Dr. R. K. Gadgil - An eminent Indian pathologist, pioneer in starting rural medical camps and a researcher who discovered an endemic focus of schistosomiasis in Maharashtra, India.

Dr. Ramchandra Krishnaji Gadgil (RKG) was a pioneer and an eminent researcher. Along with clinician colleagues, he started rural medical camps in 1952, in Maharashtra, India. Through his meticulous research, he discovered in the same year an endemic focus of schistosomiasis in the village, Gimvi, and in 1956, went on to establish a life cycle of the Schistosoma hematobium, involving a completely new intermediate Mollusk host "Ferrisia tenuis", a rather epoch making discovery in the realm of Mollusk intermediate host in relation to human schistosomiasis. His instructions and guidance to the Government Public Health department led eventually to eradication of the schistosomiasis focus in that village in 1969, thereby setting an example for pathologists to head out into the field, do clinical work and pursue with disciplined curiosity a new pathological finding in the laboratory. The fascinating story of his life, education and research is described in this paper.

Schistosomiasis then and now: what has changed in the last 100 years?

Only with the completion of the life cycles of Fasciola hepatica in 1883 and 30 years later those of Schistosoma japonicum (1913), Schistosoma haematobium and Schistosoma mansoni (1915) did research on schistosomiasis really get underway. One of the first papers by Cawston in 1918, describing attempts to establish the means of transmission of S. haematobium in Natal, South Africa, forms the historical perspective against which to judge where we are now. Molecular biology techniques have produced a much better definition of the complexity of the schistosome species and their snail hosts, but also revealed the extent of hybridization between human and animal schistosomes that may impact on parasite adaptability. While diagnostics have greatly improved, the ability to detect single worm pair infections routinely, still falls short of its goal. The introduction of praziquantel ~1982 has revolutionized the treatment of infected individuals and led directly to the mass drug administration programmes. In turn, the severe pathological consequences of high worm burdens have been minimized, and for S. haematobium infections the incidence of associated squamous cell carcinoma has been reduced. In comparison, the development of effective vaccines has yet to come to fruition. The elimination of schistosomiasis japonica from Japan shows what is possible, using multiple lines of approach, but the clear and present danger is that the whole edifice of schistosome control is balanced on the monotherapy of praziquantel, and the development of drug resistance could topple that.

Between politics and prevention: A re-examination of China's schistosomiasis control campaign in the 1950s.

In the 1950s, China is widely regarded as having made great achievements in the control of schistosomiasis, also known as snail fever. Despite the success, efforts to prevent the disease did not fare well during the Reform period (1978-present). Given this, several key questions need to be addressed. Was the schistosomiasis control campaign a real success in the context of political fervor? Would a schistosomiasis control policy be successful only when it returns to the Maoist medical model, as Miriam Gross argues? Did schistosomiasis return as advertised, or was it never eliminated since the 1950s? In this article, I argue that (1) schistosomiasis control is widely regarded as a great success in an ecological sense, but as far as a long-term mechanism of control is concerned, an approach that relies exclusively on strong political intervention and mass participation may not be effective; (2) schistosomiasis control should first focus on the establishment of a sustainable, long-term mechanism, rather than a temporary, assault-style approach to the problem; and (3) from the 1950s to the present, the spread of schistosomiasis does not represent its return, but, rather, the failure of control efforts to eliminate it.

History of schistosomiasis (bilharziasis) in humans: from Egyptian medical papyri to molecular biology on mummies.

Schistosomiasis is a parasitic infection that has evolved together with the humankind. Evidence in ancient Egyptian medical papyri or Assyrian medical texts reported signs and symptoms that could resemble schistosomiasis; similarly, some biblical passages describe an epidemic (depicted as a 'curse') that has been hypothesized to be associated with schistosomiasis' spread in Mesopotamia. In the modern era, Theodor Maximilian Bilharz and Patrick Manson (the 'father of tropical medicine') gave an impetus to the knowledge about the parasite and its spread until the present time, when immunoassays and molecular biology on mummies allowed retracing important milestones regarding schistosomiasis' evolution. Schistosomiasis affects more than 200 millions of people worldwide and it is an emblem of how hard it is to prevent, control and treat neglected tropical diseases. Our work reviews the history of schistosomiasis with regard to human infections.

Yoshitaka Komiya's visits to China and schistosomiasis investigation.

This article is about a Japanese parasitologist, Yoshitaka Komiya (1900-1976), who was invited to China for a schistosomiasis investigation in 1956. In 1955, Chairman Mao initiated a national campaign to eliminate schistosomiasis, which at that time was still common in southern China, and for this purpose, the People's Republic of China invited Yoshitaka Komiya to China. He published a report based on his observations during this visit. This article aims to explore the meaning of Komiya's visit to the People's Republic of China and his observations about the anti-schistosomiasis campaign.

[Knowledge of schistosomiasis in traditional Chinese medicine].

Schistosomiasis is a modern disease name, but it has been widespread in ancient China and exists in a specific form in traditional Chinese medicine (TCM) . The purpose of the paper is to make clear the existing form of schistosomiasis in TCM and infer the prevalence of schistosomiasis in ancient China. The paper focuses on the period when great progress was made on schistosomiasis by TCM, and sums up the understanding of TCM toward schistosomiasis in this period. By studying and analyzing the literature of schistosomiasis in this period, the paper tries to find out the representative Chinese medicine symptom description and TCM "other name" of schistosomiasis, so as to accurately judge whether the relevant description in ancient TCM books and historical documents can provide scientific basis for schistosomiasis. It is important to understand the prevalence and cognition of schistosomiasis in ancient China.

One hundred years of neglect in paediatric schistosomiasis.

Early in the history of schistosomiasis research, children under 5 years of age were known to be infected. Although this problem was recognized over 100 years ago, insufficient action has been taken to address this issue. Under current policy, such infected children only receive their first antiparasitic treatment (praziquantel - PZQ) upon entry into primary school as current mass drug administration programmes typically target school-aged children. For many infected children, they will wait up to 6 years before receiving their first medication and significant schistosomiasis-related morbidity may have already established. This inequity would not be accepted for other diseases. To unveil some of the reasons behind this neglect, it is paramount to understand the intricate historical relationship between schistosomiasis and British Imperial medicine, to underline its lasting influence on today's public health priorities. This review presents a perspective on the historical neglect of paediatric schistosomiasis, focusing on important gaps that persist from the early days after discovery of this parasite. Looking to end this inequity, we address several issues that need to be overcome to move forward towards the lasting success of schistosomiasis control and elimination efforts.

A centenary of Robert T. Leiper's lasting legacy on schistosomiasis and a COUNTDOWN on control of neglected tropical diseases.

Part of Robert T. Leiper's (1881-1969) lasting legacy in medical helminthology is grounded on his pioneering work on schistosomiasis (Bilharzia). Having undertaken many expeditions to the tropics, his fascination with parasite life cycles typically allowed him to devise simple preventive measures that curtailed transmission. Building on his formative work with others in Africa and Asia, and again in Egypt in 1915, he elucidated the life cycles of African schistosomes. His mandate, then commissioned by the British War Office, was to prevent and break transmission of this disease in British troops. This he did by raising standing orders based on simple water hygiene measures. Whilst feasible in military camp settings, today their routine implementation is sadly out of reach for millions of Africans living in poverty. Whilst we celebrate the centenary of Leiper's research we draw attention to some of his lesser known colleagues, then focus on schistosomiasis in Uganda discussing why expanded access to treatment with praziquantel is needed now. Looking to WHO 2020 targets for neglected tropical diseases, we introduce COUNTDOWN, an implementation research consortium funded by DFID, UK, which fosters the scale-up of interventions and confirm the current relevance of Leiper's original research.

Edward Leicester Atkinson (1881-1929): Antarctic explorer, scientist and naval surgeon.

Edward Leicester Atkinson qualified at St Thomas's Hospital in 1906 and joined the Navy in 1908. He was a doctor and parasitologist on Captain Scott's Terra Nova expedition to the Antarctic and had to take charge of the expedition when Scott died on his return from the South Pole. After the expedition he went to China and discovered the cause of schistosomiasis, returning at the start of the First World War in which he served with distinction, winning a DSO and Albert Medal but also being severely injured. After the war he served in various naval posts and became the youngest Surgeon Captain in the Navy before being retired on health grounds in 1928. He died at sea the following year.

[Removal of weremit from the abdomen. Interpretation and efficacy of an ancient Egyptian prescription by the newest scientific results]. / A weremit kiuzése a hasból. Óegyiptomi recept hatásosságának értelmezése az újabb kutatási eredmények alapján.

Significant percentage of today's knowledge of ancient Egyptian medicine has been acquired from papyri left behind from various periods of Egyptian history. The longest and the most comprehensive is the Ebers papyrus, kept at the University Museum of Leipzig, which was written more than one thousand years before Hippocrates (c. 460-377 BC). One of the riddles among the prescriptions of the Ebers papyrus Eb20 has been used in order to remove the so called "wemyt" weremit from the abdomen with the help of a drink, which consists of "jnnk", Conyza dioscoridis in milk or sweet beer. The authors assume that the disease could be an infection of Schistosoma haematobium and/or Schistosoma mansoni. Nowadays the tea of Conyza dioscoridis is widely used as an important part of traditional medicine against rheumatism, intestinal distention and cramps, as well as an antiperspirant, and with external use for wound healing. The authors' intent is to interpret the efficacy of the above-mentioned ancient prescription with the help of modern medical and pharmaceutical knowledge.

Co-dispersal of the blood fluke Schistosoma japonicum and Homo sapiens in the Neolithic Age.

The global spread of human infectious diseases is of considerable public health and biomedical interest. Little is known about the relationship between the distribution of ancient parasites and that of their human hosts. Schistosoma japonicum is one of the three major species of schistosome blood flukes causing the disease of schistosomiasis in humans. The parasite is prevalent in East and Southeast Asia, including the People's Republic of China, the Philippines and Indonesia. We studied the co-expansion of S. japonicum and its human definitive host. Phylogenetic reconstruction based on complete mitochondrial genome sequences showed that S. japonicum radiated from the middle and lower reaches of the Yangtze River to the mountainous areas of China, Japan and Southeast Asia. In addition, the parasite experienced two population expansions during the Neolithic agriculture era, coinciding with human migration and population growth. The data indicate that the advent of rice planting likely played a key role in the spread of schistosomiasis in Asia. Moreover, the presence of different subspecies of Oncomelania hupensis intermediate host snails in different localities in Asia allowed S. japonicum to survive in new rice-planting areas, and concurrently drove the intraspecies divergence of the parasite.