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Metagonimiasis is a disease caused by an intestinal trematode, most commonly Metagonimus yokagawai, but sometimes by M. takashii or M. miyatai. The metagonimiasis-causing flukes are one of two small flukes called the heterophyids.The incubation period is around 14 days .[1][2] Praziquantel is recommended in both adult and pediatric cases .[3][4]


The main symptoms are diarrhea and abdominal pain. Because symptoms are often mild, infections can often be easily overlooked hence diagnosis is important.[5]


Occasionally, flukes invade the mucosa and eggs deposited in tissue may gain access to circulation; this may lead to eggs embolizing in the brain, spinal cord, or heart.[6]


Metagonimus yokogawai, or the Yokogawa fluke, is a species of a trematode, or fluke worm, in the family Heterophyidae.It is a human parasite that causes metagonimiasis.[1]


Transmission requires two intermediate hosts, the first of which is snails, that is Semisucospira libertina, Semiculcospira coreana, or Thiara granifera.Infection is acquired through the secondary intermediate host, fish, that have not been thoroughly cooked.[5]


Metagonimiasis is diagnosed by eggs seen in feces. Only after antihelminthic treatment will adult worms be seen in the feces, and then can be used as part of a diagnostic procedure. [7][8]


Praziquantel is recommended in both adult and pediatric cases in many countries; however, the U.S. FDA label does not specifically mention Metagonimiasis, it is however a type of trematode infection similar to schistosomiasis and liver fluke infections.[3][4][9]

Epidemiology 1

Metagonimiasis infections are endemic or potentially endemic in 19 countries including Japan, Korea, China, Taiwan, the Balkans, Spain, Indonesia, the Philippines and Russia. Human infections outside endemic areas may result from ingesting pickled fish or sushi made from fish imported from endemic areas.[10][11]

Epidemiology 2

Food-borne trematodes are currently the most important parasitic infections in Korea and approximately 240 thousand Koreans are believed to be currently infected, M. yokagawai infections are found mostly around large and small streams .[12][13]


  1. 1.0 1.1 Shimazu, T; Kino, H (October 2015). "Metagonimus yokogawai (Trematoda: Heterophyidae): From Discovery to Designation of a Neotype". The Korean journal of parasitology. 53 (5): 627–39. doi:10.3347/kjp.2015.53.5.627. PMID 26537043. Archived from the original on 2024-04-24. Retrieved 2024-04-22.
  2. "Metagonimiasis - About the Disease - Genetic and Rare Diseases Information Center". Retrieved 4 June 2024.
  3. 3.0 3.1 Mahanta, Jagadish (2022). "Metagonimiasis". Textbook of Parasitic Zoonoses. Springer Nature. pp. 309–316. ISBN 978-981-16-7204-0. Archived from the original on 2023-09-10. Retrieved 2024-04-21.
  4. 4.0 4.1 Fukushige, Mizuho; Chase-Topping, Margo; Woolhouse, Mark E. J.; Mutapi, Francisca (17 March 2021). "Efficacy of praziquantel has been maintained over four decades (from 1977 to 2018): A systematic review and meta-analysis of factors influence its efficacy". PLOS Neglected Tropical Diseases. 15 (3): e0009189. doi:10.1371/journal.pntd.0009189. ISSN 1935-2735. Archived from the original on 6 November 2021. Retrieved 2 May 2024.
  5. 5.0 5.1 "CDC - DPDx - Metagonimiasis". 21 January 2019. Archived from the original on 7 June 2023. Retrieved 20 April 2024.
  6. Long, Sarah S.; Pickering, Larry K.; Prober, Charles G. (2008). Principles and Practice of Pediatric Infectious Diseases. Saunders. pp. 1332–1334. ISBN 978-0-7020-3468-8.
  7. Cong, W; Elsheikha, HM (June 2021). "Biology, Epidemiology, Clinical Features, Diagnosis, and Treatment of Selected Fish-borne Parasitic Zoonoses". The Yale journal of biology and medicine. 94 (2): 297–309. PMID 34211350. Archived from the original on 2024-04-18. Retrieved 2024-04-28.
  8. Toledo, Rafael; Alvárez-Izquierdo, Maria; Muñoz-Antoli, Carla; Esteban, J. Guillermo (2019). "Intestinal Trematode Infections". Digenetic Trematodes. Springer International Publishing. pp. 181–213. ISBN 978-3-030-18615-9. Archived from the original on 2023-05-28. Retrieved 2024-04-27.
  9. "BILTRICIDE" (PDF). FDA. Retrieved 9 June 2024.
  10. Lee, GS; Cho, IS; Lee, YH; Noh, HJ; Shin, DW; Lee, SG; Lee, TY (March 2002). "Epidemiological study of clonorchiasis and metagonimiasis along the Geum-gang (River) in Okcheon-gun (county), Korea". The Korean journal of parasitology. 40 (1): 9–16. doi:10.3347/kjp.2002.40.1.9. PMID 11949215. Archived from the original on 2024-04-16. Retrieved 2024-04-23.
  11. Vaishnavi, Chetana (31 March 2013). Infections of the Gastrointestinal System. JP Medical Ltd. p. 434. ISBN 978-93-5090-352-0. Archived from the original on 10 May 2024. Retrieved 30 April 2024.
  12. Cho, S. Y.; Kang, S. Y.; Lee, J. B. (1984). "Metagonimiasis in Korea". Arzneimittel-Forschung. 34 (9B): 1211–1213. ISSN 0004-4172. Archived from the original on 2024-04-30. Retrieved 2024-04-28.
  13. Berman, Jules J. (31 August 2012). Taxonomic Guide to Infectious Diseases: Understanding the Biologic Classes of Pathogenic Organisms. Academic Press. p. 143. ISBN 978-0-12-415913-6. Archived from the original on 6 May 2024. Retrieved 4 May 2024.