An Outbreak of Human Fascioliasis gigantica in Southwest China

PLoS One. 2013 Aug 8;8(8):e71520. doi: 10.1371/journal.pone.0071520. eCollection 2013.

Abstract

Fascioliasis is a common parasitic disease in livestock in China. However, human fascioliasis is rarely reported in the country. Here we describe an outbreak of human fascioliasis in Yunnan province. We reviewed the complete clinical records of 29 patients and performed an epidemiological investigation on the general human population and animals in the outbreak locality. Our findings support an outbreak due to Fasciola gigantica with a peak in late November, 2011. The most common symptoms were remittent fever, epigastric tenderness, and hepatalgia. Eosinophilia and tunnel-like lesions in ultrasound imaging in the liver were also commonly seen. Significant improvement of patients' condition was achieved by administration of triclabendazole®. Fasciola spp. were discovered in local cattle (28.6%) and goats (26.0%). Molecular evidence showed a coexistence of F. gigantica and F. hepatica. However, all eggs seen in humans were confirmed to be F. gigantica. Herb (Houttuynia cordata) was most likely the source of infections. Our findings indicate that human fascioliasis is a neglected disease in China. The distribution of triclabendazole®, the only efficacious drug against human fascioliasis, should be promoted.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Animals
  • Anthelmintics / therapeutic use
  • Benzimidazoles / therapeutic use
  • Cattle
  • Cattle Diseases / diagnosis
  • Cattle Diseases / epidemiology
  • China / epidemiology
  • Disease Outbreaks
  • Fasciola / drug effects
  • Fasciola / isolation & purification*
  • Fasciola hepatica / drug effects
  • Fasciola hepatica / isolation & purification
  • Fascioliasis / diagnosis*
  • Fascioliasis / drug therapy
  • Fascioliasis / epidemiology*
  • Female
  • Humans
  • Liver / parasitology
  • Male
  • Triclabendazole

Substances

  • Anthelmintics
  • Benzimidazoles
  • Triclabendazole

Grants and funding

The Program for the International Development Research Centre, Canada (Project No. 105509-00001002), National S & T Major Program (grant nos. 2012ZX10004-220, 2008ZX10004-011, 2009ZX10004-302 and 2009ZX10004-201), National Key Technology R & D Program (Grant No. 2008BAI56B03), and China Postdoctoral Science Foundation (Grant No. 2012M520353), Shanghai Postdoctoral Sustentation Fund (Grant No. 12R21416500). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.