Dr.T.V.Rao
MD
FASCIOLA
HEPATICA
DR.T.V.RAO MD 1
FASCIOLA
HEPATICA
DR.T.V.RAO MD 2
• Fasciola hepatica, also known as the common
liver fluke or sheep liver fluke, is a parasitic
flatworm of the class Trematoda, phylum
Platyhelminthes that infects the livers of
various mammals, including humans. The
disease caused by the fluke is called fascioliasis
(also known as fasciolosis). F. hepatica is
distributed worldwide, and causes great
economic losses in sheep and cattle. It has been
known as an important parasite of sheep and
cattle for hundreds of years.
• Phylum:
Platyhelmint
hes
• Flat worm
• Liver fluke
• Effects
sheep,
cattle, and
INTRODUCTIO
N
DR.T.V.RAO MD 3
• Fasciola hepatica is
a liver fluke
common in humans
and livestock that
can cause major
economic losses
(Diwilde et al, 2008).
Infected animals
become anaemic
and lose significant
amounts of weight.
FASCIOLA
HEPATICA
DR.T.V.RAO MD 4
MORPHOLOGY OF
F.HEPATICA
DR.T.V.RAO MD 5
F.
HEPATIC
A
• Definitive host:
• Sheep
• Cattle
• Humans (Accidental)
• Other Mammals
• Intermediate host
• Fresh Water Snail
• Geographic Range
• Cosmopolitan;
anywhere she
ep and cattle are
raised
DR.T.V.RAO MD 6
MORPHOLO
GY
• Adult fluke
• Flat leaf like
body
• 20-30mm
long
• 8-15mm wide
DR.T.V.RAO MD 7
F
.HEAPATICA
DR.T.V.RAO MD 8
CYCLE OF EVENTS IN FASCIOLA
HEPATICA
• The life cycle of Fasciola hepatica starts
when a female lays eggs in the liver of
an infected human. Immature eggs
are discharged in the biliary ducts and
taken out in the feces. If landed in water,
the eggs become embryonated and
develop larvae called miracidia. A
miracidium invades an aquatic snail and
develops into cercaria, a larva that is
DR.T.V.RAO MD 9
• The cercaria exits
and finds aquatic
vegetation where it
forms a cyst called
Metacercariae. A
human eats the raw
freshwater plant
containing the cyst.
The Metacercariae
excysts in the first part
of the small intestine,
duodenum. It then
penetrates the
intestinal wall and
CYCLE OF EVENTS IN
INFECTION
DR.T.V.RAO MD 10
DR.T.V.RAO MD 11
DR.T.V.RAO MD 12
CYCLE OF EVENTS IN
INFECTION
DR.T.V.RAO MD 13
• It finds the liver and starts eating liver
cells. This happens only a few days after
the initial contact with the parasite.
Usually the larva spends a few weeks
just browsing and eating the liver
. Then it
relocates to the bile duct where it begins
its final stage and becomes an adult. It
takes about three months for the
Metacercariae to develop into an
adult. Adults are about 3 cm long and 1
• Ingestion
Metacercari
ae
• Ex-cyst in
Duodenum
• Burrows
through
Intestinal Wall
• Enters
Peritoneal
Cavity
• Migrates to
PROGRESS OF
INFECTION
DR.T.V.RAO MD 14
PATHOLOGY AND LIVER
DAMAGE
1
5
• Little damage is done by juveniles penetrating the
intestinal wall and the capsule surrounding
the liver but much necrosis results from
migration of flukes through the liver
parenchyma Worms inbile ducts cause
inflammation and edema, which in turn
stimulate production of fibrous tissue in the
walls of these ducts. Thus thickened, the ducts
can handle less bile and are less responsive to
needs of the liver. Back pressure causes
atrophy of liver parenchyma, with
concomitant cirrhosis and possibly jaundice. In
DR.T.V
e.RA
rO
oM
dD
ed
SYMPTOM
S
• Abdominal Pain
• Anemia
• Hepatic Tenderness
• Hepatomegaly resulting from
Edema
• Intermittent Fever
• Jaundice
• Lethargy
• Nausea
• Prolonged High Fever
• Secondary Infections
• Vomiting
DR.T.V.RAO MD 16
SYMPTOM
S
• Acute
• More common in sheep
• 10,000+ Metacercariae consumed at one time
• Dramatic Liver Inflammation, Frequently Resulting in
Death
• Chronic
• More Common and Rarely Fatal
• Nonspecific Symptoms
• Halzoun
• Eating raw, infected liver
• Infects pharynx
• Causes swelling and obstructs breathing
DR.T.V.RAO MD 17
DIAGNOSI
S
• Stool Samples
• Yellow-Brown Eggs
• Eggs Don’t Show for 4
Months
• Duodenal or Biliary
Aspirate
• Antibody Test
• Can detect 2 Weeks After
Infection
• Ultrasound
• Visualize Adults in Bile Duct
• CT Scan
DR.T.V.RAO MD 18
TREATME
NT
DR.T.V.RAO MD 19
• Bithional
• Highly Effective
• Large Dose
• High Cost
• Long Treatment
Period
• Triclabendazole
• Easier to Use
• 1-2 Oral Doses in
24 hrs
• Virtually 100%
Effective
• Surgery
EPIDEMIOLOG
Y
DR.T.V.RAO MD 20
• Infection begins when Metacercariae
infected aquatic vegetation is eaten or
when water containing Metacercariae is
drunk. Humans are often infected by
eating watercress. Human infections
occur in parts of Europe, northern
Africa, Cuba, South America, and other
locales. It is one of the most important
disease agents of domestic stock
throughout the world and shows
CONTROL
METHODS
DR.T.V.RAO MD 21
• Education
• Cheapest and Most Cost Effective Way
• Wash Aquatic Vegetables in 6% Vinegar for 5-10
minutes
• Better herding practices
• Keep herds away from aquatic areas
• Moluskicide
• Controls Intermediate Snail Host
•Programme Created by
Dr.T.V.Rao MD for
Medical and
Paramedical Students in
the
Developing World
• Email
• doctortvrao@gmail.com
DR.T.V.RAO MD 22

life history of Fasciola-Hepatica (.pptx

  • 1.
  • 2.
    FASCIOLA HEPATICA DR.T.V.RAO MD 2 •Fasciola hepatica, also known as the common liver fluke or sheep liver fluke, is a parasitic flatworm of the class Trematoda, phylum Platyhelminthes that infects the livers of various mammals, including humans. The disease caused by the fluke is called fascioliasis (also known as fasciolosis). F. hepatica is distributed worldwide, and causes great economic losses in sheep and cattle. It has been known as an important parasite of sheep and cattle for hundreds of years.
  • 3.
    • Phylum: Platyhelmint hes • Flatworm • Liver fluke • Effects sheep, cattle, and INTRODUCTIO N DR.T.V.RAO MD 3
  • 4.
    • Fasciola hepaticais a liver fluke common in humans and livestock that can cause major economic losses (Diwilde et al, 2008). Infected animals become anaemic and lose significant amounts of weight. FASCIOLA HEPATICA DR.T.V.RAO MD 4
  • 5.
  • 6.
    F. HEPATIC A • Definitive host: •Sheep • Cattle • Humans (Accidental) • Other Mammals • Intermediate host • Fresh Water Snail • Geographic Range • Cosmopolitan; anywhere she ep and cattle are raised DR.T.V.RAO MD 6
  • 7.
    MORPHOLO GY • Adult fluke •Flat leaf like body • 20-30mm long • 8-15mm wide DR.T.V.RAO MD 7
  • 8.
  • 9.
    CYCLE OF EVENTSIN FASCIOLA HEPATICA • The life cycle of Fasciola hepatica starts when a female lays eggs in the liver of an infected human. Immature eggs are discharged in the biliary ducts and taken out in the feces. If landed in water, the eggs become embryonated and develop larvae called miracidia. A miracidium invades an aquatic snail and develops into cercaria, a larva that is DR.T.V.RAO MD 9
  • 10.
    • The cercariaexits and finds aquatic vegetation where it forms a cyst called Metacercariae. A human eats the raw freshwater plant containing the cyst. The Metacercariae excysts in the first part of the small intestine, duodenum. It then penetrates the intestinal wall and CYCLE OF EVENTS IN INFECTION DR.T.V.RAO MD 10
  • 11.
  • 12.
  • 13.
    CYCLE OF EVENTSIN INFECTION DR.T.V.RAO MD 13 • It finds the liver and starts eating liver cells. This happens only a few days after the initial contact with the parasite. Usually the larva spends a few weeks just browsing and eating the liver . Then it relocates to the bile duct where it begins its final stage and becomes an adult. It takes about three months for the Metacercariae to develop into an adult. Adults are about 3 cm long and 1
  • 14.
    • Ingestion Metacercari ae • Ex-cystin Duodenum • Burrows through Intestinal Wall • Enters Peritoneal Cavity • Migrates to PROGRESS OF INFECTION DR.T.V.RAO MD 14
  • 15.
    PATHOLOGY AND LIVER DAMAGE 1 5 •Little damage is done by juveniles penetrating the intestinal wall and the capsule surrounding the liver but much necrosis results from migration of flukes through the liver parenchyma Worms inbile ducts cause inflammation and edema, which in turn stimulate production of fibrous tissue in the walls of these ducts. Thus thickened, the ducts can handle less bile and are less responsive to needs of the liver. Back pressure causes atrophy of liver parenchyma, with concomitant cirrhosis and possibly jaundice. In DR.T.V e.RA rO oM dD ed
  • 16.
    SYMPTOM S • Abdominal Pain •Anemia • Hepatic Tenderness • Hepatomegaly resulting from Edema • Intermittent Fever • Jaundice • Lethargy • Nausea • Prolonged High Fever • Secondary Infections • Vomiting DR.T.V.RAO MD 16
  • 17.
    SYMPTOM S • Acute • Morecommon in sheep • 10,000+ Metacercariae consumed at one time • Dramatic Liver Inflammation, Frequently Resulting in Death • Chronic • More Common and Rarely Fatal • Nonspecific Symptoms • Halzoun • Eating raw, infected liver • Infects pharynx • Causes swelling and obstructs breathing DR.T.V.RAO MD 17
  • 18.
    DIAGNOSI S • Stool Samples •Yellow-Brown Eggs • Eggs Don’t Show for 4 Months • Duodenal or Biliary Aspirate • Antibody Test • Can detect 2 Weeks After Infection • Ultrasound • Visualize Adults in Bile Duct • CT Scan DR.T.V.RAO MD 18
  • 19.
    TREATME NT DR.T.V.RAO MD 19 •Bithional • Highly Effective • Large Dose • High Cost • Long Treatment Period • Triclabendazole • Easier to Use • 1-2 Oral Doses in 24 hrs • Virtually 100% Effective • Surgery
  • 20.
    EPIDEMIOLOG Y DR.T.V.RAO MD 20 •Infection begins when Metacercariae infected aquatic vegetation is eaten or when water containing Metacercariae is drunk. Humans are often infected by eating watercress. Human infections occur in parts of Europe, northern Africa, Cuba, South America, and other locales. It is one of the most important disease agents of domestic stock throughout the world and shows
  • 21.
    CONTROL METHODS DR.T.V.RAO MD 21 •Education • Cheapest and Most Cost Effective Way • Wash Aquatic Vegetables in 6% Vinegar for 5-10 minutes • Better herding practices • Keep herds away from aquatic areas • Moluskicide • Controls Intermediate Snail Host
  • 22.
    •Programme Created by Dr.T.V.RaoMD for Medical and Paramedical Students in the Developing World • Email • [email protected] DR.T.V.RAO MD 22