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PubMed1987

Bovine fascioliasis in the Manawatu: epidemiology and farmer awareness.

The prevalence of Fasciola hepatica was found to be 5.1% in slaughtered cattle originating from the Palmerston North Veterinary District. Approximately 4% of beef breeding, 7% of dairy and 21% of drystock herds showed evidence of infection. Of 34 dairy herd and 14 beef breeding herd owners, 0 and 21% respectively were aware of the presence of fluke on their properties. Distribution of affected dairy farms conformed with the ecological requirements of the intermediate host Lymnaea columella. The high prevalence of infection in drystock herds is consistent with the extensive movements known to occur into these herds from liver fluke-affected parts of the country. In view of the expanding geographical range of Fasciola hepatica and its intermediate host Lymnaea columella, farmers should be alerted to the potential risks that result from the introduction of infected cattle to properties which contain suitable habitats for the snail.

Journal Article↗
PubMed2003

Correlation between snails and fish in fish ponds of World Fish Center (ICLARM) with special reference to snail vectors of schistosomiasis and fascioliasis.

The abundance of snail species in earthen fish ponds, irrigation and drainage canals at World Fish Center (ICLARM) in descending order was Bellamya unicolor (50.89%) > Physa acuta (18.94%) > Cleopatra bulimoides (7.6%) > Lanistes carinatus (6.73%) > Bulinus truncatus (5.19%) > Melanoides tuberculata (4.83%) > Lymnaea natalensis (3.14%) > Gabbiella senaariensis (0.9%) > Biomphalaria alexandrina (0.55%) > Lym naea truncatula (0.4%) > Planorbis planorbis and Succinea cleopatra (0.33%) > Ferrissia isseli (0.18%). Dead snails constituted about 5.19% of all the collected specimens. There were dramatic decrease in the total number of pulmonates in fish ponds which contained only Tilapia sp., and a very small number of cat fish, whereas the numbers of prosobranchia snails were much higher in these ponds. In fish ponds which accommodated a variety of fish species, the most dominant snail was B. unicolor followed by L. carinatus. However, pulmonate snails were absent in these ponds. B. truncatus was the only snail species found in concrete tank which contained only young tilapias with a very small size (5-8 cm in standard length). In irrigation canals, the number of snails and diversity was much higher than those in fish ponds. Out of 191 snails collected from inlet irrigation canal, 71 were dead, but in the outside irrigation canals, seven out of 564 snails were dead. P. acuta was absent in all examined fish ponds, but it was alive and in a high number (497 snails) in the outside irrigation canals. The number of snails collected from Bahnasawy drain was remarkably low (128 snails), however the diversity of snails was much higher compared to those in fish ponds and irrigation canals. Snail populations were stable with constant recruitment of young to adult snails for all the studied species.

Animals↗
PubMed1988

Identification of a 17-kilodalton Fasciola hepatica immunodiagnostic antigen by the enzyme-linked immunoelectrotransfer blot technique.

Sera obtained from human patients, calves, sheep, and rabbits infected with Fasciola hepatica were tested by the Falcon assay screening test enzyme-linked immunosorbent assay (FAST-ELISA) and the enzyme-linked immunoelectrotransfer blot (EITB) techniques with Fasciola hepatica excretory-secretory antigens in order to evaluate their immunodiagnostic potential. The study included sera from 13 patients infected with F. hepatica or a history suggesting fascioliasis, 5 patients infected and treated with bithionol or praziquantel (3 were cured with bithionol), 10 patients infected with Schistosoma mansoni, 6 infected with Trichinella spiralis, and 13 controls and sera from calves, sheep, and rabbits with a primary F. hepatica infection. By FAST-ELISA with F. hepatica excretory-secretory antigens, the serum samples from fascioliasis patients gave the highest absorbance values, and the schistosomiasis patient sera gave intermediate values compared with a normal human serum control. Also by FAST-ELISA, the values for serum from patients with fascioliasis decreased steadily after cure, reaching normal levels 20 to 47 weeks postcure. In contrast, the serum from two patients who had been treated but were not yet cured had high levels of antibodies for up to 3 years of infection. By EITB, the serum samples from humans, rabbits, cattle, and sheep with fascioliasis recognized two antigenic polypeptides of 17 and 63 kilodaltons (kDa) in the form of sharp bands. For humans, this recognition lasted for at least 3 years of infection. Sera from individuals with schistosomiasis mansoni or trichinosis or from normal controls did not recognize the 17-kDa F. hepatica antigenic polypeptide. However, serum from one human with S. mansoni and one with T. spiralis infection has slight bands in the 63-kDa region, suggesting cross-reactivity. Reactivity to the 17-kDa polypeptide was absent in fascioliasis patients at 1 year postcure. Reactivity to the 63-kDa polypeptide was significantly diminished in fascioliasis patients at 1 year postcure. The sera from rabbits with a primary F. hepatica infection also recognized both the 17- and 63-kDa antigenic polypeptides by week 4 of infection. Reactivity to both antigens diminished significantly 6 weeks postcure and disappeared by 8 weeks postcure. The sera from infected cattle and sheep recognized these two antigenic polypeptides by week 8 of infection. These studies suggest that the 17-kDa F. hepatica excretory secretory antigen is an excellent candidate for the immunodiagnosis of acute and chronic fascioliasis. Purification of this antigen and its application to quantitative serologic tests will permit further analysis of its predictive value to evaluate cure.

Animals↗
PubMed2005

Risk factors for Fasciola hepatica infection in children: a case-control study.

We conducted a case-control study to clarify the risk factors for human fascioliasis in the Northern Peruvian Altiplano. Cases (n=61) were individuals who were diagnosed as having chronic fascioliasis by faecal and/or serologic (Fas2-ELISA) studies. Controls (n=61) had negative serologic and coprological results for Fasciola hepatica. We identified an association between fascioliasis and four variables (40 analysed): the habit of drinking alfalfa juice (OR=4.5; 95% CI 1.8-11.1; P<0.001); familiarity with aquatic plants (OR=4.3; 95% CI 1.8-10.6; P<0.001); dog ownership (OR=5; 95% CI 1.7-15.1; P=0.002); and raising more than five sheep (OR=0.3; 95% CI 0.1-0.8; P=0.01). According to clinical presentation and laboratory studies, dizzy spells (P=0.01), history of jaundice (P=0.01), peripheral eosinophilia (P=0.005) and Ascaris lumbricoides in stools (P=0.001) were associated with fascioliasis. The principal exposure factor for F. hepatica infection was drinking alfalfa juice. In conclusion, we suggest that human fascioliasis in Peru should be suspected in patients from livestock-rearing areas, who present with recurrent episodes of jaundice and who have a history of consumption of alfalfa juice or aquatic plants, or who have eosinophilia.

Adolescent↗
PubMed2000

Obstruction of common bile duct caused by liver fluke--Fasciola hepatica.

Three cases of obstruction of the common bile duct by Fasciola hepatica with two of the patients presenting jaundice are reported. The authors have reviewed several publications concerning common bile duct obstruction by liver fluke, a quite rare complication of fascioliasis. Only nineteen cases of common bile duct obstruction caused by Fasciola hepatica have been reported in a review of medical publications during last ten years. Clinical presentation, diagnostic methods and considerations, types of surgery are fairly uniform in all of the reported cases. Almost all of patients reviewed, had the history, symptoms and signs characteristic for cholelithiasis including recurrent colic pain in right hypochondriac area, fever or subfebrile temperature, fluctuating or stabile jaundice, and palpable painful gallbladder. The laboratory findings in all cases reviewed had shown leucocytosis, eosinophilia, high or slight elevated serum bilirubin. Echographically commonly revealed dilated intra- and extrahepatic bile ducts containing one or more hyperechogenic elements with or without casting an acoustic shadow. All patients underwent open surgery, comprised with choledochotomy and if possible extraction of the fluke. Only two postoperative cases were of necessity followed by ERCP. In all of our cases the primary pre-operative diagnosis was choledocholithiasis, with diagnose of fascioliasis established at the operation. According to the literature this uncertainty in diagnosis is common because of difficulties in differentiation of fascioliasis versus choledocholithiasis. Considerations for making the differential diagnosis--a history of origin or visiting in endemic area of infection, history of eating of aquatic vegetables, laboratory findings including eosinophilia, fasciola eggs in stool, sonography and radiological imaging results and enzyme-linked immunosorbent essay (ELISA) which has been shown to be rapid, sensitive and quantitative. In all three cases we have observed intraoperative significant signs for liver fascioliasis to include surface scarring of the left lobe on the liver--tracks caused by subcapsular migration and location of the hepatic lesions (these findings were also seen by two authors in literature) with resemblance to Japanese letters. The most effective drug for treatment of fascioliasis according to our experience and literature reviewed is bithionol.

Adult↗
PubMed2002

Time-course analysis of coproantigens in rats infected and challenged with Fasciola hepatica.

The influence of a challenge infection during an acute or chronic primary infection on Fasciola hepatica-coproantigen kinetics was established in rats. Egg-output and IgG humoral responses were also established. Two primary-infected groups were reinfected at different periods, one 4 weeks after primary infection (w.p.i.) (acute phase) and the other 11 w.p.i. (chronic phase). Another group remained without reinfection as a control. Coproantigens were first detected in the group challenged on acute fascioliasis. The highest values of coproantigens were recorded in the group reinfected during acute fascioliasis and the lowest in the group challenged during chronic fascioliasis. The IgG responses to F. hepatica excretory/secretory antigens increased after reinfection. Neither the egg output nor the parasitic burden were significantly different among the three infected groups. Our results indicate that the time of challenge affects the kinetics of coproantigens. Thus, challenge during acute fascioliasis favours the migration of the juvenile flukes from the primary infection to the bile ducts, and is responsible for the earlier presence of coproantigens in these animals. The possible relationship between coproantigen detection and T1 and T2 tegumentary antigens is discussed.

Animals↗
PubMed2005

Fas2-ELISA in the detection of human infection by Fasciola hepatica.

Fasciola hepatica has recently emerged as a major pathogen of humans from reports on areas of endemicity and hyper-endemicity for fascioliasis. This situation is aggravated by the lack of standard assays for the screen diagnosis of F. hepatica infection in humans living in endemic areas. Our laboratory has developed an enzyme-linked immunosorbent assay (Fas2-ELISA) based on the capture of IgG antibody by a purified protein Fas2, which is an adult fluke cysteine proteinase. Fas2-ELISA exhibited 95% sensitivity and 100% specificity in 38 individuals infected with F. hepatica diagnosed by finding eggs in stools and 46 serum samples from healthy volunteers. No cross-reaction was observed with 54 serum samples from patients with ten different parasitic infections including the trematodes Paragonimus westermani and Schistosoma mansoni. The high antigenicity of Fas2 is suggested by the fact that antibodies to Fas2 rise rapidly by 1-2 weeks of infection and rise until patency at 8 weeks of infection in experimentally infected alpacas. Field screening for human fascioliasis using Fas2-ELISA and coprology in three endemic locations of the Peruvian Andes resulted in 95.5% sensitivity, 86.6% specificity in a population of 664 children in an age range of 1 to 16 years old. These results provide evidence of the clinical potential of Fas2-ELISA to diagnose fascioliasis in humans exposed to liver fluke infection in endemic areas for this parasite. Fas2-ELISA is currently developed as a standard assay for both field screening for fascioliasis in people living in endemic areas and detecting occasionally F. hepatica infected patients in clinical laboratories.

Antigens, Helminth↗
PubMed2006

Anatomicopathological study of vascular and biliary systems using cast samples of Fasciola-infected bovine livers.

In 117 livers with fascioliasis, this study was focused on the number of Fasciola, the number and intrahepatic localization of affected hepatic ducts and bile ducts, and the degree of fibrosis in the hepatic segments and bile ducts. The degree of pathological changes in bile ducts caused by fascioliasis was classified into five levels. The site of Fasciola habitation was most often the hepatic ducts of the porta hepatis: it was the left hepatic duct in 101 livers and the right hepatic duct in 88 livers. Casts were prepared by infusing synthetic resin into the hepatic arterial, portal, hepatic venous and biliary systems of 15 bovine livers with fascioliasis and then examined. In the left lobe, quadrate lobe, and caudate process where atrophic fibrosis was noted, the bile ducts became rod-shaped by losing branches, and the samples resembled dead branches of liver. Portal branches were thinned or completely terminated with marked fibrosis. Fine and irregular newly formed bile ducts not parallel with portal branches were observed in livers with markedly chronic fascioliasis. Distal portal branches in the right lobe, caudate lobe, and papillary process showed hypertrophic proliferative changes. The arterial system was generally well developed in thickened walls of bile ducts and formed vascular beds, and surrounded the bile ducts as tubes. In livers with severe fibrosis, capillaries were markedly developed and resembled glass cotton.

Animals↗
PubMed1996

Antigenic components of excretory-secretory products of adult Fasciola hepatica recognized in human infections.

The antigenic components of excretory-secretory products (ESP) of adult worms of Fasciola hepatica were revealed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blot analysis using sera from 20 patients infected with F. hepatica. Sera from 184 other parasitic infections and 20 healthy volunteers were also analyzed. It was found that the ESP were composed of more than 11 polypeptides; five components detected in fascioliasis sera had molecular weights of 12.4, 16.4, 19.4, 25, and 27 kilodaltons (kD). Only the 25- and 27-kD components were recognized by all 20 fascioliasis sera. Using the ESP as antigen, it was possible to perform an enzyme-linked immunosorbent assay with a sensitivity of 95% and a specificity of 97%. Sera from other parasitic infections had antibodies to antigenic components with apparent molecular weights of 37, 38.4, 52, 63, 73, 87, 109, and 116 kD that were also found in sera from fascioliasis patients. These findings suggested that the 25- and 27-kD antigenic components may be sensitive and specific for the diagnosis of human fascioliasis.

Animals↗
PubMedDate not supplied

[Clinical characteristics of chronic infection by Fasciola hepatica in children].

Recent studies show that human fascioliasis is an infectious disease with significance in Peru and in other Latin American countries. The purpose of this study is to describe the clinical characteristics with a criteria towards the diagnosis of chronic infection by hepatic Fasciola in children. Sixty five individuals with ages ranging between 4 and 15 years were included, all from the District of Asillo (fascioliasis endemic area) in the Province of Azángaro, Department of Puno, Peru. A clinical exam was performed, as well as egg count per gram of feces (EPG count) and eosinophiles count. The group of children with ages between 8 and 11 years was the most affected, accounting for 47.5% of the total. The most frequent result in the exams was abdominal pain (82%) with epigastric location (37.7%), the Murphy symptom showed in 25 children (41% and there was a jaundice record in 17 children (27.9%). The rest of the symptoms and signs were non-specific. In the leukocyte count, 43.5% presented eosinophilia. The average count of eosinophiles and the severity of the infection (EPG count) decreased as the child became older. We concluded that chronic fascioliasis in endemic zones presents abdominal pain localized in the epigastrium and the Murphy symptom as the most frequent clinical biliary characteristics, while the rest of the symptoms are non-specific and this is probably due to the high endemic degree of other intestinal parasitosis which are present in this population. Finally the eosinophilia of chronic fascioliasis is in inverse relation with age in individuals of endemic zones and the number of parasites probably decreases as the person grows older, probably due to a modulation in the immune response of the individual or by the natural death of the parasite.

Abdominal Pain↗
PubMed1988

Evaluation of immunodiagnostic antigens in the excretory-secretory products of Fasciola hepatica.

The metabolic antigens of F. hepatica have been shown to be a source of potential immunodiagnostic antigens. We have fractionated F. hepatica excretory-secretory (ES) antigens by conventional gel filtration and HPLC, analyzed these fractions in PAGE, and evaluated their immunogenicity by ELISA with sera from experimentally infected rabbits to identify potential serodiagnostic antigens for fascioliasis. A fraction enriched in high molecular weight components of ca. 150-160 kDa was found to be very reactive with sera from early fascioliasis. This fraction was successfully adapted to the DOT-ELISA, where titers up to 1:16,000 still appeared visually as positive. Both acute and chronic fascioliasis sera also recognized, in the enzyme-linked immunoelectrotransfer blot technique (EITB), prominent 25-30-kDa polypeptides that have previously been shown to be recognized by infected rabbits, cows, and sheep. We have therefore employed conventional gel filtration and HPLC gel exclusion chromatography as a 1-step procedure to obtain fractions enriched in antigens recognized in early fascioliasis. In addition, these antigens have been successfully applied to a sensitive, visual immunodiagnostic technique that can be easily employed in field studies.

Animals↗
PubMed1997

Antigenic components of somatic extract from adult Fasciola gigantica recognized by infected human sera.

The antigenic components of Fasciola gigantica somatic extract were revealed by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting technique using sera from patients with F. gigantica infection, patients with clinically diagnosed fascioliasis, patients with other infections/illness and healthy adults. By SDS-PAGE, it was found that the somatic product comprised more than 22 polypeptides. Immunoblotting analysis revealed at least 13 components which were strongly recognized by sera of patients with fascioliasis. These antigenic components had molecular weights ranging from less than 14.4 to more than 94 kDa. One antigenic component, i.e. 38 kDa was found to give a consistent reaction with sera of patients with fascioliasis (100% sensitivity and 96.7% specificity). The finding suggests that the 38 kDa components may be a potential diagnostic antigen for fascioliasis.

Adult↗
PubMed1984

Infectivity and pathogenicity of Fasciola gigantica in West African dwarf sheep and goats.

The infectivity and pathogenicity of Fasciola gigantica for sheep and goats were investigated in animals infected with single doses of between 200 and 2,000 metacercariae. Acute fascioliasis occurred in sheep infected with 1,000 to 2,000 cysts in which 10 to 17% of the cysts became established. The infected animals died 80 to 90 days after infection. In goats given the same infective doses death from acute fascioliasis occurred earlier (70 to 83 days after infection) and 12 to 38% of cysts became established. Subacute fascioliasis could occur in both hosts with an infective dose of 200 cysts, the animals surviving for more than 100 days. It therefore appears that F. gigantica is more infective for goats and that the disease was more severe in this host than in sheep.

Anemia↗
PubMed2001

Fasciola hepatica and lymnaeid snails occurring at very high altitude in South America.

Fascioliasis due to the digenean species Fasciola hepatica has recently proved to be an important public health problem, with human cases reported in countries of the five continents, including severe symptoms and pathology, with singular epidemiological characteristics, and presenting human endemic areas ranging from hypo- to hyperendemic. One of the singular epidemiological characteristics of human fascioliasis is the link of the hyperendemic areas to very high altitude regions, at least in South America. The Northern Bolivian Altiplano, located at very high altitude (3800-4100 m), presents the highest prevalences and intensities of human fascioliasis known. Sequences of the internal transcribed spacers ITS-1 and ITS-2 of the nuclear ribosomal DNA of Altiplanic Fasciola hepatica and the intermediate snail host Lymnaea truncatula suggest that both were recently introduced from Europe. Studies were undertaken to understand how the liver fluke and its lymnaeid snail host adapted to the extreme environmental conditions of the high altitude and succeeded in giving rise to high infection rates. In experimental infections of Altiplanic lymnaeids carried out with liver fluke isolates from Altiplanic sheep and cattle, the following aspects were studied: miracidium development inside the egg, infectivity of miracidia, prepatent period, shedding period, chronobiology of cercarial emergence, number of cercariae shed by individual snails, survival of molluscs at the beginning of the shedding process, survival of infected snails after the end of the shedding period and longevity of shedding and non-shedding snails. When comparing the development characteristics of European F. hepatica and L. truncatula, a longer cercarial shedding period and a higher cercarial production were observed, both aspects related to a greater survival capacity of the infected lymnaeid snails from the Altiplano. These differences would appear to favour transmission and may be interpreted as strategies associated with adaptation to high altitude conditions.

Altitude↗
PubMed2001

Imported Fasciola hepatica infection in the United States and treatment with triclabendazole.

Infection with Fasciola hepatica, a liver trematode, is not frequently reported in the United States. We describe 2 patients, both originally from Cape Verde, who illustrate the spectrum of clinical presentations of F. hepatica as well as the means of treating infection with this parasite. Patient 1 had extensive disease and underwent multiple diagnostic procedures before the correct diagnosis was reached. Patient 2, who had few symptoms, had fascioliasis diagnosed by a noninvasive evaluation. Both patients were treated with triclabendazole without experiencing significant side effects. Fascioliasis that has been imported to the United States may elude prompt or accurate diagnosis. Obtaining a detailed travel history and recognizing the clinical presentation early in the course of infection may permit timely and noninvasive identification of infection. Triclabendazole is now the recommended drug for treating for fascioliasis because of its efficacy, safety, and ease of use.

Adult↗
PubMed1985

Induction of drug metabolizing enzymes in the liver of rats infested with Fasciola hepatica.

Adult, male rats were infected with 20 metacercariae of Fasciola hepatica given orally, other rats were left untreated. Five weeks after infestation, some animals received phenobarbitone, 3-methylcholanthrene, beta-naphthoflavone or Arochlor 1254, to induce liver drug metabolizing enzymes. Fascioliasis provoked decreases in aminopyrine N-demethylase, aniline hydroxylase, the mutagenic activity of cyclophosphamide and cytochrome P-450 concentration in untreated or phenobarbitone or Arochlor pretreated rats. In contrast, cytochrome b5, NADPH cytochrome c reductase, ethyoxycoumarin O-deethylase and the enzymatic activation of ethidium bromide were not affected by fascioliasis whatever pretreatment was given. Fascioliasis decreased liver drug metabolizing enzymes which were specifically induced by both phenobarbitone and Arochlor, this could be due to either the specific action of toxic excretions of flukes or to the particular localization of tissue damage within the liver lobule.

Animals↗