Two human cases of gnathostomiasis and discovery of a second intermediate host of Gnathostoma nipponicum in Japan

Two human cases of gnathostomiasis from ingestion of raw native Japanese loaches, Misgurnus anguillicaudatus, are reported. Seven early third-stage larval Gnathostoma nipponicum were recovered from 3,098 loaches in the same district in which 2 human patients had obtained and eaten raw loaches. Encapsulated G. nipponicum larvae were also recovered from loaches infected under laboratory conditions. All 6 weasels captured in the same district in which the naturally infected loaches were found and where the humans had become infected were infected with adult worms of the same species. This is the first report of M. anguillicaudatus serving as a second intermediate host of G. nipponicum.