Capillaria hepatica (syn. Calodium hepaticum) infection and factors influencing infection carriage in rats (Rattus spp.) in Hong Kong

Capillaria hepatica (syn. Calodium hepaticum) (Bancroft, 1893) is a nematode, which colonises the liver of a wide range of hosts including humans. The worldwide prevalence of infection in the genus Rattus can be as high as 100% and the Norway rat (R. norvegicus) and black rat (R. rattus) are considered the main host species. This study is the first to investigate the epidemiology of C. hepatica infection in wild rats trapped in various geographical locations in Hong Kong. Four species of trapped rats were identified, with 65% being R. norvegicus, followed by 30% R. tanezumi (Asian house rat), 4% R. andamanensis (Sikkim rat), and 1% Niviventer huang (South China white-bellied rat). The overall prevalence of C. hepatica infection was 36.7% (81/221) (95% CI 30.4–43.4) and R. norvegicus was the most common rat species trapped during this study, with the highest prevalence of C. hepatica infection. Two risk factors for host infection were skin wounds and geographical region, whilst sex, body weight, stage of development, and presence of ectoparasites were not risk factors for this infection. Gross hepatic lesions were absent in 17% of infected rats and when present, were not pathognomonic for the infection. Infected rats lacked severe hepatic inflammation or fibrosis, indicating that rats tolerate the infection well. Egg production was observed in the livers of 69% of infected rats, which emphasizes their role as reservoirs of this zoonotic parasite. Several infected rats in this study were trapped inside residential buildings, which highlights the zoonotic risk of C. hepatica to humans following the potential ingestion of embryonated eggs from contaminated food, water, or soil.