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Geographic Distribution

Human infection with P. westermani is prevalent in Asia (Fig. 22.1). It is endemic in Korea, Japan, Taiwan, central China and the Philippines. Human cases have been reported from Manchuria, Vietnam, Laos, Cambodia, Thailand, Malaysia, Indonesia, India, Nepal, New Guinea, Samoa, Solomon Islands and Micronesia. In Asia and the Pacific, paragonimiasis can also be caused by P. skrjabini ( syn. P. szechuanensis), P. heterotremus (syn. P. tuanshanensis), P. miyazakii, P. huerlungensis, and P. philippinensis. In Africa P. africanus and P. uterobilateralis have infected humans in Nigeria, Cameroon, Guinea, Gambia, Libya, Liberia and the Democratic Republic of Congo.

Fig. 22.1 Geographic distribution of paragonimiasis.

In the Western hemisphere various species, including P. mexicanus, P. ecuadoriensis, and P. kellicotti, have infected humans in Canada and Central and South America, especially Colombia, Ecuador, Peru, Venezuela, and parts of Brazil, as well as Costa Rica, Honduras, and Mexico. In California the Chinese mitten crab, native to Korea and China, was found with Paragonimus eggs in the South San Francisco and San Pablo Bays in 1992 and has since migrated hundreds of miles up the Sacramento and San Joaquin rivers, burrowing into river banks and levees and destroying rice plants.

Apart from humans, carnivorous animals such as the dog, cat, wildcat, tiger, leopard, panther, wolf, and fox, as well as the mink, mongoose, rat, pig, monkey and other mammals known to feed on crabs and crayfish may harbor the parasite.

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