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Korean J Parasitol > Volume 51(1):2013 > Article
Yamasaki: Current Status and Perspectives of Cysticercosis and Taeniasis in Japan

Abstract

This mini-review describes recent epidemiological trends in cysticercosis and taeniasis in Japan. Some of the topics discussed herein were presented at the first symposium on "Current perspectives of Taenia asiatica researches", that was held in Osong in Chungbuk Province, South Korea, in October 2011 and organized by Prof. K. S. Eom, Chungbuk National University School of Medicine. To better understand the trends in the occurrence of cysticercosis and taeniasis in Japan, clinical cases reported in 2005 have been updated. In addition, the current status of Taenia asiatica infections successively occurring in Japan since 2010 is also discussed.

INTRODUCTION

Cysticercosis, a parasitic disease caused by Taenia solium cysticercus, is one of the important parasitic diseases. Neurocysticercosis (NCC) is accepted to refer to cysts in the central nerve system, including the parenchyma and ventricles of the brain and the spinal cord. Subcutaneous cysticercosis (SCC) is used for the cysticercosis presenting the form of firm, mobile nodules, mainly in the soft tissues and muscles of on the trunk and extremities. NCC is clinically more serious than SCC because of the severity of the neurologic symptoms, such as epileptic seizures and paralysis that can result from infection. The disease constitutes a major public health problem in many parts of the world, including China, Southeast Asia, India, sub-Saharan Africa, and Latin America [1]. Cysticercosis has also become an important parasitic disease in developed countries, such as the United States, particularly in California and other states with a large immigrant population [2]. In Japan, although T. solium cysticercosis/taeniasis was endemic to the Okinawa region in southern Japan 50-60 years ago [3,4], the disease is no longer endemic in the area. Nonetheless, sporadic cases of cysticercosis have been reported in Japan, primarily among Japanese returning from abroad and foreigners coming to Japan (Table 1) [5].
Conversely, taeniasis, which is caused by infection with the adult tapeworm of T. solium or Taenia saginata, occurs worldwide, except in countries where people do not eat pork and beef for religious reasons [1]. Taeniasis caused by Taenia asiatica is restricted to countries in Asia, including South Korea, China, Taiwan, the Philippines, Vietnam, Thailand, Indonesia, and Japan [6]. In Japan, sporadic cases of taeniasis have been reported and most of them were caused by infection with T. saginata and were imported cases until T. asiatica infections were confirmed in 2010 (Table 2). Compared to cysticercosis, taeniasis is innocuous or asymptomatic, with most patients presenting with slight intestinal illness and mental discomfort due to persistent expulsion of the proglottids.
In Japan, the "Ordinance for Enforcement of the Food Sanitation Act" based on the Food Sanitation Law stipulates that food-borne parasitic diseases such as cysticercosis and taeniasis be treated as cases of food poisoning and that authorities be notified of their occurrence immediately. However, because parasitic diseases have never reported based on the law, it is not possible to accurately estimate the incidence of cysticercosis/taeniasis in Japan. Therefore, the author previously examined the epidemiological trends in cysticercosis and taeniasis based on clinical cases in Japan published in scientific journals [5]. Since then, new cases of cysticercosis and taeniasis have been reported and several cases of cysticercosis have been newly diagnosed in our department. The Department of Parasitology at the National Institute of Infectious Diseases, Tokyo routinely performs diagnostic tests requested for parasitic diseases from domestic and foreign medical institutions, and cysticercosis and taeniasis also are acceptable for diagnosis.
The purpose of this article is to overview the current status of cysticercosis/taeniasis in Japan and to update the data that was reported in 2005 [5] based on the cases cited in PubMed (National Library of Medicine) and Japana Centra Revuo Medicina as well as cases diagnosed in our department over the last 5 years (2007-2011).

CLINICAL CASES

Cysticercosis

According to Nishiyama and Araki [4], as many as 389 cases of cysticercosis were reported in Japan from 1908 to 1997. However, 24 cases reported between 1943 and 1979 were not included in the study. Furthermore, 41 cases, including 10 cases diagnosed by our department, have been newly confirmed between 1997 and 2011 (cases 26-66 in Table 1) [7-40]. Taken together, this gives a total of 454 cysticercosis cases that have been reported in Japan between 1908 and 2011. Table 1 shows 66 of the cysticercosis cases that have been reported over the last 22 years (1990-2011) along with cases confirmed by our department between 2007 and 2011.
Of these 66 cases, 54 (66.7%) were NCC; NCC with multiple cysts (28/54, 51.9%; Fig. 1E) was more frequent than NCC with a solitary cyst (13/54, 33.5%; Fig. 1A, B and Fig. 2A, B, E). Between 1990 and 2011, total 17 cases of SCC were reported as cases 4 [41], 16-17 [42], 24 [43], 26 [7], 28 [9], 29 [10], 34 [16], 35 [17], 44 [27,28], 45 [29], 52 [36], 56, 63, 64, 65, and 66. Two of them were systemic intramuscular cysticercosis with numerous calcified cysts; cases 44 [27,28] and 52 [36] (Fig. 1F, G; Fig. 2D, F). Very rarely, intramedullary cysticercosis in case 5 [44] and ocular cysticercosis in cases 11 [45], 36 [18], 43 [26], and 58 [38] have also been reported. Ten cases of NCC with either SCC or ocular cysticercosis were reported in cases 16-17 [42], 26 [7], 29 [10], 35 [17], 43 [26], 45 [29], 56 , 64, and 65 (Table 1). More interestingly, dual infection of cysticercosis and taeniasis was observed in 4 cases; 29 [17], 58 [51], 60, and 65 (Table 1). Furthermore, the adult tapeworm in case 41 was observed in the small intestine using capsule endoscopy to confirm the presence of the adult worm (Table 2).
Cysticercosis diagnosis is generally performed by imaging, serologic, and histopathologic examinations. In our department, molecular identification of the etiologic agents is routinely performed, if surgically removed materials are available [46-48]. Indeed, the usefulness of molecular methods for diagnosing the causative agents has successfully been demonstrated by the identification of 2 genotypes of T. solium cysticercus as well as confirmation of the agents in paraffin-embedded sections [24,25,28,31,33-35,37,40]. In addition, the localities where the patients were infected can also be inferred based on the DNA sequences of the causative agents [32,49].
In SCC, X-ray examinations have revealed the presence of rod-like, scattered, calcified lesions in the soft tissues of the extremities (Fig. 1F, G; Fig. 2D, F). These calcified cysts have histopathologically been confirmed to be T. solium in cases 16-17 [42], 26 [7], 52 [36], and 44 [27,28] (Fig. 2A, C, E).
Two types of T. solium cysticercus, cellulose- and racemose-types, are known to exist. The cellulose-type cysticercus is characterized by a single bladder measuring 3 to 18 mm in diameter with an invaginated scolex and primarily found in the cerebral parenchyma and musculature. The racemose-type presents as large multilobulated cystic lesions lacking a scolex and appears to prefer the cisternal and ventricular systems or subarachnoid space [2]. Indeed, the racemose-type cysticercus is frequently found in the subarachnoidal spaces as multilobulated lesions (Fig. 1C, D). Although cysticercosis due to racemose-type T. solium cysticercus is relatively rare, 8 cases have been documented in Japan in cases 8 [50,51], 15 [52], 18 [53], 19 [54], 39 [21], 50 [34], 61, and 62 [40] (Table 1; Fig. 1C, D; Fig. 2C). Of these, mitochondrial DNA analysis using histopathologic sections revealed that etiologic T. solium was the Asian genotype in 3 cases, 50 [32], 61, and 62 [40], and American/African genotype in case 50 [34] (Table 1). The racemose-type cysticercus is considered to be an aberrant, multilobular, non-viable T. solium cysticercus, possibly the degenerated form of a cysticercus in the basal subarachnoid space. Molecular analysis using formalin-fixed and paraffin-embedded histopathologic specimens has proved that the racemose-type cysticercus is T. solium in cases 50 [34], 61, and 62 [40].
Most of the cysticercosis cases in Japan are imported cases, meaning that the patients either lived in or visited countries where cysticercosis and taeniasis are still endemic, and where they are presumed to have been exposed to T. solium eggs. However, 13 cases have suggested that infection occurred within Japan (cases 1 [55], 8 [50,51], 10 [56], 12 [57], 20 [54], 21 [58], 22 [59], 23 [60], 28 [9], 40 [22], 52 [36], 53, and 62 [40]. NCC was diagnosed by imaging findings (Fig. 1), serology, histopathology (Fig. 2A, C, D, E), and molecular analysis.

Taeniasis

Table 2 shows 73 clinical taeniasis case reports that have been published in journals between 1990 and 2011 and diagnosed by our department between 2007 and 2011. In addition to these, 26 cases have been reported [61,62]. The most commonly encountered taeniasis cases were T. saginata infections and 48 cases (65.8%) have been confirmed to date (Table 2). Of these 48 cases, 45 were imported cases [63-78]. Although the route of infection is unknown, the possibility also exists that 4 of these cases may be attributable to domestic infections; cases 4 [65], 6 [66], 19 [73], and 22 [73]. T. solium taeniasis is extremely rare in Japan and only 1 case was reported in Okinawa in 1988 [79]. However, taeniasis solium cases with either NCC, SCC, or ocular cysticercosis have been confirmed, and all these were imported in cases 29 [10], 58 [38], 60, and 65 (Table 1) and cases 17 [10], 41, 53, and 64 (Table 2). Taeniasis caused by T. asiatica has been also recently successively confirmed in Japan and this will be discussed in the following chapter.
Taeniasis is usually diagnosed based on proglottid morphology. However, since T. saginata, T. solium, and T. asiatica are all morphologically similar, it is not always possible to accurately differentiate them. As a result, more reliable molecular diagnoses are currently employed to differentiate between taeniasis infections in our department [46-48]. Most recently, T. solium tapeworms have been observed in the small intestine using capsule endoscopy in cases 41 [23] and 53.

CURRENT STATUS OF T. ASIATICA INFECTION IN JAPAN

Although T. asiatica was not previously considered to occur in Japan [5], retrospective molecular analyses of proglottids revealed that 2 T. asiatica infections occurred in Tottori Prefecture on Honshu Island, Japan, in 1968 and 1996 [6]. Unfortunately, it is unknown whether the 2 Japanese cases were domestic infections or imported cases. As the number of Japanese travelers visiting Asian countries has increased, so too has the number of people from other Asian countries visiting Japan. This may mean that the likelihood of encountering cases of imported T. asiatica is increasing. Surprisingly, from June 2010 to December 2011, an increasing number of human cases with taeniasis have been diagnosed in the Kanto region, including Tokyo and the neighboring 5 prefectures (Gumma, Tochigi, Saitama, Chiba, and Kanagawa) in central Honshu [80-84]. Of 31 taeniasis cases, 20 were attributed to T. asiatica. Taenia asiatica tapeworms were identified based on nucleotide sequence analysis of the mitochondrial cytochrome c oxidase subunit 1 gene [25] and allelic analysis of the 2 nuclear genes for elongation factor 1-α and ezrin-radixin-moesin-like protein genes [85].
Nineteen out of 20 patients infected with T. asiatica were Japanese nationals residing in the Kanto area and 1 was a Filipino woman living in same area (Tochigi). Fifteen patients stated that they frequently ate raw pig liver (sashimi). Sixteen had never been overseas or, if they had undertaken any international travel, they traveled to countries where T. asiatica is not endemic. The infection in the Filipino woman who has returned to the Philippines several times was also considered to have been occurred in Japan.
The occurrence of taeniasis due to T. asiatica infection is thus considered to have occurred within Japan by the following reasons: i) most of the patients had never been overseas or traveled to areas where T. asiatica is not endemic, ii) most patients had histories of eating raw pig liver, iii) based on interviews with patients and meat inspectors, pigs that had been produced and slaughtered in the Kanto region were strongly suspected to be possible sources of infection, iv) although Japan imports pork from Canada, Mexico, and Europe, no raw pig liver is imported from these countries. At present, the reasons why T. asiatica infections successively occurred in the Kanto region, a region within which the disease was not reported previously, have not yet been satisfactorily clarified. Considering that patients have occurred now, it is possible that the workers and pigs on farms in the Kanto region currently constitute the T. asiatica reservoirs responsible for these infections. We have been investigating the prevalence of T. asiatica metacestodes in pigs from these farms in collaboration with local meat inspection centers. In addition, we have also disseminated information describing precautions against T. asiatica infections in Infectious Agents Surveillance Reports (http://idsc.nih.go.jp/iasr/32/374/kj3741.html) published by the Infectious Diseases Information Center at the National Institute of Infectious Diseases [80-84].

CONCLUSIONS

It is expected that cysticercosis and taeniasis will primarily be detected as imported cases with the increasing numbers of Japanese travelers to foreign countries where these diseases are endemic or visitors from these areas increase. The occurrence of human infections due to T. asiatica is currently restricted to the Kanto region in Japan, and the origins of infection have not yet been clarified. Thus, further occurrence of the disease is likely to occur, medical practitioners should be aware of the importance accurately identifying the causative agent responsible for infection.

ACKNOWLEDGMENTS

The author thanks Prof. Keeseon S. Eom and Prof. Jong-Yil Chai for their initiation to submit a review paper. The author also thanks Prof. H. Matsuoka, Prof. A. Chiba, Drs. T. Oda, S. Shiiki, T. Nagase, M. Tsuda, and S. Matsunaga, for providing imaging pictures and pathology specimens. Drs. Y. Morishima and H. Sugiyama are thanked for their valuable discussions of clinical cases, and M. Muto is also acknowledged for her technical assistance with molecular and serologic examinations of cysticercosis and taeniasis cases. The study was supported in part by Grants-in-Aid for Scientific Research from the Ministry of Health, Labour and Welfare, Japan (H20-22-Shinko-Ippan-016 and H23-Shinko-Ippan-014) and from the Japan Society for the Promotion of Science (23650602).

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68. Tomizawa I, Takizawa Y, Sakamoto Y. A case of Taenia saginata entered our hospital. Sapporo City Hosp J 1996;56: 45-47 (in Japanese).

69. Nihashi J, Shibata Y, Kajimura M, Ito G, Hanai H, Kaneko E, Terada M. A case of gastrografin-resistant tapeworm infection. Clin Parasitol 1996;7: 131-134 (in Japanese).

70. Ohgami K, Ozasa S, Takahashi K. A case of taeniasis saginata. Teishin Igaku 1997;49: 654-655 (in Japanese).

71. Nakayasu S, Kawabata M, Ishihara O, Matsuda Y, Ishii A, Terada M. A case of taeniasis saginata detected by mass-screening of the colon cancer, and treated with gastrografin method and praziquantel. Clin Parasitol 1998;9: 16-18 (in Japanese).

72. Shiono Y, Hata K, Aosai F, Norose K, Yano A, Kawashima K, Yamada M. A case of taeniasis saginata diagnosed by spontaneously expulsed segments at labor. Clin Parasitol 2001;12: 43-44 (in Japanese).

73. Ishida T, Araki T, Nishiyama T, Hirata I, Katsu K. Clinical study of diphyllobothriasis nihonkaiense and taeniasis saginata in Shinsei Hospital - special reference to treatment. Clin Parasitol 2001;12: 48-53 (in Japanese).

74. Yoshimura R, Harada N, Sadamoto Y, Takahashi M, Kubokawa K, Ito K, Tanaka M, Toyoda T, Yamaguchi Y, Ohkumi A, Miyahara M, Nawada S. Two cases of taeniasis saginata. Rinsho to Kenkyu 2002;79: 111-114 (in Japanese).

75. Yamamoto K, Kawahara K, Shimidzu N, Tanioka K, Takatoo T, Saida Y. A report of a case with taeniasis saginata. Iwata City Sogo Hosp J 2002;4: 8-11 (in Japanese).

76. Nishimura Y, Yamaguchi S, Sahara T, Nakazaki Y, Tsuruta S, Fujimori I, Kino H, Yamasaki H, Nakao M, Ito A, Kuramochi T. Two cases of intestinal cestode infections diagnosed by genetic analysis. Clin Parasitol 2007;18: 46-48 (in Japanese).

77. Miyamoto S, Komatsu N, Asai Y, Kurihara R, Asaoka A, Kawamura H, Arakawa Y, Takahashi K. A case of taeniasis saginata treated using gastrografin. Nippon Univ Med J 2003;62: 229-231 (in Japanese).

78. Oyama N, Shiozaki H, Tahara T, Takada K. A case of taeniasis saginata treated by endoscopy using gastrografin. Progr Digest Endosc 2007;70: 102-103 (in Japanese).
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79. Arakaki T, Hasegawa H, Morishima A, Ikema M, Terukina S, Higashionna A, Kinjyo F, Saito A, Asato R, Toma S. Treatment of Taenia solium and T. saginata infections with gastrografin. Jpn J Trop Med Hyg 1988;16: 293-299 (in Japanese).
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80. Yamasaki H, Morishima Y, Sugiyama H, Muto M. Taenia asiatica infections as an emerging parasitic disease occurring in Kanto district since 2010. IASR 2011;32: 106-107 (in Japanese).

81. Nakamura-Uchiyama F, Kobayashi K, Iwabuchi S, Ohnishi K. Four cases of taeniasis asiatica infected by eating raw pig liver or cattle liver. IASR 2011;32: 107-108 (in Japanese).

82. Haruki K, Tamano M, Miyoshi Y, Araki J. A case of Taenia asiatica infection. IASR 2011;32: 108 (in Japanese).

83. Kawai S, Kirinoki M, Chigusa Y, Matsuoka H, Suzuki T. Human cases due to Taenia asiatica occurring in Ryomo district of Gumma and Tochigi prefectures. IASR 2011;32: 109-111 (in Japanese).

84. Yamasaki H, Muto M, Morishima Y, Sugiyama H, Kawanaka M, Nakamura-Uchiyama F, Ohgame M, Kobayashi K, Ohnishi K, Kawai S, Okuyama T, Saito K, Miyahira Y, Yanai H, Matsuoka H, Haruki K, Miyoshi Y, Akao N, Akiyama J, Araki J. Human cases infected with Taenia asiatica occurring in Kanto district, 2010. Clin Parasitol 2011;22: 75-78 (in Japanese).

85. Okamoto M, Nakao M, Blair D, Anantaphruti MT, Waikagul J, Ito A. Evidence of hybridization between Taenia saginata and Taenia asiatica. Parasitol Int 2010;59: 70-74. PMID: 19874910.
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87. Uyama E, Cho I, Araki T, Osuga K. A case of neurocysticercosis diagnosed with severe headache during staying in Honduras. Zutu Kenkyu Kaishi 1991;18: 64-66 (in Japanese).

88. Miyashita T, Miyaji A, Nishitani H, Mano K, Kunii O, Miyashita H, Shibuya T, Chen TH. A case of neurocysticercosis with cystic lesions in the lung. Clin Parasitol 1992;3: 140-142 (in Japanese).

89. Kakizaki T, Kawai S, Takemura K, Tanaka M, Monobe T, Kim E, Nagareda T, Kotoh R, Nishiyama T, Araki T. An operated case of neurocysticercosis. Clin Parasitol 1992;3: 143-145 (in Japanese).

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Fig. 1
Imaging findings of selected cysticercosis cases. (A) plain CT image showing a solitary lesion at the left occipitoparietal area (case 48 [32], courtesy of Prof. H. Matsuoka). (B) MRI showing one of multiple cystic lesions in the left frontal and temporal lobes (case 49 [33]). (C) MRI showing a rasemose-type lesion at the basal cistern (case 50 [34], courtesy of Dr. T. Oda). (D) MRI FLAIR findings showing a giant and multilobulated mass in the subarachnoidal spaces of the right frontal lobe (case 62 [40], courtesy of Dr. S. Shiiki). (E) Cisterography showing multiple cysts in the brain (case 60, courtesy of Prof. A. Chiba). (F) X-ray findings showing typical rice grain calcifications in the muscles of buttocks and lower extremity (case 44 [27, 28], courtesy of Dr. T. Nagase). (G) CT findings showing numerous calcified cysts in muscles of the of the buttocks (case 52 [36], courtesy of Dr. M. Tsuda).
kjp-51-19-g001.jpg
Fig. 2
Histopathologic findings of cystic lesions from cysticercosis patients. (A) A cellulose-type cysticercus characterized by rabyrinth-like structure (case 40 [22], courtesy of Dr. S. Matsunaga). (B) and (E) A resected lesion and a cellulose-type cysticercus (case 48 [32], courtesy of Prof. H. Matsuoka). (C) Racemose-type cysticercus characterized by complicated cystic walls (case 62 [40], courtesy of Dr. S. Shiiki). (D) SCC showing typical rice grain calcifications in the muscles of buttocks and lower extremity and the section of the calcified lesion (case 44 [27, 28], courtesy of Dr. T. Nagase). (F) Surgically removed calcified lesions (case 52 [36], courtesy of Dr. Tsuda). Sections (A, C , D, and E) were stained with hematoxylin and eosin.
kjp-51-19-g002.jpg
Table 1.
Demographic and clinical data for cysticercosis cases reported in Japan (1990-2011)
Case No. Year Patient (Nationality/Age/Sex) Type of cysticercosis Diagnostic criteria Presumed locality of infection References
1 1990 Japanese/40/F NCC (multiple) CT/Pathology Japan (Tokunoshima, Kagoshima) 55
2 1991 Korean/73/M NCC (multiple) CT/MRI/Pathology Korea 86
3 1991 Japanese/33 /M NCC (solitary) CT/MRI/Serology Honduras 87
4 1991 Japanese/29/F SCC (solitary) Pathology/Serology Thailand 41
5 1991 Japanese/48/M Intramedullary spinal (solitary) CT/MRI/Pathology Thailand 44
6 1992 Chinese/20/M NCC (multiple) CT/MRI/Pathology China (Heilongjiang province) 88
7 1992 Japanese/41/F NCC (multiple) CT/MRI/Serology/Pathology Hong Kong, Korea or Japan 89
8 1992 Japanese/30/M NCC (multiple, racemose-type) CT/MRI/Pathology Japan (Ginowan, Okinawa) 50, 51
9 1992 Korean/42/M NCC (multiple) CT/MRI/Serology Korea 90
10 1993 Japanese/44/F NCC (solitary) CT/Pathology Japan 56
11 1993 Japanese/46/M Ocular (solitary) Funduscope/Pathology Vietnam or Cambodia 45
12 1993 Japanese/41/F NCC (solitary) CT/MRI/Pathology Japan 57
13 1993 Brazilian/26/F NCC (multiple) CT/Pathology Brazil 91
14 1993 Japanese/49/F NCC (multiple) CT/MRI/Pathology China 92
15 1993 Japanese/53/M NCC (multiple, racemose-type ?) CT/MRI/Pathology Taiwan 55
16 1994 Korean/48/M NCC (multiple) and SCC (systemic) CT/MRI/X ray/Pathology Korea 42
17 1994 Korean/43/F NCC (multiple) and SCC (systemic) CT/MRI/X ray/Pathology Korea 42
18 1994 Japanese/72/F NCC (racemose-type) CT/MRI/Serology/Pathology China 53
19 1994 Chinese/24/M NCC (racemose-type) CT/MRI/Pathology China 54
20 1994 Japanese/44/M NCC (solitary) CT/MRI/Pathology Japan 54
21 1994 Japanese/52/F NCC (solitary) CT/MRI/Serology Japan 58
22 1995 Japanese/21/F NCC (multiple) MRI/PET Japan 59
23 1996 Japanese/39/M NCC (solitary) MRI/Pathology Japan 60
24 1996 Japanese/39/M SCC (solitary) Pathology China 43
25 1996 Korean/70/F NCC (multiple) CT/MRI/Serology/Pathology Korea 93
26 1997 Chinese/68/M NCC (multiple) and SCC (multiple) CT/MRI/X ray/Serology China (Heilongjiang province) 7
27 1998 Chinese/48/M NCC (multiple) CT/MRI China 8
28 1998 Japanese/37/M SCC (solitary) Pathology Japan 9
29 1998 Japanese/34/M NCC (multiple), SCC (multiple) and taeniasis CT/MRI/Serology China (Jiujiang, Jiangxi Province) 10
30 1998 Japanese/59/M NCC (multiple) CT/Pathology China 11
31 1999 Japanese/19/F NCC (solitary) MRI/Pathology India 12
32 1999 Chinese/55/M NCC (multiple) CT/MRI/Endoscopy/Pathology China 13
33 1999 Japanese/46/M NCC (solitary) CT/MRI/Pathology Indonesia, Nigeria, or Nepal 14, 15
34 2000 Japanese/45/F SCC (multiple) CT/Pathology Thailand 16
35 2000 Cambodian/29/M NCC (multiple) and SCC (multiple) CT/MRI/X ray/Pathology Cambodia 17
36 2001 Japanese/53/F Ocular (solitary) Funduscope/US No information 18
37 2001 Japanese/43/F NCC (solitary) CT/MRI/Pathology Thailand 19
38 2001 Unknown/73/M NCC (multiple) CT/MRI No information 20
39 2001 Japanese/70/M NCC (racemose type) CT/MRI/Serology Philippines 21
40 2002 Japanese/26/M NCC (solitary) CT/MRI/Pathology/Serology Japan 22
41 2003 Japanese/22/F NCC (solitary) CT/MRI// US/Pathology India 23
42 2004 Japanese/53/F NCC (solitary) CT/MRI/Pathology/DNA India, Vietnam, Thailand or Myanmar 24, 25
43 2004 Chinese/50/M Ocular (solitary) and NCC (solitary) Funduscope/CT/Serology/Pathology China (Heilongjiang province) 26
44 2004 Japanese/83/M SCC (systemic) CT/X ray/Pathology/DNA China 27, 28
45 2005 Chinese/44/F NCC (multiple) and SCC (multiple) CT/MRI/X ray China 29
46 2005 Chinese/21/F NCC (solitary) CT/MRI/PET/Serology China (Harbin, Heilongjiang province) 30
47 2005 Filipino/9/F NCC (solitary) CT/MRI/Pathology/DNA Philippines 31
48 2006 Japanese/24/F NCC (solitary) MRI/Pathology/DNA Indonesia or Korea 32
49 2006 Indian/28/F NCC (multiple) CT/MRI/DNA India 33
50 2006 Brazilian/42/F NCC (racemose-type) CT/MRI/Pathology/DNA Brazil 34
51 2007 Japanese/38/F NCC (solitary) CT/MRI/Pathology/DNA Nepal 35
52 2007 Japanese/84/M SCC (systemic) CT/X ray/DNA Japan (Okinawa) 36
53 2007 Japanese/51/F NCC (multiple) CT/MRI Japan (Okinawa) This study
54 2007 Japanese/31/F NCC (multiple) CT/MRI India This study
55 2008 Indian/44 /F NCC (multiple) MRI/Serology/DNA India 37
56 2008 Chinese/30/M NCC (multiple ) and SCC (multiple) CT/MRI/X ray/Serology China This study
57 2008 Japanese/39/F NCC (multiple) CT/MRI/PET/Serology Asian or African countries This study
58 2009 Japanese/24/M Ocular and taeniasis Funduscope/US/Serology Malawi 38
59 2009 Korean/38/M NCC (multiple) CT/MRI/SEM/Pathology Korea 39
60 2009 Japanese/20/F NCC (multiple) and taeniasis CT/MRI/Serology/Capsule endoscopy/DNA India This study
61 2009 Japanese/61 /M NCC (multiple, racemose-type) CT/MRI/US/Serology/Pathology/DNA India, Thailand, China or Vietnam This study
62 2010 Japanese/53/M NCC (racemose-type) CT/MRI/Pathology/Serology/DNA Japan (Uruma, Okinawa) 40
63 2010 Japanese/58/F SCC (multiple) CT/MRI/X ray/DNA Japan (Akita or Okinawa) This study
64 2010 Chinese/46/F NCC (multiple) and SCC (multiple) CT/MRI/US/Serology China (Harbin, Heilongjiang province) This study
65 2010 Japanese/31/M NCC (multiple), SCC(multiple) and taeniasis CT/MRI/Serology/DNA India This study
66 2011 Nepalese/35/M SCC (solitary) CT/US/Serology/Pathology/DNA Nepal This study
Table 2.
Demographic and clinical data for taeniasis reported in Japan (1990-2011)
Case No. Year Patient (Nationality /Age/Sex) Etiologic agent (diagnostic criteria) Presumed locality of infection References
1 1990 Japanese/72/M T. saginata (/Morphology) ? 63
2 1990 Korean/52/M T. saginata (Serology/Morphology) ? 64
3 1990 Japanese/34/M T. saginata (Morphology) Ethiopia 65
4 1990 Japanese/32/M T. saginata (Morphology) Japan 65
5 1990 Japanese/26/M T. saginata (Morphology) Ethiopia or Somalia 65
6 1992 Japanese/10/F T. saginata (Morphology) Japan 66
7 1994 Japanese T. saginata (Morphology) Iran 53
8 1994 Japanese T. saginata (Morphology) ? 53
9 1994 Japanese T. saginata (Morphology) ? 53
10 1994 Japanese T. saginata (Morphology) France or Germany 53
11 1994 Japanese T. saginata (Morphology) Germany 53
12 1996 Japanese/53/F T. saginata (Morphology) ? 67
13 1996 Japanese/26/M T. saginata (Morphology) Bolivia 68
14 1996 Japanese/47/M T. saginata (Morphology) Cote D’lvoire 69
15 1997 Japanese/23/F T. saginata (Morphology) Europe 70
16 1998 Brazilian/45/M T. saginata (Colonoscope/Morphology) Brazil 71
17 1998 Japanese/34/M Probably T. solium with NCC China (Jiujiang, Jiangxi Province) 10
18 2001 Filipino/32/F T. saginata (Morphology) Philippines 72
19 2001 Japanese/26/M T. saginata (Morphology) Japan or India 73
20 2001 Japanese/47/M T. saginata (Morphology) Indonesia 73
21 2001 Japanese/30/M T. saginata (Morphology) Ethiopia 73
22 2001 Japanese/60/M T. saginata (Morphology) Japan 73
23 2002 Japanese/30/M T. saginata (Morphology) Ethiopia 74
24 2002 Japanese/51/M T. saginata (Morphology) Thailand 74
25 2002 Japanese/46/M T. saginata (Morphology) Africa 75
26 2003 Japanese/24/F T. saginata (Morphology) Vietnam 77
27 2007 Japanese/45/M T. saginata (DNA) Thailand or Indonesia 76
28 2007 Cambodian/16/M T. saginata (DNA) Cambodia 94
29 2007 Japanese/58/M T. saginata (DNA) Korea 94
30 2007 Japanese/32/M T. saginata (DNA) Ethiopia 94
31 2007 Japanese/33/M T. saginata (DNA) Cambodia or Ethiopia 94
32 2007 Japanese/40/F T. saginata (DNA) China, Kenya, Monaco or Croatia This study
33 2007 Japanese/25/M T. saginata (Endoscope/Morphology) Laos 78
34 2008 Japanese/26/F T. saginata (DNA) Nicaragua, Laos or Indonesia This study
35 2008 Japanese/26/M T. saginata (DNA) Indonesia This study
36 2008 Japanese/45/M T. saginata (DNA) Vietnam or China This study
37 2009 Japanese/24/M Taenia sp. (Morphology) with ocular type Malawi 38
38 2009 Japanese/63/M T. saginata (DNA) Thailand This study
39 2009 Japanese/57/M T. saginata (DNA) Thailand This study
40 2009 Japanese/49/M T. saginata (DNA) Thailand This study
41 2009 Japanese/20/F T. solium (Capsule endoscope/DNA) with NCC India This study
42 2010 Japanese/58/M T. asiatica (DNA) Japan 81, 84
43 2010 Japanese/41/F T. asiatica (DNA) Japan 81, 84
44 2010 Japanese/55/M T. asiatica (DNA) Japan 81, 84
45 2010 Japanese/40/M T. asiatica (DNA) Japan 81, 84
46 2010 Japanese/31/M T. asiatica (DNA) Japan 82, 84
47 2010 Japanese/41/M T. asiatica (DNA) Japan 83
48 2010 Japanese/28/M T. asiatica (DNA) Japan 83
49 2010 Japanese/30/M T. asiatica (DNA) Japan 83, 84
50 2010 Japanese/60/M T. asiatica (DNA) Japan 83
51 2010 Japanese/39/F T. asiatica (DNA) Japan 83, 84
52 2010 Japanese/24/F T. asiatica (DNA) Japan 83
53 2010 Japanese/31/M T. solium (endoscopy/DNA) with NCC India This study
54 2010 Japanese/39/M T. asiatica (DNA) Japan 84
55 2010 Japanese/56/M T. saginata (DNA) Thailand This study
56 2010 Japanese/26/F T. asiatica (DNA) Japan 84
57 2010 Japanese/43/F T. asiatica (DNA) Japan 84
58 2010 Filipino/31/F T. asiatica (DNA) Philippines This study
59 2011 Japanese/46/M T. saginata (DNA) Malaysia This study
60 2011 Japanese/35/M T. saginata (DNA) Mali This study
61 2011 Japanese/52/M T. saginata (DNA) Thailand This study
62 2011 Japanese/24/F T. saginata (DNA) Indonesia (Bali) This study
63 2011 Japanese/41/M T. saginata (DNA) Senegal This study
64 2011 Thai/21/M T. solium (DNA) Thailand This study
65 2011 Japanese/33/M T. saginata (DNA) Sudan This study
66 2011 Japanese/54/M T. asiatica (DNA) Japan This study
67 2011 Japanese/38/M T. asiatica (DNA) Japan This study
68 2011 Ethiopian/24/F T. saginata (DNA) Ethiopia This study
69 2011 Japanese/12/M T. asiatica (DNA) Japan This study
70 2011 Japanese/54/M T. asiatica (DNA) Japan This study
71 2011 Japanese/42/F T. saginata (DNA) France This study
72 2011 Ethiopian/26/F T. saginata (DNA) Ethiopia This study
73 2011 Japanese/41/F T. asiatica (DNA) Japan This study
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