1. 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

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

4. 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

5. 30 mm by 13 mm

6. Mammalian and Aquatic Life Cycle

7. 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

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

9. 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

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

11. 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

13. A New Drug: Oxfendazole