FASCIOLIASIS (Liver Fluke)
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Foodborne parasitic infections FASCIOLIASIS (Liver fluke) Fascioliasis is caused by two At least, 2.4 million people are In general, fascioliasis is more species of flatworms that mainly infected in more than 70 countries common and widespread in affect the liver: Fasciola hepatica worldwide, with several million at animals than in humans. ? and Fasciola gigantica. risk, especially where sheep or Introduction cattle are reared. The life cycle of the disease involves definitive host (in which the adult worm lives), an intermediate host (in which the larval stages of the worm develop) and a carrier (entailing suitable aquatic plants). Transmission The process begins when an infected animal and risk (cattle, sheep, buffaloes, donkeys and pigs but Eating factors also horses, goats, dromedaries, camels, llamas undercooked infected water and other herbivores) defecates in fresh-water plants sources and contaminates the water with the Definitive host parasites’ eggs. (Fluke) Lack of sanitation The eggs hatch into first‐stage larvae (miracidia) and and open lodge in water snails. defecation Free living The larva reproduces asexually inside the snail and Free living releases more larvae into the water that can swim to nearby aquatic or semi-aquatic plants and form small cysts (metacercariae). Use of contaminated Intermediate Animals and humans are infected through water in agriculture ingestion of the water plants with host metacercariae or free metacercariae floating in contaminated water. After infection, individuals experience a Triclabendazole, the only medicine symptomless incubation period lasting a few days recommended by WHO against human fascioliasis, to a few months, followed by an acute and a chronic is active against both immature and adult parasites, clinical phase. and may therefore be employed during the acute Signs and Symptoms of the acute phase include fever, Treatment and chronic phases. symptoms nausea, a swollen liver, skin rashes and extreme Cattle and sheep can be treated with several drugs abdominal pain. including triclabendazole, closantel and nitroxynil. Symptoms of the chronic phase include intermittent pain, jaundice and anaemia. Long‐term 1. Preventive chemotherapy with a single inflammation can lead to fibrosis. oral dose of triclabendazole in communities In animals, clinical signs depend on the species of where cases are clustered, targeting either animal affected, the number of parasites and the school-aged children, usually with the highest phase of the parasite. Disease can be acute, sub- Public health prevalence of infection, or the entire community acute or chronic. prevention 2. Prevention and control in animals and control Diagnosis may be based on the clinical picture, an • Improved animal husbandry, stall feeding individual’s recall of consuming raw vegetables, • Treatment of domestic animals the detection of eosinophilia or on the findings of 3. Snail control Detection ultrasound or tomography scans. Confirmation of and diagnosis requires parasitological, immunological 4. Water, sanitation and hygiene (WASH) diagnosis and molecular techniques. 5. Risk communication cultivation of In animals, diagnosis is based on clinical signs, vegetables in water free from faecal microscopy, and necropsy. Immunological contamination and thorough washing and techniques can also be used. cooking of vegetables before consumption www.who.int/health-topics/foodborne-trematode-infections Reference number (FAO) CB1127EN/1/10.20 │ Reference number (OIE) OIE/FPIFS_F/2021.4 │ www.oie.int/diseasecard_fasciola Reference number (WHO) WHO/UCN/NTD/VVE/2021.4 i © World Health Organization (WHO), Food and Agriculture Organization of the United Nations (FAO) and World Organisation for Animal Health (OIE), 2021. All rights reserved..