5. 5
Fasciolahepatica
 Fasciolahepatica, also known as the common
liverfluke or sheep liverfluke.
 Is a parasitic flatworm of the class Trematoda,
phylum Platyhelminthes that infects liver of
various mammals, including humans.
 The disease caused by the fluke is called
fascioliasis (also known as fasciolosis).
6. Geographical Distribution
- Found in Rural areas of
temperate and tropical
regions
- Especially located in
regions with cattle and
sheep herding
- Found on every
continent with nearly 180
million people at risk and
an estimated 2.4 million
people already infected
worldwide.
7. Transmission
- Occurs through the ingestion of raw, fresh water
vegetation
- Plants become exposed to the metacercariae
when the body of water that the vegetation is
growing in becomes contaminated by eggs in
the fecal mater of the infested host
- A form of infection known as halzoun (in the
Middle East) is contracted by eating the raw
liver of an infected animal
8. Morphology
- Adult has a flat leaflike
body
- About 20-30 mm long by
8-15 mm wide
- Has an anterior
elongation where oral and
ventral suckers are
located
- Intestines are very
branched
11. Life Cycle (Cont’d)
- The adult F. he patica lives in bile ducts of the
host’s liver
- Begin to produce eggs 2-4 months after initial
infection
- Eggs pass down the bile duct through gastrointestinal
tract and are released in the hosts feces
- Require water of temperature above 10 C to hatch
- The egg hatches and releases miracidiae within two
weeks
- These newly hatched miracidiae must find a Lymanae
snail host within 24 of hatching or they will die
13. Life Cycle (Cont’d)
- Inside the Lymanaea miracidium loses its cilia
and develops into a sporocyst
- Each sporocyst develops into a ridia which then
burst the sporocyst and migrate to the hepato-
pancreas of the snail
- Ridia then develop into cercariae
- Cercariae attach to plant matter and encyst,
forming metacercariae which is the infective
form of the fluke
- Mammalian host consumes the vegetation with
the metacercariae which then excyst in the small
intestine
14. Life Cycle (Cont’d)
- Metacercariae burrow through the intestinal
wall, move through the peritoneal cavity and
enter the liver parenchyma
- Immature flukes migrate through the liver
patanchyma for 6-8 weeks giving rise to acute
symptoms
- Once mature they settle in the bile ducts and
begin to produce their own eggs after about a
month.
17. Acute Phase
- Rarely seen in humans
- Fever, tender hepatomegaly, and abdominal
pain are frequent symptoms.
- Vomiting, diarrhea, and anemia may also be
present
18. Cronic Phase
- More common in human population
- Symptoms include: bilary cholic, abdominal
pain, tender hepatomegaly, and jaundice
- In children: severe anemia is common
- Inflammation of the bile ducts eventually leads
to fibrosis and a condition called “pipestem liver”
- Severe infections can lead to death
19. Halzoun & Ectopic Infection
- Occurs when an
individual consumes
infected raw liver
- The adult worms can
cause considerable pain,
edema, and bleeding
that can interfere with
respiration
- Adults can live in biliary
ducts and cause
symptoms for up to 10
years.
- In frequent, but can occur
in peritoneal cavity,
intestinal wall, lungs,
subcutaneous tissue,
and very rarely in other
locations.
20. Diagnostic Tests
- Most widely used form of diagnosis is the directly
observed presence of F. hepatica eggs either in a stool
sample, duodenal aspirate or biliary aspirate
- Flukes do not begin to produce eggs until about 4
months after infection, so you cannot test the stool
- Prior to 4 months: serological tests can be used
- FAST-ELISA (most popular)
- Ultrasound can be used to visualize adult flukes in the
bile ducts
- CT scan can reveal burrow tracts made by the worms
21. Treatment
- Many countries use a 5-10 day course of oral
bithionol at 30mg/kg body weight
- Triclabendazole is a preferred antihelmintic
agent, but is unavailable in most countries.
- The resistance is rising to this drug
- Along with pharmaceutical therapy, surgery may
be necessary in very extreme cases to clear the
biliary tract
22. Control Methods
- Education
- Molluscicides: application of malluscicides to
decrease the population of Lymnaea snails
- Chemotherapy
23. Review Questions
- 1. What is the average size of an adult F. he patica?
a. 20 mm x 5mm
b. 30 mm x 13 mm
c. 10 mm x 5 mm
2. What continent can F. He patica be found?
a. Africa
b. Asia
c. America
d. All of the above
24. Review (Cont’d)
- 3. What is the most effective way to treat fascioliasis?
a. bithionol
b. flagyl
c. triclabendazole