Fasciolopsiasis

Fasciolopsiasis is an intestinal fluke infection caused by Fasciolopsis buski. Initial symptoms are diarrhea, constipation, vomiting, and anorexia. Humans, swine, and sometimes dogs are the main hosts. Humans are infected after eating aquatic plants to which the metacercariae have attached.

CASES/YEAR
0 (US); 45,000,000 (Global)
CATEGORY
AGENT TYPE
Helminths
OTHER NAMES
Fasciolopsis buski infection; Intestinal flukes (Fasciolopsiasis);
ACUITY
Subacute/Chronic
INCUBATION
3 months from ingestion to appearance of eggs in stool; [CCDM];
INITIAL SYMPTOMS
Diarrhea, constipation, vomiting, anorexia; [CCDM]
PRECAUTIONS
"No direct person-to person transmission." [CCDM, p. 209]
COMMENTS
Humans, swine, and sometimes dogs are the main hosts for this trematode infection of the small intestine. Humans are infected after eating aquatic plants to which the metacercariae have attached. Findings of heavy infection may include intestinal obstruction, ascites, anemia, and edema of the face, abdominal wall, and legs. [CCDM, p. 209] Symptoms begin 30-60 days after exposure. Marked eosinophilia is present early. Eosinophilia may or may not be present during chronic infection. Worms may live for 6 months or longer in humans. [Guerrant, p. 943] Except for heavy infections, most cases are asymptomatic. Epigastric pain and diarrhea may occur about 1-2 months after exposure. Some patients have edema and hypoalbuminemia secondary to protein-losing enteropathy. [PPID, p. 3460] May cause intestinal hemorrhage, obstruction, and malabsorption; [Cecil, p. 2126-7]
DIAGNOSTIC
Identification of adult fluke or eggs in stool or vomitus; [CCDM]
SCOPE
Pig-raising areas of southeastern Asia, especially central and south China, Thailand, and some areas of India; [CCDM]
SIGNS & SYMPTOMS
  • >fatigue, weakness
  • G abdominal pain
  • G blood in stool
  • G constipation
  • G diarrhea
  • G nausea, vomiting
  • H anemia
  • H eosinophilia
  • *bowel obstruction
ANTIMICROBIC

Yes

VACCINE

No

ENTRY
Ingestion
SOURCE
Eating Contaminated Food, Eating Contaminated Produce
RESERVOIR
Dogs, Swine, Human
RISK FACTORS
  • Ingest infectious agents in food/water
  • Travel to endemic area
TREATMENT
The drug of choice is praziquantel. [CCDM]
REFERENCES FOR CASES/YEAR
1.
2. (Global) 56 million suffered and 7000 died from foodborne trematodiases in 2005; [Fact sheets from WHO] 50 million people infected; This group include Fasciolopsis buski and other intestinal flukes, e.g., Heterophyes heterophyes found in the Nile Delta of Egypt and in the Far East; [Cecil, p. 2126] Guesstimate: Assume that 10% of 50 million are Heterophyiasis;