Are you thinking of traveling to East, Southeast, or Central Asia? These are exciting destinations for cultural explorations, historical appreciation, and world-class cuisine. However, be cautious when eating undercooked or raw fresh-water fish, as a high prevalence of cases of liver fluke infection have been found mainly in these global regions. As well, cases have occurred in South America, Africa and Eastern Europe. Researchers estimate that around 17 million people worldwide, most in Southeast Asia, are affected by opisthorchiasis.
Liver fluke disease is a serious parasitic inflammatory disease of the bile ducts caused by eating fluke-infested fish from freshwater sources like rivers and lakes. A liver fluke is a flatworm. Three most common types of liver flukes that induce infections in humans are Opisthorchis viverrini, Opisthorchis felineu, and Clonorchis sinensis. Once ingested, they make their way into the liver’s bile ducts where they incubate and grow. Adult flukes live in the small intrahepatic bile for 20 to 30 years and may cause severe and long-lasting inflammation of the bile ducts.
What are the tell-tale signs of liver fluke infections?
While liver fluke infections don’t present symptoms in most infected individuals, many experience severe inflammation suffer from nonspecific abdominal, malaise, hives, nausea, fever, vomiting, decreased appetite and weight loss, diarrhea, and jaundice. More severe consequences are an enlarged liver, stone formation, recurrent pyogenic cholangitis — and cholangiocarcinoma, which is a type of cancer that grows in the bile ducts, both inside and outside the liver.
In severe cases of liver fluke infections, the outlook is not very good: a five-year survival rate for this type of liver cancer, and with only 20-50% chances of survival — even when the cancer is detected early.
Because liver fluke infections are asymptomatic for many people, it is hard to detect them. In asymptomatic cases, people with liver fluke infections can live their lives normally. When symptoms arise, they can be treated and most often curable. However, to ensure that liver fluke infection is cleared, a thorough medical checkup should be in place.
Testing for liver fluke infections
Methods to detect liver fluke infections include the following: full blood count, ultrasound or CAT scans of the liver, stool analysis, and immunological testing to detect worm-specific antibodies in blood samples or worm-specific antigens in feces samples. The most common method of testing is stool analysis because it is easier to perform and is more affordable than the other methods.
Common Treatment
The World Health Organization recommends Triclabendazole to treat fascioliasis, which is an infectious disease caused by fasciola parasites or flatworms also known as liver flukes. The use of triclabendazole as a treatment for liver fluke disease has been proven to be effective in the majority of the cases because it is effective against immature and adult parasites, and therefore can be administered as treatment throughout all phases of the liver fluke infection. Aside from the high success rate, the documented side efforts are also usually mild and temporary. The recommended single dosage for prevention and treatment is 10 mg/kg body weight.
How to avoid liver fluke infection
Remember these important tips to prevent infection, especially when traveling to places with known cases:
1. Avoid eating raw or undercooked fresh-water fish.
2. After traveling to regions with high cases of liver fluke infections, have yourself tested for this particular disease.
3. Should you choose to eat it raw or undercooked, buy your fish from trusted, reputable hygiene-focused food establishments that are conscientious about potential cross-contamination through utensils and food handling.
4. Practice utmost hygiene when eating or sharing food with others.
5. Seek medical attention upon experiencing symptoms of liver fluke infections.
To learn more about liver fluke disease, check out these useful resources:
- https://www.healthline.com/health/liver-fluke
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3088844/
- https://www.medicalnewstoday.com/articles/319479.php
