Trematodes

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Background

Microbiology

  • Trematodes (flukes) are platyhelminths
  • All have an intermediate snail host, and most have a second intermediate host before reaching humans via ingestion of the intermediate
Organism First intermediate Second intermediate Distribution
Blood flukes
Schistosoma haematobium Bulinus none; penetrates skin Africa and the Middle East
Schistosoma intercalatum Bulinus Central and West Africa
Schistosoma japonicum Oncomelania Asia
Schistosoma mansoni Biomphalaria Africa, the Middle East, and South America
Schistosoma mekongi Neotricula Southeast Asia
Intestinal flukes
Echinostoma ilocanum snails and fish Middle and Far East
Fasciolopsis buski water vegetables, especially watercress, bamboo, and water chestnuts China, Thailand, India, Bangladesh, with pig reservoir
Heterphyes heterophyes fresh-/brackish-water fish Middle and Far East
Metagonimus yokogawai fish Middle and Far East
Liver flukes
Clonorchis sinensis (Chinese liver fluke) fish China, South Korea, Japan, Vietnam, and eastern Russia; common
Dicrocoelium dendriticum (lancet liver fluke)
Fasciola gigantica underwater vegetation Africa, Hawaii, western Pacific, Southeast Asia
Fasciola hepatica (sheep liver fluke) Lymnaea underwater vegetation, especially watercress Bolivia and Peru, but also Europe, South America, and Middle East, near sheep rearing areas
Metorchis conjunctus (Canadian liver fluke)
Opisthorchis felineus Western Europe and Siberia
Opisthorchis viverrini (Southeast Asian liver fluke) freshwater fish Southeast Asia
Lung flukes
Paragonimus westermani Semisulcospira seafood, especially crayfish or crab China, Japan, Korea, the Philippines, and Thailand