Surgical Complications of Massive Infestations with Ascaris lumbricoides

Crane, Paul S.; Pak, Young Hoon; Lee, Hyun Kwan

doi:10.1097/00000658-196507000-00005

Cited by 11 publications

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“…We then looked at data given in case reports, noting the total worm burden (as counted at surgery, autopsy, or after an anthelmintic), age and outcome (survival/death). Only 24 case reports (Watson 1920;Baugh 1923;Alles 1924;Levin & Porter 1924;Watkins & Moss 1924;Hsu et al 1940;Jenkins & Beach 1954;Aiken & Dickman 1957;Cole 1965;Crane et al 1965;Gandhi 1965;Piggott et al 1970;BustamenteSarabia et al 1979;Rathi et al 1981;Katz et al 1985;Baird et al 1986; Mpairwe 1991) which specified all of the above were found among 53 publications which described a total of more than 1000 patients.…”

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Worm burden in intestinal obstruction caused by Ascaris lumbricoides

Silva

Guyatt

Bundy

1997

Tropical Med Int Health

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SummaryExamination of 24 case reports suggests the worm burden in those presenting to hospital with intestinal obstruction is >60 and is about tenfold higher in fatal cases.keywords Ascaris lumbricoides, ascariasis, intestinal obstruction, worm burden, morbidity, mortality correspondence Dr N. R. de Silva, Department of Parasitology, Faculty of Medicine, University of Kelaniya, Talagolla Road, Ragana, Sri Lanka It is generally accepted that a 'large' number of worms must necessarily be present in the small intestine in order to cause obstruction. However, the number meant by 'large' seems somewhat uncertain: figures mentioned in this context range from 15 to more than 100 (Baird et al. 1986; Thein-Hlaing et al. 1990;O'Hanley & Pool 1995;Gilles 1996). Better knowledge of the average worm burden in patients with Ascaris-induced intestinal obstruction could be of predictive value in calculating morbidity rates due to acute complications of ascariasis (Chan et al. 1994).An exhaustive search failed to reveal any reports in the mainstream literature on worm burden in an identified series of patients. We then looked at data given in case reports, noting the total worm burden (as counted at surgery, autopsy, or after an anthelmintic), age and outcome (survival/death). Only 24 case reports (Watson 1920;Baugh 1923;Alles 1924;Levin & Porter 1924;Watkins & Moss 1924;Hsu et al. 1940;Jenkins & Beach 1954;Aiken & Dickman 1957;Cole 1965;Crane et al. 1965;Gandhi 1965;Piggott et al. 1970; BustamenteSarabia et al. 1979;Rathi et al. 1981;Katz et al. 1985;Baird et al. 1986; Mpairwe 1991) which specified all of the above were found among 53 publications which described a total of more than 1000 patients.Nine of the 24 cases were fatal. The worm burden in these 9 (median 639, mean 659.2, range 23-1978) was significantly higher than in the non-fatal cases (median 59, mean 219.3, range 4-990, P=0.045, Kruskal-Wallis H-test) (Figure 1) . Four of the 9 fatal cases and 9 of the 15 non-fatal were below Figure 1 Comparison of worm burden in fatal (n=9) and non-fatal (n=15) cases, and in under-fives (n=13) and older patients (n=11). Vertical line indicates range, box indicates 25th and 75th percentiles. , Median; , mean.

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Worm burden in intestinal obstruction caused by Ascaris lumbricoides

Silva

Guyatt

Bundy

1997

Tropical Med Int Health

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“…In 1963, Dr. Paul Crane, American missionary surgeon in Jeonju, Korea, operated on a 9-year-old girl with serious abdominal pain caused by intestinal obstruction and recovered 1,063 Ascaris worms which ultimately proved fatal [18]. The wretched news was reported in a Korean newspaper which called for social concern on ascariasis (Fig.…”

Section: Prevalence Of Ascaris Lumbricoides Infections Until 1969mentioning

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What was the main factor in successful control of ascariasis in Korea?

Cho

Hong

2023

Parasites Hosts Dis

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In the l950s, under the legacy of traditional agriculture, Ascaris lumbricoides, spread epidemically in the war-bitten society of Korea. Consensus on the parasite control was drafted in the Parasite Disease Prevention Act, which passed a parliamentary agreement in 1966, and established safe disposal of feces and mass chemotherapy as control strategies. Biannual stool examinations and treating infected schoolchildren were basic scheme of the control activity through which revenue could be secured for organized business. In the 27 years following 1969, a maximum of 16 million stool examinations had been done every year. Cellophane thick smear enabled the task. The infection declined remarkably in the 1970s when industrialization and green revolution proceeded. A population study of A. lumbricoides in the late 1970s helped us better understand its epidemiology. The data also settled down the understandable protest of teachers against the repeated stool examinations. In the 9 years following 1987, the target population was gradually reduced when the egg positive rate was below 0.1%. An article in the Korean Law, stipulating obligatory stool examinations, was made optional. Although the long-term Korean effort of Ascaris control was a success, the effect of mass chemotherapy was not as succinct in terms of lowering reinfection. In the period of control, Korean agricultural technology changed, and the economy grew and supplied sanitary facilities by which the vicious cycle was disconnected. Reduction of morbidity was a benefit of mass chemotherapy, which is the only control method feasible in economically difficult countries. The most important hurdle of parasite control in the 1960s was poverty of general population and limited financial resources in Korea but the society formed a consensus on the priority of intestinal helminthiasis control during the ordeal period. The national consensus in the 1960s was the critical milestone for Ascaris control in Korea. Under the social agreement, application of timely technical and research advancements in parasitology achieved the success of ascariasis elimination. The successful experience of ascariasis elimination in Korea can be a benchmark for countries where neglected tropical diseases are endemically recycled.

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“…수술 후 집계된 바로는 총 1,063마리, 4kg의 회충이 아동의 장에서 제거되었다. 회충 제거는 성공적이었지만, 결국 아동은 회복하지 못하고 수술 후 9시간 만에 사망했다( Crane et al, 1965: 34-35 ) [ 37 ].…”

Section: 한국전쟁 이후 회충의 시각화 : 한 소녀의 신체에 천 마리의 회충이unclassified

“…크레인 박사가 제1저자였으나, 당시 한국인이 공동 저자로 참여해 한국의 사례를 해외 학술 잡지에 실을 수 있었던 것은 이례적인 일이었다. 증례보고에는 사망한 아동의 얼굴이 그대로 실렸으며, 심지어 수술 직후 침대에 누워있는 아동 바로 옆에 제거한 회충을 늘어놓은 사진도 등장했다( Crane et al, 1965: 35 ). 이 사진들은 신문 기사에 고스란히 다시 사용되었다.…”

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A Social History of Ascariasis in the 1960s Korea : From a Norm to a Shameful Disease*

2016

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Until the 1950s, Ascaris was regarded as an essential part of life which controls every aspect of human physiology among Koreans. Therefore, Ascaris should not be removed from human body. Efforts from medical professionals and the Korean government officials who wished to push forward the parasite control program, had to constantly contest with this perception of Ascaris among ordinary Koreans. In 1966, the 'Parasitic Disease Prevention Act' was promulgated and 'the Korean Association for Parasite Eradication (KAPE)' established in Korea. From the 1970s, Korea mobilized 15 million people each year to achieve the eradication goal. Such mass mobilization could not be possible without public awareness on necessity of parasite eradication. Until the early 1960s, however, Korean people were not sympathetic to the needs of eradication of parasites, especially that of Ascaris. Then, what changed the social perception towards Ascaris during the 1960s? What contributing factors allowed the mass mobilization and public involvement for that campaign? Employing newspaper articles and periodicals, this paper analyzes how social perception on Ascariasis changed during the 1960s, when the 'Parasitic Disease Prevention Act' was established. During the 1960s, Ascariasis became a shameful disease for Koreans. A series of events made Ascariasis more visible and shameful to Koreans. First event happened with Korean miners who were dispatched to Germany in 1963. When the miners turned out to have been infected with intestinal parasites, they were prohibited from work at the mines by the authorities in Germany and quarantined for several weeks. This humiliating experience of Korean expatriate people having bodies swarmed with parasites became a national shame to Koreans. The parasite infected bodies of Korean workers were revealed to the World through German newspapers. Second event happened when a child died of intestinal obstruction due to Ascariasis. The doctor retrieved 1,063 Ascaris from the bowel of the 9 year-old girl, and the photo of the 1,063 worms was published in several newspapers. It was a shocking visualization of Ascariasis in Korean society. Through these visualizations of Ascariasis, the Korean society began to perceive Ascariasis as a shame of the nation as well as that of an individual.

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Surgical Complications of Massive Infestations with Ascaris lumbricoides

Cited by 11 publications

References 1 publication

Worm burden in intestinal obstruction caused by Ascaris lumbricoides

Worm burden in intestinal obstruction caused by Ascaris lumbricoides

What was the main factor in successful control of ascariasis in Korea?

A Social History of Ascariasis in the 1960s Korea : From a Norm to a Shameful Disease*

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