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Background  Human capillariasis caused by  Capillaria hepatica (syn. Calodium hepaticum)  is a rare disease with no more than 40 cases registered around the world. Classically, the disease has severe symptoms that mimic acute hepatitis. Natural reservoirs of  C. hepatica  are urban rodents ( Mus musculus  and  Rattus novergicus ) that harbor their eggs in the liver. After examining the feces of 6 riverine inhabitants (Rio Preto area, 8° 03'S and 62° 53' W to 8° 14'S and 62° 52'W) of the State of Rondonia, Brazil, and identifying  C. hepatica  eggs in their feces, the authors decided to investigate the real dimension of these findings by looking for two positive signals.    Methods  Between June 1 st  and 15 th , 2008, 246 out of 304 individuals were clinically examined. Blood samples were collected, kept under -20°C, and test by the indirect immunofluorescence technique.    Results  The first positive signal was the presence of specific antibodies at 1:150 dilution, which indicates that the person is likely to have been exposed to eggs, most likely non-infective eggs, passing through the food chain or via contaminated food (total prevalence of 34.1%). A second more specific signal was the presence of antibodies at higher titers, thus indicating true infection.    Conclusions  The authors concluded that only two subjects were really infected (prevalence of 0.81%); the rest was false-positives that were sensitized after consuming non-embryonated eggs. The present study is the first one carried out in a native Amazonian population and indicates the presence of antibodies against  C. hepatica  in this population. The results further suggest that the transmission of the parasite occurs by the ingestion of embryonated eggs from human feces and/or carcasses of wild animals. The authors propose a novel mode of transmission, describing the disease as a low pathogenic one, and showing low infectivity.

parasites and vectors

Capillariaisis (Trichurida, Trichinellidae, Capillaria hepatica) in the Brazilian Amazon: low pathogenicity, low infectivity and a novel mode of transmission