Purpose of the review This review aims to critically assess current knowledge about the epidemiology, diagnosis, and management of Fasciola infection in humans. Recent findings Fascioliasis is an emerging neglected zoonotic infection affecting the health and wellbeing of human populations. The burden of infection is unclear, and studies have shown the geographic expansion of fascioliasis in human and livestock likely related to climate change. The infection can be asymptomatic or present in acute or chronic forms. Regardless of the presentation, fascioliasis can be associated with long-term complications such as anemia and malnutrition. Early in the infection, antibody testing is the only tool available for diagnosis confirmation. In the chronic forms serology and stool microscopy are helpful. Other tests such as antigen detection and PCR-based methods including isothermal tests have shown promising results. Triclabendazole is the only drug available to treat Fasciola infection. However, reports of resistant infections in livestock and human threaten the clinical care and control of the infection in endemic areas. Summary Fascioliasis is an emerging infection around the world with an uncertain burden. Lack of standardization of diagnostic testing and treatment alternatives hinder treatment and control of the infection.

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Human Fascioliasis: Current Epidemiological Status and Strategies for Diagnosis, Treatment, and Control.

Fascioliasis and fasciolopsiasis: Current knowledge and future trends.

The Northern Bolivian Altiplano is the fascioliasis endemic area with the reported highest human prevalence and intensities. A multidisciplinary One Health initiative was implemented to decrease infection/reinfection rates detected by periodic monitoring between the ongoing yearly preventive chemotherapy campaigns. Within a One Health axis, the information obtained throughout 35 years of field work on transmission foci and affected rural schools and communities/villages is analysed. Aspects linked to human infection risk are quantified, including: (1) geographical extent of the endemic area, its dynamics, municipalities affected, and its high strategic importance; (2) human population at risk, community development and mortality rates, with emphasis on problems in infancy and gender; (3) characteristics of the freshwater collections inhabited by lymnaeid snail vectors and constituting transmission foci; (4) food infection sources, including population surveys with questionnaire and reference to the most risky edible plant species; (5) water infection sources; (6) household characteristics; (7) knowledge of the inhabitants on Fasciola hepatica and the disease; (8) behavioural, traditional, social, and religious aspects; (9) livestock management. This is the widest and deepest study of this kind ever performed. Results highlight prevention and control difficulties where inhabitants follow century-old behaviours, traditions, and beliefs. Intervention priorities are proposed and discussed.

/pdf/one-health-action-against-human-fascioliasis-in-the-bolivian-3r1i8qw0.pdf

One Health Action against Human Fascioliasis in the Bolivian Altiplano: Food, Water, Housing, Behavioural Traditions, Social Aspects, and Livestock Management Linked to Disease Transmission and Infection Sources

Fasciolosis is a food-borne disease that causes great distress to a range of hosts, including humans. The objectives of this study were to (1) evaluate the liver damage and carcass weight of cattle naturally infected with Fasciola hepatica from the state of Rio Grande do Sul (RS), Brazil, and to (2) determine the distribution of adult flukes in 12,236 cattle liver from RS. The data from these experiments were used to calculate the overall economic loss due to F. hepatica infection. Eighteen adult Polled Hereford cows were divided into a triclabendazole (TbG) and a F. hepatica-positive group (FhG). For Experiment 1, a generalized linear mixed model revealed a statistical difference in carcass weight (49.8 kg) between TbG and FhG. The Monte Carlo analysis also revealed that the animals' weight differences were due to the disease. For Experiment 2, the prevalence of infected livers was above 16% (1904/12,236), mostly (20.1%) from the south-west region of RS. The Susceptible-infected-recovered (SIR) epidemic model revealed the evolution of the infection using a high infectivity and low recovery rate. Other distinctive scenarios that occur in RS were also established with different rates of infectivity. The economic assessment showed a potential loss of US$45 million to the beef cattle industry of RS, with an overall State cost of US$90.3 million. These novel findings reveal the importance of fasciolosis infection, which can cause a significant health condition and poor animal welfare.

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/286E1B57415D71ECA67D9B6AC3181F0B/S0022149X2000067Xa.pdf/div-class-title-span-class-italic-fasciola-hepatica-span-infection-in-cattle-and-the-use-of-simulation-models-for-endemic-areas-div.pdf

Fasciola hepatica infection in cattle and the use of simulation models for endemic areas

Fascioliasis is a zoonotic infection linked to significant economic losses in the livestock industry. Infection prevalence and estimated financial burden vary across locations owing to different di...

Comparison of Liver Condemnation and Bile Microscopy As Tools to Estimate Fasciola hepatica Prevalence and Burden in the Anta Province of Cusco in Peru.

Fasciolosis is a zoonotic food- and waterborne infection related to great economic losses on ruminant production. In order to determine the prevalence of bovine liver condemnations due to fasciolosis in an abattoir at the Central Andes of Peru, we evaluated the records of an authorized slaughterhouse in Huancayo, at 3300 m above sea level, over 16 months. Subsequently, the average weights of condemned viscera and carcasses were also estimated to determine the direct and indirect economic losses. Fasciolosis was the main cause of liver condemnation, with a prevalence of 55.72% (3926/7046; CI 95%: 56.88–54.56%). The livers infected were more than double the amount of livers supplied to markets in this period. Although the average price of liver in the Peruvian Andes is very cheap, approximately 16.45 tons of livers were destroyed, estimating a direct economic loss of US$ 35,080 (CI 95%: US$ 29,178–40,938). The indirect loss due to decreased body weight gain (calculated using 10% of the average weight of a healthy animal carcass) was estimated at US$ 354,570 (CI 95%: US$ 387,908–US$ 321,227). Fasciolosis is an important zoonotic disease that threatens food security in the Andean region, with major repercussions on the income of the livestock industry and the availability of cheap protein sources.

Daniela Córdoba

Papers

Economic impact of the liver condemnation of cattle infected with Fasciola hepatica in the Peruvian Andes