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| Also known as:
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| '''Liver Fluke
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Fasciola Hepatica is an hepatic parasite found in ruminants, namely cows and sheep.  It is commonly found within the UK, with its prevalence ever increasing.  It is responsible for a 10-15% production loss in each infected animal, as it affects meat, milk and wool production, so is of huge economic consequence.
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{{Taxobox
*can cause severe haemorrhagic [[Liver - Anatomy & Physiology|liver]] damage
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|name              =''Fasciola hepatica
*death in heavy infestations in sheep during migratory phase (1 month) through the [[Liver - Anatomy & Physiology|liver]] tissue
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|kingdom            =Animalia
*recovered animals will have scarred [[Liver - Anatomy & Physiology|livers]]
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|phylum            =Platyhelminthes
*more commonly associated with chronic bile duct inflammation - cholangitis [need link to below]
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|class              =[[:Category:Trematodes|Trematoda]]
**the adults live in the bile ducts
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|sub-class          =Digenea
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|order              =Echinostomida
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|super-family      =
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|family            =Fasciolidae
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|sub-family        =
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|genus              =Fasciola
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|species            =''Fasciola hepatica
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}}
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Also known as: '''''Liver Fluke
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[[Image:Fasciola hepatica.jpg|300px|thumb|right|'''Fasciola hepatica (Copyright Adam Cuerden, Wikimedia Commons) ''']]
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==Introduction==
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'''Acute Fascioliasis'''
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''Fasciola Hepatica'' is an hepatic parasite of the class [[:Category:Trematodes|Trematoda]], found mainly in ruminants, namely cows, sheep and goats, but also known to affect horses, pigs, deer and man.  It is found Worldwide, and within the UK, with its prevalence ever increasing.  It is responsible for a 10-15% production loss in each infected animal, as it affects meat, milk and wool production, so is of huge economic consequence.
*acute disease associated with immature fluke migration through the [[Liver - Anatomy & Physiology|liver]]  
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*occurs in late autumn and winter
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*severity of outbreaks depend on a number of epidemiological factors
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*the [[Liver - Anatomy & Physiology|liver]] of animals which die of this disease will be
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**enlarged
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**haemorrhagic
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**honeycombed with the tracts of migrating flukes
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***tracts become filled with blood and degenerate hepatocytes later infiltrated with [[Eosinophils|eosinophils]], [[Lymphocytes|lymphocytes]] and replaced by fibrosis
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**surface is covered with a fibrinous peritonitis, especially the ventral lobe
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**subcapsular haemorrhages are frequent
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**rupture into the abdomen is not an uncommon finding
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[[Image:Fasciola hepatica - life cycle.jpg|300px|thumb|right|'''Fasciola hepatica life cycle(Copyright Centres for Disease Control and Prevention) ''']]
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''Fasciola Hepatica'' has a definitive ruminant mammalian host and an intermediate molluscan host (indirect life cycle). Within Europe the intermediate host is almost exclusively the amphibious snail ''Galba truncatula'' (previously called ''Lymnaea truncatulata''). The snail habitat is crucial to the survival of the parasite, so wet conditions are favourable to the development and spread of ''Fasciola hepatica''.
'''Chronic Fascioliasis'''
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======Gross======
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*[[Liver - Anatomy & Physiology|liver]] is reduced in size, unevenly
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**left lobe is most severely affected with atrophy of the extremities
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*hypertrophy may occur in some cases
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**dorsal lobe
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**this changes size and distorts shape of [[Liver - Anatomy & Physiology|liver]]
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*the surface will be uneven with areas of fibrous tissue replacing the cells damaged by the migrating flukes
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*bile ducts
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**prominent thick protruding white bile ducts on the '''visceral surface''' spreading from the hilus to the left lobe
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**the bile ducts are dilated, black, and calcified on '''cut surface'''
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**numerous adult flukes can be expressed from the bile ducts
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**chronic cholangitis
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**''''pipe stem'''' appearance in cattle because bile ducts are very much thickened and often calcified
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*bile
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**dark brown, thick, and gritty in consistency
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NB: the fibrosis which occurs in the chronic stage is realted only partly to the healing of the migratory tracts and the rest may be related to the development of immunity and rechallenge
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======Microscopically======
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[[Image:Fasciola hepatica.jpg|400px|thumb|right|''Fasciola hepatica'' <br> Adam Cuerden 2007, Wikimedia Commons]]
*reactive hyperplasia of the bile ducts
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*substantial inflammatory cell infiltrate and peripheral fibrosis
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*calcification of the chronically damaged tissue
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==Life Cycle==
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Adult flukes in the bile ducts shed '''eggs''' directly into the bile, which then subsequently enter the intestine. Eggs are then passed out in the faeces of the mammalian host, where they develop and hatch releasing motile ciliated '''miracidia'''.  These require 9-10 days at optimal temperatures, of around 22-26 degrees. The miracidium have a short life and must locate a suitable snail, the intermediate host, within approximately 3 hours if they are to be effective and continue the life cycle.
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If successful, the miracidium will then develop into '''sporocysts''', then enter the '''redial stages''' to the final stages within the intermediate host, which is development into '''cercaria'''.  These cercaria are then released from the snail, and attach to surfaces such as the tips of grass.  Here they encyst and form '''metacercaria'''. This represents the infective stage of the lifecycle. 
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Development from miracidium into metacercariae takes around 6-7 weeks under favourable conditions, however, this period can be much longer in unfavourable conditions.
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Upon ingestion by the final or definitive host from the grass, metacercariae  excyst to present as immature  flukes in the  small intestine. These then migrate  across the  peritoneal  cavity over a period of roughly one week, and invade the liver. Larvae continue to migrate within the hepatic parenchyma, becoming more destructive as they grow to a length of up to one centimetre. The young liver flukes migrate through the liver for around 6-8 weeks before entering the bile ducts where they mature to adults and begin to produce eggs. They may also migrate into the gall bladder, where they reach full sexual maturity.
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The prepatent period of ''Fasciola hepatica'' is 10-12 weeks. In untreated sheep it may survive and continue to infect for many years. In cattle it is usually less than 1 year.
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==Identification==
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The egg is relatively large; around 140μm x 70μm.  It is oval shaped, with a thin outer shell, and is browny-yellow.
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The fully mature adult fluke is a dark brown colour, and around 3cm in length.
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==Snail biology==
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[[Image:Lymnaea truncatula.jpg|thumb|right|150px|''Lymnaea truncatula'' - Francisco Welter Schultes, Wikimedia Commons]]
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=== ''Lymnaea truncatula'' ===
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''Lympnea truncatula'' is around 5-10mm long. It has a distinctive brown-black shell, with 5-6 spirals present on the outer surface.  The first spiral is approximately half the total length of the snail.
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It feeds on green slime, and when this is present in abundance, they may multiply rapidly.
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Most die in the British winter, due to the harsh, cold conditions, but they may survive in milder winters.  Survivors will lay eggs in spring, which will hatch in June.
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===Habitats===
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''Lymnaea'' are found predominantly in muddy areas, but do not survive well in highly acidic soils.  Habitats may be permanent; seen in dry summers or temporary; found in wet summers.
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===Epidemiology===
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Wet summers increase both the number of snail habitats and the hatching of fluke eggs, leading to many infected snails. These in turn shed many cercariae, which form a high density of metacercariae on herbage to increase the risk of fasciolosis. Conversely, in dry summers, fewer fluke eggs hatch and snails are restricted to their permanent habitats. Fewer snails become infected and cercariae and metacercariae numbers are low and confined to the areas where snails can survive. The risk of fasciolosis is therefore reduced.
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In temperate areas, there are two superimposed epidemiological cycles, known as the summer and winter infections of the snail. On mainland Britain, the summer cycle predominates as a high proportion of snails perish during the winter, but very occasionally, weather sequences allow the winter cycle to affect the pattern of disease. On the west coast of Ireland, the winter cycle of events determines the timing of clinical outbreaks.
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==== Summer infection of the snail ====
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The fluke eggs passed in spring will hatch in June. This coincides with the hatching of the snail. The miracidia will then infect the newly hatched snails, mature and then multiply within the snail hepatopancreas during the summer months.
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The cercariae are shed from late August onwards. The metacercariae develop and are ingested by a host; the sheep for example.  The immature flukes then migrate through the liver, causing acute disease between the months of September and November, or chronic disease from January onwards.
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====Winter infection of the snail====
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In this case the fluke eggs are passed in the late summmer, which then infect the snails.  Environmental conditions play a vital role in the success of the fluke development.  Temperatures below 10 degrees will see the development being haltered, and the flukes will remain trapped in the hibernating snails throughout the winter.  Development will then resume when temperatures rise above 10 degrees. The cercariae are then shed from July, and disease may be seen from August onwards.
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==Pathogenesis==
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The severity of the infection, [[Fasciolosis]], is mainly dependent on the number of metacercariae ingested.  The pathogenesis is often described as two-fold. The first stage occurring when the parasite migrates through the liver parenchyma, causing liver damage and haemorrhage.  The second phase occurs when the parasite is in the bile ducts, and damage is a result of the haematophagic activity of the adult flukes.
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{{Learning
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|literature search = [http://www.cabdirect.org/search.html?rowId=1&options1=AND&q1=%22Fasciola+hepatica%22&occuring1=title&rowId=2&options2=AND&q2=&occuring2=freetext&rowId=3&options3=AND&q3=&occuring3=freetext&publishedstart=2000&publishedend=yyyy&calendarInput=yyyy-mm-dd&la=any&it=any&show=all&x=46&y=7 ''Fasciola hepatica'' publications since 2000]
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|flashcards = [[Trematodes_Flashcards|Trematodes Flashcards]]
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}}
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==References==
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Taylor, M.A, Coop, R.L., Wall,R.L. (2007) '''Veterinary Parasitology''' ''Blackwell Publishing''
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G.L. Pritchard et al., Emergence of fasciolosis in cattle in East Anglia, ''The Veterinary Record'', November 5, 2005.
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{{review}}
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==Webinars==
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<rss max="10" highlight="none">https://www.thewebinarvet.com/parasitology/webinars/feed</rss>
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[[Category:Trematodes]]
 
[[Category:Liver Trematodes]]
 
[[Category:Liver Trematodes]]
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[[Category:Cattle Parasites]][[Category:Sheep Parasites]][[Category:Horse Parasites]][[Category:Pig Parasites]][[Category:Goat Parasites]]
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[[Category:To_Do_-_Max]]
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[[Category:Expert_Review - Parasites]]