Fascioliasis

Abstract

AbstractFascioliasis in Latin America is caused by Fasciola hepatica. Animal fascioliasis is distributed throughout. Human infection occurs in many countries, mainly Cuba, Mexico, and all Andean countries. Peru is the country where more people are affected, mainly in altitude areas. The Northern Altiplano, in Bolivia and Peru, is the area with higher prevalence and intensities in humans. Children and females are the most affected. Cattle and sheep are the main reservoirs throughout. Pigs and donkeys play an additional reservoir role in human endemic areas. Snail vectors belong to the Galba/Fossaria group of lymnaeids, excepting Pseudosuccinea columella. Human fascioliasis in Latin America includes hypoendemic, mesoendemic, and hyperendemic situations, human epidemics in both human and nonhuman endemic areas, and other areas with authochthonous isolated cases and imported cases. The altiplanic and valley patterns at high altitude and the Caribbean insular pattern are the most important transmission patterns. Different freshwater and terrestrial vegetables, local traditional beverages, and water drinking have been reported as human infection sources. Pathology and clinical manifestations in Latin America do not differ from the main pictures known elsewhere, including from no symptoms up to death. Diagnosis mainly relies on stool and serological techniques. Triclabendazole is of choice for human treatment, although resistance to this drug has already been reported in South America, including even a human endemic area. The large WHO control initiative is based on the costless availability of triclabendazole. Successful pilot action in Bolivia and Peru furnished the base for the present mass treatments of children.KeywordsHuman fascioliasis Fasciola hepatica Latin AmericaLivestockAnimal reservoirsLymnaeid snail vectorsGeographical distributionTransmission patternsEpidemiological situationsDisease burdenHuman infection sourcesPathology and major manifestationsDiagnosisTreatmentControl