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Athough few case reports of human fascioliasis have been reported from different parts of India, there is no case reported from Kashmir valley till date. Here in we report two cases of human fascioliasis. The both patients presented with fever, marked eosinophilia and liver leisions on imaging. Hepatobiliary imaging showed vague features like mild biliary dilatation and liver leisions representing burrows. Liver biopsy in one of the patients revealed eosinophilic granuloma. Both patients were diagnosed definitively with endoscopic retrograde cholangio-pancreatography (ERCP) by demonstrating live adult fasciola worms. Any patient presenting with fever, marked eosinophilia and liver leisions on imaging should be evaluated for fascioliasis.

The only drug effective against the infection caused byThe present review focuses on the evidence of TCBZ for the treatment of fascioliasis. For acute fascioliasis, there is a lack of studies to measure the presence of eggs of Fasciola in stool samples on the follow-up after initial TCBZ treatment. For chronic fascioliasis, WHO recommends a single oral dose of TCBZ 10 mg/kg whereas CDC recommends two doses of TCBZ 10 mg/kg 12 h apart. Incremental number of treatment failures have been documented worldwide. There are currently no therapeutic alternatives for the treatment of fascioliasis in humans.Most cases of human fascioliasis are successfully treated with TCBZ, but some continue excreting eggs in the stools despite 1-2 standard of care regimens of TCBZ. A precise regimen is unclear for those patients who fail the initial treatment with TCBZ. Further clinical trials are needed to address the possible TCBZ emerging resistance.

Background Fascioliasis is a snail-borne zoonotic trematodiasis emerging due to climate changes, anthropogenic environment modifications, and livestock movements. Many areas where Fasciola hepatica is endemic in humans have been described in Latin America altitude areas. Highest prevalences and intensities were reported from four provinces of the northern Bolivian Altiplano, where preventive chemotherapy is ongoing. New strategies are now incorporated to decrease infection/re-infection risk, assessment of human infection sources to enable efficient prevention measures, and additionally a One Health initiative in a selected zone. Subsequent extension of these pilot interventions to the remaining Altiplano is key. Methods To verify reproducibility throughout, 133 specimens from 25 lymnaeid populations representative of the whole Altiplano, and 11 used for population dynamics studies, were analyzed by rDNA ITS2 and ITS1 and mtDNA cox1 and 16S sequencing to assess their classification, variability and geographical spread. Results Lymnaeid populations proved to belong to a monomorphic group, Galba truncatula. Only a single cox1 mutation was found in a local population. Two cox1 haplotypes were new. Comparisons of transmission foci data from the 1990’s with those of 2018 demonstrated an endemic area expansion. Altitudinal, northward and southward expansions suggest movements of livestock transporting G. truncatula snails, with increasing temperatures transforming previously unsuitable habitats into suitable transmission areas. Transmission foci appear to be stable when compared to past field observations, except for those modified by human activities, including construction of new roads or control measures undertaken in relation to fascioliasis. Conclusions For a One Health initiative, the control of only one Fasciola species and snail vector species simplifies efforts because of the lower transmission complexity. Vector monomorphism suggests uniformity of vector population responses after control measure implementation. Hyperendemic area outer boundary instability suggests a climate change impact. All populations outside previously known boundaries were close to villages, human dwellings and/or schools, and should therefore be considered during disease control planning. The remarkable southward expansion implies that a fifth province, Aroma, should now be included within preventive chemotherapy programmes. This study highlights the need for lymnaeid molecular identification, transmission foci stability monitoring, and potential vector spread assessment.

This review aimed to provide a comprehensive overview of ruminant and human fascioliasis in Malaysia and to identify research gaps in knowledge of the prevalence of fascioliasis in Malaysia and risk factors for the disease using available evidence-based data. We conducted a scoping review based on the framework of Arksey and O'Malley. The preferred reporting items for systematic reviews and meta-analyses were used to guide the review process. The citation search was performed between May and September 2018. Using specific keywords, literature published between 1998 to September 2018 was retrieved from electronic databases. Six articles related to fascioliasis in Malaysia were included in the final review from 1,932 screened articles and reports. Five studies focused on ruminants, including cattle, buffaloes, sheep and goats in the states of Terengganu and Perak. The most frequent ruminant fascioliasis outbreaks involved cattle and goats, with a prevalence of 82%-95% and these outbreaks occurred in Terengganu. Only one study examined the risk of fascioliasis in cattle. In the study, the age and sex of the cattle were important risk-related parameters. The search returned only one documented report of a suspected case of human fascioliasis with an atypical clinical presentation. At present, human fascioliasis in Malaysia remains under-reported and its prevalence remains unknown. The data summarised in this review based on existing evidence identifies research gaps on fascioliasis in ruminants and humans.

Fascioliasis has emerged as a significant public health problem among ruminants and humans. Human fascioliasis is a neglected food-borne parasitic disease, which has emerged or reemerged in more than 60 countries worldwide. In China, the first case of human fascioliasis was reported in 1921 in Fujian Province. The first major outbreak of this parasitic disease in 29 patients occurred in 2012 in Yunnan Province. Nonetheless, the prevalence of fascioliasis in China is probably underestimated due to the poor sensitivity of diagnostic tests, limited epidemiological data, and a poor understanding of the impact of subclinical illness. This study aimed to review the prevalence and risk factors of fascioliasis in China so as to improve the prevention and control of this disease.

Background: Fascioliasis is a neglected zoonotic disease, caused by Fasciola species in human and livestock. We aimed to detect the seroprevalence of human fascioliasis Gorgan City, Golestan Province, northern Iran using ELISA method in 2017. Methods: Overall, 612 serum samples were analyzed. A relevant questionnaire for demographic data was obtained for all cases. An indirect ELISA test was used to detect IgG antibodies against Fasciola in the sera. The data analysis was performed employing SPSS program version 21. Results: Eleven cases (1.79%) were seropositive for fascioliasis. The seroprevalence of fascioliasis was 1.9% and 1.1% among males and females, respectively. There was no statistically significant association between the fascioliasis and analyzed variables such as sex, age, residence, job, education, etc. Conclusion: This study was conducted only on the people referring to the Reference Laboratory of Gorgan. It cannot be distributed to the whole city. Thus, due to importance of the disease, finding the seroprevalence of fascioliasis in a comprehensive survey in Golestan Province should be accounted in further studies.

Background: Fascioliasis is a zoonotic disease caused by the liver parasites, Fasciola hepatica, and F. gigantica. Objectives: The aim of this study was to determine the seroprevalence of fascioliasis in Zahedan and the surrounding towns (i.e., Zabol, Chabahar, Iranshahr, etc.) in the Southeast of Iran. Methods: This cross-sectional study was conducted in 2017. Based on statistical estimations, 251 human serum samples were collected randomly in Zahedan and surrounding towns (Zabol, Chabahar, Iranshahr, and others), then the samples were analyzed using indirect enzyme-linked immunosorbent assay (ELISA) test. A questionnaire was obtained from each individual. Statistical analysis was performed using the chi-square test in SPSS, version 20. Results: Of the 251 samples, the anti-fasciola antibody was detected in 6 (2.40%) samples. There was a significant relationship between the use of local freshwater vegetables and seropositivity to fasciolosis. Conclusions: This study showed that the prevalence of human fascioliasis was higher among women (2.70%) compared to men (0.0%), and raising health levels and health education can reduce the prevalence of human fascioliasis disease.

Human fascioliasis is a zoonotic disease caused by two parasites of class Trematoda, namely Fasciola hepatica and F. gigantica. It is prevalent, particularly in regions with farming communities having sheep or cattle. In India, cases are not frequently reported despite being one of the dominant countries in livestock production. Usually, humans are incidental hosts that acquire infection by ingesting contaminated aquatic vegetation or water. If not diagnosed timely, it can lead to fatal complications.The authors report a case of hepatobiliary fascioliasis in a female presented with non-specific complaints. A thorough investigation including parasitological evaluation helped to reach the diagnosis. This case highlights the importance of awareness, diagnosis and appropriate treatment of fascioliasis with Triclabendazole for complete cure.

Fascioliasis is a food-borne anthropozoonotic disease caused by Fasciola hepatica that affects multiple hosts, including humans. We herein report the first case of human fascioliasis in the state of Santa Catarina, Brazil. A 57-year-old female patient complaining of abdominal pain was admitted to the hospital for a clinical investigation. The diagnosis of F. hepatica was confirmed by ultrasound and indirect enzyme-linked immunosorbent assay. Authorities of the Northern coast of Santa Catarina were notified to investigate other cases and risk factors for contamination. The disease is also prevalent in cattle, which could pose as a potential route for infection.

SUMMARYBefore the 1990s, human fascioliasis diagnosis focused on individual patients in hospitals or health centres. Case reports were mainly from developed countries and usually concerned isolated human infection in animal endemic areas. From the mid-1990s onwards, due to the progressive description of human endemic areas and human infection reports in developing countries, but also new knowledge on clinical manifestations and pathology, new situations, hitherto neglected, entered in the global scenario. Human fascioliasis has proved to be pronouncedly more heterogeneous than previously thought, including different transmission patterns and epidemiological situations. Stool and blood techniques, the main tools for diagnosis in humans, have been improved for both patient and survey diagnosis. Present availabilities for human diagnosis are reviewed focusing on advantages and weaknesses, sample management, egg differentiation, qualitative and quantitative diagnosis, antibody and antigen detection, post-treatment monitoring and post-control surveillance. Main conclusions refer to the pronounced difficulties of diagnosing fascioliasis in humans given the different infection phases and parasite migration capacities, clinical heterogeneity, immunological complexity, different epidemiological situations and transmission patterns, the lack of a diagnostic technique covering all needs and situations, and the advisability for a combined use of different techniques, at least including a stool technique and a blood technique.

A patient who underwent mastectomy of the left breast owing to breast cancer was referred to our department for abdominal ultrasonography during her routine check-up. Radiological examinations demonstrated multiple masses that tended to form clusters in the liver parenchyma, and the lesions were initially thought to represent metastases from the breast cancer. Multisite biopsies and serological tests confirmed the diagnosis of Fasciola hepatica infestation. To our knowledge, this is a unique case report of a patient with a known malignant neoplasm. We also present an overview of the literature about human fascioliasis in Turkey.

Triclabendazole is reported to be highly effective in treatment of human fascioliasis. We present 7 of 19 selected cases of human fascioliasis referred to our center in the Cusco region of Peru that failed to respond to triclabendazole. These were mostly symptomatic adults of both sexes that continued passing Fasciola eggs in the stool despite multiple treatments with 2 doses of triclabendazole at 10 mg/kg per dose. We documented the presence of eggs by rapid sedimentation and Kato Katz tests after each treatment course. We found that repeated triclabendazole courses were not effective against fascioliasis in this group of people. These findings suggest that resistance to triclabendazole may be an emerging problem in the Andes., Author Summary Fascioliasis is a zoonotic food borne trematode infection with a wide distribution. The complex epidemiology of this infection makes control efforts difficult. The paucity of drugs available for treatment may further hinder their success. Triclabendazole, the only first line drug for Fasciola, has been used for many years in the livestock industry. Resistant livestock Fasciola infections have emerged in developing and developed countries. However, most human trials report triclabendazole efficacies close to 100% after a few doses. Only a few cases of triclabendazole treatment failure have been published. We document 7 patients infected with Fasciola hepatica in Cusco–Peru that failed several treatment courses with triclabendazole. This raises concerns regarding preparedness to address resistant parasite infections and calls for more research to find new medications and tools to evaluate resistance.

Human fascioliasis with Fasciola species occurs worldwide and is most common among rural people who tend sheep and eat uncooked water vegetables, particularly watercress. The natural history of the acute phase begins with ingestion of metacercariae encysted on various kinds of aquatic vegetation such as watercress. Fascioliasis primarily involves the liver, bile ducts, gallbladder, and occasionally ectopic sites. We describe herein a case of ectopic fascioliasis. This uncommon form of disease was peritonitis; both visceral and parietal peritoneal layers were affected with the formation of multiple nodules and ascites.

Fascioliasis, an emerging parasitic infection, impacts significantly on both veterinary and human health worldwide. Endemic foci are not limited only to areas of extensive livestock farming, but owing to the parasite's abilities to colonise new intermediate hosts and adapt to new environments, also occur in other places, including Cuba. In Cuba, despite a high prevalence of fascioliasis in livestock, and the widespread occurrence of two potential intermediate hosts, human infection has decreased steadily over the past 10 years. In other parts of the world, human fascioliasis is apparently becoming more frequent. Problems in counteracting the spread of fascioliasis, and approaches used in Cuba to limit zoonotic transmission are discussed, with emphasis on diagnostic and treatment problems, malacological initiatives, and the importance of an integrated control programme. Such programmes may be of benefit in other countries where the prevalence of human fascioliasis is increasing, and lessons may perhaps be learned from the Cuban approach.

Fascioliasis is a foodborne trematode infection that affects patients worldwide causing both liver inflammation and biliary obstruction. In developed countries, the disease is rare but a number of focal outbreaks have been reported. Here, we report a case of human fascioliasis in which acute and chronic manifestations coexisted and discuss the newest evidence regarding pathogenesis, diagnostic approach, and treatment, with emphasis on strategies to control the incidence of this emergent disease.

Considered a secondary zoonotic disease until the mid-1990s, human fascioliasis is at present emerging or re-emerging in many countries, including increases of prevalence and intensity and geographical expansion. Research in recent years has justified the inclusion of fascioliasis in the list of important human parasitic diseases. At present, fascioliasis is a vector-borne disease presenting the widest known latitudinal, longitudinal and altitudinal distribution.Fasciola hepaticahas succeeded in expanding from its European original geographical area to colonize five continents, despite theoretical restrictions related to its biology and in turn dependent upon environmental and human activities. Among the different epidemiological situations, human hypo- to hyperendemic areas, including epidemics, are noteworthy. A global analysis of the distribution of human cases shows that the expected correlation between animal and human fascioliasis only appears at a basic level. Areas presenting very high human prevalences and intensities, especially in children and females, have been recently described. In hypo- to hyperendemic areas of Central and South America, Europe, Africa and Asia, human fascioliasis presents a range of epidemiological characteristics related to a wide diversity of environments. Thus far well-known epidemiological patterns of fascioliasis may not always explain the transmission characteristics in any given area and control measures should consider the results of ecoepidemiological studies undertaken in the zones concerned.

The aim of this study was to survey the prevalence of fascioliasis in slaughtered cattle in order to provide breeders with feedback which may prevent cattle fascioliasis, as well as human fascioliasis.The results of meat inspection and the information extracted from the Discriminative Data Base on Individual Livestock in Japan were analyzed statistically in 6,224 cattle slaughtered at the Tsuyama Abattoir during the fiscal year 2002.The age-adjusted fascioliasis and cholangitis rates of all cattle were 2.0% and 7.2%, respectively. When analyzed by cattle breed, both rates were significantly higher in Japanese native cattle than in Holstein or Jersey (Chi-square test, p0.01). The cattle raised in Okayama Prefecture, Tochigi Prefecture and Shimane Prefecture were significantly different from cattle raised in other prefectures in the age-adjusted fascioliasis and cholangitis rates.The age-adjusted fascioliasis and cholangitis rates of all cattle can be considered as nationwide rates for slaughtered cattle. The results of the comparisons suggest that cattle fascioliasis is related to feeding with rice straw and that the measures to prevent cattle fascioliasis might differ a mong prefectural governments.

School Health Programmes offer the opportunity to deliver public health interventions to a great number of beneficiaries at a relatively low cost and are seen with growing interest by policy makers in developing countries and the donors' communities. In Egypt a pilot School Health Programme has been implemented for the past 6 years in Behera, the largest and most populous Governorate of the Nile Delta. The Programme integrated additional activities for the control of soil-transmitted helminthiasis, human fascioliasis and anaemia in the National Schistosomiasis Control Programme (NSCP), implemented in Egypt since 1988 by the Ministry of Health and Population (MoHP). To facilitate planning and direct actions, a strong monitoring system was also developed, that generated useful information for the schistosomiasis control programme. The practical steps adopted to develop the programme are presented and discussed. Results from three rounds of monitoring (2000, 2001, 2002) are analysed and compared with baseline data conducted in 1996, together with the cost of each activity. On the basis of the experience gained by the Behera School Health Programme a number of operational recommendations are formulated.

Our objective was to describe MR imaging findings of liver lesions in human fascioliasis. The MR imaging of the liver was performed in 29 patients with fascioliasis. Seventeen patients were women and 12 were men, with a mean age of 47.5 years (age range 17-75 years). Hepatic lesions were grouped into five types based on their signal characteristics. Three patients had normal imaging findings. One or more lesions were observed in the other 26 patients. The lesion types and the frequency of appearances were as follows: hyperintensity of the liver capsule on T2-weighted images (n=16, 55.2%); ill-defined slightly hyperintense areas on T2-weighted images (n=18, 62.1%); lesions which were hypointense on T1-weighted and hyperintense on T2-weighted images (n=10, 34.5%); hypointense on T1-weighted images and centrally hypo- or hyperintense, surrounded by peripherally less hyperintense area on T2-weighted images (n=4, 13.8%); and hypointense foci or ill-defined hypointense areas on T1- and T2-weighted images (n=10, 34.5%). We describe the MR imaging features of the disease. Our findings may help the differential diagnosis in which fascioliasis should be added to the list.

This report presents two cases of human fascioliasis from different states in India. Although only few cases of human fascioliasis have been reported from India previously, both these cases were encountered within a span of three months at this tertiary care centre. Case 1 had significant symptoms with episodes of fever, abdominal pain and eosiniphilia and underwent multiple diagnostic procedures before the correct diagnosis was reached. Case 2, who had few symptoms, had fascioliasis diagnosed with minimal evaluation. These different presentations seen at two ends of the clinical spectrum of disease along with findings of peripheral eosinophilia, and radiological findings led to a presumptive diagnosis that was then confirmed by microscopic examination of bile. Morphometric analysis of ova from these cases was suggestive of infestation with F. gigantica or a F. gigantica-like hybrid. Both patients were treated with triclabendazole which was imported from Geneva. The need to be aware of the possibility of occurrence of this disease and the inclusion of drugs used for treating the disease, in the Indian drug list, should be emphasized.

Human fascioliasis cases in Japan have been reported infrequently and the most appropriate therapy for this disease remains to be determined. This case report describes a patient with the infection unsuccessfully treated with multiple high doses of praziquantel for over 1 year and eventually cured by the administration of triclabendazole in two single doses of 10 mg/kg and 12.5 mg/kg 5 months apart.

La fasciolosis humana es un problema de salud pública debido a la mayor incidencia de casos reportados en los últimos años alrededor del mundo. La necesidad de contar con técnicas o métodos de diagnóstico para Fasciola hepatica de mayor sensibilidad y especificidad es importante tanto para la práctica clínica como para determinar zonas endémicas. Objetivo: Evaluar las técnicas coprológicas y serológicas para el diagnóstico de la infección por Fasciola hepatica en humanos. Material y métodos: La población de estudio comprendió a niños en edad escolar entre 1-16 años de edad, pertenecientes a una zona de alta endemicidad (Junin, Perú). Se obtuvieron un total de 194 muestras de heces y 158 muestras de suero. Se evaluaron tres métodos coproparasitológicos: Método de Concentración éter-formol (MCEF), Técnica de Sedimentación Espontánea (TSE) y la Técnica de Sedimentación Rápida (TSR) modificada por Lumbreras, y tres métodos serológicos: Arco 2, Western blot para F. hepatica y Fas2-ELISA. Resultados: La TSR modificada por Lumbreras fue la de mayor rendimiento (20.61%) en comparación con la TSE (13.40%) y MCEF (7.72%). La sensibilidad de Fas2-ELISA fue de 96.77% superior a la del Western blot y Arco 2, con sensibilidades de 71.87% y 35.48%, respectivamente. Conclusiones: La TSR es superior a TSE y MCEF para el diagnóstico de la fasciolosis humana en la fase crónica. Fas2-ELISA, es una prueba de inmunodiagnóstico altamente sensible y que se propone debe ser usada como la prueba de diagnóstico de fasciolosis humana y de tamizaje de la infección en poblaciones humanas que habitan en regiones de alta endemicidad para esta parasitosis. Human fasciolasis is a growing health problem, with an increasing worldwide incidence of reported cases. Improving its diagnosis through more sensitive and specific techniques is important to clinical practice and to epidemiology, specially to determine new endemic areas. Objective: To evaluate coprological techniques and serological tests for diagnosis of Fasciola hepatica (Fh) infection in humans. Material and methods: The study population involved children aged from 1 to 16 years, in a highly endemic area (Junin, Perú). A total of 194 stool samples and 158 sera were examined. Three coprological techniques were compared: formolether concentration (Ritchie’s), spontaneous sedimentation (SST) and Lumbreras’ rapid sedimentation (RST). Three serological test for Fh were evaluated: Arc 2 (double-diffsion), enzyme-linked immunoelectrotransfer blot (EITB) and Fas2-ELISA. Results: RST showed higher recovery rates (20.61%) of eggs in stools than SST (13.40%) and Ritchie’s (7.72%). The sensitivity of the serological tests was compared with total infected patients diagnosed by all the fecal tests: most sensitive was Fas2-ELISA with 96.77%, EITB was 71.87% and Arc 2, was 34.48%. Conclusion: We conclude that RST is better than the SST and Ritchie’s techniques for the diagnosis of the chronic phase of human infection by Fh using fecal examinations, and that Fas2-ELISA is a very highly sensitive immunodiagnostic test, which may be used for the diagnosis of human Fh infection in both clinical and epidemiological settings, specially for screening human populations living in endemic areas.

The detection of IgG avidity in sera is potentially useful in the diagnosis of acute and chronic infection. We studied IgG avidity in 31 patients with fascioliasis, with the aim of evaluating the clinical application of this test to confirm the diagnosis of incubating cases and to distinguish between acute and chronic cases. Of the 31 cases, 13 were incubating and had a mean avidity index of 57.28 +/- 5.79%. The 18 chronic cases had an avidity index of 68.80 +/- 8.92%. The difference was highly significant. We conclude that IgG avidity is a reliable means of identifying the stage of fascioliasis and suggest a cut-off point of 59.90% to distinguish between acute and chronic infection.

The tolerance and efficacy of triclabendazole CGP 23030, specially prepared for human use, were assessed in 50 patients in the chronic phase of fascioliasis. After clinical examination, investigation and ultrasonography of the liver and biliary system, triclabendazole 10 mg/kg, either as a single or split dose, was administered. The clinical picture was studied daily for six days and the investigations were repeated 6, 30 and 60 days after treatment. The drug was tolerated. Its side-effects, which included upper abdominal pain, mild fever and limited derangement of liver function, were considered negligible. The cure rate at 2 months was 94% when assessed by the disappearance of eggs in stools and 88% when assessed by both the absence of eggs in stools and of worms in the biliary system. The use of triclabendazole for the treatment of human fascioliasis was found to be justified

We experienced a case of human fascioliasis diagnosed by a resected specimen and postoperative immunoserological tests. A 71-year-old man was admitted to the hospital because of transient upper abdominal pain and a hepatic abnormal shadow on abdominal ultrasonography and computed tomography. The laboratory data revealed eosinophilia and elevations in biliary emzymes and carcinoembryonic antigen. Imaging procedures showed multiple nodular masses localized in left lobe of the liver. On suspicion of malignant tumor, a left lobectomy of the liver was performed. The lesion was found by microscopic examination to be multiple abscesses with remarkable infiltration of eosinophils. Though parasitic disease was suspected, no parasitic body nor egg was detected in the resected specimen and feces. The diagnosis of fascioliasis was established by immunoselorogical methods (Ouchterlony test and immunoelectrophoresis). After the operation and subsequent medication with prasziquantel, the laboratory data were normalized.

There is no consensus about the optimal treatment for fascioliasis. Here we report 5 cases of fascioliasis and 12 cases of fascioliasis reviewed from the literature, and discuss the clinical characteristics and treatment of this parasitic disease. The diagnosis was made in 88% of all patients by the serological test and eggs in the feces were negative in all patients. The characteristic CT findings of all patients in our series were cluster of multiple abscess-like lesions in the liver. Eosinophilia was present in all patients. Bithionol was effective in all of the 13 patients and praziquantel was effective in 4 of 8 patients. Three of 4 patients, in whom praziquantel was not effective, were treated with bithionol successfully. No severe side effects were noticed in all patients. Bithionol seems to be more effective against fasciola sp. than praziquantel. Bithionol is proposed as the drug of choice for the treatment of human fascioliasis.

Human fascioliasis has the widest latitudinal, longitudinal and altitudinal distribution of any vector-borne disease, yet only 3 cases have been reported from South Africa, the last in 1964. We report 2 cases from the same geographic area associated with local consumption of watercress, suggesting an endemic focus.

Os autores relatam um caso bem documentado de fasciolíase hepática (FH) tratado com êxito com triclabendazole. As manifestações clínicas predominantes foram febre, eosinofilia marcante e dor abdominal. Triclabendazole foi dado em duas doses únicas orais de 10 mg/kg cada. Não houve efeitos colaterais, nem recaídas clínicas ou parasitológicas até três meses após tratamento. Baseados nesta experiência e em outros poucos dados revistos na literatura, triclabendazole poderia ser uma alternativa terapêutica válida no tratamento da fasciolíase humana. A well documented case of hepatic fascioliasis (HF), successfully treated with triclabendazole, is reported. Predominant clinical manifestations were fever, marked eosinophilia and abdominal pain. Triclabendazole was given as two single oral doses of 10 mg/kg each. Neither side effects nor clinical or parasitological relapses were seen after three months of follow up Based on this experience and few other similar reports in the literature, triclabendazole might be a valid therapeutical alternative in the treatment of human fascioliasis.

膵頭部腫瘍との鑑別に苦慮し, 後腹膜リンパ節炎で発症した肝蛭症の1例を経験したので報告する.症例は49歳の女性.主訴は発熱.血液検査では好酸球増多とγ-glutamyltranspeptidase (GTP) の上昇を認め, computed tomography (CT), ultrasonogram (US) では膵頭部に約4cmの嚢胞状病変を認めた.嚢胞性膵腫瘍を疑い開腹すると, 膵頭部から大動脈前面にかけて膵上縁に接する腫瘤がありこれを摘出した.病理組織検査では化膿性リンパ節炎と診断された.術後外来経過観察中に多房性肝膿瘍の出現があり, 血清学的検査 (Ouchterlony法) で肝蛭症と診断した.Bithionolの内服により肝膿瘍およびリンパ節炎が消退した.

Fasciola hepatica, the aetiological agent of fascioliasis in the Caribbean region, occurs throughout the major islands of the Greater Antilles and in localised zones on two islands (Martinique and Saint Lucia) of the Lesser Antilles. However, apart from Puerto Rico, information regarding human fascioliasis in islands of the Caribbean is out of date or unavailable, or even nonexistent as in Haiti. The authors conducted a retrospective, cross-sectional serological survey in Port-au-Prince using a Western blotting test (LDBIO Diagnostics) on human fascioliasis in Haiti. A total of 216 serum samples obtained from apparently healthy adults were tested. The frequency of antibodies in serum samples of the study population was 6.5% (14/216). The immunodominant bands recognised in Western blots were 27-28 kDa (100%), 42 kDa (64%), 60 kDa, and 8-9 kDa (28%). This is the first survey to reveal a relatively low proportion of asymptomaticF. hepatica-infected humans in Haiti.

A 30-y-old farmhand was admitted to our clinic in September 2000 with a 6-week history of increasing fatigue and polydipsia/polyuria after an initial short spell of gastroenteritis. No evidence of disease was discovered. During follow-up he developed leucocytosis with prominent eosinophilia, leading to the discovery of multiple liver abscesses and subsequently to the diagnosis of human fascioliasis of domestic origin. Although not uncommon in Europe, the infestation has hitherto not been reported from Scandinavia. The patient was successfully treated with praziquantel.

From 1981 to 2000 sixty-one cases of human fascioliasis were detected in the province of Gipuzkoa (Spain), most of them during the period of parenchymal invasion. Four family outbreaks were recorded. Thirty, 15, 13 and three cases were detected during the four consecutive 5-year periods. The decrease in this infection over the years is probably related to the change in eating habits.

A case of human fascioliasis is presented in which the patient remained symptomatic after treatment with praziquantel and other agents but eventually responded to bithionol. The difficulties in finding an efficacious and tolerable drug therapy for this condition are reviewed with reference to the life cycle and pathogenesis of the parasite. It is concluded that while bithionol remains the current drug of choice, triclabendazole may play a dominant role in the near future.

We report a case of necrotic granuloma of the liver by human fascioliasis. The lesion showed unusual findings at sonography, computed tomography, and magnetic resonance imaging that have not been reported previously.

One of the neglected food-borne-diseases in the international public health arena is fascioliasis. It is a serious infectious parasitic disease infecting humans and animals worldwide and tops all the zoonotic helminthes. Human cases are being increasingly reported from Europe, the Americas, Oceania, Africa and Asia. Hence, human fascioliasis is considered now as a zoonosis of major global and regional importance. In Egypt, animal and human fascioliasis is an endemic clinical and epidemiological health problem. Doubtless, understanding the epidemiology of the parasitic diseases and factors affecting their incidence provides the foundation upon which effective prevention and control programs should be established. This article reviews the history, life cycles, transmission, incidence, geographical distribution, and environmental and human determinants that contribute to the epidemiological picture of fascioliasis with special reference to Egypt.

This report presents four cases of human fascioliasis in Gondar town, northwest Ethiopia. There are only few case reports of human fascioliasis in Ethiopia as the disease mostly affects animals. However, the need to be aware of the possibility of occurrence of this disease in humans and the inclusion of drugs used for treating the disease, in the Ethiopian drug list, should be emphasized. Ethiopian Journal of Health Development Vol. 19(3) 2005: 237-240

Fascioliasis is a zoonotic infection caused by Fasciola hepatica. Because of population migration and international food trade, human fascioliasis is being an increasingly recognised entity in nonendemic zones. In most parts of Asia, hepatobiliary fascioliasis is sporadic. Human hepatobiliary infection by this trematode has two distinct phases: an acute hepatic phase and a chronic biliary phase. Hepatobiliary infection is mostly associated with intense peripheral eosinophilia. In addition to classically defined hepatic phase and biliary phase fascioliasis, some cases may have an overlap of these two phases. Chronic liver abscess formation is a rare presentation. We describe a surprise case of hepatobiliary fascioliasis who presented to us with liver abscess without intense peripheral eosinophilia, a rare presentation of human fascioliasis especially in non-endemic zones.

Background Fasciola hepatica primarily involves the liver, however in some exceptional situations other organs have been reported to be involved. The ectopic involvement is either a result of Parasite migration or perhaps eosinophilic reaction. Case presentation Here we report a known case of multiple myeloma who was under treatment with prednisolone and melphalan. He was infected by Fasciola hepatica, which involved many organs and the lesions were mistaken with metastatic ones. Discussion Presented here is a very unusual case of the disease, likely the first case involving the pancreas, spleen, and kidney, as well as the liver.

The fascioliasis situation in humans and livestock of Iranian Mazandaran is analysed for the first time. Coprological studies showed 7.3% and 25.4% global prevalences in sheep and cattle, respectively. Studies in slaughterhouses indicate that sheep and cattle may be the main reservoir species, buffaloes may play local roles in the transmission, and goats and horses probably only participate sporadically. Morphometric studies by computer image analysis showed that forms intermediate between Fasciola hepatica and F. gigantica appear in addition to both species. A total of 107 infected humans were diagnosed during the 1999-2002 period, which suggests that fascioliasis may be widespread. The absence of differences in human fascioliasis among gender and age groups differs from other human endemic areas. Both human and animal infections show marked differences between western and eastern Mazandaran. Traditions in herbal condiments for human consumption, methods of animal husbandry and annual rainfall may explain the higher prevalences in western Mazandaran.

Enzyme-linked immunosorbent assay (ELISA) and micro-ELISA were evaluated for their ability to detect anti- Fasciola hepatica antibodies in humans by using excretory-secretory antigen. The sensitivity of each method was 100%, but the specificity was 100% for ELISA and 97% for micro-ELISA. The micro-ELISA could be used as a screening assay and ELISA could be used as a confirmatory method for the serodiagnosis of human fascioliasis.

An IELISA was developed to evaluate the performance of Fasciola E/S antigens in diagnosis and cure assessment of human Fasciola infection. Twenty patients with acute (prepatent) fascioliasis and another 20 with patent infection were enrolled in the study. Patients were treated with TCZ and followed at 1, 3 and 6 months after therapy. At inspection, the sensitivity of the test to diagnose prepatent cases was 100% compared to 70% for patent infections. There was a gradual decrease of antigenaemia over the follow-up period in acute cases. In chronic cases antigen disappeared from 13 cases (65%) at 1 month; this proportion did not change at 3 or 6 months.

Of all neglected tropical diseases (NTDs), arguably the most neglected are helminthic infections, which comprise the top 5 of the top 10 NTDs in terms of disability-adjusted life years. Despite this, they are often assigned low priority in international public health research funding, and on a national scale, some helminth infections are considered to be non-endemic in particular countries or regions, hence little attention is paid to them. In this issue of the SAMJ, Black et al. describe a case series of geographically linked human fascioliasis, an infection about which most physicians are unaware. Indeed, the last recorded case of human fascioliasis originating in South Africa (SA) was reported more than 50 years ago and there have only been 3 published case reports in total.

A 32-year old housewife, living in Seoul, recognized incidentally a painless mass at the left chest wall. During later 3 months, she experienced spontaneous swelling and regression of the mass repeatedly for 4 times. Surgical resection showed a granuloma at anterior serratus muscle containing a nearly matured adult of Fasciola species without vitellaria and uterus. This is the 11th human fascioliasis and the first extra-abdominal infection reported in Korea.