Fasciola hepatica

Sarah Richards
Max Karpyak

Scientific Classification
Kingdom: Animalia
Phylum: Platyhelminthes
Class: Trematoda
Subclass: Digenea
Prder Echinostomida
Family: Fasciolidea
Genus: Fasciola
Species:hepitica

General Information
- Commonly known as liver fluke
- A parasitic flatworm

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.

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

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

Hosts
- Cattle
- Sheep
- Sometimes humans

Life Cycle

Life Cycle (Contd)

- The adult F. hepatica lives in bile ducts of the

hosts 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

Life Cycle (Contd)

- 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 hepatopancreas 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

Life Cycle (Contd)

- 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.

http://www.cdfound.to.it/hTML/fh2a.htm

Four Symptomatic Patterns

-

Acute Phase
Cronic Phase
Halzoun
Ectopic Infection

Acute Phase
- Rarely seen in humans
- Fever, tender hepatomegaly, and

abdominal pain are frequent

symptoms.
- Vomiting, diarrhea, and anemia may
also be present

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

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.

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

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

Control Methods
- Education
- Molluscicides: application of

malluscicides to decrease the

population of Lymnaea snails
- Chemotherapy

Review Questions
- 1. What is the average size of an adult F. hepatica?
a. 20 mm x 5mm
b. 30 mm x 13 mm
c. 10 mm x 5 mm
2. What continent can F. Hepatica be found?
a. Africa
b. Asia
c. America
d. All of the above

Review (Contd)
- 3. What is the most effective way to treat
fascioliasis?
a. bithionol
b. flagyl
c. triclabendazole

References
- Fascioliasis Retrieved: 2/19/2007
-

http://www.stanford.edu/class/humbio103/fa
scioliasis/Fasciola.htm
Fasciola hepatica. Wikipedia, free
encyclopedia. Retrieved: 2/19/2007
http://en.wikipedia.org/wiki/Fasciola_hepat
ica
Fasciola hepatica. Retrieved: 2/19/2007
http://www.cdfound.to.it/html/fas1.htm