Fasciola Infection

TYPES

Before the symptoms appear, there are four phases in fascioliasis. These includes:

Incubation phase, which occurs from ingestion of metacercariae to the arrival of the first symptoms. This will take three days up to months.

Acute phase  is the start of fluke migration to the bile duct. This phase results to the destruction of hepatic tissue and allergic reactions.

Symptoms may include the following at this stage:

• Fever
• Urticaria
• Abdominal pain
• Nausea and diarrhea
• Cough
• Chest pain
• Anemia
• Skin rashes

Latent phase can last months to years. This phase is asymptomatic and will be discovered only after a patient is diagnosed.

Chronic phase is a phase that develops for months or when the adult flukes grow up a year after involvement of the bile ducts, further causing inflammation of the epithelium. The result  is cholangitis and cholecystitis.

SYMPTOMS

Symptoms of the disease may include the following:

• Fatty food intolerance
• Epigastric pain
• Nausea
• Jaundice
• Right upper abdominal tenderness
• Anemia
• Bacterial infections

DIAGNOSIS

The infection is diagnosed by examining the stool specimen. In a person infected with fasciola, the stool has fasciola eggs which can be seen through a microscope.

The blood test can be helpful in diagnosing fasciola infection, as it detects antibodies to the parasites in the blood.

Other imaging modalities may include the following:

• Ultrasound to visualize adultflukes in bile duct
• CTScan that may reveal burrows in the liver

TREATMENT

The first step is to make sure that the diagnosis made is correct.

Triclabendazole is the only medicine recommended by the WHO. The cure rate is higher with this medication.The drug is given by mouth usually in two doses. It has an active compound against the fasciola parasite.

There is also alternative for triclabendazole, Nitazoxanide, which may be used during the chronic phase of infection. Its is given 500mg twice a day for seven days in adults.

To prevent fasciola infection, avoid consuming raw plants and meat that contains metacercariae. When travelling to other countries, drink only bottled water, especially in less developed areas that do not have proper sanitation.