[4] Most immunodiagnostic tests detect infection with very high sensitivity, and as concentration drops after treatment, it is a very good diagnostic method.

[4] Humans are infected by eating watergrown plants, primarily wild-grown watercress in Europe or morning glory in Asia.

Veterinary vaccines are in development, and their use is being considered by several countries on account of the risk to human health and economic losses resulting from livestock infection.

[4] Educational methods to decrease consumption of wild watercress and other water plants have been shown to work in areas with a high disease burden.

The resulting cholangitis and cholecystitis, combined with the large body of the flukes, are sufficient to cause mechanical obstruction of the biliary duct.

In this phase, biliary colic, epigastric pain, fatty food intolerance, nausea, jaundice, pruritus, right upper quadrant abdominal tenderness, etc., are clinical manifestations indistinguishable from cholangitis, cholecystitis and cholelithiasis of other origins.

In case of obstruction, the gall bladder is usually enlarged and edematous with thickening of the wall (Ref: Hepatobiliary Fascioliasis: Sonographic and CT Findings in 87 Patients During the InitialPhase and Long-Term Follow-Up.

Adnan Kabaalioglu, Kagan Ceken, Emel Alimoglu, Rabin Saba, Metin Cubuk, Gokhan Arslan, Ali Apaydin.

[18][19] Economical effect of fasciolosis in sheep consists in sudden deaths of animals as well as in the reduction of weight gain and wool production.

In this case, the disease is similar to sheep and is characterized by weight loss, anemia, hypoalbuminemia, and (after infection with 10,000 metacercariae) death.

As C. novyi is common in the environment, black disease is found wherever populations of liver flukes and sheep overlap.

[31] Human F. hepatica infection is determined by the presence of the intermediate snail hosts, domestic herbivorous animals, climatic conditions, and the dietary habits of man.

In Europe, Nasturtium officinale (common watercress), Nasturtium sylvestre, Rorippa amphibia (wild watercress), Taraxacum dens leonis (dandelion leaves), Valerianella olitoria (lamb's lettuce), and Mentha viridis (spearmint) were reported as a source of human infections.

[17] Occasionally, ectopic locations of flukes such as the lungs, diaphragm, intestinal wall, kidneys, and subcutaneous tissue can occur.

[4] In humans, diagnosis of fasciolosis is usually achieved parasitologically by findings the fluke eggs in stool, and immunologically by ELISA and Western blot.

[citation needed] Moreover, in many human infections, the fluke eggs are often not found in the faeces, even after multiple faecal examinations.

The antigenic preparations used have been primarily derived from extracts of excretory/secretory products from adult worms, or with partially purified fractions.

In addition, biochemical and haematological examinations of human sera support the exact diagnosis (eosinophilia, elevation of liver enzymes).

This situation (with its potential for misdiagnosis) can be avoided by having the patient follow a liver-free diet several days before a repeat stool examination.

However, clinical signs, biochemical and haematological profile, season, climate conditions, epidemiology situation, and examinations of snails must be considered.

Individual people can protect themselves by not eating raw watercress and other water plants, especially from endemic grazing areas.

[11] Vegetables grown in fields, that might have been irrigated with polluted water, should be thoroughly cooked, as should viscera from potentially infected animals.

[4] Only clorsulon and albendazole are approved for use in the treatment of domestic animals in the United States, but the available flukicides used worldwide also include triclabendazole, netobimin, closantel, rafoxanide, nitroxynil, and oxyclozanide; however, this list of available drugs has some drawbacks.

[57] Closantel, nitroxynil, and oxyclozanide are not effective against young liver flukes and should only be used to treat subacute and chronic infections.

[58] The timing of treatment is critical for success, and is determined by environmental factors and analysis of the expected distribution and prevalence of the disease.

The predictions are dependent on guessing when environmental conditions that are most conducive to parasite multiplication will occur, such as the amount of rainfall, evapotranspiration, and the ratio of wet to dry days in a particular month.

[citation needed] Studies carried out in recent years have shown human fasciolosis to be an important public health problem.

For instance, in South America, hyperendemics and mesoendemics are found in Bolivia and Peru where the veterinary problem is less important, while in countries such as Uruguay, Argentina, and Chile, human fasciolosis is only sporadic or hypoendemic.

fall into five main chemical groups:[62] Triclabendazole (Fasinex) is considered the most common drug due to its high efficacy against adult as well as juvenile flukes.

[67] Countries where fasciolosis in livestock was repeatedly reported:[citation needed] On September 8, 2007, Veterinary officials in South Cotabato, Philippines said that laboratory tests on samples from cows, carabaos, and horses in the province's 10 towns and lone city showed the level of infection at 89.5%, a sudden increase of positive cases among large livestock due to the erratic weather condition in the area.