Ming-gang Chen

“ Schistosomiasis in China is mainly caused by the infection of Schistosoma japonicum. Schistosomiasis japonica has a long history for more than 2100 years evidenced by the finding of the eggs in the liver of an ancient corpse. The first clinical case was discovered in 1905 confirmed by typical S. japonicum eggs found in a patient’s stool. The disease caused millions of death in the last century. Both the morbidity and mortality were considerably high. Scientific records on the morbidity of the disease were few before the founding of the People’s Republic of China in 1949. ”

“ However, China is still facing the problems in both the transmission and disease control: such as to further reduce the prevalence, morbidity and to interrupt the transmission in still endemic areas, to treat and rescue symptomatic patients (advanced cases) both in endemic areas and post-transmission areas, as well as to control and eliminate important sources of S. japonicum infection from domestic animal reservoirs (mainly cattle and buffaloes) are a long-term and hard task. ”

“ Clinical disease is mainly seen in the acute and advanced phases and a number of photos are presenting showing historical morbidity. Nowadays the number of acute and advanced schistosomiasis is much less than it was before. Animal reservoir is a problem for S. japonicum in China which increases the complicity in the epidemiology and control of the disease both to humans and animal husbandry. However, the prevalence in domestic animals is under effective control. ”

“ In the special hospitals for schistosomiasis with 50 to 100 beds in heavily endemic areas, dozens of ascetic patients could be found, as shown by Figures 6 and 7, which were taken in small hospitals in 1959 in the Guichi County, Anhui Province, and in 1965 in Changshu County, Jiangsu Province, respectively. The collective photos of advanced cases with ascites could only be taken in the earlier phase of the national control program, i.e., in the 1950s until the 1970s, and, thanks to the intensive control program, after 1980, the number of ascetic patients significantly decreased. ”

“ The prevalence of schistosome infection in cattle and buffaloes based on fecal examination in the three national surveys is provided with comparative human prevalence from the same surveys as references [31] - [33] . As a whole, the prevalence in bovine is usually higher than in humans. A nationwide survey conducted in China in 2011 on the infection of S. japonicum in domestic animals in seven endemic provinces showed a further significant reduction. ”

“ Another survey from the mountainous region in the Yunnan Province in the 1990s showed that the egg contamination rate in the fields from cattle, humans, and other domestic animals was 61%, 33%, and 6%, respectively [34] .
Data from three large-scale national sampling surveys on the epidemiology of schistosomiasis carried out in 1989, 1995, and 2004, respectively, showed that the prevalence of schistosomiasis was on the decline, although still relatively high (see Table 1) . ”

“ In a retrospective review in 1984 on mortality due to all malignancies in seven S. japonicum endemic counties in the Jiangsu Province, it was shown that the prevalence rate of schistosomiasis and the mortality rate due to colorectal cancer increased in parallel [62] , and persons with schistosomiasis had a significantly higher mortality rate due to colorectal cancer than those without [63] . ”

“ Early in this century, a few human clinical cases of a new species of Schistosoma, i.e., Schistosoma nanjingi, were reported with the discovery of eggs both in the feces and the urine of human hosts, and were restricted to limited endemic areas close to Nanjing City, Jiangsu Province [6] . ”

“ In cases of intestinal cancer associated with schistosomiasis, the locality of the cancer was predominately seen in the rectum, as was also reported in Japan [64] , followed by the sigmoid colon, and finally in the other part of the colon, while cancer in the small intestine was a rarity which coincides with relative distribution of S. japonicum eggs in the intestine of man [44] , [58] , [65] - [66] . ”

“ Conducting autopsies in deceased patients who had diseases other than schistosomiasis, schistosome eggs and egg granulomas were found in the tissues of a number of corpses without histories of identification of schistosomiasis and anti-schistosome treatment during their lifetimes [22] . ”

“ The pathological changes in the brain are local reactions in response to the presence of eggs, and, although ectopic parasitism of the adult worms in the cerebral vessels has been suggested, up until now, no worm has ever been found in specimens of the human brain. ”

“ Epileptic seizures usually with granulomatous lesions in the brain are the main clinical manifestations of the cerebral disease in the chronic phase. Symptoms common with brain tumors such as headaches, disturbance of speech, and paralysis often develop. ”

“ Megalosplenia is another form of advanced schistosomiasis quite commonly seen in the 1950s and 1960s. Persons usually have a very large spleen and hypersplenism. The enlarged spleen may be palpated across the level of umbilicus or abdominal midline, i.e., ≧3 in Hackett size, as shown in Figure 10. ”

“ Foxes and rabbits the village roam; weeds only fill the rooms” [25] . “Died are thousands of villages, crying and singing are only ghosts.” The situation was vividly described in the famous poem, Farewell, God of Plague, written in 1958 by Mao Zedong, late chairman of the Chinese Central Government. Mao wrote the poem knowing about the epidemic situation of schistosomiasis before the 1950s. ”

“ Shanghai Publishing House for Sciences and Technology Anonymous. Bureau of Endemic Disease Control, Ministry of Health, 2001 ↑ Nakashima, T; Okuda, K; Kojiro, M; Sakamoto, K; Kubo, Y & Shimokawa, Y (1975) , “Primary liver cancer coincident with schistosomiasis japonica. ”

“ Wang, JP; et al. (1981) , “Analysis of 62 cases of acute schistosomiasis japonica treated with praziquantel or amoscanate”, Acta Acad Med Sin 3 (suppl) : 52–55 ChenMGFuSYangJSWangJSWangMJZhuPJChengAGWangJPTaoCGLiuBLShenSB ↑ Wang, KC (1962) , “Adult worms of Asiatic Schistosoma in lung of acute schistosomiasis case”, Chin Med J 3 (6) : 398–402 WangKC ↑ Yu, BR; Xiao, X; Zhuang, WH; Zhang, RY & Yang, GY (1986) , “Postmortem pathological observation on two cases with acute schistosomiasis”, Acta Jiangxi Med Coll 3 (2) : 13–17 YuBRXiaoXZhuangWHZhangRYYangGY 1 2 Zheng, JS ”