Let's learn more about liver flukes. This is important for you too!

Have you ever heard of liver flukes? You might be thinking, 'Oh, I can't get them.' But some things we do without realizing it can cause these conditions. So today, let's talk about what liver flukes are, how they enter the body, and how we can protect ourselves.

What is Liver Fluke?

Simply put, liver flukes are parasitic worms . They live in our bodies and suck our nutrients. It's like they're just coming into your home uninvited and eating all the food and drink in the house. Liver flukes can damage your liver, gallbladder, and bile ducts . The main ways they get into your body are by eating raw or undercooked fish, aquatic plants (especially watercress), or drinking dirty water. They can affect farm animals like cattle and goats, as well as pets like dogs and cats.

Although these worms are not directly fatal, they can live inside your body for a long time . A chronic infection like this can cause inflammation of the liver and damage organs. In some cases, this condition can even lead to dangerous diseases like cancer.

Are there different types of liver worms?

Yes, there are several types of liver flukes that affect humans. We are mainly talking about three types:

• Clonorchis sinensis: This is the most common type of liver fluke infection. The infection caused by this type is called clonorchiasis .
• Opisthorchis: There are two species of this parasite that affect humans. They are O. viverrini (Southeast Asian liver fluke) and O. felineus (feline liver fluke). O. viverrini is the second most common species that causes liver fluke infections. Infections caused by these species are called opisthorchiasis .
• Fasciola: There are two types of this, F. hepatica and F. gigantica, that can infect humans. These infections are called fascioliasis . However, this type of Fasciola is more common in farm animals than in humans.

What are the symptoms of a liver worm infection?

Now you're probably thinking, 'Okay, how do I know if I have this?' There are some common symptoms that are common to all types of liver fluke infections. They are:

• Nausea
• Vomiting
• Abdominal pain or tenderness
• Diarrhea
• Constipation
• Fever
• Feeling cold (Chills)
• Skin rash
• Difficulty breathing (dyspnea)
• Muscle aches
• Swollen lymph nodes
• Sore joints

Importantly, some people may not have any symptoms at all, or they may not pay much attention to symptoms if they do.

How do these liver worms get into the body?

Okay, now let's see how these worms get into our bodies. The larvae of the Opisthorchis and C. sinensis worms live in the form of fluid-filled cysts in the bodies of freshwater fish. The cysts of the Fasciola worms can be found floating in the water or embedded in aquatic plants such as water lilies.

So, you get this worm infection if you eat something that has these infected cysts in it. When these cysts get into your digestive tract , they break open and the larvae come out. Then these larvae travel to your liver, gallbladder, and bile ducts, where they grow into large worms.

So, exactly how does this spread?

You can get a liver fluke infection from things like:

• There is also a risk from eating raw or undercooked fish. There is also a risk from eating lightly salted, smoked, or pickled fish.
• Eating raw watercress or other aquatic plants (these may contain worm larvae).
• By drinking dirty, contaminated water or accidentally swallowing such water.
• Eating vegetables washed in contaminated water, or vegetables grown in such water.

Is this disease contagious?

No, liver fluke infection is not contagious . This means that it is not contagious.

Who is at higher risk of developing this?

If you live in an area where liver flukes are common, or have traveled to one, and if you work with animals such as cattle and goats, you are at increased risk of developing this infection.

Where are these liver worms most common?

Liver flukes require specific environmental conditions to survive and reproduce. Therefore, although they are found all over the world, they are more common in specific areas than in every country. Different types of liver flukes are found in different parts of the world. For example, the type `F. hepatica` can be found on almost every continent except Antarctica. `C. sinensis` is common in countries like China, South Korea, and Vietnam. `O. viverrini` is found in Asian countries like Thailand and Laos.

What complications can occur if left untreated?

If a liver fluke infection is not treated properly, conditions such as:

• Malnutrition
• Enlarged liver (hepatomegaly)
• Liver scarring or `fibrosis`
• Gallbladder inflammation or `cholecystitis`
• Bile duct inflammation or `cholangitis`
• Bile duct cancer (cholangiocarcinoma)

Not only that, but these liver flukes can also travel to other parts of your body. For example:

• Pancreas
• Lungs
• Skin
• Urinary tract
• Eyes
• Brain

How do you accurately diagnose this disease?

To find out for sure if you have a liver fluke infection, a doctor will take a stool sample and look for parasites in it. They may take samples more than once, over several days. In addition, they may do the following tests:

• Blood tests: These check for antibodies against parasites (called serology), liver function, and an increase in a type of cell called eosinophils in the blood. An increase in eosinophils can be a sign of a parasitic infection.
• Imaging: With an ultrasound, CT scan (computed tomography scan), or MRI (magnetic resonance imaging), your doctor may be able to see signs of a liver fluke infection (such as cysts).
• Liver biopsy: This involves taking a small piece of tissue from the liver and examining it for signs of parasites.

How do I get rid of these liver worms? (Treatment)

Doctors treat liver fluke infections with antiparasitic medications . Some examples are:

• Triclabendazole (this is given for Fasciola infections)
• Praziquantel (This is given for Opisthorchis and Clonorchis infections)
• Albendazole (also given for Opisthorchis and Clonorchis infections)

What to expect if you have a liverworm infection?

Antiparasitic drugs can cure liver flukes when taken for a short period of time (about one to seven days) . However, if left untreated, liver flukes can live in your body for five to twenty-five years . People who have this infection for a long time can develop serious health problems, such as damage to the liver, gallbladder, and bile ducts.

How do you prevent these liverworm infections?

There are several things you can do to reduce your risk of developing liver fluke infections:

• Do not eat watercress and other aquatic plants raw.
• Do not eat raw or undercooked freshwater fish. This includes fish that has been smoked, pickled, or lightly salted. When cooking fish, cook it to the temperature recommended by the FDA (Food and Drug Administration).
• Wash vegetables well, peel them, or cook them well before eating.
• If you live in an area with poor sanitation or where you think the water may be contaminated, use bottled water for drinking and cooking.
• Avoid putting potentially contaminated water into your mouth or nose, especially from places like swamps, ponds, or waterlogged meadows.

When should I see a doctor?

If you have symptoms of a liver fluke infection, especially if you live in an area where these worms are common or have traveled to one , be sure to see a doctor. If you think you may have eaten or drunk something contaminated, even if it was years ago , tell your doctor .

When should I go to a hospital (ETU) as soon as possible?

If you have these severe symptoms, go to an emergency room immediately:

• If the fever is higher than 103 Fahrenheit (40 Celsius).
• It's okay if you're vomiting heavily, or if you have diarrhea.
• If there is confusion or disorientation.
• If your skin or eyes turn yellow (jaundice).
• If you have symptoms of dehydration (e.g., excessive thirst, very little urination, weakness, increased heart rate).

What questions should you ask the doctor?

When you see a doctor, you may find it helpful to ask questions like these:

• "How do I take this medicine?"
• "How long will it take me to get well?"
• "How long have I had this infection?"
• "Have I suffered any long-term damage?"
• "What is my outlook in this situation?"

Are these liver flukes common in humans? Why is it called "liver fluke"?

It is estimated that about 50 million people worldwide are infected with some form of liver fluke. These infections are very common in parts of countries such as China, Thailand, and Russia.

Why is it called a 'Liver Fluke'? 'Fluke' is the common name given to a type of flatworm ('trematodes' or parasitic flatworm) . Some people may confuse it with a type of flatfish, which is also called a 'fluke'. These worms are called 'liver flukes' because they affect the liver.

So, what are the most important things we should take home from this story?

Liver fluke infection is something that we don't often hear about in Sri Lanka, but in some parts of the world, millions of people may have it, perhaps without even knowing it. If you live in an area where these worms are common, or if you have traveled to one, it is very important to be aware of the symptoms of this infection. If you have symptoms, or if you think you may have eaten or drunk something unclean, don't forget to tell your doctor . Because, if this continues for a long time, it can lead to serious illnesses, but there is usually quick and effective treatment. Therefore, if you have any doubts or symptoms, it is best to seek medical advice.

` Liver fluke, Parasitic infections, Liver disease, Eating raw fish, Aquatic plants, Health