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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)

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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).

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