Fascioliasis Due to<i>Fasciola hepatica</i>and<i>Fasciola gigantica</i>Infection: An Update on This ‘Neglected’ Neglected Tropical Disease

Abstract

Fascioliasis, an infection due to the food- and water-borne trematodes Fasciola hepatica and Fasciola gigantica, is among the most neglected of the neglected tropical diseases. Among the estimated 91.1 million humans at risk for infection worldwide, as many as 17 million may be infected. Certain areas of the world bear the burden of the highest prevalence of infection. There, school-age children are the most likely to be infected. In the United States, rare cases have been reported among immigrants from endemic areas, returned travelers to endemic regions, and individuals residing in Hawaii, California, and Florida. Indigenous cases have almost always been associated with consumption of watercress. Diagnosis is made serologically most often, although stool examination for the eggs is fruitful if obtained when the adult worm is laying eggs. With an appropriate index of suspicion, laboratory and imaging studies often confirm the suspected diagnosis. Triclabendazole is the treatment of choice.