George M. Davis

Schistosomiasis in the People's Republic of China: Prospects and Challenges for the 21st Century

SUMMARY Schistosomiasis japonica is a serious communicable disease and a major disease risk for more than 30 million people living in the tropical and subtropical zones of China. Infection remains a major public health concern despite 45 years of intensive control efforts. It is estimated that 865,000 people and 100,250 bovines are today infected in the provinces where the disease is endemic, and its transmission continues. Unlike the other schistosome species known to infect humans, the oriental schistosome, Schistosoma japonicum, is a true zoonotic organism, with a range of mammalian reservoirs, making control efforts extremely difficult. Clinical features of schistosomiasis range from fever, headache, and lethargy to severe fibro-obstructive pathology leading to portal hypertension, ascites, and hepatosplenomegaly, which can cause premature death. Infected children are stunted and have cognitive defects impairing memory and learning ability. Current control programs are heavily based on community chemotherapy with a single dose of the drug praziquantel, but vaccines (for use in bovines and humans) in combination with other control strategies are needed to make elimination of the disease possible. In this article, we provide an overview of the biology, epidemiology, clinical features, and prospects for control of oriental schistosomiasis in the Peoples Republic of China.

Mathematical modelling of schistosomiasis japonica: comparison of control strategies in the People's Republic of China

We present the first mathematical model on the transmission dynamics of Schistosoma japonicum. The work extends Barbours classic model of schistosome transmission. It allows for the mammalian host heterogeneity characteristic of the S. japonicum life cycle, and solves the problem of under-specification of Barbours model by the use of Chinese data we are collecting on human-bovine transmission in the Poyang Lake area of Jiangxi Province in China. The model predicts that in the lake/marshland areas of the Yangtze River basin: (1) once-yearly mass chemotherapy of humans is little better than twice-yearly mass chemotherapy in reducing human prevalence. Depending on the heterogeneity of prevalence within the population, targeted treatment of high prevalence groups, with lower overall coverage, can be more effective than mass treatment with higher overall coverage. Treatment confers a short term benefit only, with prevalence rising to endemic levels once chemotherapy programs are stopped; (2) depending on the relative contributions of bovines and humans, bovine treatment can benefit humans almost as much as human treatment. Like human treatment, bovine treatment confers a short-term benefit. A combination of human and bovine treatment will dramatically reduce human prevalence and maintains the reduction for a longer period of time than treatment of a single host, although human prevalence rises once treatment ceases; (3) assuming 75% coverage of bovines, a bovine vaccine which acts on worm fecundity must have about 75% efficacy to reduce the reproduction rate below one and ensure mid-term reduction and long-term elimination of the parasite. Such a vaccination program should be accompanied by an initial period of human treatment to instigate a short-term reduction in prevalence, following which the reduction is enhanced by vaccine effects; (4) if the bovine vaccine is only 45% efficacious (the level of current prototype vaccines) it will lower the endemic prevalence, but will not result in elimination. If it is accompanied by an initial period of human treatment and by a 45% improvement in human sanitation or a 30% reduction in contaminated water contact by humans, elimination is then possible.

Molecular systematics of Hydrobiidae (Mollusca: Gastropoda: Rissooidea): testing monophyly and phylogenetic relationships

Abstract The rissooidean family Hydrobiidae Troschel, 1857 is supposedly one of the largest gastropod families with more than 400 recent genera assigned. Due to the limited number of robust anatomical characters in hydrobiids, the high degree of intraspecific variation, the unknown phylogenetic significance of anatomical characters, and the high degree of homoplasy in anatomical characters, its systematic is confusing and phylogenetic relationships within the family and with other rissooidean groups are poorly understood. We studied fragments of the COI and 18S genes from representatives of 40 genera to determine if the family Hydrobiidae (as defined by Kabat and Hershler, 1993) is monophyletic, if the family Hydrobiidae could be resolved using these genes, and whether the Cochliopidae are a distinct family as previously suggested. The cluster patterns in the combined 18S + COI tree as well as in the individual 18S and COI trees show that the Hydrobiidae of Kabat and Hershler (1993) are polyphyletic. The analyses also confirm previous studies suggesting that the Cochliopidae are a family distinct from the Hydrobiidae. The following subfamilies are tentatively assigned to the Hydrobiidae: Hydrobiinae, Pseudamnicolinae, Nymphophilinae, Islamiinae, and Horatiinae. Three hydrobiid genera, Mercuria, Hauffenia, and Graziana, could not be assigned unambiguously to one of these subfamilies. The phylogenetic relationships of the families studied are discussed in the light of the available anatomical data and the performance of the two gene fragments used.

Environmental effects on parasitic disease transmission exemplified by schistosomiasis in western China

Environmental effects on the transmission of many parasitic diseases are well recognized, but the role of specific factors like climate and agricultural practices in modulating transmission is seldom characterized quantitatively. Based on studies of Schistosoma japonicum transmission in irrigated agricultural environments in western China, a mathematical model was used to quantify environmental impacts on transmission intensity. The model was calibrated by using field data from intervention studies in three villages and simulated to predict the effects of alternative control options. Both the results of these interventions and earlier epidemiological findings confirm the central role of environmental factors, particularly those relating to snail habitat and agricultural and sanitation practices. Moreover, the findings indicate the inadequacy of current niclosamide-praziquantel strategies alone to achieve sustainable interruption of transmission in some endemic areas. More generally, the analysis suggests a village-specific index of transmission potential and how this potential is modulated by time-varying factors, including climatological variables, seasonal water-contact patterns, and irrigation practices. These time-variable factors, a villages internal potential, and its connectedness to its neighbors provide a framework for evaluating the likelihood of sustained schistosomiasis transmission and suggest an approach to quantifying the role of environmental factors for other parasitic diseases.

Evolutionary relationships between trematodes and snails emphasizing schistosomes and paragonimids

Snails and digeneans have been associated for at least 200 million years. Their inter-relationships over such a time-span must have been complex and varied. Few studies have attempted to explore these relationships in the light of knowledge of the phylogeny of both host and parasite groups. Here we focus on two important families of digeneans, the Schistosomatidae and the Paragonimidae, for which molecular phylogenies are available. We investigate the types of evolutionary relationships between host and parasite, operating at different phylogenetic depths, that might explain current host specificity and distributions of both associates. Both families of parasites utilise a number of highly diverged gastropod families, indicating that host extensions have featured in their histories. However, schistosomatids and paragonimids show different patterns of association with their snail hosts. As befits the apparently more ancient group, schistosomatids utilise snails from across a wide phylogenetic range within the Gastropoda. The genus Schistosoma itself has experienced one long-range host switch between pulmonates and caenogastropods. By contrast, paragonimids are restricted to two superfamilies of caenogastropods. Despite these differences, modern schistosomatid species appear to be more host specific than are paragonimids and host additions, at the level of host family, are far less common among species of schistosomatids than among paragonimids. Some species of Paragonimus exhibit remarkably low levels of host specificity, with different populations utilising snails of different families. Existing knowledge relating to the phenomenon will be presented in the context of phylogenies of schistosomatids, paragonimids, and their snail hosts. Discussion focuses on the usefulness of current theories of snail-digenean coevolution for interpreting these findings. In the past, much emphasis has been placed on the idea that digeneans engage in a one-to-one arms race with their snail host. We consider that phylogenetic tracking rather than an arms-race relationship might be a common alternative. Not being bound by the restrictions imposed by an arms race, some digeneans might be able to extend to new host species more easily than the literature suggests. Switches into related host taxa are most likely. However, ecologically equivalent but unrelated gastropod hosts may also be exploited. Given the right ecological setting, digeneans are able to switch across considerable phylogenetic distances. Examples from the Paragonimidae and Schistosomatidae are given.

A molecular perspective on the genera Paragonimus Braun, Euparagonimus Chen and Pagumogonimus Chen

The status of the genera Euparagonimus Chen, 1963 and Pagumogonimus Chen, 1963 relative to Paragonimus Braun, 1899 was investigated using DNA sequences from the mitochondrial cytochrome c oxidase subunit I (CO1) gene (partial) and the nuclear ribosomal DNA second internal transcribed spacer (ITS2). In the phylogenetic trees constructed, the genus Pagumogonimus is clearly not monophyletic and therefore not a natural taxon. Indeed, the type species of Pagumogonimus, P. skrjabini from China, is very closely related to Paragonimus miyazakii from Japan. The status of Euparagonimus is less obvious. Euparagonimus cenocopiosus lies distant from other lungflukes included in the analysis. It can be placed as sister to Paragonimus in some analyses and falls within the genus in others. A recently published morphological study placed E. cenocopiosus within the genus Paragonimus and probably this is where it should remain.

Multiple near-identical genotypes of Schistosoma japonicum can occur in snails and have implications for population-genetic analyses

We genotyped (using 16 or 17 microsatellite loci) numerous adult Schistosoma japonicum raised in rabbits exposed to pooled cercariae from small numbers of naturally infected snails from several localities in China. As expected, duplicate multi-locus genotypes (MLGs) were found among these worms. Additionally, many more MLGs, often near-identical, were found than snails used as sources of cercariae. Explanations for these results include (i) genotyping errors, (ii) development within each infected snail of multiple sibling miracidia and (iii) somatic mutation producing genetically varied cercariae from a single miracidium. To control for genotyping errors we re-analysed samples from many individual worms, including repeating the initial PCR. Explanations invoking the development of multiple sibling miracidia within a single snail are not likely to be correct because almost all duplicate MLGs fell within same-sex clusters in a principal coordinates analysis. We would expect both sexes to be represented in a multi-miracidium infection. In addition, we exposed several snails to infection by a single miracidium. One such snail, via an experimentally infected mouse, yielded 48 adult worms. The presence of at least nine near-identical MLGs among these worms was confirmed by re-genotyping. We regard somatic mutation as the most likely explanation for our results. The implications of multiple MLGs for population-genetic studies in S. japonicum are discussed.

Oncomelania hupensis (Gastropoda: Rissooidea) in eastern China: molecular phylogeny, population structure, and ecology.

The rissooidean snail genus Oncomelania is of medical interest as various taxa are hosts for the human blood fluke Schistosoma and the lung fluke Paragonimus; because of close co-evolved host-parasite-relationships, snail diversity may reflect parasite diversity. There is a considerable amount of confusion regarding the identity of smooth- and ribbed-shelled populations of Oncomelania hupensis in eastern China. We therefore studied the genetic variation, population structure, phylogenetic relationships and ecology of five smooth- and five ribbed-shelled populations in Hubei, Hunan, Anhui, Zhejiang, and Jiangsu provinces. Based on sequencing data of a fragment of the mitochondrial gene for cytochrome oxidase I from 80 individuals, we found little genetic variability within the ingroup-individuals studied here (average pi=0.01922). Moreover, within the ingroup, smooth-shelled individuals cluster together with ribbed-shelled individuals. We therefore consider all smooth- and ribbed-shelled populations of Oncomelania throughout the lower Yangtze River basin to belong to the subspecies O. hupensis hupensis. Our data indicate that ribbing in O. h. hupensis is associated with the annual floods of the Yangtze River. The greatest haplotype (d(H)) and nucleotide diversities (pi) are found in aggregates of ribbed-shelled snails along areas of the Yangtze River drainage subject to flooding. In areas not affected by flooding, the shells are smooth and genetic diversity decreases significantly.

Anatomical variation in cryptic mudsnail species: Statistical discrimination and evolutionary significance

Abstract In the present paper, the brackish-water mudsnail genus Hydrobia is used to assess the degree of anatomical differentiation among cryptic species. Detailed anatomical data for seven populations from four taxa are compared to genetic data in order to test whether there are discrete anatomical differences among taxa, whether it is possible to partition the total anatomical variation into hierarchical among-taxa and among-population components, to find those anatomical characters that statistically discriminate taxa, and to make inferences about the mode of evolution. A qualitative anatomical analysis did not yield any character states that could be used to differentiate among taxa, and a PCA of quantitative anatomical characters did not discriminate among species. Moreover, no significant variance component could be detected in the nested analysis of morphological variance among lineages and/or populations. However, discriminant analyses (DA) with mtDNA lineages as grouping variables resulted in highly significant discrimination models for sexes combined, females and males. The DAs retained up to 16 variables and up to six of them showed significant differences among lineages. Generally, shell characters were performing better than soft body characters. The poor performance of soft body characters is attributed to an unusually high intraspecific variability in Hydrobia. Anatomical, ecological, and biogeographical characteristics that could have contributed to the high variability are discussed. The evolution of anatomical variables among lineages was tested for deviation from expectations derived from a stochastic evolution model. The test showed that the null hypothesis of stochastic evolution according to the Brownian motion model could not be rejected, indicating that anatomical characters in Hydrobia are neither subject to diversifying nor to constrained evolution. Based on genetic and supportive anatomical data, one of the taxa in the study, Hydrobia sp. A, is considered to be a new species and formally described as Hydrobia djerbaensis n.sp. Species nova: Hydrobia djerbaensis Wilke, Pfenninger & Davis.

Stirred, not shaken: genetic structure of the intermediate snail host Oncomelania hupensis robertsoni in an historically endemic schistosomiasis area

BackgroundOncomelania hupensis robertsoni is the sole intermediate host for Schistosoma japonicum in western China. Given the close co-evolutionary relationships between snail host and parasite, there is interest in understanding the distribution of distinct snail phylogroups as well as regional population structures. Therefore, this study focuses on these aspects in a re-emergent schistosomiasis area known to harbour representatives of two phylogroups - the Deyang-Mianyang area in Sichuan Province, China. Based on a combination of mitochondrial and nuclear DNA, the following questions were addressed: 1) the phylogeography of the two O. h. robertsoni phylogroups, 2) regional and local population structure in space and time, and 3) patterns of local dispersal under different isolation-by-distance scenarios.ResultsThe phylogenetic analyses confirmed the existence of two distinct phylogroups within O. h. robertsoni. In the study area, phylogroups appear to be separated by a mountain range. Local specimens belonging to the respective phylogroups form monophyletic clades, indicating a high degree of lineage endemicity. Molecular clock estimations reveal that local lineages are at least 0.69-1.58 million years (My) old and phylogeographical analyses demonstrate that local, watershed and regional effects contribute to population structure. For example, Analyses of Molecular Variances (AMOVAs) show that medium-scale watersheds are well reflected in population structures and Mantel tests indicate isolation-by-distance effects along waterways.ConclusionsThe analyses revealed a deep, complex and hierarchical structure in O. h. robertsoni, likely reflecting a long and diverse evolutionary history. The findings have implications for understanding disease transmission. From a co-evolutionary standpoint, the divergence of the two phylogroups raises species level questions in O. h. robertsoni and also argues for future studies relative to the distinctness of the respective parasites. The endemicity of snail lineages at the regional level supports the concept of endemic schistosomiasis areas and calls for future geospatial analyses for a better understanding of respective boundaries. Finally, local snail dispersal mainly occurs along waterways and can be best described by using cost distance, thus potentially enabling a more precise modelling of snail, and therefore, parasite dispersal.