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Fasciola hepatica

Fasciola hepatica. Cris Scott and Angel Knopick. Liver rot and you!. Until 1300 thought to be a leech From 1970 to 1995, about 300,000 cases were reported in 61 countries. 2.4 million are infected and 160 million more at risk 2009 evidence of an emerging problem?

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Fasciola hepatica

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  1. Fasciolahepatica Cris Scott and Angel Knopick

  2. Liver rot and you! • Until 1300 thought to be a leech • From 1970 to 1995, about 300,000 cases were reported in 61 countries. • 2.4 million are infected and 160 million more at risk • 2009 evidence of an emerging problem? • In regions of Bolivia, 38% of children ages 5 to 19 may be infected.

  3. Classification/Taxonomy • Kingdom: Animalia • Phylum: Platyhelminthes • Class: Trematoda • Order: Echinostomida • Family: Fasciolidae • Genus: Fasciola • Species: hepatica

  4. Geographic Range • WORLDWIDE! • Human infections: Europe (especially France, Spain, Portugal), North Africa, South America (especially Bolivia), Cuba, United States • Need temperate, slow-moving, or standing water • urbanization

  5. What is affected?? aka…HOSTS • Definitive hosts: Sheep, cattle, buffalo, goats, and rabbits • Intermediate hosts: Snail • Fossariamodicella or Stagnicolabulimoides • Accidental hosts: Humans??

  6. Morphology • Adult • One of the largest flukes in the world • Average is 30 mm long and 13 mm wide • Leaf/cone shaped • 1 posterior and 1 anterior sucker • Egg • Average 140 µm long and 75 µm wide

  7. Life Cycle • Eggs from human or other host are passed in feces: no embryo. • Eggs are released into water: embryo. • Eggs hatch and miracidia are released. • Miracidia invade a snail (intermediate host). In the snail, the parasite undergoes three levels of development: Sporocyst, Rediae, and Cercariae. • The cercariae are excreted from the snail and encyts as metacercariae on aquatic vegetation (lose tails). • Cattle and sheep acquire the parasite by eating the vegetation containing the metacercariae. • Humans normally become infected by eating contaminated watercress. • The metacercariaeexcyst in the duodenum. • The metacercariae migrate through the intestinal wall, the peritoneal cavity, and the liver into the biliary ducts • They develop into adult flukes, and eggs are excreted in the feces.

  8. Fascioliasis: infection by liver flukes • Humans: • Abdominal pain • Fever • Eye infection- blindness • Jaundice • Eosinophilia • Diarrhea • Hepatomegaly (enlarged liver) • Skin rash • Anemia • Animals • Acute Type I: > 5000 ingested metacercariae, quick death without clinical signs • Acute Type II: 1000- 5000 metacercariae, slowly die • Subacute: 800 – 1000 metacercariae, anemia, weight loss, and death, • Chronic: 200 – 800 metacercariae, bottle jaw, emaciation, weight loss, and edema

  9. Diagnosis • Liver blockage coincides with the consumption of watercress • Eggs in stool • Fast-ELISA • False results are possible when patients have eaten infected liver and F. hepatica eggs pass through the feces • Liver free diet • Early diagnosis is essential to prevent irreparable damage to the liver

  10. Control and Treatment • Avoid “wild” watercress • Thoroughly cook liver • Education on eating uncooked aquatic plants (kjosco) • Control host reservoir populations • Control snail populations • Triclabendazole (drug of choice) & Rafoxanide

  11. Vaccines • Proteases secreted immunizing antigens • Proteases/hemoglobin: egg viability reduced • Cysteine proteases: worms reduced 75% ≠

  12. Economic Importance • Infection leads to mortality, reduction of milk and meat production • Leads to secondary bacterial infections • In Montana, 17% of cattle livers were infected • In Mexico, over 400,000 out of 6 million cattle slaughtered were confiscated

  13. References • CDC: http://www.dpd.cdc.gov/dpdx/html/fascioliasis.htm, 15 Feb 2011 • NIH: http://www.ncbi.nlm.nih.gov/pubmed/8589147\, 15 Feb 2011 • Wiki: http://en.wikipedia.org/wiki/Fasciolosis , 15 Feb 2011 • WHO: http://whqlibdoc.who.int/bulletin/1995/Vol73-No3/bulletin_1995_73(3)_397-401.pdf, 15 Feb 2011 • WHO: http://www.who.int/neglected_diseases/integrated_media/integrated_media_fascioliasis/en/, 15 Feb 2011 • Roberts, Larry S., Gerald D. Schmidt, and John Janovy. Gerald D. Schmidt & Larry S. Roberts' Foundations of Parasitology. Boston: McGraw-Hill Higher Education, 2009. Print.

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