INTESTINAL FLUKES - IS: Metacercaria

- Diagnosis: Finding eggs in the stool

1. Fasciolopsis buski - 1st IH: Snails (Semisulcospira libertina, Thiara, Hua ningpoensis)
- Known as the “Giant intestinal fluke” - 2nd IH: Salmonoid fishes (Plectoglossus alpitvelis, Salmo perryi)
- MOT: Ingestion - Testes: One big, one small
- IS to Human: Metacercaria
- 1st IH: Snails (Genus Segmentina, Gyraulus and Hippeotis) 3. Haplorchis yokogawai
- 2nd IH: Water chestnut (Eleocharis tuberosa) - 1st IH: Egypt: Pirenella conica; Japan: Cerithidea; Thiara
- Can cause eosinophilia as a symptom - 2nd IH: Egypt: Tilapia masomhica; Philippines: Biya; Japan: Acanthogobius
- Preventive Measure: Immerse aquatic vegetable in boiling water for a few seconds then wash with cool and - Testes: One big testis
clean water.

2. Echinostoma ilocanum
- Known as “Garrison’s Fluke”
- Discovered by Garrison
- Discovered from a native in Luzon (an Ilocano)
- A parasite of aquatic birds
- Not a parasite of humans; human only becomes an accidental host
- MOT: Ingestion of Metacercaria
- Diagnosis: Finding of eggs in stool
- Testes: Dumbbell in tandem
- 1st IH: Snail (Gyraulus convexiusculus)
- 2nd IH: Freshwater fish (Pila luzonica)

HETEROPHYIDS/HETEROPHID FLUKES
- known to be the smallest but deadliest, causing hemorrhagic brain convulsion, cardiac Beri Beri and paralysis

1. Heterophyes heterophyes
- MOT: Ingestion of raw or fresh mullets or fessikh (known as salted mullets) pickled for less than 14 days
- IS: Metacercaria
- DH: Humans, Dogs, Cats
- Diagnosis: Finding eggs in the stool
- Common among fish-eating mammals and fish-eating birds (pelicans)
- 1st IH: Brackish water snails (Egypt: Pirenella conica; Japan: Cerithidea)
- 2nd IH: Freshwater fishes (Egypt: Tilapia masomhica; Japan: Acanthogobius)
- Testes: Two lobed and obliquely oriented

2. Metagonimus yokogawai
- common in the Far East
- Synonyms:
-- In 1912, Kobayashi gave the name Loxotrema ovatun
-- In 1913, Yokogawa gave the name Metagonimus ovatus
- Common name: Yokogawat Fluke
- Disease: Metagonimiasis
- DH: Human, Cats, Dogs, Hogs
- MOT: Ingestion of Raw/freshwater fishes