An international research coordinated by Santiago Mas-Coma, Expert Member of the World Health Organisation (WHO) for tropical parasitic diseases and Full University Professor of Parasitology of the Universitat de València, described the origin of the urogenital schistosomiasis epidemic in Europe, as well as the characteristics of its causal agent.
The study was published in the journal ‘Lancet Infectious Diseases’ and has been developed together with multidisciplinary centres from France, Spain, United Kingdom and Belgium.
The work coordinated by the also director of the WHO Collaborating Centre and the FAO/United Nations Reference Centre attached to the Universitat de València is part of his responsibilities as general coordinator of the Parasitic Disease Quick Response Committee of the European Federation of Parasitologists.
Schistosomiasis is a parasitic disease caused by parasitic flatworms, a type of worms (helminths of the trematodes group) that grow inside the human circulatory system and transmitted by freshwater snails. It is one of the most important infection diseases of humanity due to its high morbidity and the high number of infected people in the world (more than 200 millions, 85% of them are in the sub-Saharan Africa).
The article, Outbreak of urogenital schistosomiasis in Corsica (France): an epidemiological case study, proves the existence of three different strains on the infectious agent in European patients, Schistosoma haematobium of human nature; Schistosoma bovis of cattle nature; and a hybrid of both. Studies indicate an introduction of all of them in Corsica coming from Senegal.
Professor Mas-Coma highlights the importance of both aspects, “the detection of the hybrid Schistosoma represents a note of warning, since an eventual adaptation to the European cattle would represent a great complication for control measures of this disease in Europe”. Urogenital schistosomiasis, of a great pathology importance due to its capacity of causing cancer in the urinary bladder, was always considered specific of humans, this is, incapable of develop in humans and. thus, without reservoirs in its transmission.
At the introduction focus of the Mediterranean island of Corsica many French, German and Italian tourists were infected, in addition to people from the island, in an epidemic started in 2011 that was not properly diagnosed until 2014, and continued until the summer of 2015, when the last cases were detected, according to the Valencian researcher. ‘Having cleared up the geographical origin of the introduction is crucial, since it allows us to take the necessary measures to avoid a repetition of the situation’, adds Mas-Coma.
The full university professor of the Universitat de València emphasises the characteristics of the introduction of a vector borne disease and zoonotic nature due to the origin of the hybrid agent. ‘If we analyse the epidemics of the last years, including the current epidemic spreading of dengue fever, chikungunya and Zika, as well as schistosomiasis and fasciolosis in Asia, all of them share common characteristics. Ebola and flu avian and pig viruses are also zoonotic, although in their transmission do not interfere any vectors. Thus, it is evident that we are before an epidemic in which phenomena such as globalisation and climate change are playing a significant role”, indicated Santiago Mas-Coma.
The director of the FAO Reference Centres assigned to the Universitat de València emphasises the rapidity of action from the moment in which the infection of a patient by Schistosoma in Europe (2014) was identified for the first time, and the prompt availability of the centres of Spain, United Kingdom and Belgium for collaborating with France in this initiative, even without having funds for this specific objective.
This lack of financing by the different organisms is a very significant aspect when we compare with the current Zika situation in which several international organisms have responded by providing research funds immediately. ‘We still have a path to run, but it is evident that we all have learnt from what happened with Ebola’, concludes Mas-Coma.
‘The joint European initiative continues, because it is necessary analysing which are the areas in southern Europe through which this disease can be introduced again given the presence of transmitting vectors snails and of appropriate environmental, climate and immigration characteristics’, according to the expert.
In Spain, The Cooperative Research Network of Tropical Diseases (RICET) of the Health Ministry is the one leading the multidisciplinary studies on the topic. In it, the Centre of the WHO and FAO/UN of the Universitat is the expert centre in the Valencian Community. These works are also being carried out in collaboration with the Central Seat of the WHO in Geneva and the European Centre for Disease Prevention and Control in Stockholm.
Article:
Boissier J. et al. Outbreak of urogenital schistosomiasis in Corsica (France): an epidemiological case study. Lancet Infectious Diseases, published online May 16, 2016
