Fasciolosis

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Fasciolosis
Synonyms	Fascioliasis, liver fluke infection
Pronounce	N/A
Specialty	N/A
Symptoms	Fever, abdominal pain, hepatomegaly, jaundice
Complications	Cholangitis, liver abscess
Onset	4 to 7 weeks after infection
Duration	Chronic if untreated
Types	N/A
Causes	Infection by Fasciola hepatica or Fasciola gigantica
Risks	Consuming contaminated watercress or other aquatic plants
Diagnosis	Serology, stool examination
Differential diagnosis	Hepatitis, cholecystitis, gallstones
Prevention	Avoiding consumption of raw aquatic plants in endemic areas
Treatment	Triclabendazole
Medication	Triclabendazole
Prognosis	N/A
Frequency	2.4 million people infected worldwide
Deaths	Rare

Fasciolosis is a parasitic disease caused by the liver flukes of the genus Fasciola. The two primary species responsible for this condition are Fasciola hepatica and Fasciola gigantica. This disease affects a wide range of mammalian hosts, including humans, and is of significant veterinary and medical importance.

Life Cycle

The life cycle of Fasciola species involves several stages and requires an intermediate host, typically a freshwater snail. The adult flukes reside in the bile ducts of the definitive host, where they lay eggs that are excreted in the feces. Upon reaching a suitable aquatic environment, the eggs hatch into miracidia, which then infect the intermediate snail host. Inside the snail, the miracidia develop into sporocysts, rediae, and finally cercariae. The cercariae are released from the snail and encyst as metacercariae on aquatic vegetation. When the definitive host ingests the contaminated vegetation, the metacercariae excyst in the duodenum, migrate through the intestinal wall, and eventually reach the liver to mature into adult flukes.

Symptoms

In humans, fasciolosis can present in two phases: the acute (or invasive) phase and the chronic phase. The acute phase is characterized by symptoms such as fever, abdominal pain, nausea, and eosinophilia, resulting from the migration of the immature flukes through the liver. The chronic phase occurs when the flukes reside in the bile ducts, leading to symptoms like biliary colic, jaundice, and hepatomegaly. In livestock, fasciolosis can cause significant economic losses due to reduced productivity, weight loss, and liver condemnation.

Diagnosis

Diagnosis of fasciolosis can be challenging and typically involves a combination of clinical signs, serological tests, and imaging techniques. The detection of eggs in stool samples is a common diagnostic method, although it is more effective in the chronic phase. Serological tests, such as enzyme-linked immunosorbent assay (ELISA), can detect antibodies against Fasciola antigens and are useful in the early stages of infection. Imaging techniques like ultrasound and computed tomography (CT) scans can help visualize liver damage and fluke presence.

Treatment

The primary treatment for fasciolosis is the administration of anthelmintic drugs. Triclabendazole is the drug of choice due to its high efficacy against both immature and adult flukes. Other drugs, such as Nitazoxanide and Bithionol, may also be used, although they are generally less effective. In addition to pharmacological treatment, control measures include the management of snail populations and the avoidance of consuming contaminated water and vegetation.

Prevention

Preventive measures for fasciolosis focus on reducing the risk of infection in both humans and livestock. These measures include:

• Proper management of water sources to prevent contamination with fluke eggs.
• Control of intermediate snail hosts through environmental modifications and molluscicides.
• Educating at-risk populations about the dangers of consuming raw or undercooked aquatic vegetation.
• Regular deworming of livestock to reduce the prevalence of infection.

Epidemiology

Fasciolosis is a global disease, with higher prevalence in regions where livestock farming is common and where there are suitable habitats for the intermediate snail hosts. It is particularly prevalent in parts of South America, Africa, and Asia. Human cases are often associated with the consumption of contaminated watercress and other aquatic plants.

See Also

• Helminthiasis
• Liver fluke
• Parasitic disease
• Veterinary medicine

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