Global Warming Opens Pandora’s box A Study of Parasite: Schistosoma(血吸虫 )

Cheng Zhang（张程）8-year Program, Clinical Medicine

Tutor: Pro. Weiqing PanChairman of WHO Gene Synthesis & Express Cooperation Center

The Thaw （解冻）

1. Epidemic Status

2. Influence of Global Warming

3. Our Work

1. Epidemic Status

Neglected Tropical Disease

The PLoS Blog. 2015. Neglected Tropical Diseases: Challenges for the Post-2015 Development Era.

Soil-Transmitted Helminth, STH

Buruli Ulcer

Chagas disease Dengue

Dracunculiasis

Echinococcosis, ECHFood-Borne Trematode Infections, FBT

Human African Trypanosomiasis

Leishmaniasis

Leprosy

Lymphatic FilariasisRabies

Schistosomiasis, SCH （血吸虫病）

Cysticercosis Taeniasis, CT

Trachoma

Yaws

Schistosoma （血吸虫）

Blood

Major Parasitic Diseases

WHO. 2010. First WHO report on neglected tropical diseases.

1950s

China Disability Reported productivity loss

Malaria >30 M — —

Schistosomiasis >10 M >2 M

The disability rate was regarded as the most

important. A total of 45.4 days off-work lost per

infected person/year was obtained.

Ancylostomiasis >50 M >1 M More than US$ 40 per treated person. Deworming

may increase adult income by 40%.

Filariasis >30 M >6 M

Annual economic burden of lymphatic filariasis

measured in lost productivity reported in 1998 was

about US$ 1.7 billion in 2008. Lymphatic filariasis

causes almost US$ 1.3 billion/year in lost

productivity.

Leishmaniasis >0.5 M — —

千村薜荔人遗矢，

万户萧疏鬼唱歌。

— 毛泽东《送瘟神》

Lancet. 2014. Human Schistosomiasis.

（日本血吸虫）

Schistosoma japonicum

Cercariae （尾蚴） The child form of the parasite which looks like a tadpole.

<10 sInfested Water

Nature Review.

DefinitiveHost( 终宿主 )

Epidermis human skin

Cercariae

Frequent Contact With Water

Swimmer’s Itch （游泳者痒疹） /Cercarial Dermatitis （尾蚴性皮

炎） Dermatitis （皮炎） .

Itching and breaking of skin.

Raised papules （丘疹） .

Secondary infections.

Pathology

( 肝门静脉 )

300-3000 eggs

Pathology Granulomatous Responses （肉芽肿）

Portal hypertension

Collateral circulation( 侧支循环 )

Esophageal varices( 食管静脉曲张 )

Hepatosplenomegaly( 肝脾肿大 )

Cachexia( 恶病质 )

Results

Markell and Voge's Medical Parasitology

2. Global Warming

Mean January Temperatures Across China

Am. J. Trop. Med. Hyg. 2008. 78(2), pp. 188–194.

Snail Temperatures have a

significant effect on the survival of the interme-diate host: snail.

Acta Tropica. 2005. Control of schistosomiasis in China.

The Risk & Predicted Risk Map

Am. J. Trop. Med. Hyg. 2008. 78(2), pp. 188–194.

2000 2030 2050

Highly epidemic and seriously neglected

Global warming opens Pandora’s box

Acute cases increased 22% than 2002

I’m BACK!

WHO. 2013. Schistosomiasis: Progress report 2001–2011.

Traditional Faecal Test( 粪检 )

Reasons:

The intestinal wall fibrosis

Period of lower egg production

Low-intensity infections

Traditional Faecal Test: Low efficiency

Egg: very low or absent

ZHOU Xiao-Nong, Chairman of Chinese CDC

Coding 15,000 proteins

419

270

204

35

8

1

SjSP-13

Nature. 16 July 2009. Vol 460: 345–351.

rSP13-ELISA KitLike HBV Test( 乙肝检测 )

Clinical Test: a field study

Lancet Infect Dis. 2014. 14: 489–97.

Faecal Test（粪检）

rSP-13 ELISA

Results of the field study

Lancet Infect Dis. 2014. 14: 489–97.

Kato-Katz SP13-ELISA

participants 1371 1371

positive 74** 465

negative 1365 906

Positive rate (%) 5.1 33.9

Faecal Test

Faecal Test SP13-ELISA

Faecal Test

SP13-ELISA

* Faecal Test: Traditional Method† SP13-ELISA: Our Work

Laboratory validation: Specificity of SP13-ELISA

174 human serum samples from Schistosomiasis-free regions(Shanghai)

Lancet Infect Dis. 2014. 14: 489–97.

Sea-ELISA SjSP13-ELISA

Sample No 174 174

Positive 13 2

Negative 161 172

False Positive rate

(%) 7.5 1.1*

SEA-ELISA SP13-ELISA

SEA-ELISA

SP13-ELISA

† SEA-ELISA: Traditional Rapid Diagnosis† SP13-ELISA: Our Work

WHO, Lancet. 2014, 2006.

When nature becomes a terrorist,

human would have only a dead

end.

Acknowledgements

Pro. Yan Zhang Pro. Weiqing Pan

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