Chinese liver fluke
Mareike Müller is a freelance writer in the medical department and assistant doctor for neurosurgery in Düsseldorf. She studied human medicine in Magdeburg and gained a lot of practical medical experience during her stays abroad on four different continents.
More about the experts All content is checked by medical journalists.Chinese liver fluke (Clonorchis sinensis) is a parasite. The suction worm infects the bile ducts in humans and causes inflammation there. It is particularly common in East Asia. The Chinese liver fluke can be treated well with a wormer. Read everything you need to know about the Chinese liver fluke here.
ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. B66
Chinese liver fluke: description
The Chinese liver fluke (Clonorchis sinensis or Opisthorchis sinensis) is a small, lanceolate worm. The parasite causes the infectious disease clonorchiasis (opisthorchiasis) in humans. Sometimes related species are also triggers of the disease: Opisthorchis felineus (Cat liver gel) and Opisthorchis viverrini.
The Chinese liver fluke belongs to the class of flukes (trematodes) and is a hermaphrodite. It is mainly found in Southeast Asia, but also in the South Pacific, Africa and the Middle East. The parasite needs a host to feed on. Depending on the stage of development, it parasitizes in various host animals, including humans. About 40 million people in East Asia are infested with the Chinese liver fluke.
Chinese liver fluke: symptoms
A Chinese liver fluke mainly affects the bile ducts. Therefore, clonorchiasis manifests itself primarily through symptoms that are caused by an obstruction or inflammation of the biliary tract. These include:
- Loss of appetite
- Bloating
- diarrhea
- Inflammation of the gallbladder (cholecystitis) with pain in the upper right abdomen
- Inflammation of the liver (hepatitis)
- Jaundice (jaundice): discoloration of the conjunctiva of the eyes and skin
A Chinese liver fluke infestation does not always cause problems. Many patients do not notice him. Only when there are over 100 worms in the body do patients complain of symptoms.
Chinese liver fluke: causes and risk factors
As a parasite, a Chinese liver fluke uses other living things to reproduce and mature. When the larvae (miracidia) of Clonorchis sinensis When they get into fresh water, they look for water snails as intermediate hosts. In them they mature into another type of larva - the zirconia. These are released into the water, where they can pierce the skin of carp-like freshwater fish, which they use as a further intermediate host.
If the infested freshwater fish is then eaten by humans, dogs or cats, the larvae enter the bile ducts of these final hosts via the gastrointestinal tract. There they grow into sexually mature, two centimeter large liver fluke within about four weeks. They lay eggs, which are excreted in the stool through the host's intestines.
Chinese liver fluke: risk factors
The most important risk factor for contracting Clonorchis sinensis is the consumption of raw fish. Therefore, make sure that fish is always heated sufficiently long and strongly (to 55 ° C) during preparation. As a result, the larvae die and humans can no longer become infected.
A Chinese liver fluke also benefits from poor hygienic conditions. If fecal matter is not disposed of professionally, but the wastewater is discharged into surrounding waters, the worm eggs get out of the stool into fresh water. There they meet water snails, in which they develop further.
Chinese liver fluke: examinations and diagnosis
If you feel sick after a stay abroad, you should first see your general practitioner. He asks you in detail about your medical history (anamnesis). Possible questions are:
- Where have you been abroad?
- At what time were they there?
- Did you eat fish there?
- Since when are you having those complaints?
Your doctor will then examine you. He will feel your stomach to examine it for pain. Then he feels the edge of the liver and your spleen to determine whether the organs are enlarged.
In the case of diarrheal illnesses, the physical examination is often ambiguous, so that you have to analyze a stool sample for various pathogens in a laboratory. A Chinese liver fluke is not detected directly. Rather, worm eggs are sought in stool, bile or secretion from the duodenum (duodenal secretion).
Chinese liver fluke: treatment
If worm eggs have been found in the stool by the Chinese liver fluke, you will receive a drug with the active ingredient praziquantel. This is a wormer (antihelminthic) that can be swallowed. It paralyzes and kills the Chinese liver fluke. The parasite is then excreted in the stool. Praziquantel must be taken for three weeks. Then the stool is again examined for worm eggs.
Chinese liver fluke: disease course and prognosis
With correct and quick treatment, a Chinese liver fluke infestation has a good prognosis. Without therapy, however, the parasite can survive in human bile ducts and lay eggs for up to 30 years. The long and constant irritation of the biliary tract increases the risk of malignant diseases such as bile duct cancer (bile duct carcinoma). A Chinese liver fluke also increases the risk of liver cirrhosis, gallstones, inflammation of the pancreas (pancreatitis) and enlargement of the liver and spleen (hepatosplenomegaly).
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