hand, it has been known that
H. nocens is the dominant intestinal fluke species among the residents of western and southern coastal areas, i.e., Buan-gun, Muan-gun, Shinan-gun, Gangjin-gun, and Sacheon-si, in Korea [
4-
11]. Accordingly, by the present study, it became clear that the endemic areas of
H. nocens are closely related to the distribution of mullets highly infected with the metacercariae of this species.
More than 18 fish species have been reported as the second intermediate hosts of
H. continua in Asian countries, such as Japan, China, Korea, and Vietnam [
15,
16,
19-
27]. Among them, mullets are most widely distributed and highly important as the source of human infections. Human infection cases have been sporadically reported in western and southern coastal areas, i.e., Buan-gun (Jeollabuk-do), Muan-gun, Shinan-gun, Gangjin-gun, Haenam-gun, Youngam-gun (Jeollanam-do), and Sacheon-si, (Gyeongsangnam-do), in Korea [
5,
6,
8-
10,
22,
28]. Although infection rates and densities of
H. continua metacercariae were relatively low, they were found in mullets from western and southern coastal areas, i.e., Gochang-gun (Jeollabuk-do), Shinan-gun, Haenam-gun, Gangjin-gun, Boseong-gun (Jeollanam-do), Hadong-gun, and Geoje-si (Gyeongsangnam-do) in the present study.
Collectively, heterophyid flukes, including P. summa, are prevalent in western and southern coastal areas, which developed the tideland in brackish zones. However, it has been confirmed for the first time that P. summa metacercariae are heavily infected in mullets from some lakes in eastern coastal areas of Korea.