The public health burden due to foodborne trematodiases is predominantly due to morbidity rather than mortality with early and light infections often going unnoticed. Chronic infections are associated with severe morbidity with symptoms reflecting the organ in which the adult worms are located in.
Clonorchis and Opisthorchis species have adult flukes that lodge in the smaller bile ducts of the liver, resulting in inflammation and fibrosis of surrounding tissues. Acute or early infection may result in non-specific gastrointestinal symptoms. Chronic infection can result in cholangiocarcinoma, a fatal bile duct cancer. Both C. sinensis and O. viverrini are classified as carcinogens.
Fasciola adult worms lodge in larger bile ducts and gall bladder resulting in inflammation, fibrosis, blockage, colic pain and jaundice. Chronic infection can result in liver cirrhosis.
The final location of Paragonimus species is in the lung tissue, resulting in a chronic cough, blood-stained sputum, chest pain, dyspnoea (shortness of breath) and fever. These symptoms can be confounded with tuberculosis. Adult worms may also infect extra-pulmonary locations such as the brain and can result in symptoms of headaches, mental confusion, convulsions and cerebral haemorrhage
Foodborne trematode infections
Foodborne trematodes are a group of diseases that include the parasites Clonorchis, Opisthorchis, Fasciola and Paragonimus. These parasitic flukes have a complex life cycle involving diverse definitive hosts and one or two intermediate hosts. Foodborne trematodes cause infection in humans via the consumption of contaminated food (raw fish, crustaceans or vegetables). Infection can result in severe liver and lung disease and together these diseases are estimated to cause 2 million life years lost to disability and death worldwide every year.
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