Schistosomiasis In China

       University of California, Berkeley

Environmental Determinants

Snail ecology
Miricidia-Snail interactions
Cercarial risk

Gating effects

The range of topographic conditions in Sichuan Province, from flatlands along the lake to steep and highly terraced landscapes at higher elevations, provide an opportunity to identify environmental factors responsible for differences in transmission intensity between villages.  A major focus of our research is assessing how variations in the agricultural landscape, ecology, hydrology and microclimate in our study villages mediate the high heterogeneity in environmental risk and disease burden observed across the study region. 

Snail Ecology

The geographic relationship between snail intermediate hosts and humans plays an important role in the epidemiology of schistosomiasis. In Sichuan Province, the subspecies Oncomelania hupensis robertsoni inhabits a complex network of small irrigation channels in a mountainous agricultural region within an elevation range of approximately 500 – 2000 m. Snails are often distributed along these irrigation ditches, which supply water resources to rice fields and terraces.  Annual cross-sectional snail densities have been traditionally collected in China as a part of larger surveys aimed at identifying high priority sites for schistosomiasis disease surveillance based on their potential to support snail populations.  The strong relationships between land-use, soil conditions, climate and snail habitat suggest that environmental modification and changing agricultural practices may be effective control strategies for O. hupensis robertsoni. 

Methods: Snail sampling                                                                      Publications: Snail Ecology

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Miricidia-snail interactions

The ecological interactions between miricidia and the intermediate snail host are fundamental to understanding the link between environmental contamination and subsequent environmental risk to humans from water contact.  We assume that new snail infections by miricidia, and the subsequent shedding of cercaria into surrounding waters, are proportional to the product of the density of snails and the density of eggs along irrigation ditches.  While it is feasible to measure snail density and approximate egg contamination in the environment, quantifying the amount of eggs needed, relative to snail population numbers, to produce and sustain infected snail populations remains a challenge. The spatial coincidence of snails and miracidia is extremely challenging to estimate, yet is a crucial component of successful propagation of the disease cycle.

The interaction between parasite and snail, as mediated by environmental factors, also operates on evolutionary scales.  Past studies reviewed in Davis (1980, 1992) suggest a strong coevolutionary bond between the snail hosts and Schistosoma japonicum.  It is hypothesized that over time, infected snails evolve defense mechanisms to counter the parasite, and parasites then evolve a response to evade the host’s defense, an escalating interaction often referred to as The Red Queen Hypothesis. The effects of these interactions have been documented in the flood affected areas of the Yangtze River Valley where migratory snails lacking resistance to new parasitic strains were observed to be infected at higher numbers than were more stable snail populations (Shi et al., 2002).

Methods: Genetic analysis, Landscape genetics                         Publications: Miricidia-Snail Interactions

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Cercarial Risk

Cercariae are the free-swimming form of the parasite infective to mammals.  Location-specific variability in cercarial density has been shown to be high in agricultural villages in the mountains of Sichuan Province.  The high spatial and temporal heterogeneity of cercaria density complicates the estimation of human exposure and obscures the relationship between water contact and infection intensity (Spear, Zhong, Mao, Hubbard, Birkner, Remais, Qiu, 2004). Cercarial risk in village irrigation systems is associated with a number of village level variables including snail density, village level human infection intensity, and the application of manure-based fertilizers.  Based on our studies in Xichang County we found that despite the roughly 30-fold difference in the snail density between some villages, mean village snail density was not a significant independent predictor of the cercarial risk as determined by mouse bioassay results.  Other findings suggest that once a threshold in snail density exists, cercarial risk becomes highly variable. 

Methods: Molecular detection / cercariometry
Publications: Cercarial risk

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Gating Effects

Gating effects are the time variable modifiers of transmission that determine the endemic level of disease realized in an isolated village in a semi-stable environment and in the absence of control activity.  In general terms these effects include the impact of environmental variables like temperature and rainfall, but also the temporal patterns of both uninfected snail population dynamics and human water contact throughout the annual agricultural cycle. In the transmission model these effects are realized as mathematical functions, for example, the precipitation-and/or irrigation-dependent forces that modulate the average daily production and transport of miricidia and cercariae. 

Methods: Transmission modeling                                                  Publications: Transmission modeling

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