Liver fluke


Fasciolosis is an infectious disease caused by the trematode Fasciola, which is a flatworm called liver fluke.

Adult sexually mature flukes are found in the bile ducts and livers of infected humans and animals such as cattle. The disease more often affects livestock and other larger wild animals than humans.

Two types of Fasciola parasites can infect humans. The main species that infect humans are Fasciola hepatica, which is a helminth better known as hepatic fluke or sheep liver fluke and Fasciola gigantica – large fluke.

The disease has been found in more than 50 countries in the world, especially in areas where sheep and cattle are raised. Fasciola hepatica is found on all continents except Antarctica.

Fasciola gigantica is more widespread in tropical regions. With the exception of some regions of Western Europe, the human form of the disease is observed most often in developing countries, and Bulgaria also falls into this group .

A person can become infected by accidentally ingesting the parasite. The main way this can happen is from consuming raw watercress /not found in Bulgaria/ or other contaminated freshwater plants.

It can also happen by drinking contaminated water or by eating vegetables that have been washed or irrigated with contaminated water.

Is it possible for the parasite to cause infection when it passes from one person to another?

The helminth cannot be transmitted directly from one person to others. Eggs passed in the faeces of infected people or animals must mature into some species of freshwater snails and, under favorable environmental conditions, they can infest a person or animal.

There are also described cases, which are still rare, in which people were infected by insufficiently well heat-treated goat or sheep liver, which contained immature forms of the trematode.

What are the signs and symptoms and when does the infection start?

Some of those infected never get sick. But other people show symptoms early in the infection, while the immature flukes breach the surface of the intestines and the abdominal cavity and migrate to the liver.

Clinical manifestations of the acute /migratory / phase may begin 4-7 days after exposure and may last several weeks or months.

In some cases, the infected become ill only in the chronic phase, when the adult flukes are in the bile duct. And if they do develop any symptoms, it happens months to years after exposure.

For example, clinical manifestations may be the result of inflammation and obstruction of the bile ducts.

During the two phases of the parasitosis, its clinical manifestations may consist of fever, fatigue, abdominal pain, eosinophilia, hepatomegaly – an enlarged liver.

Hepatic flu treatment

The disease is treatable. The drug of choice is triclabendazole. It is given orally, usually in 1 or 2 doses. Most people respond well to treatment and are able to clear themselves of the trematode and its forms.


One can protect oneself by not eating raw plants from freshwater basins, especially from endemic grassland areas.

As with any other infection, travelers to areas with poor public hygiene, which in Bulgaria are settlements without sewage, should avoid food or water that may be contaminated.

There is no vaccine that protects people from flu.

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