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Ahasan SA, De Elías-Escribano A, Artigas P, Alam MZ, Mondal MMH, Blair D, Chowdhury EH, Bargues MD, Mas-Coma S. Wide variation of heterozygotic genotypes of recent fasciolid hybrids from livestock in Bangladesh assessed by rDNA internal transcribed spacer region sequencing and cloning. One Health 2023; 17:100614. [PMID: 37649708 PMCID: PMC10462839 DOI: 10.1016/j.onehlt.2023.100614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/07/2023] [Accepted: 08/07/2023] [Indexed: 09/01/2023] Open
Abstract
Fascioliasis causes high economic losses in livestock and underlies public health problems in rural areas, mainly of low-income countries. The increasing animal infection rates in Bangladesh were assessed, by focusing on host species, different parts of the country, and rDNA sequences. Fasciolid flukes were collected from buffaloes, cattle, goats and sheep from many localities to assess prevalences and intensities of infection. The nuclear rDNA internal transcribed spacer (ITS) region including ITS-1 and ITS-2 spacers was analyzed by direct sequencing and cloning, given the detection of intermediate phenotypic forms in Bangladesh. The 35.4% prevalence in goats and 55.5% in buffaloes are the highest recorded in these animals in Bangladesh. In cattle (29.3%) and sheep (26.8%) prevalences are also high for these species. These prevalences are very high when compared to lowlands at similar latitudes in neighboring India. The high prevalences and intensities appear in western Bangladesh where cross-border importation of animals from India occur. The combined haplotype CH3A of Fasciola gigantica widely found in all livestock species throughout Bangladesh fits its historical connections with the western Grand Trunk Road and the eastern Tea-Horse Road. The "pure" F. hepatica sequences only in clones from specimens showing heterozygotic positions indicate recent hybridization events with local "pure" F. gigantica, since concerted evolution did not yet have sufficient time to homogenize the rDNA operon. The detection of up to six different sequences coexisting in the cloned specimens evidences crossbreeding between hybrid parents, indicating repeated, superimposed and rapidly evolving hybridization events. The high proportion of hybrids highlights an increasing animal infection trend and human infection risk, and the need for control measures, mainly concerning goats in household farming management. ITS-1 and ITS-2 markers prove to be useful for detecting recent hybrid fasciolids. The introduction of a Fasciola species with imported livestock into a highly prevalent area of the other Fasciola species may lead to a high nucleotide variation in the species-differing positions in the extremely conserved fasciolid spacers. Results suggest that, in ancient times, frequent crossbreeding inside the same Fasciola species gave rise to the very peculiar characteristics of the present-day nuclear genome of both fasciolids.
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Affiliation(s)
- Syed Ali Ahasan
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicente Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
- Department of Pathology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
- Department of Livestock Services, Dhaka, Bangladesh
| | - Alejandra De Elías-Escribano
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicente Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Patricio Artigas
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicente Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Mohammad Zahangir Alam
- Department of Parasitology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
| | - M. Motahar Hussain Mondal
- Department of Parasitology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
| | - David Blair
- College of Science and Engineering, James Cook University, James Cook Dr 1, Townsville 4814, Queensland, Australia
| | - Emdadul Haque Chowdhury
- Department of Pathology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
- Department of Livestock Services, Dhaka, Bangladesh
| | - M. Dolores Bargues
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicente Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Santiago Mas-Coma
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicente Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
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Perrodin S, Walti L, Gottstein B, Kim-Fuchs C, Candinas D, Banz V. Fasciola hepatica in a country of low incidence: a tricky diagnosis. Hepatobiliary Surg Nutr 2019; 8:597-603. [PMID: 31929986 DOI: 10.21037/hbsn.2019.04.02] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Fasciola hepatica is a foodborne trematode present worldwide. Definitive hosts are mostly ruminants such as cattle and sheep, as well as humans. In Switzerland, Fasciola infection in humans is rare. Unfortunately, many patients are likely to undergo multiple unnecessary investigations before the parasite is suspected and fascioliasis diagnosed, especially if symptoms are unspecific. Methods Retrospective analysis of all patients diagnosed with Fasciola hepatica at the University Hospital of Bern between 2005 and 2018. Diagnosis was positive if a positive serology and/or eggs in stool samples correlated with clinical presentation (symptoms and/or imaging). Patients were excluded if serology was weakly positive and another diagnosis more likely. Personal data, laboratory results, imaging, proposed treatment and outcome were collected from patient files. Results Sixty patients had a positive serology during this time period. Forty-seven of them had a more plausible alternative diagnosis and were not included in the study, leaving 13 patients for analyses; 46.2% (6/13) were male, mean age was 45.8 years old (range, 17-80 years old). Four patients (4/13, 30.8%) were asymptomatic, nine (9/13, 69.2%) presented with symptoms ranging from right upper quadrant abdominal pain (44.4%) and generalized pruritus (33.3%) to weight loss and night sweats (33.3%). The mean duration of symptoms until correct diagnosis was 8.9 months (range, 1-48 months). Five patients (5/13, 38.5%) had documented eosinophilia, four (4/13, 30.8%) elevated liver enzymes and seven (7/13, 53.8%) elevated cholestasis parameters. Mean antibody level on serology was 88 AU/mL (range, 3-134 AU/mL). Ultrasound was used most frequently (7/13, 53.8%), followed by magnetic resonance imaging (4/13, 30.8%), computed tomography and endoscopic retrograde cholangiopancreatography (3/13, 23.1%). The most common findings were bile duct dilatation, followed by hepatic lesions. Treatment consisted of Triclabendazole 10 mg/Kg. One patient needed a second treatment course for persistent disease. There were no recurrences. Conclusions With a low incidence of Fasciola hepatica in Switzerland, correct diagnosis is often substantially delayed. Raising awareness among Swiss physicians is paramount, and a higher level of suspicion necessary when confronted with unspecific symptoms or liver imaging, thus avoiding a long delay in diagnosis, as well as unnecessary tests.
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Affiliation(s)
- Stéphanie Perrodin
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Laura Walti
- Department of Infectious Diseases, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Bruno Gottstein
- Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, Institute of Parasitology, University of Bern, Bern, Switzerland
| | - Corina Kim-Fuchs
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Daniel Candinas
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Vanessa Banz
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
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Qureshi AW, Zeb A, Mansoor A, Hayat A, Mas-Coma S. Fasciola hepatica infection in children actively detected in a survey in rural areas of Mardan district, Khyber Pakhtunkhawa province, northern Pakistan. Parasitol Int 2018; 69:39-46. [PMID: 30445198 DOI: 10.1016/j.parint.2018.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 10/05/2018] [Accepted: 11/11/2018] [Indexed: 11/26/2022]
Abstract
Human fascioliasis is a freshwater snail borne, zoonotic disease caused by Fasciola liver flukes which are widely spread throughout Pakistan and has recently proved to be endemic in humans of the Punjab province. To verify whether fasciolids are also affecting humans outside this province, studies were conducted in four communities comprising rural and urban areas of Mardan district, Khyber Pakhtunkha province, northern Pakistan. Activities comprised two surveys, a coprological one to look for Fasciola infection and another to get information on potential human infection sources and risk factors by means of a questionnaire. Out of 540 subjects of all ages surveyed, only 4 children (0.74%) were found positive for Fasciola eggs: two 9- and 13-year old boys and two 7- and 16-year old girls. Burden per child ranged 73-146 eggs per gram of faeces (epg), with an average of 106 ± 15.4 epg. Based on the egg size, the infection was diagnosed to be caused by F. hepatica. Serum analyses showed eosinophilia and elevated enzyme values in liver function tests. The Mardan area fits well to all transmission and epidemiological requirements of F. hepatica, namely the presence of infected livestock reservoirs throughout, the appropriate climatic factors (mainly monthly temperature variation along the year), and the existence of adequate freshwater collections. The existence of the specific lymnaeid snail vector species for F. hepatica transmission was reported in the neighbouring Swat valley time ago. Results show that human fascioliasis may be widespread in Pakistan and that both F. hepatica and F. gigantica may be involved.
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Affiliation(s)
- Asma W Qureshi
- Department of Zoology, GC Women University, Sialkot, Pakistan.
| | - Aurang Zeb
- Department of Zoology, University of Hazara, Mansehra, Pakistan
| | - Abu Mansoor
- Department of Zoology, GC Women University, Sialkot, Pakistan
| | - Azam Hayat
- Department of Zoology, University of Hazara, Mansehra, Pakistan
| | - Santiago Mas-Coma
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain.
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Sah R, Khadka S, Lakhey PJ, Pradhan S, Shah NP, Singh YP, Mas-Coma S. Human case of Fasciola gigantica-like infection, review of human fascioliasis reports in Nepal, and epidemiological analysis within the South Central Asia. Acta Parasitol 2018; 63:435-443. [PMID: 29975653 DOI: 10.1515/ap-2018-0053] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 03/28/2018] [Indexed: 11/15/2022]
Abstract
The diagnosis of a 22 year-old male patient from Kerabari, Morang District, Nepal led to the review of human fascioliasis cases and analysis of the epidemiological situation in that country not included in the WHO fascioliasis map. Symptom onset one month before egg detection and normal levels of ALT and AST did not agree with the 3-4-month migratory period of fascioliasis. A shorter acute phase may happen when the main biliary duct is reached by the migratory juveniles directly from the intestinal lumen. The causal agent was ascribed to F. gigantica-like worms after considering adult fluke morphology, altitude of the patient's infection area, fasciolid characteristics in the neighbouring Bangladesh, and lymnaeid snail vector species known in Nepal and in the patient's infection area. Previous reports of human infection by Fasciola in Nepal are reviewed. The patient in question proved to be the twelfth case and the first in whom a F. gigantica-like infection is reported. In Nepal, the wide geographical distribution of livestock fascioliasis, with high prevalences in buffaloes, cattle and goats, and the reports of Fasciola-infected schoolchildren close to the capital Kathmandu, give rise to concern on the situation in remote rural areas in a country where most of the population lives in rural areas. Moreover, the climate change impact in Nepal remembers Pakistan, where human fascioliasis emergence has been related to climate change and man-made irrigation. All in all, the present analysis suggests that human infection by Fasciola may be underestimated in Nepal.
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Affiliation(s)
- Ranjit Sah
- Department of Microbiology, Tribhuvan University and Teaching Hospital (TUTH), Institute of Medicine, Kathmandu, Nepal
| | - Shusila Khadka
- Department of Microbiology, Tribhuvan University and Teaching Hospital (TUTH), Institute of Medicine, Kathmandu, Nepal
| | - Paleswan Joshi Lakhey
- Department of Gastrointestinal Surgery and General Surgery, Tribhuvan University and Teaching Hospital (TUTH), Institute of Medicine, Kathmandu, Nepal
| | - Sumita Pradhan
- Department of Gastrointestinal Surgery and General Surgery, Tribhuvan University and Teaching Hospital (TUTH), Institute of Medicine, Kathmandu, Nepal
| | - Niranjan Parsad Shah
- Department of Microbiology, Tribhuvan University and Teaching Hospital (TUTH), Institute of Medicine, Kathmandu, Nepal
| | - Yogendra Prasad Singh
- Department of Gastrointestinal Surgery and General Surgery, Tribhuvan University and Teaching Hospital (TUTH), Institute of Medicine, Kathmandu, Nepal
| | - Santiago Mas-Coma
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
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Sürücü E, Demir Y, Dülger AC, Batur A, Ölmez Ş, Kitapçı MT. Fasciola Hepatica Mimicking Malignancy on 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography. Mol Imaging Radionucl Ther 2016; 25:143-146. [PMID: 27751978 PMCID: PMC5100087 DOI: 10.4274/mirt.97759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
A 48-year-old female with complaints of gastrointestinal symptoms such as abdominal pain, fatigue, vomiting, nausea, and weight loss was diagnosed with neuroendocrine tumor after removal of a 2 mm lesion from the stomach with endoscopic biopsy. Her magnetic resonance imaging that was performed due to on-going symptoms showed multiple linear hypointense lesions in the liver. Positron emission tomography/computed tomography (PET/CT) scan was performed for differential diagnosis, which showed high fluorodeoxyglucose (FDG) uptake in these lesions. Clinical and laboratory findings revealed the final diagnosis as Fasciola hepatica. The imaging features of this case is presented to aid in differentiating this infectious disease from malignancy and avoid misdiagnosis on FDG-PET/CT.
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Affiliation(s)
- Erdem Sürücü
- Yüzüncü Yıl University Faculty of Medicine, Department of Nuclear Medicine, Van, Turkey, Phone: +90 553 608 10 95 E-mail:
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Norizuki M, Sasahara T, Gomi H, Morisawa Y, Takamura N, Kenzaka T, Kobayashi T, Fujiya Y, Kato Y, Matsuoka H. A Case of Fascioliasis Treated Successfully Without Sequelae in a Japanese Expatriate Living in Jakarta. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2015; 8:61-3. [PMID: 26309420 PMCID: PMC4533845 DOI: 10.4137/ccrep.s26578] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 06/08/2015] [Accepted: 06/11/2015] [Indexed: 11/26/2022]
Abstract
A 46-year-old Japanese female expatriate living in Jakarta presented with intermittent fever lasting for a month. Although she was considered at low risk of Fasciola spp. infection because she lived in an upper-class residential area of the city, the patient presented with eosinophilia after consuming organic raw vegetables; in addition, contrast-enhanced computed tomography detected microabscesses in a tractlike pattern in the liver. These findings led to an early diagnosis of fascioliasis, which was successfully treated without sequelae. In any patient with a history of consuming raw vegetables, fascioliasis should be suspected regardless of where the patient has lived.
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Affiliation(s)
- Masataro Norizuki
- Center for Clinical Infectious Diseases, Jichi Medical University Hospital, Tochigi, Japan
| | - Teppei Sasahara
- Department of Infection and Immunity, School of Medicine, Jichi Medical University, Tochigi, Japan
| | - Harumi Gomi
- Center for Global Health, Mito Kyodo General Hospital, University of Tsukuba, Ibaraki, Japan
| | - Yuji Morisawa
- Center for Clinical Infectious Diseases, Jichi Medical University Hospital, Tochigi, Japan
| | - Noriko Takamura
- Division of General Internal Medicine, Jichi Medical University Hospital, Tochigi, Japan
| | - Tsuneaki Kenzaka
- Division of General Internal Medicine, Jichi Medical University Hospital, Tochigi, Japan
| | - Tetsuro Kobayashi
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshihiro Fujiya
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yasuyuki Kato
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroyuki Matsuoka
- Division of Medical Zoology, School of Medicine, Jichi Medical University, Tochigi, Japan
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Ashrafi K, Bargues MD, O'Neill S, Mas-Coma S. Fascioliasis: A worldwide parasitic disease of importance in travel medicine. Travel Med Infect Dis 2014; 12:636-49. [DOI: 10.1016/j.tmaid.2014.09.006] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 07/10/2014] [Accepted: 09/17/2014] [Indexed: 12/31/2022]
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Fürst T, Duthaler U, Sripa B, Utzinger J, Keiser J. Trematode Infections. Infect Dis Clin North Am 2012; 26:399-419. [DOI: 10.1016/j.idc.2012.03.008] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Trifina E, Spenger J, Zandieh S, Haller J, Auer H, Österreicher C, Klaushofer K, Mikosch P. Multiple Leberherde und Eosinophilie – ein Fallbericht einer Fasciola hepatica-Infektion. Wien Med Wochenschr 2011; 161:448-54. [DOI: 10.1007/s10354-011-0030-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Accepted: 08/16/2011] [Indexed: 10/16/2022]
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Fica A, Dabanch J, Farias C, Castro M, Jercic MI, Weitzel T. Acute fascioliasis--clinical and epidemiological features of four patients in Chile. Clin Microbiol Infect 2011; 18:91-6. [PMID: 21668579 DOI: 10.1111/j.1469-0691.2011.03575.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Because of its infrequent and protean presentation and the lack of clinical data, the management of acute infections with the foodborne trematode Fasciola hepatica is challenging. We report four serologically confirmed cases that illustrate our experience with this parasitic infection in Chile. All patients were adults presenting with upper abdominal pain. Other symptoms included fever, nausea/vomiting, and cutaneous manifestations. In all cases, marked eosinophilia was present. All patients lived in an urban environment, and three reported the consumption of raw watercress. Computed tomography (CT) scans showed hypodense hepatic lesions, whereas ultrasonography findings were unremarkable. One patient suffered portal vein thrombosis, which might be a rare complication of acute fascioliasis. All patients were successfully treated with triclabendazole. Our case series demonstrates that patients with acute fascioliasis typically present with a combination of upper abdominal pain, marked eosinophilia, and hypodense hepatic lesions on CT imaging. Diagnosis should be confirmed by serological investigation. A history of recent consumption of raw watercress is an important finding, but in some patients the source of infection remains obscure.
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Affiliation(s)
- A Fica
- Servicio de Infectología, Hospital Militar, Santiago, Chile
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