Rebecca Flint

Fascioliasis

Fascioliasis has world wide effects

• WHO designated extremely neglected disease

• Cases in 51 different countries

• 17 million people affected

Oral-fecal transmission route

• Reservoir in livestock

• Watercress

Disease manifests in the liver

• Acute phase– Flukes traveling to bile

ducts

– Nausea, vomiting, abdominal pain

– Inflammation and bleeding

– Liver tissue destruction

• Chronic phase– Producing eggs in

bile ducts– Asymptomatic– Symptomatic

Diagnosis can be difficult

• Stool ova test

• ELISA or Western Blot

• Liver ultrasound

Few drugs have been used for treatment

• Bithionol

- Less effective

Triclabendazole

- 1983

- Effective against early stage

parasites

- Inhibits parasitic microtubule

formation

- Resistance in 1995

Cathepsin L proteases vaccine testing

• Fascilitate in tissue penetration, feeding, and immune system evasion

• Cathepsin L1 and L2 are the major fasciola proteases

FhSAP2 as a potential vaccine

• Potential to protect against subsequent fasciola hepatica metacercariae infections

• Fluke burden– Reduced 83.3% with cDNA-FhSAP2– Reduced 60% with FhSAP2 protein

Difficulty controlling Fasciola spread

• Individualized control plans• Separation of livestock and farming• Sanitation• Cooked vegetables

References• http://www.stanford.edu/class/humbio103/ParaSites2006/Fascioliasis/index.htm• http://perutravelnews.info/Peru_geography.html• http://www.dpd.cdc.gov/dpdx/html/fascioliasis.htm• http://www.bvgh.org/Biopharmaceutical-Solutions/Global-Health-Primer/Diseases/cid/ViewDetails/ItemID/

23.aspx• Farid Z, Kamal M, Woody J (1988). Treatment of acute toxemic fascioliasis. Trans R Soc Trop Med Hyg, 82, 299.• Dawes B. Some apparent effects of Bithionol (Actamer) on Fasciola hepatica. Nature. 209. 424–425.• http://www.cdc.gov/parasites/fasciola.html• http://www.sciencedirect.com/science/article/pii/S0020751903001711• http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3260556/• http://www.who.int/foodsafety/foodborne_disease/Fascioliasis.pdf• http://www.who.int/bulletin/archives/77(4)340.pdf• Neglected tropical diseases of the Middle East and North Africa: Review of their prevalence, distribution and

opportunities for control• http://ac.els-cdn.com/S001448000700010X/1-s2.0-S001448000700010X-main.pdf?

_tid=82eb0beb26d3784c63b3fcd658db039e&acdnat=1333563684_9e8fd6d27e3ffb1fd0161e28213982e4• http://ac.els-cdn.com/S0020751903001711/1-s2.0-S0020751903001711-main.pdf?

_tid=34f4d59141feb9d940a11d5c27187d3b&acdnat=1333563744_ba4fe537c7008eb34a64f709d662597b• http://ac.els-cdn.com/S0304401709001642/1-s2.0-S0304401709001642-main.pdf?

_tid=2428d0ca1d59c164e22da2549d1bead9&acdnat=1333563799_59532b3db68dd198cec5000e8417e16d• http://ac.els-cdn.com/S1090023399903775/1-s2.0-S1090023399903775-main.pdf?

_tid=241c67a32596ceb3ca75909744fc71c6&acdnat=1333563903_2ff3d34d9679ff21d2ec7451b180156a• http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3260556/