Adult Opisthorchis viverrini Flukes in Humans, Takeo, Cambodia

infected by ingesting unwashed vegetables contaminated by animal feces containing strongyloid larvae. Larvae mature into adults in the intestines. Sporadic cases of this infection in humans have been reported in many countries (7). In France, several autochthonous cases were suspected, but because of their rarity and diffi culty in identifi cation, they are not commonly reported (8). Eggs of Trichostrongylus spp. can be differentiated from those of Necator and Ancylostoma spp. because they are longer, narrower, and elongated. After 6 days of culture, T. colubriformis nematodes can be distinguished from similar stages in Strongyloides and Ancylostoma spp. by the bead-like swelling at the tip of the tail. Except for isolation of adult worms, which are rarely found in feces, sequencing of the ITS2 region is the most accurate method for specifi c identifi cation of Trichostrongylus spp. isolated from humans. This familial outbreak highlights increased risk for animal parasitosis in humans in an industrialized country, which may have been caused by an increasing trend of persons using ecologic and organic farming methods. These cases confi rm that hygienic recommendations for use of organic fertilizer must be disseminated on a large scale. It is also mandatory that fresh vegetables be washed carefully and thoroughly before ingestion, and only dried manure should be used as an organic fertilizer.