Liver Fluke is a type of parasite. They have the capacity to cause infections in humans that can result in liver or bile duct infections.
Overview
The Liver Fluke is a phylum Platyhelminthes parasitic trematode. They are primarily liver parasites that infect a wide range of mammals, including humans.
They can travel via the bloodstream and can be found in the bile ducts, gallbladder and liver parenchyma. They ultimately lead to parasite illnesses in these organs by causing pathological lesions.
They have complicated life cycles that require two or three hosts, as well as free-living larval stages in water.
Types of Liver fluke
Humans are susceptible to liver flukes from parasites that can damage the liver and bile ducts. Two families of liver flukes, the Opisthorchiidae (which contains the species of Clonorchis and Opisthorchis) and the Fasciolidae (which includes the species of Fasciola), are known to infect people. Geographic distribution, life cycle, and long-term outcomes after clinical infection vary between these two groups of liver flukes.
Opisthorchis infection
Humans are susceptible to liver fluke parasites known as Opisthorchis species by consuming raw or undercooked fish, crabs, or crayfish from Asia and Europe. Individuals with liver flukes have bile duct, gallbladder, and liver infections.
While most infected people do not exhibit symptoms, prolonged infections can cause severe symptoms and deadly illnesses. Infections can linger untreated for 25–30 years, which is how long the parasite can live.
Clonorchis infection
Humans may acquire the liver fluke parasite Clonorchis by consuming raw or undercooked fish, crabs, or crayfish caught in an area where the infection is present.
Individuals with liver flukes have bile duct, gallbladder, and liver infections.
While most infected people do not exhibit any symptoms, prolonged infections can cause severe symptoms and deadly illnesses. Infections can linger untreated for up to 25–30 years, which is how long the parasite can live.
Fasciola infection
The parasite Fasciola hepatica, sometimes known as the common or sheep liver fluke, is the most prevalent cause of fascioliasis.
People typically contract the disease by consuming uncooked watercress or other aquatic plants contaminated with parasite larvae. Both prevention and treatment are available for Fasciola infection.
Symptoms of Liver Fluke
People can become infected with Liver Flukes by swallowing the parasite, which most commonly occurs through the intake of contaminated water or raw vegetables.
An infected person may never feel unwell or display signs of infection in some situations. Fever, stomach pain, chills, liver enlargement, nausea, vomiting and hives are all possible symptoms of Liver Flukes, depending on the kind and severity of the infection.
Abdominal Pain
Abdominal pain can be caused due to inflammation of the intestinal walls, peritoneal surfaces, bile ducts, parenchymal organs and obstructions in the bile ducts.
Fever
Though parasites cause fever, this can also be a symptom of untreated and chronic infections.
Nausea
Nausea is a result of the Flukes that grow and reproduce in a healthy human body, leading to infections and making the host sick.
Vomiting
A block in the intestine or bile duct can cause vomiting or abdominal cramping.
Diarrhoea
Fluke eggs get attached to intestinal walls and cause diarrhoea. These Flukes sometimes live in humans for years, showing no signs of their presence. When symptoms appear, diarrhoea is the first indicator.
Hives
Liver Flukes show symptoms of hives (urticaria) or itching caused due to allergic reactions that occur because of the presence of this parasite in the body.
Malaise
Malaise is a feeling of discomfort or uneasiness. Malaise is also a common symptom of Liver Fluke.
Decreased appetite and weight loss
Weight loss occurs due to decreased appetite and poor nutrient absorption. It is also a way to ward off the Fluke from the body.
Causes of Liver Fluke
The trematode parasite Fasciola hepatica causes Liver Fluke disease, fasciolosis.
The presence of adult Flukes in the bile ducts can cause disease by allowing huge numbers of immature Flukes to migrate through the liver.
The young worms make their way into the bile ducts through the intestinal wall, abdominal cavity and liver tissue, where they mature into adult Flukes that lay eggs.
All animals, including humans, can be infected with Liver Fluke. Sheep and cattle are most commonly affected, with the sheep being the more susceptible one.
People are frequently infected by eating raw watercress or other water plants that have been contaminated with parasite larvae.
Risk Factors of Liver Fluke infection
Living in or travelling to places where Liver Fluke is common increases the risk of infection.
People who have eaten undercooked or raw fish or any water plants like watercress are at risk.
Liver Fluke doesn’t spread from one individual to another, but chances are high if people of the same family consume the same meal.
Life cycle of a Liver Fluke
The Liver Fluke parasite goes through several phases of development. It's crucial to know this so that one can figure out when an infection might start.
Phase 1: Egg
Parasites lay immature eggs in the bile duct, which are then expelled along with the faeces. These eggs can hatch and create larvae, which are known as miracidia when they come into contact with water.
Phase 2: Intermediate Host
The parasite transmits the infection to a host that serves simply as a conduit for the parasite's final host.
For instance, it can infect a small organism and enlarge into larger larvae, after which they exit from the host’s body and are independent.
These parasites grow and mature before they are ready to move on to larger hosts such as humans and animals.
Phase 3: Young Fluke
Having entered into larger hosts, the Fluke penetrates through the walls of the small intestine to reach the peritoneal cavity.
It then has direct contact with the liver, where it begins to feed on liver cells. The foregoing happens a few days after the parasite has made contact with the host. After consuming a large number of liver cells, the young Flukes enter the bile duct and develop into adult Liver Flukes.
Phase 4: Adult
The metacercariae transform into an adult Liver Fluke in about three months. An adult Liver Fluke is around 3 cm in length.
20,000 to 25,000 eggs are laid in a single day by an adult female Liver Fluke during her later stages of pregnancy.
Diagnosis of Liver Fluke infections
Blood tests, imaging tests of the liver and examination of stool help in diagnosing Liver Fluke.
Examination of a stool sample
Stool examination reveals Fluke eggs in the faeces or the intestinal content. This leads to the diagnosis of Opisthorchis, Clonorchis or Fasciola infections. Discovering eggs in the stool can be challenging.
Imaging tests of the liver
Damage to the liver or bile duct is assessed through imaging procedures like ultrasonography, Magnetic Resonance Imaging (MRI), Endoscopic Retrograde CholangioPancreatography (ERCP), Computed Tomography (CT) or Cholangiography can be used.
Endoscopy is done to see the inside of the digestive tract, through which doctors occasionally discover adult Flukes in the bile duct.
Blood tests for antibodies
Antibodies to the Flukes can be detected through blood tests. Antibodies can be found in the bloodstream weeks before eggs appear in the faeces.
Fluke infection tends to increase the count of eosinophils in a person. Eosinophils levels in the blood are measured using tests to diagnose Liver Fluke.
Prevention of Liver Fluke
People can protect themselves by avoiding certain water plants like raw watercress, particularly those found in Fasciola prone regions.
Contaminated food and water should be avoided by tourists visiting places with poor sanitation.
The vegetables cultivated in fields using contaminated water for irrigation should be properly cooked or avoided.
There is currently no vaccine available to treat Liver Fluke infection.
Treatment of Liver Fluke infection
Liver Fluke is usually treated with medications. In rare cases, when there is an obstruction in the bile duct, surgery may be required.
Medication or Surgery
Liver Fluke can be treated and cured with medications.
Triclabendazole is the frequently used medication to treat this infection. Favourable responses are noticed in patients who take one or two doses of this medicine. Corticosteroids are also proven to help relieve extreme symptoms.
Cholangitis, a bile duct infection, may necessitate surgery.
Anthelmintic drug
Medicines are present to treat and cure parasitic worm infections in humans. These drugs are called anthelmintics.
Drugs that eliminate liver Fluke from the body include,
Praziquantel or albendazole for clonorchiasis
Praziquantel serves to be an effective treatment for infections due to Liver Flukes.
They produce worm contraction, spastic paralysis and damage to the worm's membranes, which activates the host's defence mechanisms.
Triclabendazole
Fascioliasis is treated using Triclabendazole in both adults and children aged above 6. Triclabendazole is an anthelmintic drug that kills flatworms.
Nitazoxanide
Nitazoxanide is considered a viable alternative to Triclabendazole, which is currently the most effective treatment for chronic Fascioliasis.
The efficacy of nitazoxanide against helminthiasis and intestinal protozoans is a major benefit. Helminthiasis and intestinal protozoans regularly co-infect Liver Fluke-infected people in human endemic areas.
Alternative treatments
Parasite cleanses, a common alternate treatment, is a supplement, diet or certain detox product that assists in getting rid of parasites from one’s body.
Goldenseal and colon cleansing are a few other replacements for medications.
Symptom relief
Traditional methods of treating abdomen pain and fever with acetaminophen are also used to relieve symptoms. Nausea and vomiting are decreased using anti-nausea medications.
Surgery for blockages in the bile ducts
Intraductal cholestasis is caused when tiny bile ducts within the liver are blocked by certain Liver Fluke eggs such as Fasciola hepatica, Clonorchis and Sinensis.
The effective method for eliminating live or dead Liver Flukes present in the biliary tree is Endoscopic Retrograde CholangioPancreatography.
Sphincterotomy is also performed to remove the Liver Fluke eggs.
Conclusion
Liver Fluke is a parasitic infection that frequently affects the liver or bile duct of humans. This is mostly caused as a result of eating raw watercress or other water plants that have been contaminated with parasite larvae. Medications and surgery form the major part of Liver Fluke treatment.
FAQ’s
1.What are the symptoms of Liver Flukes?
2.What causes Liver Fluke?
3.What does Fluke do to humans?
The infection can last up to a parasite’s lifetime, 25-30 years, when left untreated.
