Michael Parkinson, John P. Dalton and Sandra M. O’Neill

in Oxford Textbook of Zoonoses

Second edition

Published on behalf of Oxford University Press

ISBN: 9780198570028
Published online July 2011 | e-ISBN: 9780199697823 | DOI:

Series: Oxford Textbooks


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Liver fluke disease, or fasciolosis, of livestock and humans is caused by endoparasitic trematodes of the genus Fasciola. Fasciola hepatica is responsible for the disease in temperate climates whereas F. gigantica is found in tropical zones. Recently, hybrids between F. hepatica and F. gigantica have been described (Le et al. 2008, Periago et al. 2008). Fasciolosis is a true zoonoses as it is predominantly a disease of animals that can be transmitted to humans at a specific stage of the parasite’s complex life cycle. There are a number of definitive hosts which includes sheep, cattle, and humans but this parasite has evolved to infect many other mammalian hosts including pigs, dogs, alpacas, llamas, rats, and goats (Apt et al. 1993; Chen and Mott 1990; Esteban et al. 1998). While prevalence of infection in humans may be relatively low in relation to animals, in specific geographic locations, for example in Bolivia, the prevalence of fasciolosis is so high in the human populations (hyperendemic) that it contributes to the spread of disease in animals (Esteban et al. 1999; Mas-Coma et al. 1999).

Archeological studies showing Fasciola eggs in ancient mummies in Egypt demonstrate that fasciolosis is an ancient human disease (David 1997). Sporadic cases of fasciolosis were reported in Egypt in 1958 (Kuntz et al. 1958). The first to carry out an extensive review on human fasciolosis were Chen and Mott (1990). They reported 2,595 cases in over 40 countries in Europe, the Americas, Asia, Africa and the western Pacifi c from 1970 1990. This review raised awareness of fasciolosis in humans and triggered a growth in epidemiological studies and a consequential dramatic increase in reporting of cases in the literature. Now human fasciolosis is recognized by the World Health Organization (WHO) as an important disease in humans with an estimated 2.4 million people infected annually and 180 million at risk to infection in over 61 countries (Haseeb et al. 2002). There have been several cases of large scale epidemics in France (Dauchy et al. 2007), Egypt (Curtale et al. 2007) and Iran (Rokni et al. 2002).

However, the only extensive epidemiological studies to determine the rate of infection have been carried out in Egypt and Bolivia (Curtale et al. 2003, 2007; Esteban et al. 2002; Parkinson et al. 2007). These studies have shown that co-infection with other diseases is a common occurrence and this may lead to under-reporting of the incidence of fasciolosis (Esteban et al. 2003; Maiga et al. 1991). In many countries, the overall rates of infection are extrapolated from sporadic reports of the disease and, consequently, worldwide disease prevalence is uncertain. In this chapter we will review the cause and effect of human fasciolosis, and particularly highlight important considerations in designing control strategies to reduce infection in at-risk communities.

Chapter.  10772 words.  Illustrated.

Subjects: Public Health and Epidemiology ; Infectious Diseases ; Epidemiology

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