The autochthonous cases of acute opisthorchiasis in the Moscow region

Acute stages of parasitic diseases are rare diagnosed and therefore, clinicians have limited knowledge of their clinical features. We describe five autochtnonous acute cases of opisthorchiasis  in Moscow region acquired from eating raw ides ( L. idus). The most frequent clinical symptoms were febrile, eosinophilic syndrome with cholestasis.  The patients were positive for IgG antibodies to O.felineus . Eggs of O.felineus were found in one patient. As egg production O.felineus starts 1 month after exposure and opisthorchiasis cases in Moscow region have low numbers of worms, the sensitivity of microscopy is low. Therefore we consider opisthorchiasis in all patients of unexplained acute fever, pain in upper right abdominal quadrant, and eosinophilia with cholestasis, when patients confirm the ingestion of raw fish.  We recommend one day of praziquantel 25 mg/kg TID to patients infected with O.felineus . In previous publications describing the  autochtnonous  cases of opisthorchiasis  in Moscow region  the authors supposed that cases of local infection will be found again in Moscow region, and this is just a matter of time. The cases reported here confirm that this infection is endemic  in Moscow region.  The local people living close to rivers  especially those who eat raw fish  are at risk of infection  O. felineus .  There is a clear need to undertake special studies pertaining to the ways of promoting people living in Moscow region become aware of  opisthorchiasis and to be motivated in preventive measures and treatment.