Since childhood, we know how tasty and healthy fish is, boiled, fried, baked in the oven. We are told about phosphorus, iodine and omega-3, however, it is often forgotten to say that it is the fish that can be a serious cause of the not very pleasant disease called opisthorchiasis.
This disease has become quite widespread, in the world there are 21 million people who are infected with these helminths. This "uncontrollable" parasitic disease is very difficult to diagnose, its symptoms are diverse and nonspecific, it causes a number of serious complications, and its outcome is the most unfavorable.
It happens that patients for years are unsuccessfully treated by a pulmonologist, an allergist, an oncologist, and other specialists.
How can you get infected?
How does opisthorchosis infection occur, and what is it? Opisthorchiasis - a disease caused by flatworms of the class of flukes (opistorhis). The most common pathogens are liver flukes, cat and Siberian fluke. These are very small parasites of a lanceolate form with a length from 8 to 18 mm. They develop with the help of two intermediate hosts, after which they get to a person or any carnivorous animal, thereby infecting it and causing disease.
The main source of infection is a sick person or animal, whose feces along with the eggs of the parasite falls into the water. In the future, the eggs may be swallowed by the snails, in which the larvae of the parasite will multiply, then they will come out in the water in the form of larvae - cercariae.
In what fish is opisthorchosis known - cercariae are very abundant in fish of the carp family: we are talking about yazra, crucian carp, dace, roach, roach, rudd, carp and bream. The probability of infection from pike is extremely small. Sturgeon (sterlet), salmon (chum salmon, pink salmon, salmon) and sea fish are safe against infection with opistorch. Further development of cercariae occurs in the muscles and subcutaneous tissue of carp fish, where they turn into metacercariae.
Infection of humans and animals occurs when consuming invasive, poorly treated (raw, lightly salted) fish. In the gastrointestinal tract of the final host, under the action of the duodenal juice, the capsule and the membranes of the larvae dissolve, resulting in the metacercaries migrating to the common bile duct, intrahepatic bile ducts, and also to the pancreatic ducts.
In the hepatopancreatobiliary system, after 3-4 weeks, the metacercarium becomes a mature opistorchis capable of producing eggs. The full cycle of development of the helminth from the egg to the mature individual lasts 4-4.5 months. The invasion of a person by opistorhis can vary from a few to tens of thousands. In the organism of the final owner, the cat fluke can parasitize for 20-25 years.
Symptoms of opisthorchiasis
After infection with opisthorchosis, the symptoms in adults may not appear for quite a long time, but after the onset of the activity of helminths, they will not be difficult to detect.
Symptoms of opisthorchiasis will begin to appear as a result of the reproduction of larvae in the region of the liver and pancreas, after their detection, diagnosis and treatment should be immediate. Although the symptoms of opisthorchiasis are not life threatening, remember, treatment in the early stages of the disease is much easier.
Acute phase (or acute opisthorchiasis). Characterized by the development of a "bright" clinical picture:
- Soreness in muscles and joints.
- Bad appetite, weight loss.
- Soreness in the right hypochondrium, possibly the appearance of encircling pains with localization (location) of the inflammatory process in the pancreas with irradiation (spreading) in the left arm and / or the left half of the chest.
- Increased body temperature (up to 38-40 ° C) with chills, increased sweating, intoxication (poisoning) of the body.
- Allergic reactions - itchy skin, allergic urticaria (rash on the skin of an allergic nature, arising from the contact of an allergen (a substance that is perceived by the immune system as foreign and causes an allergic reaction) with the skin);
dyspeptic (digestive disorders) disorders (nausea, vomiting, diarrhea).
The clinical picture of acute opisthorchiasis is characteristic of many infectious diseases. Therefore, its diagnosis is difficult.
At this stage, it is possible to detect symptoms characteristic of diseases such as hepatitis, cholecystitis, pancreatitis, and gastroduodenitis. In chronic opisthorchiasis, the symptoms may be constantly present or occur periodically with alternating periods of exacerbation and remission (no symptoms of the disease).
In the right hypochondrium, paroxysmal pains, similar to biliary colic, are transmitted to the right half of the chest. Observed dyspeptic disorders. Since the parasite also affects the nervous system, this is manifested by the corresponding symptoms. The patient complains of fatigue, insomnia, irritability, nervousness.
There is increased sweating, tremor of the hands, eyelids and tongue. Quite often, neurological symptoms come to the fore, which contributes to misdiagnosis. In addition to the patient listed, allergic manifestations may occur (urticaria, pruritus, angioedema, food allergies).
How does opisthorchosis, in the photo you can see the causative agent of the disease.
In the case of opisthorchiasis, the diagnosis is difficult in the early period of the disease, since from the moment the onset of clinical manifestations of the disease to the release of parasite eggs with feces passes, on average, to six weeks.
Most often, the algorithm of diagnostic measures is as follows:
- Anamnesis is collected, during which it becomes clear whether the patient lived in a place where opisthorchiasis is often diagnosed, and if there were episodes of eating poorly processed thermal fish of carp.
- In general, a blood test revealed leukocytosis, increased ESR, a high degree of eosinophilia. Biochemical analysis of blood shows a decrease in the level of total protein in the blood, albumin, changes in liver enzymes.
- Comprehensive diagnosis is required, which is carried out on 3 specific markers - IgM, IgG, CEC, and they make it possible to accurately diagnose.
- Symptoms of the disease during ultrasound diagnostics of opisthorchiasis - diffuse changes in the liver, dilatation of the bile ducts and hepatomegaly.
Analysis of feces for opisthorchiasis is recommended to be carried out three times, with an interval of several days. This is due to the fact that it is not always possible to immediately detect the eggs of the pathogen. A more modern diagnostic test used to diagnose opisthorchiasis is the detection of worm DNA using a polymerase chain reaction. The method can be used in both children and adults.
Treatment of opisthorchiasis
If an adult has found the above symptoms, then one should not panic and despair, because the treatment of opisthorchiasis in adults, although problematic, can be found and rid the patient of parasites. In this case, the patient is prescribed drugs that kill the worms, thereby cleansing the liver and pancreas from their presence. This treatment is complex, it has several stages, and can be quite long.
The treatment regimen for opisthorchiasis involves several steps:
- Preparatory. It lasts from 10 to 20 days, depending on the severity of the course. During this period, drugs are prescribed to improve the condition and relieve common symptoms. These are antispasmodics, anti-inflammatory, anti-allergic agents. Bile preparations are used to optimize the flow of bile. Hepatoprotectors stabilize the liver.
- The second stage is direct degelmentization. The doctor recommends in each case a course of medicines aimed at eliminating the worms from the body. Self-treatment in such cases can have negative consequences, so you should strictly adhere to the scheme and course of the necessary drug, which are recommended by a specialist.
- The third stage (rehabilitation) is intended to restore the violations that occurred in the body as a result of invasion. In addition, it is taken into account that the person was treated with biltricid, which means that there is every reason to use choleretic therapy through various kinds of tubages, taking decoctions of herbs with choleretic effect and hepatoprotectors. Also during the entire rehabilitation period, the intestines should be cleaned with enemas or laxatives.
Against the background of drug treatment, it is undesirable to carry out treatment with traditional methods, since the load on the diseased liver is already so great. So it is better to wait until the praziquantel course is over.
The use of diet number 5 is effective in many cases of gastrointestinal diseases. And treatment of opisthorchiasis is not an exception. During the period of therapeutic treatment of opisthorchiasis, as well as for six months after, therapeutic nutrition for opisthorchiasis will contribute to recovery.
According to this diet, patients with opisthorchosis are recommended to eat boiled, steam and baked dishes, that is, those who have received a gentle heat treatment. You also can not eat sweet and muffin, very salty and spicy culinary products.
Prevention of opisthorchiasis
Primary prevention involves preventing the parasite from entering the human body.
- Opisthorchiasis occurs exclusively when infected with cysts of opisthorchis by eating fish that have not undergone proper cooking. Accordingly, you can protect yourself from infection by following certain rules for the selection and preparation of fish dishes.
- Boil the fish should be portioned at least 20 minutes after boiling, fish dumplings - at least 5 minutes from the moment of boiling. Fish (fish cakes) should be fried in portions in fat for 15 minutes. Large pieces of fish weighing up to 100 g should be fried in flattened form for at least 20 minutes. Small fish can be fried whole for 15-20 minutes. Fish pies must be baked for at least 60 minutes.
- Freezing; freezing time 7 hours at a temperature in the body of fish -40 ° C; 32 hours - at -28 ° C.
- Salting - salting in salt solution with brine density from the first day of salting 1.20 at 2 ° С; the duration of salting from 10 to 40 days, depending on the weight of the fish.
- Under no circumstances should you use raw water, be it water from streams, wells, or running water. At the same time, in order to know for sure that all the parasites that are in polluted water have died, it is better to boil it for at least ten minutes.
- Hands should be washed frequently. This is the simplest, but effective way by which a person effortlessly protects himself from the vast majority of infectious diseases.
If there are symptoms suggestive of infection, an examination should be performed, a stool should be given to detect eggs of worms and blood for opisthorchiasis. It should be remembered that a mature opistorchis that releases eggs develops from cysts for almost a month, respectively, the parasite can only be detected after this period.