Objectives  To improve the diagnosis of human fascioliasis caused by Fasciola hepatica and Fasciola gigantica, we evaluated the diagnostic accuracy of an enzyme‐linked immunosorbent assay (ELISA), with Fasciola antigen from the adult liver fluke, for the detection of IgG against fascioliasis in human sera.Methods  The sera of 54 fascioliasis cases, originating from three endemic areas, were used in this evaluation: (i) a hyperendemic F. hepatica area where humans usually shed a great number of parasite eggs in faeces (11 sera); (ii) an epidemic F. hepatica area where humans usually shed small amounts of parasite eggs (24 sera) and (iii) an overlap area of both Fasciola species and where human shedding of parasite eggs in faeces is usually scarce or non‐existent (19 sera). One hundred and sixty‐eight patients with other parasitic infections and 89 healthy controls were also analysed.Results  The respective sensitivity and specificity of this assay were 95.3% (95% confidence intervals, 82.9–99.2%) and 95.7% (95% confidence intervals, 92.3–97.5%). No correlation between egg output and the OD450 values of the F. hepatica IgG ELISA test was observed.Conclusions  This test could be used both as an individual serodiagnostic test for human fascioliasis when backed up by a compatible clinical history together with a second diagnostic technique for other cross‐reactive helminth infections, and in large‐scale epidemiological studies of human fascioliasis worldwide.

Human fasciolosis is a re-emerging disease worldwide and is caused by species of the genus Fasciola (F. hepatica and F. gigantica). Human fasciolosis can be diagnosed by classical coprological techniques, such as the Kato-Katz test, to reveal parasite eggs in faeces. However, although 100% specific, these methods are generally not adequate for detection of acute infections, ectopic infections, or infections with low number of parasites. In such cases immunological methods may be a good alternative and are recommended for use in major hospitals where trained personnel are available, although they are not usually implemented for individual testing. We have developed a new lateral flow test (SeroFluke) for the serodiagnosis of human fasciolosis. The new test was constructed with a recombinant cathepsin L1 from F. hepatica, and uses protein A and mAb MM3 as detector reagents in the test and control lines, respectively. In comparison with an ELISA test (MM3-SERO) the SeroFluke test showed maximal specificity and sensitivity and can be used with serum or whole blood samples. The new test can be used in major hospitals in hypoendemic countries as well as in endemic/hyperendemic regions where point-of-care testing is required. Fasciolosis is an important plant-borne trematode zoonosis. This disease is of both clinical and veterinary relevance and, according to the WHO, is considered a re-emerging disease that is spreading around the world. Fasciolosis has a serious impact on health because of the large size of the parasite and the effects of the parasite in down-regulating the host immune response. Human fasciolosis can be distinguished by an acute phase, in which the parasite migrates through different tissues, and a chronic phase in which it invades the bile ducts. Here we describe the development of a rapid, simple and inexpensive immunochromatographic diagnostic method, based on the use of a recombinant cathepsin L1 protein, which performs better than other more complex indirect methods, providing similar specificity and higher sensitivity. The simplicity of the method represents a great advantage for the intervention systems applied in different endemic areas by WHO, such as passive case finding (e.g. Vietnam) and selective treatment (e.g. Egypt). Because of its characteristics, the system can be applied to both phases of the disease, and in holo, meso and hyperendemic areas where point-of-care testing is required.

The risk of infection with Anisakis has been recognized for some time, but it is now emerging due to major awareness, better diagnostic techniques, and increasing preference for raw or lightly cooked food. Spain has the second-highest reported incidence after Japan, though the real anisakidosis burden is unknown because of the scarcity of epidemiological data. This study provides a 19-year review of anisakidosis-related hospitalizations describing epidemiological trends and patient characteristics. We performed a retrospective descriptive study using the Spanish Hospitalization Minimum Data Set from 1997 to 2015. Hospitalization rates were calculated and spatial distribution of cases and their temporal behavior were assessed. Clinical characteristics were described, including related codiagnoses and procedures. A total of 2471 hospital discharges were identified. A continuous increasing trend was observed, with several peaks. Most affected communities were located in the northwest inland part of the country. Almost 54% of hospitalized patients were male, with a mean age of 51.3 years. Median length of stay was 5 days, and the hospitalization median cost around €2900. Fatal outcome occurred in 0.5%. Most frequent codiagnoses were digestive diseases, mainly intestinal obstruction. Urticaria, anaphylactic reaction, and angioneurotic edema were only recorded in 2.2%, 2.4%, and 1.2%, respectively. Knowing that hospitalization is unusual in anisakidosis, we offer calculations of the real disease burden. Improving disease surveillance in parallel to disease control will be useful both in gaining extended disease knowledge and reducing morbidity and related costs.

Helminth infections impact the health of hundreds of millions of persons globally and also cause important economic losses in livestock farming. Methodological limitations as well as the low attention given to the study of helminths have impacted biological research and, thus, the procurement of accurate diagnosis and effective treatments. Understanding the biology of helminths using genomic and proteomic approaches could contribute to advances in understanding host–helminth interactions and lead to new vaccines, drugs and diagnostics. Despite the significant advances in genomics in the last decade, the lack of methodological adaptation of current transgenesis techniques has hampered the progression of post-genomic research in helminthology. However, the application of new techniques, such as CRISPR, to the study of trematodes and nematodes has opened new avenues for genome editing-powered functional genomics for these pathogens. This review summarises the historical advances in functional genomics in parasitic helminths and highlights pending limitations that will need to be overcome to deploy transgenesis tools. Graphical Abstract