Fasciola Infection Unexpectedly Found During Cholecystectomy: Review on How to Avoid Increasing Surgery Interventions in Non-human Endemic Areas.

PURPOSE: Fascioliasis is caused by Fasciola hepatica of almost worldwide distribution and F. gigantica in wide regions of Asia and Africa. Their adult stage develops in the biliary canals and gallbladder. Infection follows an initial, 3-4 month long invasive, migratory or acute phase, and a several year-long biliary, chronic or obstructive phase. METHODS: The unexpected finding of a fasciolid inside the gallbladder during a cholecystectomy for obstructive lithiasis suspicion in a patient is reported from an area of Iran where human infection had been never reported before and studies on fascioliasis in livestock are absent. RESULTS: The fluke obtained was phenotypically classified as F. hepatica by morphometry and genotypically as F. gigantica by mtDNA cox1 fragment sequencing, although with F. hepatica scattered mutations in species-differing nucleotide positions. The clinical, radiological, and biological signs observed at the acute and chronic phases often lead to some misdiagnosis. Serological methods may be useful in cases of negative coprology. Diagnostic techniques with insufficient resolution leading to unnecessary invasive interventions are analyzed. The way to avoid unnecessary surgery is described, including analyses to be made, diagnostic tools to be used, and aspects to be considered. CONCLUSION: Reaching a correct diagnosis in the confusing presentations avoids procedure delays and unnecessary surgery. A correct drug treatment may be sufficient. Except in extreme pathological presentations, lesions decrease in number and size and finally disappear or calcify after a successful treatment. Finally, the need to increase awareness of physicians about fascioliasis is highlighted, mainly in non-human endemic areas.

The prevailing infection of Schistosoma japonicum and other zoonotic parasites in bubaline reservoir hosts in the ricefield of lake ecosystem: the case of Lake Mainit, Philippines.

Bovines are important reservoir hosts of schistosomiasis, placing humans and animals in rice fields areas at risk of infection. This study reported the prevailing infection of zoonotic parasites from bovine feces in the rice fields adjacent to Lake Mainit, Philippines. Formalin Ethyl Acetate Sedimentation was performed on 124 bovine fecal samples from rice fields and documented eggs and cysts from seven parasites: Schistosoma japonicum, Fasciola gigantica, Ascaris sp., Strongyloides sp., Balantidium coli, coccidian oocyst and a hookworm species. Among these parasites, F. gigantica harboured the highest infection with a 100% prevalence rate, followed by hookworms (51.61%), B. coli (30.64%) and S. japonicum (12.09%), respectively. The intensity of infection of S. japonicum eggs per gram (MPEG = 4.19) among bovines is categorized as 'light.' Bovine contamination index (BCI) calculations revealed that, on average, infected bovines in rice fields excrete 104 750 S. japonicum eggs daily. However, across all ricefield stations, bovines were heavily infected with fascioliasis with BCI at 162 700 F. gigantica eggs per day. The study reports that apart from the persistent cases of schistosomiasis in the area, bovines in these rice fields are also heavily infected with fascioliasis. The study confirms the critical role of bovines as a reservoir host for continued infection of schistosomiasis, fascioliasis and other diseases in the rice fields of Lake Mainit. Immediate intervention to manage the spread of these diseases in bovines is recommended.

Fascioliasis associated with chronic cholecystitis in a woman from Sistan and Baluchestan province, a non-endemic region in Southeastern Iran.

BACKGROUND: Fascioliasis, caused by Fasciola hepatica, is a neglected zoonotic food-borne trematodiasis. The Caspian littoral in northern Iran is endemic for the disease, and human fascioliasis is well-known in that region. In the present study, we report the diagnosis, identification, and clinical management of a human case of fascioliasis associated with common bile duct (CBD) obstruction from a non-endemic remote area in southeastern Iran. CASE PRESENTATION: A 42-year-old female was admitted to Afzalipour Medical Center hepatobiliary surgery ward in Kerman with abdominal pain for the past three months. Dilated biliary tract and an ill-defined mass in CBD were reported in abdominal ultrasonography and magnetic resonance cholangiopancreatography, respectively. During distal CBD operation, nine leaf-like motile flatworms were isolated. A morphological study confirmed all the isolates as Fasciola, and further molecular investigations, identified the flukes as F. hepatica using both pepck multiplex PCR and cox1 sequencing. CONCLUSION: Molecular and morphological findings of the study indicated the presence of human fascioliasis in the southeastern province of Sistan and Baluchestan in Iran. Fascioliasis is among the etiologies of chronic cholecystitis, and physicians should consider chronic cholecystitis associated with fascioliasis in the differential diagnosis. In the present report, endoscopic ultrasound was usefully applied for the accurate diagnosis of biliary fasciolosis.

Evaluation of zoonotic platyhelminthe infections identified in slaughtered livestock in Iran, 2015-2019.

BACKGROUND: Platyhelminth infections of livestock can result in considerable economic losses. This study aims to evaluate the spatial frequency of cystic echinococcosis (CE), dicrocoeliasis, and fascioliasis in livestock slaughtered in Iran during the years 2015-2019 and estimate direct costs associated with organ condemnation due to these parasites. METHODS: Abattoir data from 413 abattoirs representing all 31 Iranian provinces were collected from the Iran Veterinary Organization. Infection prevalence was calculated per year at the province level. The Local Moran's I statistic was performed to evaluate spatial autocorrelation of animals positive at slaughter for the years 2015-2019. Direct costs associated with condemned livers were calculated for each parasitic condition, with costs associated with condemned lungs also included for CE. RESULTS: Overall prevalence values for the study timeframe were as follows: sheep and goat fascioliasis 1.56% (95% CI: 1.56-1.56%), cattle fascioliasis 3.86% (95% CI: 3.85-3.88%), sheep and goat dicrocoeliasis 4.63% (95% CI: 4.62-4.63%), cattle dicrocoeliasis 3.08% (95% CI: 3.07-3.09%), sheep and goat CE 5.32% (95% CI: 5.32-5.33%), and cattle CE 7.26% (95% CI: 7.24-7.28%). Northwest Iran had the highest prevalence of CE and fascioliasis. High infection areas for Dicrocoelium spp. included the provinces of Zanjan, Gilan, Qazvin, and Tehran, which are located in northern Iran. Direct economic losses for sheep and goat fascioliasis, dicrocoeliasis, and CE for the study period were US$13,842,759, US$41,771,377, and US$22,801,054, respectively. Direct economic losses for cattle fascioliasis, dicrocoeliasis, and CE for the study period were US$1,989,200, US$1,668,986, and US$2,656,568, respectively. CONCLUSION: Our findings provide valuable data for future monitoring of these important parasitic diseases in Iranian livestock. Disease control strategies are required to reduce the economic and public health impact of these platyhelminths.

Parasitic causes of meat and organs in cattle at four slaughterhouses in Sistan-Baluchestan Province, Southeastern Iran between 2008 and 2016.

This 8-year (from 2008 to 2016) retrospective study calculated the percentage of carcass and organ (lung and liver) condemnations and estimated the direct financial costs at four slaughterhouses in Sistan-Baluchestan Province, Southeastern Iran. Each carcass and organ (lung and liver) was thoroughly examined through inspection, palpation and incision following the standard protocol. Identification of the parasites was performed macroscopically. The total direct economic loss due to meat's condemnation was estimated by adding weights of each organ or carcass part and multiplying individual organ totals by their 2016 market unit price. A total of 857,039 cattle were slaughtered during this period, 64,497 livers (7.5%), 31,401 lungs (3.6%) and the carcasses of 1,171 cattle (0.1%) were condemned due to lesions caused by parasites. The main parasitic lesions in the condemned livers were attributed to Echinococcus granulosus (4.2%), Fasciola spp. (3.1%) and Dicrocoelium dendriticum (0.1%). All the condemned lungs were due to E. granulosus (3.6%). Taenia saginata cysticerci were detected in 0.1% of inspected animals. Liver condemnation due to cystic echinococcosis was the highest in fall (4.7%, p < 0.001); while lung condemnation was the highest during spring (3.98%, p < 0.001). Liver condemnation due to Fasciola spp. was the lowest in winter (2.99%, p < 0.001). Carcass condemnation as a result of cysticercosis was the highest in summer (p < 0.001). Considering the 2016 market prices, condemnations due to the studied parasites caused direct costs estimated U.S. $ 3,191,879. To the best of our knowledge, this is the first report estimating the monetary losses due to parasitic infections in the slaughterhouses of this province. Due to the high financial impact of the studied parasites, a control programme should be implemented to decrease this impact.

A study on causes of cattle liver condemnation at an abattoir in Omdurman area, Khartoum State, Sudan.

BACKGROUND: Information obtained from abattoirs on the causes of liver condemnation is important in preventing the spread of diseases and for promoting food security. The current study reviews three years (2009 to 2011) postmortem inspection records of cattle slaughtered at an abattoir in Omdurman, Khartoum State, Sudan. The aim was to determine the prevalence of diseases and conditions that lead to liver condemnation. RESULTS: From a total of 234,175 cattle slaughtered, 8,910 (3.8%) livers were condemned due to several diseases/conditions mainly fasciolosis, cysticercosis, necrosis, abscess, calcification, hemorrhages, liver cirrhosis, hydatidosis, and other miscellaneous causes. Collectively, fasciolosis was the leading cause of liver condemnation and was responsible for 51.6 % of total liver condemnations followed by necrosis (18.6%), and cysticercosis (13.5%). CONCLUSIONS: Because of their zoonotic nature, the observed high frequency of some detected diseases/conditions is thought to pose a public health risk among consumers. This survey could be used as a regional baseline for future monitoring of control programmers against these liver diseases.

One Health initiative in the Bolivian Altiplano human fascioliasis hyperendemic area: Lymnaeid biology, population dynamics, microecology and climatic factor influences / Aplicação do conceito One Health na área hiperendêmica de fasciolíase humana do Altiplano Boliviano: biologia dos limneídeos, dinâmica populacional, microecologia e influência de fatores climáticos

Abstract Fascioliasis is a freshwater snail-borne zoonotic disease. The Northern Bolivian Altiplano is a very high altitude endemic area where the highest human prevalences and intensities have been reported. Preventive chemotherapy by treatment campaigns is yearly applied. However, liver fluke infection of cattle, sheep, pigs and donkeys assures endemicity and consequent human infection and re-infection risks. A One Health action has therefore been implemented. Activity concerns lymnaeid vectors and environment diversity. Studies included growth, egg-laying and life span in laboratory-reared lymnaeids. Different habitat types and influencing factors were assessed. All populations proved to belong to Galba truncatula by rDNA sequencing. Analyses comprised physico-chemical characteristics and monthly follow-up of water temperature, pH and quantity, and lymnaeid abundance and density. Population dynamics in the transmission foci differed. Mean environmental temperature was lower than fluke development minimum temperature threshold, but water temperature was higher, except during winter. A two generations/year pattern appeared in permanent water habitats, and one generation/year pattern in habitats drying out for months. The multidisciplinary control measures can be extended from one part of the endemic area to another. These studies, made for the first time at very high altitude, constitute a baseline useful for fascioliasis control in other countries.

Resumo A fasciolíase é uma doença zoonótica transmitida para os humanos por formas evolucionárias de Fasciola hepatica oriundas de limneídeos infectados. O Altiplano Boliviano Norte é uma área endêmica de altitude muito alta, onde foram relatadas as maiores prevalências e intensidades em infecções humanas. A quimioterapia preventiva por campanhas de tratamento é aplicada anualmente. No entanto, infecção por Fasciola hepatica em bovinos, ovelhas, suínos e asininos garante endemicidade e consequentes riscos de infecção e reinfecção humana. Portanto, ações norteadas no conceito "One Health" foram implementadas. As atividades envolveram os limneídeos e a avaliação da diversidade de ambientes. Os estudos incluíram o crescimento, postura de ovos e expectativa de vida de limneídeos criados em laboratório, bem como a avaliação da influência dos diferentes hábitats. Todas as populações foram identificadas como Galba truncatula por meio do sequenciamento de rDNA. As análises incluíram características físico-químicas e acompanhamento mensal da temperatura, pH, quantidade da água, abundância e densidade de limneídeos. A dinâmica populacional nos focos de transmissão diferiu. A temperatura ambiente média foi mais baixa do que o limite mínimo de temperatura do desenvolvimento do helminto, mas a temperatura da água foi mais alta, exceto durante o inverno. Um padrão de duas gerações/ano apareceu em hábitats com água permanente, enquanto um padrão de uma geração/ano foi observado em habitats que ficam secos durante meses. Os resultados permitem concluir que as medidas multidisciplinares de controle podem ser estendidas de uma parte da área endêmica para outra. Esses estudos, realizados pela primeira vez em altitudes muito elevadas, constituem uma base útil e extrapolável para o controle da fasciolíase.

Molecular confirmation of Fasciola hepatica infection in capybaras (Hydrochoerus hydrochaeris) from the state of Espírito Santo, Brazil / Confirmação molecular de infecção por Fasciola hepatica em capivaras (Hydrochoerus hydrochaeris) do Estado do Espírito Santo, Brasil

Abstract Sixty-two fecal samples of capybara (Hydrochoerus hydrochaeris) living in eight conservation units (CUs) across the state of Espírito Santo, southeastern Brazil, were assessed for the presence of eggs of liver flukes via sedimentation. Fasciola hepatica eggs were found in 37.1% (23/62) of the samples. Positive samples were found in six CUs (75%), three CUs located in the southern region of the state and three others in the metropolitan region of the capital city of Vitória. Identification of Fasciola hepatica eggs collected from capybara fecal samples were based on morphology, and confirmed using molecular methods. Our results suggest that capybaras may serve as a wild reservoir host for F. hepatica, possibly contributing to the epidemiology and geographic range expansion of this zoonotic parasite across its vast range of distribution in South America.

Resumo Sessenta e duas amostras fecais de capivaras (Hydrochoerus hydrochaeris), coletadas em oito unidades de conservação (UCs) no estado do Espírito Santo, Brasil, foram avaliadas quanto à presença de ovos de Fasciola hepatica por método de sedimentação. Ovos foram encontrados em 37,1% (23/62) das amostras, abrangendo seis UCs (75%), três UCs, localizadas na região sul do Estado, e outras três na região metropolitana da capital Vitória. A identificação dos ovos de F. hepatica coletados nas amostras fecais foi baseada na morfologia e confirmada por métodos moleculares. Os resultados sugerem que as capivaras podem servir como hospedeiros reservatórios selvagens para F. hepatica, possivelmente contribuindo para a epidemiologia e a expansão geográfica deste parasito zoonótico em sua vasta distribuição na América do Sul.

Fasciolasis Hepática, serie de casos reportados en Matanzas. Cuba / Hepatic fasciolosis, a series of cases reported in Matanzas, Cuba

RESUMEN Introducción: la fasciolasis hepática es una enfermedad parasitaria de difícil diagnóstico. La variada y múltiple sintomatología que caracteriza la enfermedad, la expulsión intermitente y tardía de los huevos del parasito, así como el difícil acceso a los estudios inmunológicos en las zonas rurales atenta contra la confirmación de parasitosis en casos esporádicos. En la provincia de Matanzas en los últimos años se constataron enfermos sospechosos de fasciolosis procedentes de Pedro Betancourt con diversos síntomas digestivos, fiebre y eosinofilia. Objetivo: caracterizar los aspectos clínicos y epidemiológicos de los pacientes diagnosticados de fasciolosis hepática. Materiales y Método: se realizó un estudio observacional, descriptivo a pacientes hospitalizados con el diagnóstico presuntivo de fasciolosis hepática en el Servicio de Medicina Interna del Hospital Faustino Pérez en el período enero del año 2011 a diciembre del 2013. La recolección de datos se realizó a través del interrogatorio, examen físico, Historia clínica y encuestas epidemiológicas. Resultados: se muestra la presencia de consumo de plantas acuáticas y consumo de agua sin hervir en los afectados. La fase aguda de la enfermedad en estos pacientes se caracterizó por fiebre, dolor abdominal, hepatomegalia y gran eosinofilia. Conclusiones: el diagnóstico de certeza se realizó a través de pruebas inmunológicas. Esto se debe a que a pesar de los múltiples exámenes parasitológicos de las heces fecales no se identificó huevos. Los pacientes del estudio fueron tratados con el triclabendazol y se logró mejoría clínica de los pacientes y pocas reacciones adversas (AU).

SUMMARY Introduction: the hepatic fasciolosis is a parasitic disease of difficult prognosis. The varied and multiple symptoms characterizing the disease, the intermittent and late ejection of the parasite eggs, and also the difficult access to immunological studies in the country areas sometimes attempts against the confirmation of parasitism. During the last years, in the province of Matanzas, several sick persons from Pedro Betancourt were suspicious of fasciolosis with different digestive symptoms, fever and eosinophilia. Objective: to characterize the clinical and epidemiological aspects of the patients diagnosed of hepatic fasciolosis. Materials and method: an observational, descriptive study was performed in in-patients of the Service of Internal Medicine of the Hospital Faustino Perez with the presumptive diagnosis of hepatic fascilosis in the period January 2011-December 2013. Data collection was made through questioning, physical examination, clinical record and epidemiological inquiries. Results: risk behaviors are evidenced given the water plants and un-boiled water consumption in affected persons. The acute `hase in these individuals is characterized by fever, abdominal pain, hepatomegaly and big eosinophilia. The diagnosis of certainty was made by immunologic tests. The patients were treated with triclabendazol with clinical improvement and little adverse reactions. Conclusions: health professionals when assisting a patient from a country area with eating habits of fresh vegetable consumption and suggestive clinical characteristics should carry out studies to confirm Fasciola hepatica infection (AU).

Cysts and parasites in an abattoir in Northwest Ethiopia; an urgent call for action on "one health".

INTRODUCTION: Zoonotic parasitic infections such as echinococcosis affect cattle, sheep and goats by lowering quality of meat and hides as well as decreasing milk production. The burden of such diseases among humans is usually underestimated as they are difficult to diagnose. We used abattoir data to estimate the prevalence of zoonotic parasitic infections in animals. METHODOLOGY: Data from 2005-2018 was used from the registry of an abattoir in Northwest Ethiopia. Frequencies, proportions and trends over time were analyzed. Meat inspection was conducted by visualization, palpation and incision. RESULTS: A total of 58,787 animals were slaughtered in the abattoir during the study period. These included 51,956 (88 %) cattle, 5,890 (10%) sheep and 941 (2%) goats. The detected parasites included Echinococcus in 12,334/58,787 (21%) and Fasciola in 10,551/58,787 (18%) animals. Echinococcus infection was highest among goats (267/941, 28%), followed by cattle (11,591/51,956, 22%) and sheep (476/5,890, 8%). Fasciolosis was detected in 9,877/51,956 (19%) cattle and 178/941 (19%) goats. The number of animals slaughtered strongly decreased over time from 8,405 in 2006 to 1,605 in 2018. However, the proportion of parasitic infections remained high with some fluctuations over the study period. CONCLUSIONS: Echinococcosis and fasciolosis were very common with one out of five animals slaughtered infected. This is of public health concern and needs urgent multi-sectorial efforts from stakeholders at the national and regional level for control of these diseases. One health program approaches may warrant the control of transmission to humans.

Genetic Differentiation of Opisthorchis-Like Eggs in Northern Thailand Using Stool Specimens Under National Strategic Plan to Control Liver Fluke Infection and Cholangiocarcinoma.

Liver fluke infection caused by Opisthorchis viverrini is recognized as a potential risk factor for cholangiocarcinoma (CCA). The National Strategic Plan to Control Liver Fluke Infection and Cholangiocarcinoma has implemented microscopic-based stool examination screening. However, eggs of O. viverrini and minute intestinal flukes (MIFs) are nearly morphologically similar and could result in inaccurate O. viverrini diagnosis. Stool specimens were collected from eight districts of Chiang Mai Province in northern Thailand. Opisthorchis-like eggs were identified with the Kato-Katz technique and differentiated for O. viverrini and MIFs using molecular study by PCR and PCR-restriction fragment length polymorphism targeting the internal transcribed spacer 2 (ITS2) gene. Prevalence of Opisthorchis-like eggs was 5.9% from a total of 9,570 specimens. From PCR assays, all liver flukes were O. viverrini and all MIFs were Haplorchis taichui. The distribution of species was H. taichui (38.2%), O. viverrini (10.5%), coinfection of H. taichui and O. viverrini (37.2%), and 14.1% were negative from PCR. Totally, H. taichui was found in 75.4% of infections from Opisthorchis-like specimens. ITS2 nucleotide sequencing analysis showed a single variant of O. viverrini with no variation and two variants of H. taichui. This study first revealed the genetic background of Opisthorchis-like eggs in northern Thailand. Minute intestinal flukes are occasionally misdiagnosed as O. viverrini leading to misinterpretation and overestimation of the burden of O. viverrini infection. Molecular diagnosis such as PCR could effectively discriminate species of Opisthorchis-like eggs and help shape the robustness of epidemiological data to control liver fluke infection and raise awareness of other risk factors for CCA.

Prevalence of hydatid cyst, Fasciola spp. and Dicrocoelium dendriticum in cattle and sheep slaughtered in Sabzevar abattoir, Iran.

Hydatid cyst, Dicrocoelium dendriticum, and Fasciola spp. are common parasites among ruminants. The current study was conducted to assess the prevalence of these parasites in cattle and sheep slaughtered in Sabzevar abattoir, from April 2014 to March 2016. Total of 1653 cattle and 26720 sheep were inspected for helminthic infections of liver and lung in different seasons. The prevalence rates were found to be 684 (2.55%) and 235 (14.21%) in sheep and cattle, respectively. The infection rate of liver in cattle was estimated to be 5.86%, 0.84% and 5.68% for hydatid cysts, Fasciola spp. and D. dendriticum, respectively and lung infection with hydatid cyst in cattle was 1.81%. Moreover, the liver infection rate of sheep was estimated to be 0.87%, 0.06% and 2.13% with hydatid cysts, Fasciola spp. and D. dendriticum, respectively and lung infection with hydatid cyst was 0.35%. The rate of infection with D. dendriticum was higher in the both animals than the other parasites. The results of this study indicated that the prevalence of the aforementioned parasites was high, which caused high economic losses. Therefore, sanitary and preventive measures should be taken.

Gross and histological lesions in the livers of sika deer with particular emphasis on fascioliasis.

We performed gross and histological examinations of the livers of sika deer (Cervus nippon yesoensis) in Hokkaido, Japan. Out of 1,381 deer slaughtered for venison production, thickening and dilation of the large intrahepatic bile ducts and Fasciola flukes in the duct lumens were detected in 621 deer (45.0%). Furthermore, 107 non-bile lesions (75 intrahepatic and 32 capsular lesions) were detected during gross examinations. Histologically, the bile duct lesions included chronic proliferative cholangitis, papillary hyperplasia, goblet cell and pyloric gland metaplasia, and periductal fibrosis. Many of the intrahepatic non-bile duct lesions (53/75, 71%) were considered to be Fasciola fluke migration-associated lesions, including two lesion types: necrosis, hemorrhage, and eosinophilic granuloma formation (29 lesions), and lymphoid tissue formation (24 lesions). Lymphoid tissue formation was considered to result from the persistent immune responses against dead Fasciola flukes. An epidermoid liver cyst was found incidentally, which has not been reported in the veterinary literature. In summary, this study demonstrated the predominance of fascioliasis-associated lesions in sika deer livers. The gross and histological lesions caused by Fasciola flukes in sika deer were similar to fascioliasis in other animals. Moreover, we described lymphoid tissue formation as a fascioliasis-associated lesion for the first time. The fact that bile duct lesions (45.0%) had a markedly higher prevalence than fascioliasis-associated parenchymal lesions (53/1,381, 3.8%) indicated that sika deer are a permissive host for fascioliasis. Our results provide information that will aid pathological examinations of sika deer.

Copro-prevalence of Fasciola hepatica in Chilean breed horses in the province of Concepción, Chile / Copro-prevalência de Fasciola hepatica em equinos de raça chilena na província de Concepción, Chile

Abstract The aim of this research was to assess the copro-prevalence of Fasciola hepatica in owned Chilean breed horses (Equus caballus) residing in the province of Concepción, Chile. The study was carried out throughout October 2017. Samples were taken from all (100%) Chilean breed horse (124 specimens; 45 females and 79 males, aged between 7 months and 24 years old) from the Concepción province. A rectal stool sample was obtained from each animal. This was analyzed using the Army Medical School method (AMS III) technique to detect F. hepatica eggs. Information about the horse's age, sex, previous fasciolicide application, and an assessment of body condition was also obtained. Fisher tests were carried out to analyze the results. Ten horses (8.06%) were positive for the presence of F. hepatica eggs. No significant difference of copro-prevalence was found between age (young 8.47%, old 7.69%), sex (female 11.1%, male 6.33%), the previous application of fasciolicide (dewormed 10%, not dewormed 7.89%), or body condition (low condition 11.1%, high condition 0.7%) categories (Fisher tests: P>0.05 in all cases). The results of this study suggest that Chilean breed horses constitute part of the reservoir of F. hepatica for both ruminant populations and humans in the Concepción province.

Resumo O objetivo desta pesquisa foi avaliar a coproprevalência de Fasciola hepatica em equinos chilenos (Equus caballus), residentes na província de Concepción, região de Bío-Bío, Chile. O estudo foi realizado durante o mês de outubro de 2017. Foram coletadas amostras de todos os equinos estabulados (124 espécimes; 45 fêmeas e 79 machos, com idades entre 7 meses e 24 anos) da província de Concepción. Uma amostra de fezes transretal foi obtida de cada animal, analisada no Laboratório "Dr. Luis Rubilar", da Universidad de Concepción, usando-se a técnica AMS III, para detectar a presença de ovos de F. hepatica. O diagnóstico fecal foi complementado com informações sobre a idade do animal, sexo, aplicação prévia de fasciolicida e uma avaliação da condição corporal. Testes de Fisher foram realizados para analisar os resultados. Dos 124 equinos, 10 (8,06%) foram positivos para ovos de F. hepatica. Não foi encontrada associação significativa entre idade, sexo, aplicação prévia de fasciolicida ou condição corporal com a presença de ovos. Um cavalo tratado com triclabendazol foi positivo para ovos de F. hepatica.

Correlation between climate data and land altitude for Fasciola hepatica infection in cattle in Santa Catarina, Brazil / Correlação entre clima e altitude para determinar a infecção de Fasciola hepatica em bovinos em Santa Catarina, Brasil

Abstract Fascioliasis is a food-borne parasitic disease that affects a range of animals, including humans caused by Fasciola hepatica. The present study aimed to determine the spatial distribution of bovine fasciolosis and to assess the correlation between the high Positivity Index (PI) and climate data and land altitude, from 2004 to 2008 and 2010 in Santa Catarina (SC), Brazil. Condemned livers of slaughtered animals were obtained from 198 out of 293 municipalities and from 518.635 animals, exclusively from SC. There was a statistically significant difference (P < 0.001) between the prevalence of F. hepatica and land altitude ( ρ ^ s = -0.43). The highest PI (above 10.1%) was observed in cities at 500 to 600 m (P < 0.01; ρ ^ s = -0.47) of altitude. There was no correlation between fascioliasis and rainfall in SC. It was determined that weather conditions in the past decade did not impose any limitation to the occurrence of the parasite, making it a disease of permanent clinical importance. These findings are essential to regions with similar geographical and climate conditions (i.e. altitude), when considering long-term control measurements, where animals and humans can be infected.

Resumo A fasciolose é uma doença parasitária que afeta uma gama de animais, incluindo humanos, causada por Fasciola hepatica no Brasil. Este estudo teve o objetivo de determinar a distribuição espacial da fasciolose e conferir a correlação do alto índice de positividade (PI), com os dados de clima e altitude, entre 2004 a 2008 e 2010 em Santa Catarina (SC), Brasil. Foram obtidos fígados em frigoríficos de SC, de 518.635 animais de 198 municípios, de um total de 293. Houve diferença estatística significativa (P < 0,001) entre a prevalência de F. hepatica e a altitude ( ρ ^ s = -0,43). O maior PI (acima de 10,1%) foi observado em municípios de 500 a 600 m (P < 0,01; ρ ^ s = -0,47) de altitude. Não foi observada correlação entre fígados parasitados e pluviosidade em SC. Foi observado que os dados climáticos na ultima década não apresentaram limitação para a ocorrência do parasito, fazendo com que o desafio clinico da infecção tenha sido permanente. Os dados são importantes para locais com condições geográficas e climáticas semelhantes (ex. altitude), para considerar medidas de controle a longo prazo, nas quais animais e humanos poderão ser infectados.

Fascioliasis in buffaloes: A 5-year forecast analysis of the disease based on a 15-year survey in Brazil / Fasciolose em búfalos: uma análise de previsão de 5 anos da doença com base em uma pesquisa de 15 anos no Brasil

Abstract In South America, fascioliasis caused by the trematode Fasciola hepatica is an anthropozoonosis disease associated with significant economic losses and poor animal welfare. The objective of this study was to determine the prevalence of F. hepatica in the liver of buffaloes slaughtered from 2003 to 2017 in Brazil, and to perform a forecast analysis of the disease for the next five years using the Autoregressive Integrated Moving Average (ARIMA) model. Data analysis revealed an incidence of 7,187 cases out of 226,561 individuals. The disease presented a considerable interannual variation (p<0.005). Fasciola hepatica was more prevalent in the southern states of Brazil; Paraná, Rio Grande do Sul, and Santa Catarina, presenting 11.9, 7.7, and 3.2% of infected livers, respectively. The high frequency of liver condemnation in Paraná was influenced by weather conditions. The ARIMA models calculated a constant trend of the disease, depicting an average of its future prevalence. The models also described a worse-case and a positive-case scenario, calculating the effects of intervention measurements. In reality, there is an urgent need for regular diagnostic in the animals (fecal and immune diagnose) and in the environment (intermediate host), in order to avoid the high rates of infection.

Resumo Na América do Sul, a fasciolose causada pelo Trematoda Fasciola hepatica é uma antropozoonose associada a perdas econômicas significativas e baixo grau de bem-estar animal. O objetivo deste estudo foi determinar a prevalência de F. hepatica no fígado de búfalos abatidos entre 2003 a 2017 e realizar uma análise de previsão da doença para os próximos cinco anos, utilizando o modelo Auto-Regressivo Integrado de Médias Móveis (ARIMA). A análise dos dados revelou uma incidência total de 7.187 casos em 226.561 indivíduos. Houve um acentuado grau de variação interanual nas taxas de prevalência (p<0,005). Fasciola hepatica foi mais prevalente nos estados do sul do Brasil; Paraná, Rio Grande do Sul e Santa Catarina, com 11,9; 7,7; e 3,2% de fígados condenados, respectivamente. A alta incidência de condenação de fígado no Paraná foi influenciada pelo fator climático. Os modelos ARIMA indicaram uma tendência constante na ocorrência da doença, destacando um padrão futuro da doença. Os modelos também descreveram cenários de piora e de possível melhoria, calculando os efeitos de medidas de intervenção. Assim, existe a urgência de realizar diagnóstico constante nos animais (coprológico e diagnóstico imunológico) e no ambiente, para que se evite os altos índices de infecção.

Case Report: Hepatic Fascioliasis in a Young Afghani Woman with Severe Wheezing, High-Grade Peripheral Eosinophilia, and Liver Lesions: A Brief Literature Review.

A 23-year-old recent emigrant from Afghanistan presented in August 2017 with severe wheezing and dyspnea that required hospital admission. Her illness was associated with marked peripheral blood eosinophilia (9,900-15,600/µL; 45.2-68%), as well as mild nausea, epigastric pain, and decreased appetite. She had lived until 3 months earlier in close proximity to cattle in her home in Kabul and did not recall eating watercress or other leafy plants associated with Fasciola hepatica transmission. Computerized tomography scanning showed bilateral ground-glass lung consolidations and multiple distinctive hypo-attenuating linear, tubuliform, and nodular liver lesions, including a large subcapsular hematoma. Numerous tests for rheumatological and malignant disorders were negative. Fasciola hepatica infestation was suspected on epidemiological, clinical, and radiographic grounds, and was confirmed by immunoblotting at the Centers for Disease Control (CDC). Multiple stool ova and parasite examinations were negative and endoscopic retrograde cholangiopancreatography did not identify trematodes. Her acute respiratory illness resolved with asthma-targeted therapies and her eosinophilia resolved with triclabendazole, which was obtained from CDC via an FDA Investigational New Drug application. Fascioliasis is uncommon in the United States, but the prolonged warfare and civil strife in Afghanistan and adjacent areas may lead to increased incidence outside the endemic region. Her case also demonstrates how hepatic imaging features of fascioliasis can be pathognomonic in clinical scenarios with eosinophilia and appropriate epidemiology and clinical features. We also highlight her relatively unusual presentation with symptoms of Loeffler-like syndrome alone.

Echinococcus granulosus hydatid cyst location is modified by Fasciola hepatica infection in cattle.

BACKGROUND: Natural parasite infection occurs in wild and domestics animals with more than one parasite species at the same time, generating an infection called polyparasitism. Cystic echinococcosis reports are usually based only on infection with Echinoccocus granulosus leaving aside other internal parasitoses that could modulate both the immune response and pathogenesis of the natural infection. Fasciola hepatica is another cosmopolitan parasite in ruminants with a similar distribution to E. granulosus in different parts of the world, but no information of the effect of co-infection with E. granulosus has been described. The aims of this report were to establish E. granulosus prevalence and explore the association of F. hepatica co-infection and natural E. granulosus infections in cattle. RESULTS: From 1725 animals, the prevalence of E. granulosus and F. hepatica was 21.16 and 51.3%, respectively. Considering both infections, older cattle (> 4 years) presented higher prevalence compared to younger animals. In E. granulosus-infected cattle, 5.21% had fertile cysts, 71.78% infertile cysts, and in 23.01% cysts were smaller than 1 cm in diameter. Considering cyst location, 39.72% had lungs cysts, 24.72% had liver cysts and 36.94% had cysts in both organs. Cyst location significantly differed between age groups: 44.68% of younger animals had cysts only in the lungs, while older animals presented hydatid cyst in the lungs and liver simultaneously (44.15%). With E. granulosus infection alone, 30.26% of cysts were found in the lungs, 31.79% in the liver and 37.95% in both organs. Regarding the co-infection of E. granulosus with F. hepatica, the proportion was significantly different (P < 0.05) with most animals having cysts only in the lungs (49.41%) and a lower level of liver infection (15.88%). Analyzing organ cyst distribution and F. hepatica absence/presence ratio within each cyst type, small cysts showed the highest difference in ratio. CONCLUSIONS: To the best of our knowledge, this is the first report indicating that F. hepatica co-infection in cattle could be affecting the instate of hydatid cysts in the liver, displacing toward lung localization, suggesting an antagonistic relationship.

The Effect of Health Behavior Modification Program for Liver Fluke Prevention among the Risk Group in Rural Communities, Thailand

This quasi-experimental research aimed to study the effect of health behavior modification program in relation to knowledge, self-efficacy, expectation, and practice for liver fluke prevention among the risk group from Bueng Samrong sub-district, Kaeng Sanam Nang district, Nakhon Ratchasima province, Northeast Thailand. The total of 66 participants was assigned to experimental and comparison group, 33 participants in each group, 12-weeks intervene period. The experimental group was received health behavioral modification programs based on health education, self-efficacy, motivation, social support and networking. Pre-and-post-tests were measured using predesigned questionnaires. The comparative analysis was analyzed by paired sample t-test and independent sample t-test at the 0.05 level of significance. The results revealed that the experimental group had significantly greater knowledge, self-efficacy, expectation, and practice for liver fluke prevention than those in the comparison group (p < 0.05). In conclusion, this was a successful health education program for liver fluke avoidance. Participants were gained the correct knowledge and had the higher self-efficacy, expectation, and practice regrading liver fluke prevention. Therefore, it may useful for further behavior modification in the other epidemic areas.

Epidemiological and clinical-pathological aspects of fasciolosis in livers of cattle slaughtered in southern Brazil / Aspectos epidemiológicos e clínico-patológicos de fasciolose em fígados de bovinos abatidos no sul do Brasil

Infection by Fasciola hepatica is an important cause of economic loss in cattle raised in Brazil and others countries. In slaughterhouses, the losses are mainly associated with condemnation of livers; however, it is believed that these losses can extend to diminished carcass yield and productivity throughout the life of the animals. Three slaughterhouses with a daily routine of approximately 15-20 cattle slaughters were monitored from July 2016 to November 2017. After sample collection, weighing, and liver assessment, statistical studies were conducted to determine disease prevalence and measurement of economic losses caused by fasciolosis through condemnation of the organ of choice of the parasite. Of the 210 livers assessed, 79 (37.6%) were condemned because of presence of F. hepatica, 87 (41.4%) were considered appropriate for human consumption, and 44 (20.9%) were considered inappropriate because of some other macroscopic lesions. The aim of this study was to estimate the prevalence of fasciolosis, correlate epidemiological and clinical-pathological aspects, and estimate the economic losses caused by the disease. It is estimated that the losses in southwestern Rio Grande do Sul state could reach R$ 36,943,532.60 (37.6%; 95% CI = 30,753,525.80 - 43,526,55.65) or US$ 11,437,626.20 (37.6%; 95% CI = 9,521,215.40 - 13,475,713.80) only because of condemnation of livers.(AU)

A infecção por Fasciola hepatica é uma importante causa de prejuízos econômicos para o setor pecuário no Brasil e em outros países. Em frigoríficos, as perdas estão relacionadas principalmente a condenação dos fígados, porém acredita-se que esses prejuízos possam se estender a perdas no rendimento de carcaça e durante a vida produtiva do animal. Durante o período de julho de 2016 a novembro de 2017 foram realizados acompanhamentos periódicos mensais em três frigoríficos, os quais, possuem uma rotina diária de aproximadamente 15-20 abates. Após a coleta de dados, pesagem e avaliação dos fígados foram realizados estudos estatísticos para determinação da prevalência e mensuração dos prejuízos econômicos causados por fasciolose pela condenação do órgão de eleição do parasito. Dos 210 fígados avaliados, 79 (37,6%) foram condenados devido a presença de F. hepatica, 87 (41,4%) foram considerados próprios para consumo humano e 44 (20,9%) impróprios por alguma outra alteração macroscópica. O objetivo deste estudo foi estimar a prevalência da fasciolose, e associar os aspectos epidemiológicos e clinico patológicos, além de estimar os prejuízos econômicos causados pela doença. Estima-se que as perdas na mesorregião Sudeste Rio-grandense possam chegar à R$ 36.943.532,60 (37,6%; IC.95% = 30.753.525,80-43.526.55,65) ou US$ 11.437.626,20 (37,6%; IC.95% = 9.521.215,40-13.475.713,80) somente devido a condenação de fígados.(AU)