Fasciolasis Hepática, serie de casos reportados en Matanzas. Cuba / Hepatic fasciolosis, a series of cases reported in Matanzas, Cuba

RESUMEN Introducción: la fasciolasis hepática es una enfermedad parasitaria de difícil diagnóstico. La variada y múltiple sintomatología que caracteriza la enfermedad, la expulsión intermitente y tardía de los huevos del parasito, así como el difícil acceso a los estudios inmunológicos en las zonas rurales atenta contra la confirmación de parasitosis en casos esporádicos. En la provincia de Matanzas en los últimos años se constataron enfermos sospechosos de fasciolosis procedentes de Pedro Betancourt con diversos síntomas digestivos, fiebre y eosinofilia. Objetivo: caracterizar los aspectos clínicos y epidemiológicos de los pacientes diagnosticados de fasciolosis hepática. Materiales y Método: se realizó un estudio observacional, descriptivo a pacientes hospitalizados con el diagnóstico presuntivo de fasciolosis hepática en el Servicio de Medicina Interna del Hospital Faustino Pérez en el período enero del año 2011 a diciembre del 2013. La recolección de datos se realizó a través del interrogatorio, examen físico, Historia clínica y encuestas epidemiológicas. Resultados: se muestra la presencia de consumo de plantas acuáticas y consumo de agua sin hervir en los afectados. La fase aguda de la enfermedad en estos pacientes se caracterizó por fiebre, dolor abdominal, hepatomegalia y gran eosinofilia. Conclusiones: el diagnóstico de certeza se realizó a través de pruebas inmunológicas. Esto se debe a que a pesar de los múltiples exámenes parasitológicos de las heces fecales no se identificó huevos. Los pacientes del estudio fueron tratados con el triclabendazol y se logró mejoría clínica de los pacientes y pocas reacciones adversas (AU).

SUMMARY Introduction: the hepatic fasciolosis is a parasitic disease of difficult prognosis. The varied and multiple symptoms characterizing the disease, the intermittent and late ejection of the parasite eggs, and also the difficult access to immunological studies in the country areas sometimes attempts against the confirmation of parasitism. During the last years, in the province of Matanzas, several sick persons from Pedro Betancourt were suspicious of fasciolosis with different digestive symptoms, fever and eosinophilia. Objective: to characterize the clinical and epidemiological aspects of the patients diagnosed of hepatic fasciolosis. Materials and method: an observational, descriptive study was performed in in-patients of the Service of Internal Medicine of the Hospital Faustino Perez with the presumptive diagnosis of hepatic fascilosis in the period January 2011-December 2013. Data collection was made through questioning, physical examination, clinical record and epidemiological inquiries. Results: risk behaviors are evidenced given the water plants and un-boiled water consumption in affected persons. The acute `hase in these individuals is characterized by fever, abdominal pain, hepatomegaly and big eosinophilia. The diagnosis of certainty was made by immunologic tests. The patients were treated with triclabendazol with clinical improvement and little adverse reactions. Conclusions: health professionals when assisting a patient from a country area with eating habits of fresh vegetable consumption and suggestive clinical characteristics should carry out studies to confirm Fasciola hepatica infection (AU).

Characterization of the molluscicidal activity of Bauhinia variegata and Mimusops elengi plant extracts against the fasciola vector lymnaea acuminata / Caracterização da atividade moluscicida dos extratos das plantas Bauhinia variegata e Mimusops elengi contra o vetor da Fasciola, Lymnaea acuminata

The molluscicidal activity of Bauhinia variegata leaf and Mimusops elengi bark was studied against vector snail Lymnaea acuminata. The toxicity of both plants was time and concentration-dependent. Among organic extracts, ethanol extracts of both plants were more toxic. Toxicity of B. variegata leaf ethanolic extract (96h LC50- 14.4 mg/L) was more pronounced than M. elengi bark ethanolic extract (96h LC50-15.0 mg/L). The 24h LC50 of column purified fraction of B. variegata and M. elengi bark were 20.3 mg/L and 18.3 mg/L, respectively. Saponin and quercetin were characterized and identified as active molluscicidal component. Co-migration of saponin (Rf 0.48) and quercetin (Rf 0.52) with column purified bark of M. elengi and leaf of B. variegata on thin layer chromatography demonstrate same Rf value i.e. 0.48 and 0.52, respectively. The present study clearly indicates the possibility of using M. elengi and/or B. variegata as potent molluscicide.

A atividade moluscicida das folhas da Bauhinia variegata e da casca do Mimusops elengi foi testada contra o vetor caracol, Limnaea acuminata. A toxicidade de ambas as plantas é dependente do tempo e da concentração. Entre os extratos orgânicos, os extratos de etanol de ambas as plantas foi mais tóxico. A toxicidade do extrato etanólico da folha da B. variegata (96 h LC50 - 14,4 mg/L) foi mais pronunciada do que o extrato etanólico da casca do M. elengi (96h - LC50 - 15,0 mg/L). As frações purificadas em coluna durante 24 h LC50 do B. variegata e da casca do M. elengi foram 20,3 mg/L e 18,3 mg/L, respectivamente. A saponina e a quercentina foram caracterizadas e identificadas como os componentes ativos moluscicidas. A co-migração da saponina (Rf 0,48) e da quercentina (Rf 0,52) com a casca purificada por coluna do M. elengi e as folhas da B. variegata na cromatografia demonstraram o mesmo valor Rf isto é, 0,48 e 0,52 respectivamente. O presente estudo indica claramente a possibilidade de usar M. elengi e/ou B. variegata como moluscicidas potentes.

DNA multigene sequencing of topotypic specimens of the fascioliasis vector Lymnaea diaphana and phylogenetic analysis of the genus Pectinidens (Gastropoda)

Freshwater lymnaeid snails are crucial in defining transmission and epidemiology of fascioliasis. In South America, human endemic areas are related to high altitudes in Andean regions. The species Lymnaea diaphana has, however, been involved in low altitude areas of Chile, Argentina and Peru where human infection also occurs. Complete nuclear ribosomal DNA 18S, internal transcribed spacer (ITS)-2 and ITS-1 and fragments of mitochondrial DNA 16S and cytochrome c oxidase (cox)1 genes of L. diaphana specimens from its type locality offered 1,848, 495, 520, 424 and 672 bp long sequences. Comparisons with New and Old World Galba/Fossaria, Palaearctic stagnicolines, Nearctic stagnicolines, Old World Radix and Pseudosuccinea allowed to conclude that (i) L. diaphana shows sequences very different from all other lymnaeids, (ii) each marker allows its differentiation, except cox1 amino acid sequence, and (iii) L. diaphana is not a fossarine lymnaeid, but rather an archaic relict form derived from the oldest North American stagnicoline ancestors. Phylogeny and large genetic distances support the genus Pectinidens as the first stagnicoline representative in the southern hemisphere, including colonization of extreme world regions, as most southern Patagonia, long time ago. The phylogenetic link of L. diaphana with the stagnicoline group may give light to the aforementioned peculiar low altitude epidemiological scenario of fascioliasis.

Fascioliasis hepática / Hepatic fascioliasis

La fascioliasis hepática es una enfermedad parasitaria infecciosa producida por el trematodo Fasciola hepática. El humano es infectado accidentalmente al ingerir vegetales (principalmente berros) contaminados con las formas enquistadas del parásito (metacercarias). Clínicamente se reconoce una fase hepática (fase aguda) que comprende desde la liberación de la larva en el duodeno hasta su llegada a la vía biliar, y una fase biliar (fase crónica), en donde la Fasciola se localiza en la vía biliar, madura a su forma adulta y produce huevos. El diagnóstico requiere un alto índice de sospecha dado el polimorfismo en la presentación y muchas veces el desconocimiento de antecedentes epidemiológicos. Las manifestaciones clínicas dependen del período en el cual se encuentra la enfermedad, sin embargo, lo más habitual es la presencia de dolor abdominal y eosinofilia. El diagnóstico definitivo requiere la demostración del parásito a través de métodos directos (visualización por medio de colangiografía retrógrada endoscópica o búsqueda de huevos en deposiciones o bilis) o a través de la demostración por métodos serológicos. El tratamiento actualmente disponible con triclabendazol es altamente efectivo.

The hepatic fascioliasis is a parasitic disease caused by infectious trematode fasciola hepática. Man is infected accidentally by ingesting vegetables (mainly watercress) contaminated with the parasite encysted forms (metacercariae). Clinically a hepatic phase (acute phase) is recognized, ranging from the release of the larvae in the duodenum to their arrival to the bile duct and a bile phase (chronic phase), where fasciola is located in the bile duct, and the parasite matures to the adult form and produces eggs. The diagnosis requires a high index of suspicion given the polymorphism in the presentation and the frequent lack of epidemiological history. The clinical manifestations depend on the current period of the disease is, however, the most common is the presence of abdominal pain and eosinophilia. Definitive diagnosis requires demonstration of the parasite through direct methods (visualization by ERCP or search for eggs in stool or bile), or through the demonstration by serological methods. The currently available treatment is highly effective with triclabendazole.

Distribution of Lymnaeidae (Mollusca: Pulmonata), intermediate snail hosts of Fasciola hepatica in Venezuela

An extensive malacological survey was carried out between 2005-2009 in order to clarify the exact number of lymnaeid species which may be intermediate hosts of Fasciola hepatica in Venezuela. Four species were discovered during this survey, including two local species: Lymnaea cubensis and Lymnaea cousini and two exotic species: Lymnaea truncatula and Lymnaea columella. The most common local species was L. cubensis which was found at 16 out of the 298 sampling sites. This species has a large distribution area throughout the Northern part of Venezuela and was encountered from sea level to an altitude of 1,802 m in state of Trujillo. The second local species L. cousini was collected at only two sites of the Andean Region at altitudes of 3,550 m and 4,040 m, respectively. The European L. truncatula was found at 24 sites all located in the states of Mérida and Táchira at an altitude varying between 1,540-4,000 m. The respective distribution areas of L. cubensis and L. truncatula do not appear to overlap, but more detailed malacological surveys are needed. The fourth lymnaeid species, L. columella was collected in a canal from Mérida at an altitude of 1,929 m and in an irrigation canal from the state of Guárico, at an altitude of 63 m. The role of these four lymnaeid species in the transmission of fascioliasis in Venezuela is discussed.

Prevalence of slaughter and liver condemnation due to Fasciola hepatica among sheep in the state of Rio Grande do Sul, Brazil 2000 and 2005

The aim of this study is to determine the prevalence of Fasciola hepßtica among sheep in the state of Rio Grande do Sul, Brazil, by reviewing slaughter and liver condemnation data obtained from the Federal Inspection Service, afflliated with the Brazilian Ministry of Agriculture, Animal Husbandry and Supply, for years 2000 to 2005. Liver condemnation amounted to 14.57 percent (18,072/ 124,078) in 2000,10.14 percent (11,998/118,332) in 2001,10.96 percent (11,372/103,762) in 2002, 9.96 percent (10,802/ 108,461) in 2003, 5.42 percent (6,245/114,596) in 2004, and 2.27 percent (2,750/121,172) in 2005. The overall prevalence of liver condemnation due to F. hepßtica corresponded to 8.87 percent (61.239/690.361). In conclusion, fascioliosis was found to be prevalent among sheep in the state of Rio Grande do Sul and to account for major economic losses to farmers, meat packing plants and to the government.

O objetivo deste trabalho foi determinar a prevalência de Fasciola hepática em ovinos no Estado do Rio Grande do Sul, Brasil, através de laudos de abate e condenação de fígados ovinos. Os dados de condenação de 2000 a 2005 foram obtidos do Servico de Inspeção Federal (SIF) do Ministerio da Agricultura, Pecuaria e Abastecimento (MAPA). No ano de 2000 foi de 14,57 por cento (18.072/124.078); em 2001 foi de 10,14 por cento (11.998/118.332); em 2002 foi de 10,96 por cento (11.372/103.762); em 2003 foi de 9,96 por cento (10.802/108.461); em 2004 foi de 5,42 por cento (6.245/ 114.596) e em 2005 foi de 2,27 por cento (2.750/ 121.172). A prevalência geral de condenação de fígados por F. hepática foi de 8,87 por cento (61.239/ 690.361). Conclui-se que a fasciolose ovina é prevalente no Rio Grande do Sul, acarretando perdas para os produtores, frigoríficos e para o Estado.

Anatomical studies of sibling species within neotropical lymnaeids, snail intermediate hosts of fascioliasis

Several anatomical parameters of the reproductive system have been used to distinguish Lymnaea cubensis from L. viatrix, the snail hosts of fascioliasis in South America and the Caribbean area. Three samples have been collected in the type localities of L. cubensis (Cuba), L. viatrix var. A ventricosa (Argentina, Río Negro Lower Valley), and L. viatrix var. B elongata (Peru, Lima), respectively. Only one parameter, the relative lengths of the penis sheath and preputium, showed significant differences between L. viatrix var. ventricosa and the two other taxa. None of the studied parameters separated L. cubensis from L. viatrix var. elongata.

Fascioliasis in relatives of patients with Fasciola hepatica infection in Peru

Altas tasas de fasciolosis humana han sido descritas en varias regiones del Perú. Estudiamos 20 familias en una área endémica del Perú para determinar la proporción de infección con F. hepatica en los familiares de los sujetos diagnosticados y para identificar factores de riesgo asociados. El estudio incluyó un total de 93 sujetos, quienes contribuyeron con muestras de heces y sangre. Las edades comprendieron desde 1 a 53 años (media = 18.6; DS = 14.2). La prevalencia general de fasciolosis por exámenes de heces fue 33.3% (n = 83) y por serología, 51.9% (n = 86). La prevalencia en el grupo de edad I (< 19 años de edad) por pruebas coprológicas y serológicas fueron 61.4% y 75.9%, respectivamente; en el grupo II (> 19 años de edad) 15.4% y 37.5%. El principal factor de riesgo asociado con fasciolosis fue comer ensaladas (OR = 3.29, IC = 1.2-9.0, p = 0.02). En conclusión, la fasciolosis humana es altamente prevalente en familiares de los casos índices y el factor de riesgo más significante para adquirirla en la familia es comer ensaladas en las áreas endémicas.

Up-date of fasciolosis-transmitting snails in Egypt [review and comment]

Several snail species may contribute in transmission of fasciolosis in Egypt. These molluscs show a variable sensibility to natural infections with Fasciola species. Radix natalensis is considered to be the essential intermediate host for F. gigantica based on field and experimental studies. Cercarial production from R. natalensis experimentally infected with F. gigantica is affected by the species of definitive host from which the eggs are obtained, as well as the different laboratory conditions. Another lymnaeid, Galba truncatula, may play a role in transmitting this parasite in Egypt, as it was found naturally infected with F. gigantica. Latter snail species, originated from France, was susceptible to experimental infections with Egyptian miracidia of F. gigantica and it had a cercarial production close to that of local R. natalensis. Two other snails, Pseudosuccinea colurmella and Biomphalaria alexandrina, were naturally found harboring larvae of Fasciola sp. At the level of intermediate hosts of F. gigantica, the conditions are thus favorable in Egypt to transmit fasciolosis which could also be caused by another fasciolid, F. hepatica, as the existance of this fluke was confirmed in Egypt

Proposal of a geographic information system for modeling zoonotic fasciolosis transmission in the Andes

El presente estudio describe la base para el desarrollo de un Sistema de Información Geográfica (SIG) para dirigir un análisis epidemiológico de la fascioliosis humana y animal en los Andes. La metodología propone el uso de varias bases de datos - derivadas de estudios epidemiológicos multidisciplinarios y de datos medioambientales derivados de estaciones terrestres y de satélites.

Corralation between snails and fish in fish ponds of world fish center [ICLARM] with spicial refernce to snail vectors of schistosomiasis and fascioliasis

The abundance of snail species in earthen fish ponds, irrigation and drainage canals at World Fish Center [ICLARM] in a descending order was Bellamya unicolor [50.89%] > Physa acuta [18.94%] > Cleopatra bulimoides [7.6%] > Lanistes carinatus [6.73%] > Bulinus truncatus [5.19%] > Melanoides tuberculata [4.83%] > Lymnaea natalensis [3.14%] > Gabbiella senaarensis [0.9%] > Biomphalaria alexandrina [0.55%] > Lymnaea truncatula [0.4%] > Planorbis planorbis and Succinea cleopatra [0.33%] > Ferrissia isseli [0.18%]. The dead snails constituted about 5.19% of all the collected specimens. There was a dramatic decrease in the total number of pulmonates in fish ponds, which contained only Tilapia sp., and a very small number of cat fish, whereas the numbers of Prosobranchia snails were much higher in these ponds. In fish Ponds, which accommodated a variety of fish species, the most dominant snail was B. unicolor, followed by L. carinatus. However, pulmonate snails were absent in these ponds. B. Truncatus was the only snail species found in concrete tank, which contained only young tilapias with a very small size [5-8 cm in standard length]. In irrigation canals, the number of snails and diversity was much higher than those in fish ponds. Out of 191 snails collected from inlet irrigation canal, 71 were dead, but in the outside irrigation canals, 7 out of 564 snails were dead. P. acuta was absent in all examined fish ponds, but it was alive and occurred in a high number [497 snails] in the outside irrigation canals. The number of snails collected from Bahnasawy drain was remarkably low [128 snails]; however, the diversity of snails was much higher compared with those in fish ponds and irrigation canals. Snail populations were stable with constant recruitment of young to adult snails for all the studied species

Infection of two lymnaeid snails with fasciola gigantica in Giza, a field study

Population density of Lymnaea natalensis and L. columella and their natural infection with Fasciola gigantica were followed in two water bodies in Abou-Rawash area, Giza Governorate over two years. L. natalensis snails were more abundant during December- February, while L. columella snails had high density during autumn. According to the snail size, it was found that the reproduction of the two vector snails occurred in summer and early autumn. Fasciola was presented in 0.6 and 2.0% of the examined L. natalensis and L. columella snails, respectively. A high prevalence of F. gigantica in L. columella snails occurred in summer and early autumn, while their presence in L. natalensis was irregular. Naturally infected Lymnaea snails, with Fasciola, are usually of large size [>10 mm] of a given population sample

Scanning eleectron micropical studies on cercaria and metacercariae of fasciola gigantica

The surface topography of Fasciola gigantica cercariae and metacercariae was studied by scanning electron microscopy. The head of F. gigantica cercaria is covered with several small knobs and its tail is provided with two lateral folds, fused ventrally, near the distal end of the tail. The oral sucker is smaller than the ventral one and possesses a characteristic surface structure. The outermost layer [layer I] of the outer cyst wall of the metacercaria is roughened with irregular furrows. The inner surface of the outer cyst wall [layer II] is more homogeneous and nearly smooth. The outermost layer of the inner cyst wall [layer III] is smooth and lacks any furrows or tubercles. The differences between F. gigantica and F. hepatica cercariae and metacercariae were discussed

Fascioliasis en la República Oriental del Uruguay / Fasciolasis in Uruguay

Se realizó una revisión y puesta al día de la situación médica y veterinaria de la distomatosis en Uruguay. Se trata de una zoonosis parasitaria altamente prevalente, producida por el trematode Fasciola hepatica actuando como huésped intermediario el molusco Limnaea viatrix. Afectca a los rumiantes de importancia económica para el país y en forma accidental al ser humano. La prevalencia en el ganado bovino es de 57 por ciento, encontrándose focalmente distribuida en todos los departamentos del país. Los casos humanos han sido esporádicos, y en su mayoría relacionados con la ingestión de berro (Nasturtium officinale). El diagnóstico se hacía accidentalmente durante el acto quirúrgico o por examen coproparasitario. Desde 1991 se ha podido detectar mayor número de casos mediante la aplicación de pruebas serológicas sensibles y específicas. Las medidas de control implementadas para el ganado son la dosificación con fasciolicidas y prácticas de manejo. No existen aún fármacos específicos eficaces para casos humanos. Se revisan las bibliografías nacionales sobre el tema

Studies on human fascioliasis in Egypt 1- seasonality of transmission

The present study aimed at investigating the seasonality of human fascioliasis. The monthly distribution of acute infection was studied together with the monthly Lymnaea cailliaudi snail density and infection. Infection was observed in both snail and human host throughout the year. However, maximal snail infection was observed during the months of June and July, while the number of acute human infections peaked in August. It was concluded that summer was the highest transmission season. The clinical incubation period was considered one or two months

Moluscos límnicos de uma área do Alto Araguaia (Brasil) / Lymnic molluscs from Alto Araguaia area (Brazil)

Säo mostrados os resultados do levantamento dos moluscos de água doce de 5 municípios da área de influência de uma usina hidrelétrica em estudo, formada pelas redondezas da Cachoeira Couto Magalhäes no Rio Araguaia. Foram examinados 624 moluscos procedentes de amostras coletadas em 20 coleçöes hídricas. O exame revelou a ocorrência de 8 gastrópodes pulmonados e um prosobrânquio, além de um bivalvo esferídeo. Devido ao envolvimento com a saúde pública, merece destaque o encontro de Biomphalaria straminea e Lymnaea columella, respectivamente hospedeiros intermediários de Schistosoma mansoni e Fasciola hepatica