Epidemiology of human fascioliasis: a review and proposed new classification

The epidemiological picture of human fascioliasis has changed in recent yea rs. The number of reports of humans infected with Fasciola hepatica has inc reased significantly since 1980 and several geographical areas have been de scribed as endemic for the disease in humans, with prevalence and intensity ranging from low to very high. High prevalence of fascioliasis in humans d oes not necessarily occur in areas where fascioliasis is a major veterinary problem. Human fascioliasis can no longer be considered merely as a second ary zoonotic disease but must be considered to be an important human parasi tic disease. Accordingly, we present in this article a proposed new classif ication for the epidemiology of human fascioliasis. The following situation s are distinguished: imported cases; autochthonous, isolated, nonconstant c ases; hypo-, meso-, hyper-, and holoendemics; epidemics in areas where fasc ioliasis is endemic in animals but not humans; and epidemics in human endem ic areas.