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Paragonimus

Hardly anyone in the Western world has heard of Paragonimus, yet this parasite affects 21 million people in South East Asia. Paragonimus is a fluke, in other words a slug-like looking worm, that is acquired upon ingesting raw crustaceans. It migrates from the digestive tract to the lung, where it induces blood in the sputum and other symptoms easily mistaken for tuberculosis or lung cancer, leading to patients being put on incorrect and dangerous treatments.

Several species of Paragonimus cause most infections; the most important is P. westermani, which occurs primarily in Asia including Japan, China, South Korea, the Philippines, Thailand, Vietnam, and Taiwan. P. mexicanus causes infection in Central and South America and P. africanus causes infection in Africa. Specialty dishes in which shellfish are prepared only in brine, wine, or vinegar without cooking or consumed raw play a key role in the transmission of paragonimiasis. Raw crabs or crayfish are also used in traditional medicine practices in Korea, Japan, and some parts of Africa.

Infection with Paragonimus spp. can result in an acute syndrome with cough, abdominal pain, discomfort, and low-grade fever that may occur 2 to 15 days after infection. Persons with light infections may have no symptoms. Symptoms of long-term infection may mimic bronchitis or tuberculosis, with coughing up of blood-tinged sputum.