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Monday, December 4, 2017

Re-emerging zoonosis: Fascioliasis.

Re-emerging zoonosis are zoonotic infections that have been recognized before and has protocol measures of prevention and treatment in place,but now these infections have higher incidences and wider geographic scope. Fascioliasis is one of such re-emerging zoonotic infections that was common in developing nations of Africa and sparse dispersion in America,Europe and Asia. Today this infection is widespread and with higher prevalence. The food-borne trematodes causing infection in man are Fasciola hepatica and gigantica are the 2 most common in the tropics. Transmission is by ingestion of flukes in under-cooked or poorly processed liver. Drinking water contaminated with the flukes and eating water plants or vegetables washed with such water. Accidental ingestion of flukes from infected liver as shown below is very common in developing countries. Butchers usually cut up affected liver in strips to cut out the white tracts formed by the flukes. This is usually called Eedo oni ishan, they typically sell to food vendors and people who want meat that you chew for long before swallowing. The next time you visit your butcher and observe livers cut up with tracts,donot buy.
Acute phase. when the immature worms penetrate the intestinal wall and the peritoneum, the protective membrane surrounding the internal organs .They puncture the liver's surface and eat their way through its tissues until they reach the bile ducts. This invasion kills the liver cells and causes intense internal bleeding. Typical symptoms include fever, nausea, a swollen liver, skin rashes and extreme abdominal pain and inflammation. Chronic phase. The chronic phase begins when the worms reach the bile ducts, where they mature and start producing eggs. These eggs are released into the bile and reach the intestine, where they are evacuated in faeces, thereby completing the transmission cycle. Symptoms include intermittent pain, jaundice and anaemia. Pancreatitis and gallstones. Patients with chronic infections experience hardening of the liver (fibrosis) as a result of the long-term. The fluke sometimes migrates from the liver to the eye and nervous tissue. The migration causes neurological signs such as tremors/seizures .Ocular lesions arise from migration to the eyes, where there is occasional moving out of fluke from orbit.

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