Emerging Cases of Fascioliasis in Lorestan Province, Western Iran: Case Series Report

Abstract

Fascioliasis is a zoonotic disease caused by Fasciola spp. We report five serologically and molecularly confirmed cases in an emerging region in Iran. A retrospective, case series study, performed in Lorestan Province, west of Iran between January 2015 and June 2016. From 1256 patients examined, 16 patients had positive serum ELISA. Five cases were approved as infected with fasciolosis using stool exam and PCR. Age ranged from 24 to 80 yr with mean age of 45 years. All of patients were adults and four of them had abdominal and back pain. Other symptoms included fever and chills, coughing and sore throat, weight loss, cutaneous manifestations. All patients lived in the rural environment, and four reported the ingestion of raw aquatic plants such as watercress. In fecal examination for fluke eggs, four samples were positive for F. hepatica eggs. Conventional PCR analysis showed that five human stools were positive for F. hepatica. All of 5 patients were treated with the usual dose of triclabendazole. A history of recent consumption of raw aquatic plants (in 4 out of 5 patients) is an important finding, but in one patient the source of infection remained unclear. Lorestan should be considered as an emerging region for this disease and further research in this province should be carried out.

Seroprevalence of Fasciola sp. and Toxoplasma gondii Infections in Rural and Urban Inhabitants of Jolfa County, Northwest Iran

“…Heydarian et al [ 21 ] investigated the seroprevalence of human fascioliasis in Lorestan Province, Western Iran, on 1256 humans. They detected anti- Fasciola antibodies in 16 individuals (1.3%).…”

“…They detected anti- Fasciola antibodies in 16 individuals (1.3%). Also, no significant differences were reported between infection and age groups, sex, level of education, and occupation; yet significant differences were recorded regarding the location of residency, consuming local freshwater plants, and water sources with seropositivity [ 21 ]. In another similar study in the same region, Lorestan Province, Eshrati et al studied seroepidemiology of human fascioliasis on 1053 humans.…”

Fascioliasis associated with chronic cholecystitis in a woman from Sistan and Baluchestan province, a non-endemic region in Southeastern Iran

“…Subsequently, World Health Organization (WHO) considered Iran among the six most infected countries with serious concerns about Fasciola infection [4]. In Iran, the disease is most frequently seen in the humid regions of northern Gilan province, and few cases have been rarely reported from other parts of the country e.g., Yasuj, Lorestan, and Kermanshah in the west [5][6][7]. Moderate temperature, rainfall during the year, a high population of Lymnaeid freshwater snails as intermediate hosts, and large pastures for ruminants provide appropriate conditions for the transmission of fascioliasis in this area.…”

Seroprevalence of Fasciola infection among Iranian patients hospitalized during the initial wave of COVID-19

“…Fasciola infection appears mainly in Europe, the Americas and Oceania, and some countries in Africa and Asia. According to the WHO, Iran is an important endemic area of fascioliasis, having many health problems and economic losses among the human and animal populations [6,7].…”