Liver and intestinal flukes.

A number of trematodes besides schistosomes parasitize humans and domesticated animals. Although they do not have as great a public health impact as schistosomiasis, they are prevalent in Southeast Asia as well as among the greater than 1 million immigrants from this region to North America. The human biliary flukes include C. sinensis, O. viverrini, and O. felineus. These chronic infections are often asymptomatic but over time may cause biliary thickening, cholangitis, and a predisposition to cholangiocarcinoma. Zoonotic trematode infections include the sheep liver fluke F. hepatica and the intestinal flukes Fasciolopsis, Echinostoma, Heterophyes, and Metagonimus.