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Journal of Clinical Microbiology, September 1998, p. 2723-2726, Vol. 36, No. 9
Departamento de
Parasitología1 and
Subdirección de
Epidemiología,2 Instituto de
Medicina Tropical "Pedro Kouri" (IPK), Ciudad de La Habana, Cuba
Received 12 February 1998/Returned for modification 16 March
1998/Accepted 27 May 1998
In the present study the dynamics of antigenemia and
coproantigens were studied in patients with
Fasciola hepatica infection during an outbreak occurring in
La Palma, Pinar del Río, in the West Province of Cuba. Stool
and serum samples were collected from 67 patients and 40 healthy
subjects. Stool samples were studied by a simple gravity sedimentation
technique and an ES78 sandwich enzyme-linked immunosorbent assay
(ELISA) for observation of eggs and detection of parasite
coproantigens, respectively. Serum samples were also
studied by the ES78 sandwich ELISA and an indirect ELISA to detect
circulating antigens and antibodies, respectively. At the beginning of
the study, 8 of 67 patients had patent infections and 59 had prepatent
infections, which was determined by the recent consumption of lettuce
contaminated with metacercariae of F. hepatica, the
presence of clinical symptoms, and the absence of Fasciola eggs in their stools. Patients with prepatent infections were monitored
by all techniques until patency. Circulating antigens were not detected
in patients with patent infections. However, coproantigens were clearly detected in all patients
with patent infections. On the other hand, 28.8% of patients with
prepatent infections tested positive for circulating antigens and
81.4% tested positive for coproantigens in the first
stool sample studied. Only two other coproantigen
determinations were necessary to diagnose 93.2% of the patients. While
circulating antigen levels diminished in all patients during the
infection, coproantigen levels increased. The present
study demonstrates that the ES78 sandwich ELISA is a better tool than
parasitological examination for diagnosis of active early infection,
since by the combination of the circulating-antigen detection assay and
the coproantigen detection assay 91% of patients were
able to be diagnosed at the beginning of the study. In contrast, a
coprologic analysis repeated over several weeks was necessary to
diagnose 100% of the patients.
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Dynamics of Antigenemia and Coproantigens during
a Human Fasciola hepatica Outbreak
*
Corresponding author. Mailing address: Departamento de
Parasitología, Instituto de Medicina Tropical "Pedro Kouri"
(IPK), Aptdo. 601, Zona 13, Ciudad de La Habana, Cuba. Phone: (53-7) 22 04 26. Fax: (53-7) 24 60 51. E-mail:
AMEspino{at}ipk.sld.cu.
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