What is it about ?
Liver fluke (or hepatic distomatosis) is contamination of the liver by fluids or trematodes. There are different types, the main ones being Fasciola hepatica, Clonorchis sinensis and Opistorchis. These are small tapeworms, which can attach to tissue by suction.
Fasciola hepatica is mostly found in herbivorous animals, such as sheep and beef. As an adult, this worm lives in the liver, where it lays eggs which are passed through the bile in the stool. Humans are usually infected by eating aquatic vegetables (mainly watercress), and sometimes also by drinking contaminated water, eating contaminated raw mutton or goat meat, or chewing on sprigs. grass that has been in contact with animal droppings.
Clonorchis and Opistorchis are spread by eating raw or partially cooked fish. The larvae evolve in worms inside the small intestine. They then pass through the wall of the intestine and nestle in the liver and bile ducts. The adult worms lay eggs there, which emerge with the stool. And the cycle can start again.
Where and how often do they occur?
Humans are occasional hosts for these worms. The number of people infected with Fasciola is estimated at around 2.4 million worldwide, mainly in areas where sheep farming is intense (for example, South America). Clonorchis is found mainly in China, Vietnam and Korea. An estimated 28 million people are infected. Opistorchis is rare and is found almost exclusively in Southeast Asia and Russia. Sometimes travelers are also infected.
How to recognize them?
Symptoms are usually the result of the worms’ characteristic journey through the intestine, to the liver and bile ducts. During this migration, the person develops a fever, stomach ache (especially on the right side, where the liver is located), and sometimes a rash. Weight loss is also possible. If the worms are very numerous, they can damage the liver and block the bile ducts, which can cause the whites of the eyes and skin to turn yellow (jaundice or jaundice). Over time, the infection becomes chronic. And, usually, the symptoms go away.
How is the diagnosis made?
On physical examination, the doctor sees an enlargement of the liver, and sometimes also signs of anemia and jaundice. The diagnosis is made by identifying eggs in the stool or in the bile. In the blood, there is sometimes an increase in a specific type of white blood cell (eosinophils) and we can also find antibodies.
What can you do ?
Although this is often not enough to prevent contamination, always wash watercress thoroughly before consuming it. The ideal is to control the origin (for example, a farm where animals cannot easily come into contact with watercress fields). Also avoid eating raw fish.
What can your doctor do?
Worm infections are treated with deworming drugs. Liver fluke is so rare in Belgium that medicines to treat it are not available with us. The only drugs available are for veterinary use. Tablets for human use can be ordered by your general practitioner from the manufacturer, abroad or through the Institute of Tropical Medicine (Antwerp).
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