Focused Issue of This Month Traveling and Imported Parasitic Diseases Myoung-Hee Ahn, MD Department of Parasitology, Hanyang University College of Medicine Email : mhahn@hanyang.ac.kr J Korean Med Assoc 2007; 51(11): 993-1004 Abstract Recently, many peoples travel abroad for sightseeing, business, missionary and other works. At the same time, imported parasitic diseases including malaria has been increased in Korea. The vector borne and food borne diseases were imported from many other countries, Africa, Middle East and South east Asia. Recently many foreigners entered to Korea for studying, working and other purposes. Imported foods, fishes, meats, vegetables are important for parasitic infection, too. The author reviewed imported parasitic diseases in Korea from 1970 to 2006 with literatures. Malaria is most prevalent. And babesiosis of 6 cases, cutaneous leishmaniasis of over 20 cases, visceral leishmaniasis of 5 cases, loiasis of 3 cases, gnathostomiasis of 40 cases, angiostrongylosis of 10 cases, heterophydiasis of 2 cases, schistosomiasis haematobium of 6 cases, schistosomiasis mansoni of 3 cases, hydatidosis of 24 cases, cutaneous larva migrans of 4 cases, and one case of ancylostomiasis, syngamosis, cutaneous myiasis and pentastomiasis are reported, respectively. The protozoa of 5 species and helminthes of 11 species are imported from many other countries. In Korea, re-emerging malaria was appeared at Demilitarized zone (DMZ) on 1993. Last year, 2,051 cases of indigenous malaria were reported by Korean Center for Diseases Control (KCDC). However, the most prevalent imported malaria was Plasmodium falciparum and indigenous malaria was only P. vivax. For the prevention of imported parasitic diseases, the education, training for tropical medicine, supply of medication and vaccine are needed. The surveillance system for imported diseases was started by KCDC on 2001. Keywords : Imported diseases; Parasite; Malaria; Korea; International travel 993
Ahn MH Table 1. The imported and indigenous malaria cases in Korea from 2001 to 2006 Year No. of imported cases* No. of indigenous cases (reemerging) 2001 68 2,556 2002 36 1,799 2003 64 1,171 2004 38 864 2005 45 1,369 2006 30 2,051 total 281 9,810 * Data from Korean CDC 994
Traveling and Imported Parasites Table 2. Imported parasitic diseases in Korea from 1970 to 2006 Parasitic Diseases Areas of Acquisition No. of Cases Reporters 1. Malaria South East Asia, Middle East, 80 Soh et al.(1985) Africa, Australia, Latin America 281 Korea CDC*(2006) 2. Babesiosis Ivory Coast 1 Kim et al.(1988) Ivory Coast 1 Shim et al.(1991) Ethiopia & Uganda 1 Lee et al.(1997) Gabon 1 Kweon et al.(1998) Tanzania 1 Kweon et al.(1998) USA 1 Kweon et al.(1998) 3. Cyclosporiasis Indonesia 1 Yu & Sohn (2003) 4. Cutaneous Leishmaniasis Saudi Arabia, Jordan, Afghanistan >20 Yoo et al.(1978) ~ Kim et al.(2006) 5. Visceral Leishmaniasis Manchuria 3 Heu (1952) Saudi Arabia 1 Chi et al.(1983) Argentina 1 Kim et al.(2004) 6. Loiasis Nigeria 1 Min et al.(1987) Cameroon 1 Chun et al.(1998) Cameroon 1 Cho et al.(2007) 7. Gnathostomiasis Thai 1 Lee et al.(1988) Myanmar 1 Lee et al.(2001) Myanmar 38 Chai et al.(2003) 8. Angiostrongylosis Samoa 10 Lee et al.(1981) 9. Heterophyiasis Saudi Arabia 2 Chai et al.(1986) 10. Schistosomiasis N. Yemen 5 Min et al.(1982) N. Yemen 1 Lee et al.(1987) Middle east 1 Kim et al.(194) Yemen 1 Lee et al.(1995) Middle East 1 Lim et al.(1995) 11. Hydatid Disease Kuwait, Sau Arabia, Libya, 24 Chung et al.(1983) Pakistan, Uzbekistan ~ Jeon et al.(2007) 12. Cutaneous larva migrans Brazil, Thailand 2 Park et al.(2001) Cambodia 1 Kwon et al.(2003) Thailand 1 Kim et al.(2006) 13. Ancylostomiasis Philippine 1 Yong et al.(1992) 14. Syngamosis China 1 Kim et al (1998) 15. Cutaneous Myiasis Cameroon 1 Kim et al.(1990) 16. Pentastomiasis Saudi Arabia or Indonesia 1 Park et al.(1985) * Korean Center of Disease Control (2001~2006) Summary on hydatid disease in Table 3 995
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Ahn MH Table 3. Summary of human hydatid diseases reported in Korea No. Age Sex Involved organ History of abroad travel Chief complaint & sign Reporter 1. 27 F Lung absent Chest pain Chung et al.(1983), Yim et al. (1985) 2. 25 M Lung Kuwait Chest pain Chung et al.(1983), Yim et al.(1985) 3. 31 M Lung Middle East Weight loss Park et al.(1985), Suh et al.(1989) 4. 30 M Lung Middle East Chest pain Lee et al. (1986) 5. 32 M Liver Saudi Arabia Epigastric discomfort Kim et al.(1986) 6. 39 M Liver Saudi Arabia General malaise, epigastic pain Kim and Chang (1987) 7. 49 M Lung Saudi Arabia Pneumonia Im et al. (1987) 8. 25 M Liver Pakistan Epigastric pain Suh et al.(1987), Kim et al.(1993) 9. 39 M Liver Saudi Arabia Fatigability, epigastric pain Jeon et al.(1988) 10. 33 M Retro-peritoneum Saudi Arabia Low abdominal discomfort Lee et al.(1988) 11. 26 M Lung Libya Asymptomatic Kwon et al.(1988), Park et al.(1988) 12. 39 M Liver Saudi Arabia General malaise Huh et al. (1988) 13. 44 M Lung Saudi Arabia Asymptomatic Suh et al.(1989) 14. 55 M Liver Middle East Epigastric discomfort Kim et al. (1993) 15. 43 M Liver Saudi Arabia Epigastric discomfort Kim et al. (1993) 16. 38 M Liver Middle East Epigastric discomfort (1995) 17. 26 F Liver Yunbyun, China Abdominal pain Choi et al (1996) 18. 43 M Pelvis (recurrence of No. 10) Kang et al. (1999) 19. 52 M Liver Vietnam Kim et al. (2001) 20. 31 M Liver Uzbekistan Anaphylactic shock Jeoung et al. (2003) 21. 66 M Liver Koh et al.(2003) 22. 38 M Bladder Uzbekistan* Kim et al. (2004) 23. 33 F Orbit Uzbekistan* Ryou et al. (2006) 24. 56 F Kidney absent Jeon et al. (2007) unknown * Uzbeg working in Korea 998
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Ahn MH Peer Reviewer Commentary 1004