Parasitic Diseases, Trematodes (Flukes)

Animals Involved

Cattle, sheep, water buffalo, horses, rabbits, other herbivores are definitive hosts; snails are intermediate hosts

Known Distributions

Worldwide or nearly worldwide; previously thought to be mainly in temperate areas but may be more widely distributed

Probable Means of Spreading

Ingestion of contaminated greens, eg, watercress, or water that contains metacercariae

Clinical Manifestations in People

Gastroenteritis, hepatomegaly, fever, urticaria possible acutely; biliary colic and obstructive jaundice in chronic cases; aberrant migration with extrahepatic signs (eg, pulmonary infiltrates, neurologic signs, lymphadenopathy, skin lesions or subcutaneous swelling) in some

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