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[Clinical diagnosis and treatment in an outbreak of Fasciola gigantica infection in Yunnan Province].

OBJECTIVE
To carry out clinical diagnosis and treatment of Fasciola gigantica infection during an outbreak in Yunnan Province.


METHODS
Data on epidemiology, diagnosis and treatment were collected from 27 patients. A questionnaire survey to the patients and partial villagers was carried out including history of raw food-eating and pet-raising. Animal feces were collected and examined by precipitation method and eggs incubation method. Cattle from two patients families were dissected to find Fasciola infection. Serum samples from patients, family members, and villagers were detected. Possible intermediate snails were collected from the vicinity of streams and ponds in 15 villages where patients lived.


RESULTS
The earliest onset of symptoms among the patients was on March 10, 2011 and the last case was on January 10, 2012. The clinical manifestations were mainly fever with unknown reason, decreasing hemoglobin, increasing eosinophils, and hepatosplenomegaly. No parasite eggs were found in feces. Antibodies against F. gigantica were positive by ELISA in 23 patients. Fasciola eggs were then found in 4 patients' feces on February 16, 2012. F. gigantica eggs and adults were found in the hepatobiliary system of dissected cattle. Triclabendazole [10 mg/(kg x d) x2 d] was administered orally for the patients and the clinical symptoms eased. Snails including Physa acuta, Radix swinhoei and Galba pervia were collected and cercariae were found in only one snail.


CONCLUSION
An outbreak of F. gigantica infection has been confirmed and the diagnosed cases effectively treated with triclabendazole.