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[Changes in the liver lipids of rats with fascioliasis and in fascioliasis combined with protein-calorie malnutrition].

The author examined the amount of total lipids and single lipid fractions of liver in 78 female rats with fascioliasis and with facioliasis combined with energy-protein deficit on the 10th, 30th, 90th, 180th and 240th day after the parasitic invasion. The used a thin-layer chromatographic technique for separation and determination of the concentration of single lipid reactions. There was a tendency to an increase of the liver fats in fascioliasis, but to a reduction in the combination of fascioliasis with undernourishment at the acute stage. She discusses the pathogenesis of the observed changes in the lipid metabolism in connection with the course of the infectious process.

Animals↗

Studies on human fascioliasis in Egypt. 2. Serum iron and copper in chronic fascioliasis.

Twenty-three patients diagnosed as established fascioliasis were enrolled in the present study. Fasciolia cases were investigated for serum iron, copper and their carrier proteins together with haemoglobin and some blood indices. A significant reduction in serum iron was detected in the examined group. This reveals the occurrence of iron deficiency anaemia in patients with chronic fascioliasis.

Adolescent↗

Successful treatment of acute fascioliasis with bithionol.

Fascioliasis is the parasitic infestation of the liver and biliary tract related to Fasciola hepatica. Bithionol is proposed as the treatment of choice for human fascioliasis without major side effects. However, the efficacy of bithionol has been evaluated in chronic but not in acute fascioliasis. In this study we report on the success of treatment with bithionol in 10 patients with fascioliasis, 8 having acute fascioliasis. The criteria for the diagnosis of fascioliasis were hypereosinophilia, positive immunoelectrophoresis and indirect hemagglutination. Bithionol was given orally to hospitalized patients at the daily dose of 25 mg/kg body wt for 10 days. Three patients with acute fascioliasis received a second course of bithionol 2 or 3 mo after the first because of the recurrence of diarrhea and fatigue in one patient and persistent hypereosinophilia in two patients. All patients were cured. The follow-up period after the first course of treatment was between 16 and 47 mo. No major side effects were observed. We conclude that bithionol is the drug of choice for both acute and chronic fascioliasis. Moreover, its oral administration may allow treatment of fascioliasis in outpatients who do not have serious symptoms.

Acute Disease↗

A review on fascioliasis in Egypt.

Fascioliasis, caused by Fasciola species, is a disease of herbivorous animals. It has a worldwide distribution in a large variety of grass-grazing animals as sheep, goats, cattle, buffaloes, horses and rabbits. In Egypt, donkeys and camels as well, are hosts for F. gigantica. Fascioliasis may occasionally affect man. Human infection causes serious hepatic pathological sequences that add to the already known threats to the liver of the Egyptian population. Two clinical stages are recognized in human fascioliasis. An acute stage coincides with the larval migration and worm maturation in the hepatic tissue, and a chronic stage coincides with the persistence of Fasciola worms in the bile ducts. Human infection with fascioliasis was very sporadic until the last three decades where clinical cases and outbreaks were reported. The estimated the number of people currently having fascioliasis to be 360,000 in Bolivia, 20,000 in Ecuador, 830,000 in Egypt, 10,000 in Islamic Republic of Iran, 742,000 in Peru, and 37,000 in Yemen. The total estimated number of people infected is 2.4 million in 61 countries and that the number at risk is more than 180 million throughout the world. Human fascioliasis has to be differentially diagnosed from some diseases as acute hepatitis, infection with other liver flukes as schistosomiasis, visceral toxocariasis, biliary tract diseases and hepatic amoebiasis. The parasitological diagnosis is based on identification of eggs in stool, duodenal contents or bile, also by the recovery of adult worm during surgical exploration, after treatment or at autopsy. However, the eggs may be present in very small number at irregular intervals, hence difficult to be found. Besides, the eggs may be transiently present in stool after ingestion of raw or undercooked liver from infected animals. The direct methods of diagnosing the egg are usually unsatisfactory. The symptoms may be present for several weeks before eggs are recovered in stool. Thus, the serologic tests are the alternative method of confirming early and extrabiliary human fascioliasis. However, cross-reactions with other helminthic antigen may confuse the interpretation of the results.

Animals↗

Hyperendemic fascioliasis associated with schistosomiasis in villages in the Nile Delta of Egypt.

Coprologic surveys were carried out in villages of the Behera Governorate in the Nile Delta region of Egypt to characterize the epidemiologic features of human fascioliasis caused by Fasciola hepatica and F. gigantica in this lowland endemic area by comparison with fascioliasis caused by only F. hepatica in areas hyperendemic for human disease in the Andean highlands of South America. The fascioliasis prevalences detected (range = 5.2-19.0%, mean = 12.8%) are the highest obtained in Egypt. The comparison with previous results suggests that in the Nile Delta, fascioliasis is spreading from an original situation of sporadic human cases in well-known endemic foci for animal disease to an endemic distribution in humans, which may be characterized as a mesoendemic region that includes several hyperendemic areas for human disease. As in Andean countries, a relationship with sex was found, although in Egypt prevalences, but not intensities, appeared to be significantly higher in females. All ages appear to be susceptible to liver fluke infection, with prevalences and intensities being lower before and after school age, a situation that is consistent with that detected in Andean countries, although the peak in the 9-11-year-old age group appears less pronounced in Egypt. The intensities were very high when compared with those found in subjects sporadically infected in areas endemic for animal disease, but relatively low for a hyperendemic situation, although the intensities may not be conclusive because of the transmission seasonality of fascioliasis in the Nile Delta. The marked similarities in the qualitative and quantitative spectrums of protozoans and helminths, multiparasitisms, and associations between liver flukes and other parasitic species suggest physiographic-hydrographic and behavioral-social characteristics similar in all areas hyperendemic for human fascioliasis, which are independent of other factors such as climate, altitude, and cultural or religious features. The significant positive association between liver fluke infection and schistosomiasis mansoni detected in one locality has never been described elsewhere, and must be considered relevant from clinical, pathologic, diagnostic, and therapeutic points of view. Interestingly, the relationships of schistosomiasis prevalences and intensities with sex and age follow patterns similar to those found in fascioliasis.

Adolescent↗

Fascioliasis in eosinophilic patients in the Isparta region of Turkey.

BACKGROUND: The aim of this study was to investigate fascioliasis in a group of eosinophilic and non-eosinophilic patients in the Isparta region of Turkey. PATIENTS AND METHODS: All cases were examined for antibodies against Fasciola hepatica by the modified ES-ELISA method. Seropositive patients with fascioliasis were investigated by radiological and laboratory evaluations. RESULTS: Of the 756 eosinophilic patients, 6.1% were found to be positive for fascioliasis by ES-ELISA, while the rate was only 0.9% among the non-eosinophilic group (statistically significant, p < 0.001). Among the seropositives, 19 cases were evaluated further. Ultrasonographic findings were found in 14 of the 19 cases. In six of nine cases, computed tomography findings were related to fascioliasis. F. hepatica eggs were found in ine of the 19 cases. CONCLUSION: Fascioliasis was demonstrated in the Isparta region of Turkey for the first time. The higher prevalence of fascioliasis among patients with eosinophilia indicates the importance of this sign for this infection.

Aged↗

An outbreak of acute fascioliasis among Aymara Indians in the Bolivian Altiplano.

Fasciola hepatica is a common and important parasite of sheep, cattle, and other ruminants. In May 1991, 30 persons with possible acute fascioliasis were identified by health care providers at a district hospital in the Bolivian Altiplano, and two deaths were associated with this illness. A cross-sectional survey of a random sample of 30 (20%) of the 148 households in the community and a case-control study were performed to determine the extent of the outbreak and the vehicle of transmission. Ninety-one members from 23 of the 30 selected families participated in the cross-sectional survey. Twenty-one of the 91 members met the case definition for acute fascioliasis (illness since 16 February 1991 that was characterized by fever and abdominal pain plus serum IgG antibodies to F. hepatica), and 38 (49%) of 78 members had serum IgG antibodies to F. hepatica. If this rate is extrapolated to the entire community, an estimated 116 individuals (23% of 504) would have acute fascioliasis and 247 individuals (49% of 504) would have evidence of current or previous infection. Case-control analysis indicated that the only factor associated with illness was eating kjosco (an aquatic plant) while tending animals in the fields; 27 (52%) of the 52 case-patients vs. 9 (14%) of the 66 controls ate kjosco (OR = 6.84; 95% CI = 2.60, 18.44). The cause of the two deaths attributed to fascioliasis could not be firmly established. Fascioliasis is a significant human health problem and is highly endemic in the Aymara Indian community in the Bolivian Altiplano. Efforts to prevent fascioliasis should include educating people to avoid eating uncooked aquatic plants such as kjosco.

Acute Disease↗

Epidemiology of human fascioliasis: a review and proposed new classification.

The epidemiological picture of human fascioliasis has changed in recent years. The number of reports of humans infected with Fasciola hepatica has increased significantly since 1980 and several geographical areas have been described as endemic for the disease in humans, with prevalence and intensity ranging from low to very high. High prevalence of fascioliasis in humans does not necessarily occur in areas where fascioliasis is a major veterinary problem. Human fascioliasis can no longer be considered merely as a secondary zoonotic disease but must be considered to be an important human parasitic disease. Accordingly, we present in this article a proposed new classification for the epidemiology of human fascioliasis. The following situations are distinguished: imported cases; autochthonous, isolated, nonconstant cases; hypo-, meso-, hyper-, and holoendemics; epidemics in areas where fascioliasis is endemic in animals but not humans; and epidemics in human endemic areas.

Animals↗

IgM and IgG cystatin capture enzyme linked immunosorbent assays: a tool for serodiagnosis and assessment of cure of acute fascioliasis after triclabendazole (TCZ; Fasinex) therapy.

This study included 71 individuals: 25 patients with confirmed acute fascioliasis, 9 patients with suspected fascioliasis, 27 patients with parasitic infections other than fascioliasis and 10 normal controls. Patients with fascioliasis were treated with TCZ as a single dose and followed up 1 and 4 months after therapy. The results showed that both IgM and IgG cystatin capture ELISAs had very high sensitivity and specificity of 100%. They were also able to diagnose early fascioliasis even before indirect haemagglutination test (IHAT) became positive. Within 4 months after treatment, only 20 patients (80%) with fascioliasis were cured as evidenced clinically, by normal eosinophil count and negative IHAT. After the first month of treatment, IgM and IgG cystatin capture ELISAs became negative in 16.6% and 83.3% of the cured cases respectively, reaching 95% for both assays after 4 months. They remained positive in 5 cases (20%) not responding to treatment.

Acute Disease↗

Fascioliasis among live and slaugthered animals in nine centers of Dakahlia Governorate.

Fascioliasis is an important zoonotic disease. Infected animals are the main source for human fascioliasis. Consequently, this work clarifies the status of animal fascioliasis in Dakahlia centers based on parasitological examination of cows, buffaloes, sheep and goats. The overall rates of infection were 12.31%, 9.73%, 17.84% and 5.40% respectively. The mean eggs per gram stool were 22, 13.6, 148.3 and 8.6 for cows, buffaloes, sheep and goats. The mean numbers of Fasciola worms/liver/animal were 69.1, 62.7 and 208.1 for cows, buffaloes and sheep respectively. The highly infected sheep was in Manzalla (23.07%), the lowest was in Mataria (6.35%). The highly infected cows was in Manzalla (20.9%), the lowest was in Sherbeen (9.43%). The highly infected buffaloes was in Manzalla (19.29%), the lowest was in Mit Ghamr (4.93%). The relatively highly infected goats was in Manzalla (12.5%) and the lowest was zero in Mit Ghamr. So, sheep are the main reservoir host for environmental pollution and human fascioliasis. On the other hand, the overall partial condemnation of liver was 3.81% (1997), 3.24% (1998), 2.66% (1999) and 2.64% (2000). Regarding the type of animal, it was 6.38% in cows, 1.74% in buffaloes and 1.0% in sheep. It seems that sheep are most susceptible to fascioliasis treatment, followed by buffaloes and lastly cows. The epidemiological role of these farm animals as source for fascioliasis infection to animals and man was discussed.

Animals↗

[Application of micro-ELISA in serodiagnosis of fascioliasis in cattle]

Fascioliasis in cattle is one of the most common and very serious trematode diseases in Korea. In the present study, the enzyme linked immunosorbent assay (ELISA) was applied in the diagnosis of fascioliasis using antigen of Fasciola hepatica, peroxidase of conjugate anti-cattle IgG and orthophenylenediamine as a substrate by micro-method technique of Voller et al. (1976b) and MacLaren (1978) with a slight modification. Results obtained from the present study are as follows: In assay for optimal dilution of stock antigen, the antigen (protein contents; 0.8 mg/ml) was diluted from 1/50 to 1/600 with carbonate buffer (pH 9.6), and then absorbance values were measured with 1/100 diluted sera. The regression equations between the OD values of ELISA and dilution of antigen were log Y=-0.181-0.00127X in infected sera, and log Y= -0.578- 0.000879X in normal sera. The significantly higher (p<0.05) OD value was observed in the former. In assay for optimal dilution of sera, the sera were diluted from 1/25 to 1/400 with in PBS/ Tween 20(pH 7.4), and absorbance values were measured with 1/200 diluted antigen. The regression equation between the OD values of ELISA and dilution of sera were log Y=-0.1540-0.0007238X in infected sera and log Y=-0.4834-0.00116X in normal sera. The former was higher than the latter (p<0.05). In the 27 cases of negative intradermal test, OD values of the ELISA are 0.447 +/- 0.144, the 95 percent confidence interval (Mean + 2 x SD) of the values was 0.735, and there was no case over the values. Therefore, the sensitivity of the antigen to diagnose fascioliasis was 100 percent in the negative case. The OD value 0.7 which is designed as a criterion (detection level of positive one) is useful for the performance of the ELISA in fascioliasis. According to the OD value of criterion in the regression equations, the optimal dilutions of stock antigen and serum were 1/250 and 1/100, respectively. In the 58 cases of fascioliasis from which the adult could be found in the bile ducts, the OD value was 0.846 +/- 0.224). The 75 percent (44 cattle) among them had higher value with compared to the criterion, and the 60 percent (20 cattle) of the cases of proliferative cholangitis of 33 cattle which had been infected previousely with Fasciola sp. is higher than the criterion. Prevalence of fascioliasis was 43.4 percent in the application of the ELISA to 272 cattle which were reared in Jeonbug district.

Journal Article↗