Echinostoma Ilocanum

Common name: Garrison's fluke

Causing: Echinostomiasis

Introduction and morphology

- There are 11 species of flukes belonging to family

Echinostomatidae that infects human and of these only
one species confirmed endemic in the Philippines Eggs
- Straw colored
Adult worm - operculated
- Inhabits the small intestine - Ovoid
- Reddish gray in color - Measures 83-166 by 58-69u
- Measures 2.5 - 6.5 in length - Immature when passed out with the feces
- 1-1.35mm in width - It is Morphologically similar to eggs of Fasciola and
- Tegument is covered with Plaquelike scales Fasciolopsis except that it is Slightly smaller
- Anterior end is provided with a Circumoral disk,
surrounded with a crown of 49-51 spines

- Oral sucker lies in the center of the disk

- Ventral sucker is located in the anterior fifth of the body
- Testes are deeply lobed and are arranged in tandem
- Ovary is located in front of the testes
Cercaria
- Has simple tail and a body that resembles in miniature
form that of the adult worm
- Spination in the Circumoral disk or head collar is
similar to that in the adult worm
- Cercaria emerge from the snails 42-50 days after to
infect the second intermediate host which is also a
snails, Pila luzonica or KUHOL
- Cercaria will then transform into Metacercariae, and
when the infected snail is ingested, the Metacercariae
excyst in the Duodenum.
- The Juvenile fukes attaches itself to the intestinal wall
and develop into adult worm

Other common Echinostome species found in other countries

are E. malayanum, E. hortense, E, Lindoense and E,
malayanum was recently found to be in the Philippines

Life cycle
- Adultworm lives in the small intestine and produces
Pathology
immature eggs that is voided together with the feces
- Within the egg shell the larva develops into Miracidium
- Inflammation will occur at the site of attachment of the
in 6-15 days
worm, on the intestinal wall
- The Miracidium that hatches from the eggs infects two
- In heavy infections, Diarrhea sometimes bloody and
known species of Planorbid snails, Gyraulus
abdominal pain may also develop
convexiusculus and Hippeutis and daughter rediae
 - The absorption of the metabolites of the worms may
result in general intoxication

Diagnosis
- Demonstration of the egg in the stool by Fecalysis

Epidemiology
- Infection of this parasite is prevalent in Northern Luzon,
Leyte, Samar and Mindanao
- Surveys shows that it is present also in Rats and this
serves as an important reservoir host of the
parasite

- It is also found in Indonesia, India, China, and Thailand

- Acquiring infection of this parasites is attributed to the
habit or eating raw snails that serves as the second
intermediate host of the parasite

Treatment
- Hexylresorcinol, Tetrachloroethylene and Praziquantel
are the drugs of choice
- Infection can be prevented by thorough cooking of
snails that serve as the second intermediate host of
this parasite