Opisthorchiasis — Causes and symptoms of opisthorchiasis, diagnosis and treatment

Opisthorchiasis – what is it?

We are accustomed to the fact that the diet must include seafood, including fish is a frequent guest on our tables. It is served in various forms, as heat treated and raw. Its beneficial properties can not be underestimated. But few know that its use can lead to negative consequences, such as liver and pancreas, associated with opisthorchiasis. Opisthorchiasis – what is it?

Opisthorchiasis is a parasitic disease caused by worms of the class Trematoda. By eating infested fish they enter the body, causing disease. Often this disease is difficult to diagnose, but the number of people infected is high – 21 million worldwide, of which two-thirds of infected persons live in Russia. Opisthorchiasis is dangerous not only for liver but for the whole nervous system, can lead to a broad range of unpleasant symptoms, reduced performance.

Cause of disease

Pathogens — Opisthorchis felineus and O. viverrini. These worms are similar, infest the same organs and cause almost identical symptoms. They affect the liver and the pancreas of man, as well as the main domestic animals – cats and dogs, and other carnivorous mammals. Are infected most often through contact with infected people or food containing larvae of the parasite. The food is not dangerous if heat treated, but the risk of infection exists not only in the use of raw fish. Opisthorchiasis cause human also pieces of fish tissue caught in food because of improper use of a cutting Board: for example, it cut the seafood, and then the bread. Thus, the larvae fall into bread and then into the body, because the flour and similar products not thermally processed.

Life cycle of parasite development

Before getting into the human body, opistorchis is the development cycle of the parasite. To the definitive host, it uses two intermediate.

• Definitive hosts can be humans or other mammals. To them as the worm passes through certain animals. The first and second intermediate host are Cadiella shellfish and fish of the carp family:
• Cadiella — lives in fresh waters, rich vegetation and the bottom mud. When food intake swallows the larvae of the parasite, trapped in a body of water through the feces of the last owner.

Fish of the carp family — bream, Rudd, white-eye and many other representatives.

With the feces of a previous host eggs of the parasite get into the water and there swallowed a clam. Within two months, the parasite undergoes changes, becomes out of miracidia in cercaria. After leaving the body of the mollusk cercariae penetrate into the fish body, where it remains in the subcutaneous tissue and muscles. Here he is six weeks loses its tail, gets a double shell. After that the fish becomes fully infected, and people can become infected when it is not used.

Once in the intestine or the stomach of the definitive host, the parasite migrates to the liver, where a few weeks to reach sexual maturity. After that, he can stay in the body for 10-30 years.

Type of disease

The symptoms of opisthorchiasis differ depending on the amount trapped in the body of larvae, immunity, infection, and disease. There are two varieties: acute and chronic opisthorchiasis. In chronic disease you may mistakenly diagnose hepatitis or pancreatitis, and symptoms alternate with periods of exacerbation and remission. This is the stage when the disease becomes milder after the acute stage. Acute disease is characterized by a reaction to the penetration of the parasite, similar to the symptoms of allergic. It also produce symptoms of intoxication. In acute form, the symptoms subside after 2 weeks, while the incubation period is 21 days.

Symptoms for opisthorchiasis

Symptoms vary depending on the type of disease and can be diagnosed incorrectly due to the similarity with other diseases. Will help determine the opisthorchiasis of the following symptoms.

The symptoms of chronic opisthorchiasis

To point to a disease such as opisthorchiasis, maybe next:

• Persistent pain in the right hypochondrium
• Dyskinesia of the gallbladder
• Dyspeptic syndrome
• Reduced endurance, rapid loss of vitality
• Problemschair
• The increase in body temperature by 0.5-1 °C
• Swelling of the eyelids with the appearance of them lighter lesions
• Cracks on the tongue
• Insomnia, nervousness and other problems with the nervous system
• Hand tremor
• Angioedema
• Food allergies and itching, but in a smaller form than in the acute phase

Pain often manifest seizures, Allergy symptoms, weak, but in rare cases can be almost flush with the acute form. The typical symptoms of hepatitis, gastroduodenitis, cholecystitis.

Symptoms of acute opisthorchiasis

The symptoms of this phase are most pronounced and can not only reduce the level of human forces, but to deprive him at the time of disability. Highlight:

• The increase in body temperature to 38 or even 40 degrees
• Poor appetite
• The weight loss
• Increased sweating, intoxication
• Allergic reaction with symptoms of hives
• Nausea and other dyspepsia
• Pain in the hypochondrium, as in the acute form
• Pain in the joints
• In severe catarrhal phenomena of upper respiratory tract, lose them like pneumonia
• Increasing fever

Featuring a range of brighter pronounced than in the chronic form, the symptoms, the acute form is still not as dangerous to health.

Consequences and complications of opisthorchiasis

Opisthorchiasis, a dangerous disease that if not treated, and late treatment can cause several complications, such as:

• Cancer of the liver and its ducts
• Ulcer
• Cholangitis
• Rupture of the biliary tract
• Acute or chronic hepatitis
• Abscess of the gallbladder
• Mechanical jaundice
• Purulent cholangitis
• Peptic ulcer of the duodenum

Complications often develop in chronic course of the disease when the effects on the body almost incessant.

Diagnostics

There is a specific procedure in the diagnosis of opisthorchiasis, consisting in several stages. Problems arise when the early attempts of detection of the disease, because the incubation period takes up to six weeks.

Traditionally there are four stages, but at the moment it is not regulated:

• Medical history, in which found out all the details of the period prior to the infection. Data is collected on the meals of the patient, it turns out, lived-in areas of intense transmission. The defining characteristics most likely to be techniques food fish of carp breeds are bad or do not thermally processed
• Detection through a blood test a few signs: leukocytosis, a high degree of eosinophilia. If the decrease level of protein, albumin, or a change in liver enzymes is a serious reason to believe that the patient is suffering from opisthorchiasis.
• Comprehensive diagnostic criteria IgM, IgG, CEC. They allow accurate diagnosis, in contrast to the other stages.
• If no accurate opinion about illness, resort to determination through ultrasound. Discusses the patient for changes in the liver, hepatomegaly and enlargement of the bile ducts.
• Can also be used to identify the DNA of the worm with the help of modern diagnostics is the polymerase chain reaction.
• 4-6 weeks after infection accurate diagnosis is made with detection of the parasite in the stool.

Some studies need to take place repeatedly, because the incubation period of the parasite can remain undetected.

Treatment

Find out what opisthorchiasis, and after discovering the exact symptoms of this disease, you need to start treatment. The symptoms of opisthorchiasis can be smoothed with the help of improvised means, for example antipyretics, but the complete disappearance of the disease must undergo treatment.

There are three stages of treatment:

• Preparatory. At this time, prescribers for improving the condition of within 10-20 days. The preparatory stage allows you to prepare for the intensive course of treatment and overcome the initial symptoms.
• Degelmintizatsiya. At this stage, get rid of parasites directly, thus saving us from disease. After a course of degelmintizatsii the patient is often weak, he needs rest.
• Rehabilitative. It allowed not only to rejuvenate, but also to avoid reactivation of the disease: the patient may not be until the end free from the parasite, so it requires the supervision of a physician.

In accordance with the stages used the following medications:

1. Allergy, sorbents, detoxifying of the body, medicines against inflammation and bacteria.
2. De-worming, choleretic drugs. Medicine, specializing in the fight against opisthorchiasis.
3. Vitamins and minerals, enzyme and choleretic drugs and hepatoprotectors.

Based on this system of treatment, the doctor prescribes medicines for each patient individually. As the drugs and dosage depend on the physical characteristics of the patient: the immune system, tolerance to drugs and the like. You should not self-medicate, consult a doctor.

Prevention

Undoubtedly, prevention will help to reduce the risk of disease and complications, often very severe. It lies in a few simple actions related to hygiene and eating raw foods.

1. Never used General choppingBoard for finished products and those that must undergo heat treatment. Getting the first particles from parasites will inevitably lead to disease.
2. Treat the food before its use – this applies not only to fish but also meat, because the final host can be and some mammals. Heat treatment is the most reliable, Smoking or salting even can reduce the risk, but not completely.
3. Heat treatment may consist in heat and cold. The best option is to freeze food for 7 hours at -40 ºC.
4. Do not eat raw, unboiled water. Parasites are often there, and not only in natural bodies of water — wells in particular. You want to boil water for at least 10 minutes to be sure to get rid of the larvae.
5. Frequent hand washing is the surest way to get rid of parasites, obtained through contact with an infected.
6. After bathing in the waters thoroughly clean your body, do not take food without washing hands. This is for freshwater, because in the sea of this parasite in its pure form is not found.

Under the prevention can involve the immune system strengthening, since the person is able to cope with the disease in rare cases and without the help of a doctor (only in the initial stages). Use vitamins and other ways of its increase will not only help to cope with the disease in the case of the small amount trapped in the body of parasites, but then it is easier to transfer the disease.

Subject to these terms of prevention there is a huge probability forever to protect themselves from infection opisthorchiasis, whose consequences no one wants to experience.