An outbreak of acute fascioliasis among aymara indians in the bolivian altiplano

Jostein Bjorland, Ralph T. Bryan, Wilma Strauss, George V. Hillyer, James B. Mc Auley

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78 Scopus citations


Fasciola hepatica is a common and important parasite of sheep, cattle, and other ruminants. In May 1991, 30 persons with possible acute fascioliasis were identified by health care providers at a district hospital in the Bolivian Altiplano, and two deaths were associated with this illness. A cross-sectional survey of a random sample of 30 (20%) of the 148 households in the community and a case-control study were performed to determine the extent of the outbreak and the vehicle of transmission. Ninety-one members from 23 of the 30 selected families participated in the cross-sectional survey. Twenty-one of the 91 members met the case definition for acute fascioliasis (illness since 16 February 1991 that was characterized by fever and abdominal pain plus serum IgG antibodies to F. hepatica), and 38 (49%) of 78 members had serum IgG antibodies to F. hepatica. If this rate is extrapolated to the entire community, an estimated 116 individuals (23% of 504) would have acute fascioliasis and 247 individuals (49% of 504) would have evidence of current or previous infection. Case-control analysis indicated that the only factor associated with illness was eating kjosco (an aquatic plant) while tending animals in the fields; 27 (52%) of the 52 case-patients vs. 9 (14%) of the 66 controls ate kjosco (OR = 6.84; 95% CI = 2.60, 18.44). The cause of the two deaths attributed to fascioliasis could not be firmly established. Fascioliasis is a significant human health problem and is highly endemic in the Aymara Indian community in the Bolivian Altiplano. Efforts to prevent fascioliasis should include educating people to avoid eating uncooked aquatic plants such as kjosco.

Original languageEnglish
Pages (from-to)1228-1234
Number of pages7
JournalClinical Infectious Diseases
Issue number5
StatePublished - Nov 1995
Externally publishedYes

Bibliographical note

Funding Information:
Received 25 July 1994; revised 7 July 1995. The use of specific trade names is for identification only and does not indicate the endorsement of the U. S. Public Health Service. Grant support: G. V. H. was supported by National Science Foundation— Experimental Program to Stimulate Competitive Research grant no. EHR-9108775. Reprints or correspondence: Dr. James B. McAuley, Department of Pediatrics, Rush-Presbyterian-St. Luke's Medical Center, 1653 West Congress Parkway, Chicago, Illinois 60612-3833.


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