Heterophyiasis is an intestinal fluke that causes abdominal pain and diarrhea. Infection occurs after eating raw or undercooked, freshwater fish.
The disease is endemic to the Far East, Middle East, and Egypt and may cause intestinal hemorrhage, obstruction, and protein-losing enteropathy.
0 (US); 5,000,000 (Global)
Heterophyes heterophyes infection; Metagonimus yokogawai infection; Intestinal flukes (Heterophyiasis, Metagonimiasis, Haplorchiasis)
Adults produce eggs in about 9 days; [PPID, p. 3460]]
Abdominal pain and diarrhea;
Symptoms include abdominal pain and diarrhea. Infection occurs after eating raw or undercooked, freshwater fish. [Merck Manual, p. 1721-2] Snails are the intermediate hosts and freshwater fish the second intermediate hosts. The adult worms are found in the small intestine. Flukes attach to the intestinal where they live for a few months. Occasionally flukes penetrate the mucosa and eggs may embolize causing myocarditis and brain/spinal cord lesions. [PPID, p. 3452t, 3460] Of the 10 or more human species, Heterophyes heterophyes, H. nocens, and Metagonimus yokogawai are the most prevalent. [Guerrant, p. 866] May cause intestinal hemorrhage, obstruction, and protein-losing enteropathy; [Cecil, p. 2126-7]
Identification of eggs in stool sample;
Endemic to the Far East, Middle East, and Egypt; [Merck Manual, p. 1721] H. heterophyes: Nile delta, Tunisia, Turkey, and Iran; M. yokogawai: most prevalent in Far East; [PPID, p. 3460]]
SIGNS & SYMPTOMS
G abdominal pain
G blood in stool
*brain abscess or lesion
Animal Tissue, Eating Contaminated Food, Eating Infected or Toxin-Containing Fish
Fish and Shellfish
- Eat undercooked meat or fish
- Travel to endemic area
REFERENCES FOR CASES/YEAR
2. (Global) 56 million suffered and 7000 died from foodborne trematodiases in 2005; [Fact sheets from WHO] See "Fasciolopsiasis."