Advanced Biology Medical Response

Fasciola hepatica

Presented to

Mr .Andrew “James” Filipczak

By

Putt Choonhanirunrit 1101

Norapath Arjanurak 1102
Piyoros Iamphaibool 1104
Pume Albert Engkamaratron 1104
Tanagone Songvatanakamchon 1105

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Table of Content

1. Executive
Summary(BLUF)..................................................................................................3
2.Situation…………………….…………………...….…….……..…….....……….....4-8
2.1 Organism………………………..………………………….....…………...4-8
2.1.1 Life cycle…………………………………………........…….......4
2.2 Area………………...……………………………...……….....…………....6
2.3 Situation………………………….…………………………......…..………6
2.4Health…………………………...…………………………….....…..………8
3.Constraint/Restraint…………………….…………………………….....…...……...8
4. Response Procedure………………………………….…………….....……..…….9-15
4.1 Care for Sick…………………………………………………......………...9
4.2 Care for Abnormal People…………..……………………….......……….9
4.3 Crowdfunding………………………………………………….....…..…….10
4.4 Law………………………………………………………….....……..……..10
4.5 Projection……………………..…………………………….....…..…...…..11-12
4.6 Cost…………………………………………………..….….....……......…..13-14
4.6.1 Comparing Cost Now and Cost Delay……….....…….....…….15
5. Prevention Steps………………..…………………………………........…..………15
6. Conclusion………………...……………………………………….....…..………….16
7. Source……………………………………………………………….....……...……...17

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1. Executive Summary (BLUF)

- This is a medical response report for the outbreak infection that had occurred in
the northern part of Thailand. Symptoms that indicate an infection include, fever,
diarrhea, nausea, loss of appetite were common among the 202 who were
infected, if left untreated could be fatal with currently 34 fatal cases had been
recorded . The towns in the area were interconnected and there are no mass
transits between them, the infection might be caused from polluted regions near
the area that they live. The area is also populated with mammals, reptiles and
other species of animals. People in the area usually get their food and resources
from forest, livestock and river. The situation had been concluded as an outbreak
of ​Fasciola hepatica. This plan will include the current situation of the outbreak,
prevention steps and response procedures that will help in recovering the
townsfolk to full health and potentially eliminate any more outbreak in the future.

- A man presenting himself to the emergency room back in September of the

current year. He showed signs of nausea, fever and weight loss. A blood test
came out later in the day and doctors confirmed an infection and the doctor
speculates that by the time the patient presented himself to the hospital,
thousands of eggs had been laid in the patient’s liver. Later, the doctor
diagnosed him with Faciolosis or liver fluke infection. Upon further investigation,
we found out that the parasite can be found along with vegetation collected from
the river near town and since this vegetation is part of the townsfolk’s diet. From
the data, we can predict that the number of infected could potentially be reduced
by 15 cases per month until the number of cases reaches zero.

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2. Situation

2.1 Organism

- Common Liver Fluke is a type of Platyhelminthes or flatworms. There are

many species of a liver fluke but the one that is causing the infection
currently is Fasciola Hepatica or also known as Common Liver Fluke. This
species of Fluke can be found in every continent except for Antarctica
especially in areas where there are many livestocks like cows and sheep.

- People can get infected by eating watercress that contains immature

parasite larvae. Once inside, it burrows itself into the intestinal walls, into
the liver tissue, and into the bile duct where it matures and produces eggs.

- The life cycle begins when a female lays eggs in the liver of the infected
human and gets taken out by the feces. If it lands on the water, it will
hatch into larvae called miracidia. These larvae then invade aquatic snails
and develop until they have a large tail. Then it swims to aquatic
vegetation and forms a cyst called metacercaria. If the human eats the
vegetation with the cyst, the parasite will enter the human body and
penetrates the intestinal wall and makes its way to the liver where it
develops into an adult and the cycle continues.

- Treatable and preventable

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Life Cycle

1. Eggs of the liver fluke is excreted through organism’s feces

2. When conditions are right, the eggs hatched into larvaes
3. Once hatched, the larvae finds a host preferably a snail
4. Once inside the snail, the larvae will multiply and will leave the snail and seek
vegetations waiting to be eten
5. Once eaten by lifestocks, the larvae will burrow itself in the intestinal wall and
making its way to the liver
6. In the liver, the larvae will mature into an adult and produce eggs and the life
cycle continues

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2.2 Area

- Flora/Fauna
● Flora: Forest, Trees
● Fauna: Rats, Dogs, Mice, Bats, Snakes, Skinks, Snails, Freshwater Fish,
Mollusk
- Population
● Towns are interconnected with each other and have a total of 10,000
people.
- Diet
● Animals from the forest and rivers
- Local Economy
● Almost one-third of the population raises animal as a source of income
● Meats from livestock were exported to major cities

2.3 Situation

- Initial Condition
- At present, there are 202 known cases that have resulted in 34
deaths. the actual number of people infected may be much higher.

- Spread Potential
- If we intervene now, you predict that you can slow the rate of
infections by an average of 15 cases per month until 0 new cases;
but if we wait 3 months, we predict that you can slow the rate of
infections by 10 cases. per month. If we don’t do anything, the
infection rate will continue to rise.

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2.4 Health

- Signs/Symptoms:
- ​Abdominal pain
- Fever
- Nausea
- Vomiting
- Diarrhea
-​ ​Hives
- Malaise
- ​Decreased appetite and weight loss
- Prognosis (long term):
- ​Chronic infection, including right upper quadrant pain, loss of
appetite
and weight loss.
- long-lasting chronic inflammation of the bile ducts, ​resulting in
severe
symptoms and serious illness.
- if left ​untreated, infections may persist for up to 25–30 years.

3) Constraints & Restrains

Constraints

- We cannot harm any animals

- We cannot use human in the experiment
- We cannot eat a raw aquatic animal

Restrains

- We will not destroy the habitat of the animals living there

- We will not harm the environment.
- We will not kill any living things.
- We will not contaminate any water sources

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4. Response Procedures

4.1 Care for Sick

Fasciolosis can cause many symptoms, some of the common ones are
fever and diarrhea, each symptom can be treated differently with the use of
different drugs. If the patient experiences fever, an everyday household medicine
will be able to relieve some of the fever. Drugs like ​acetaminophen or tylenol and
ibuprofen are recommended over the counter drugs by doctors. The
recommended dosage of tylenol is ​352-650 mg every 4-6 hours. The dosage of
ibuprofen is 2​00 to 400 mg every 4 hours and a maximum of 3200 mg per day.

Diarrhea can cause the body to dehydrate due to excessive amounts of

water loss. The best way to treat diarrhea is to drink a large amount of fluid,
around 2-3 liters a day in order to compensate for the amount of water loss.
Some doctors might even recommend sports drinks as it contains mineral,
potassium, salt, and electrolytes. You should also avoid food that can produce a
large amount of gas. Also avoid exercising as it will cause dehydration in the
body.

4.2 Response for abnormal people

Make a serious responsibility for the old people and the people who have
a kidney problem. In this case, it had more chances for this group of people to
have severe symptoms. Immediately send a medical team to gather the patient.
This action is essential for saving older people or the one who has a problem
with his kidney to become more severe.

Some people don’t want to meet a doctor because they care about their
money. So in this case, we will announce that it is free to cure a patient in the
case that they had a symptom. This could make sure that most of the citizens will
be checked.

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4.3 Crowd Refunding(Ask for money)
Immediately proposing a charity or donation from major cities to help fund
the hospital to make the hospital more reliable and have the resources to treat
patients. The charity might hold an event like running the marathon or selling
goods and the money earned will be sent to the hospital.

4.4 Law
If the patients increase rapidly, the medical team would immediately
announce the warning to society. People should stop eating food that could
spread the fluke like aquatic plants or raw fish. In the case that people don’t listen
to the announcement, they would get punishment by paying 1000 Baht or
impermanent lock away. If they were captured or reported with efficient evidence.

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4.5 Projection

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4.6 Cost

Cost Now

Month Total Case Cost

September 1 1,000
October 4 4,000
November 14 14,000
December 39 39,000
January 68 68,000
February 103 103,000
March 155 155,000
April 202 202,000
May 234 234,000
June 251 251,000
July 253 253,000
August 253 253,000

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 Cost (Delay)

Months Total Case Cost

September 1 1,000
October 4 4,000
November 14 14,000
December 39 39,000
January 68 68,000
February 103 103,000
March 155 155,000
April 202 202,000
May 272 272,000
June 362 362,000
July 485 485,000
August 598 598,000
September 710 710,000
October 794 794,000
November 877 877,000
December 950 950,000
January 1013 1,013,000
February 1066 1,066,000
March 1109 1,109,000
April 1142 1,142,000
May 1165 1,165,000
June 1178 1,178,000
July 1181 1,181,000
August 1181 1,181,000

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 4.6.1 Comparing cost now and cost delay.
The factor that differentiate between now and delay is time. The money that is
used for a patiences in delay is higher than now responding. The delay responding
shows a long term infection, long time means more people are infected. On the other
hand, the now responding show that lower cost was used to cure patiences.

5. Prevention Steps
- Convince people to eat fully cooked water plant products by creating a campaign.
We will create a new academy for providing any beneficial information to citizens.
We will use this center to inform people in the nearby area. People will have long
term awareness.

- Inform people to avoid eating plants grown in areas where herbivorous mammals
(especially sheep) are found.

- Build a closed system farm for water plants to be able to control the quality of the
plants. How are we going to build up this system? We will ask for the supplement
(every material and staff). Engineers will help society to build a system in our
area.

- Bring experts to teach 10,000 people how to build a water filter system
throughout all households for people to be able to access clean water.

- Educate people on what are these parasites and how to avoid them as
mentioned above by bringing in experts and lecturers.

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6. Conclusion

The common liver fluke is a parasite which is found in the freshwater area. When
an organism drinks the water or eats the aquatic plants in that area. The parasite would
enter the body and stop to feed and reproduce at the liver.

The people should be aware that eating raw aquatic plants could lead to an
infection. If you are infected by the common liver fluke parasite would transport to your
liver causing abdominal pain, fever, nausea, etc. Tylenol will relieve some of the pain
and headaches. There will be experts to educate 10,000 people to understand the life
cycle of the parasite and to understand how the parasite affects your body. We will
cover all of the hospital bills for the patients who were infected with the parasite. If this
plan is operated, the number of people infected will decrease by 15 each month. If this
plan is delayed, the number of the infected would increase and the number of cases
would decrease by 10 each month.

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Source

1. https://www.healthline.com/health/liver-fluke#symptoms-and-side-effects
2. https://www.cdc.gov/parasites/liver_flukes/index.html
3. https://www.scops.org.uk/internal-parasites/liver-fluke/lifecycle/
4. https://reproductive17.weebly.com/common-liver-fluke.html
5. http://www.wormboss.com.au/sheep-goats/worms/flukes/liver-fluke.php
6. https://www.drugs.com/dosage/ibuprofen.html
7. https://www.medscape.com/answers/820200-27207/what-are-the-recommended-
maximum-daily-dosages-of-acetaminophen-in-adults-and-children
8. https://www.youtube.com/watch?v=KaZwZ3LKC-A
9. https://www.webmd.com/digestive-disorders/understanding-diarrhea-treatment#1
10. https://www.emedicinehealth.com/diarrhea/article_em.htm

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