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Volume 15, Number 11—November 2009
Letter

Imported Human Fascioliasis, United Kingdom

Meera A. ChandComments to Author , Joanna S. Herman, David G. Partridge, Kirsten Hewitt, and Peter L Chiodini
Author affiliations: Hospital for Tropical Diseases, London, UK (M.A. Chand, J.S. Herman, P.L. Chiodini); Royal Hallamshire Hospital, Sheffield, UK (D.G. Partridge); Health Protection Agency Centre for Infections, London (K. Hewitt); London School of Hygiene and Tropical Medicine, London (P.L. Chiodini)

Main Article

Table

Characteristics of human fascioliasis case-patients during enhanced surveillance, United Kingdom, January 1, 2008–January 31, 2009*

Case no. Age, y/sex Country of origin Years since migration Other travel Risk factor Clinical features Eosinophil count, x109/L) Abnormal liver function Hepatic imaging IFAT†
1 45/F Yemen 7 Yemen regularly Khat use Abdominal pain 8.4 Yes Mixed-density liver lesion (CT) 1:128
2 44/M Somalia 16 Ethiopia 2007 Khat use Fever, abdominal pain 3.4 Yes Serpiginous lesion (MRI) 1:64
3 34/F Ethiopia 3 S. Africa regularly Khat use Fever, abdominal pain 11.4 No Heterogeneous lesion (USS) 1:128
4 44/F Somalia 7 Somalia 2004, Netherlands Khat use Abdominal pain 8.3 No Heterogeneous lesion (USS) 1:128
5 54/F Somalia 21 (to Netherlands),
4 (to UK) None Khat use Anorexia 8.4 No Low-density lesion (CT) 1:32
6 43/M Somalia 28 (to India), 21 (to UK) None Khat use Fever 1.0 Yes Heterogeneous lesion (USS) 1:128
7 28/F UK – Uganda 2007–2008 – Abdominal pain, hepatomegaly 1.84 Yes Hepatomegaly with large mixed cystic and solid lesion (USS) 1:512
8 67/M UK – Kenya 2008, prior world travel – Malaise, abdominal pain 0.04 Yes Multiple gallstones (MRCP) 1:256
9 38/M Ethiopia 10 Ethiopia 2006 – Abdominal pain, fever 18.7 Yes Normal (USS, MRCP) 1:128
10 28/M Ethiopia Unknown Unknown – Fever, gram- negative sepsis; new HIV diagnosis <0.04 Yes Lesion in hepatic vein 1:64
11 47/F Somalia 16 (to Yemen),
6 (to UK) Unknown Khat use Abdominal pain, fever 16.8 Yes Low-density lesion (CT) 1:256

*IFAT, immunofluorescent antibody test; CT, computed tomography; MRI, magnetic resonance imaging; USS, ultrasound scan, MRCP, magnetic resonance cholangiopancreatography.
†Titer of IFAT (screening titer 32).

Main Article

Page created: December 09, 2010
Page updated: December 09, 2010
Page reviewed: December 09, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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