Imported Human Fascioliasis, United Kingdom

To the Editor: We initiated enhanced surveillance for human fascio-liasis after a reported increase in livestock cases in the United Kingdom. human cases were confi rmed by the reference laboratory for England and Wales, compared with 6 cases during the preceding 10 years. The Scottish reference laboratory detected no human cases during the study period. Fascioliasis was defi ned as a positive Fasciola immunofl uorescent antibody test with a screening titer of 1:32 and either compatible clinical or radiologic features consistent with the disease. We obtained clinical and radiologic information from the referring physician. Clinical features of both acute and chronic infection include fever, upper abdominal pain, malaise, eosinophilia, and impaired liver function; therefore, distinguishing between the 2 phases can be difficult. Fifty percent of chronic infection is subclinical (1,2). Compatible radio-logic features are capsular enhancement with contrast, hypodense nodu-lar areas, and low-density serpiginous lesions (2). Our analysis comprised 11 cases (Table). Two patients were white British, both of whom had recently traveled to sub-Saharan Africa. Cases from the preceding 10 years diagnosed in our laboratory were all in persons with histories of travel to fascioliasis-endemic areas. Therefore, these cases do not provide fi rm evidence of indigenous zoonotic transmission within England and Wales.