What is the Sheep Liver Fluke? Parasitic infection caused by two species Fasciola hepatica Fasciola gigantica Larval flukes that migrate through the intestinal wall, abdominal cavity, liver tissue and into bile ducts where they produce eggs

Eukaryotic Kingdom: Animalia Phylum: Platyhelminthes (Flatworms) Class: Trematoda (Flukes) Order: Echinostomida (Bile Ducts)

Four Phases of Infection Incubation phase – ingestion to first symptom signs Acute phase – fever, vomiting, abdominal pain, rash, Anemia, Jaundice Latent phase – months or year Chronic phase – develop months to years after infection - inflammation of liver, gallbladder, and pancreas, biliary obstruction can lead to fibrosis and cirrhosis

30 mm by 13 mm

Mammalian and Aquatic Life Cycle

Assessing the Parasite Mature Flukes do not produce eggs until about 4 months after infection Development of blood tests - ELISA CT scans for burrows from the worms

Treatment Protocols Triclabendazole – 1 to 2 doses in 24 hour period Bithionol – 5 to 10 dose course

Moving Forward Strict control of the sale of watercress and other water plants Thoroughly cook vegetables and avoid contaminated water Pesticides against host snails Chemotherapy to decrease animal reservoir

First Appearance First discovered by a French man in 1379 in his sheep Eggs have been discovered in mummies

A Widespread Distribution Over 75 countries – none free from risk South American highlands Highly endemic areas – prevalent in school age children Hypo-endemic pattern – climate dependent Vast

A New Drug: Oxfendazole

http://www.stanford.edu/class/humbio103/ParaSites2001/fascioliasis/Fasciola.htm http://www.cdc.gov/parasites/fasciola/ http://www.bvgh.org/Biopharmaceutical-Solutions/Global-Health-Primer/Diseases/cid/ViewDetails/ItemID/23.aspx http://www.who.int/foodborne_trematode_infections/fascioliasis/fascioliasis_epidemiology/en/ http://en.wikipedia.org/wiki/Fasciola_hepatica