An Outbreak of Human Fascioliasis gigantica in Southwest China

• Published in: PloS one 2013-08, Vol.8 (8), p.e71520
• Main Authors: Chen, Jia-Xu, Chen, Mu-Xin, Ai, Lin, Xu, Xue-Nian, Jiao, Jian-Ming, Zhu, Ting-Jun, Su, Hui-Yong, Zang, Wei, Luo, Jia-Jun, Guo, Yun-Hai, Lv, Shan, Zhou, Xiao-Nong
• Format: Article
• Language: English
• Subjects: Adult; Animals; Anthelmintics - therapeutic use; Benzimidazoles - therapeutic use; Biology; Cattle; Cattle Diseases - diagnosis; Cattle Diseases - epidemiology; China - epidemiology; Coexistence; Coma; Disease Outbreaks; Eggs; Eosinophilia; Epidemiology; Fasciola; Fasciola - drug effects; Fasciola - isolation & purification; Fasciola gigantica; Fasciola hepatica; Fasciola hepatica - drug effects; Fasciola hepatica - isolation & purification; Fascioliasis - diagnosis; Fascioliasis - drug therapy; Fascioliasis - epidemiology; Female; Fever; Fluke infections; Goats; Health aspects; Human populations; Humans; Infections; Lesions; Liver; Liver - parasitology; Livestock; Malaria; Male; Medical records; Medicine; Mitochondrial DNA; Outbreaks; Parasites; Parasitic diseases; Patients; Public health; Ribosomal DNA; Sheep; Triclabendazole; Tropical diseases; Ultrasound; Veterinary Science
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0071520

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.