Fascioliasis in Man: An Outbreak in Hampshire

During the autumn of 1958, in the Hampshire market town of Ringwood (population 7,000), several patients presented themselves with a mysterious illness characterized by pain in the right hypochondrium and an irregular pyrexia lasting over six weeks.The most striking finding in each case was the presence of a marked eosinophilia.Some form of helminthiasis was naturally suspected, and the symptoms suggested the possibility of infection with the liver fluke Fasciola hlepatica.This theory was supported by the evidence of a veterinarian that the incidence of the infection among local farm animals was very high.A preliminary notification of this outbreak has been published (Facey, 1959).Six cases are here reported, in five of which the diagnosis was subsequently confirmed by the findir-g of ova of F. hepaitica in the faeces.Several other cases with similar symptoms were se2n, but have not been included because the diagnostic evidence was not fully conclusive.So far as we can discover this is the first occasion that epidemic infection with this helminth has been recorded in Britain.A search of the records back to 1903 has revealed reports of 12 cases, but all were isolated observations and in most of them the parasite was found at operation or necropsy (Ward, 191 1; Owen, 1928; Patterson, 1928; Biggart, 1937; Manson- Bahr and Walton, 1941 ; Shaw and Clyne, 1941; O'Donnell, 1949; Murphy and Pascall, 1950, three isolated cases; Ramage, 1951 ; Catchpole and Snow, 1952).Ward refers to four earlier cases, bringing the number up to 16 in all.Several hundred cases have occurred abroad, including a number of outbreaks of acute illness due to the invasive stage of the disease.