Parasites (other) – Fasciola

Detection of Fasciola (liver fluke)
Microbiology
Parasitology
Microscopy ○ Stool Serology ○ Whole blood ○ Serum
Other Information
Stool
○ Collect 1 specimen per day (1 Yellow top and 1 White top container) for 3 days in each vial for a total of six (6) specimens per patient with suspected parasitic infection.

○ Ensure patient avoids anti-diarrheal medications, radiological dye (barium) and antibiotics prior to producing the specimen as they may interfere with parasite detection.

○ Please provide appropriate clinical information on the requisition (e.g. travel history or country of origin if refugee, returned traveller or recent immigrant, consumption of certain food products, eosinophilia, HIV, immunocompromise, critical illness, admitted to ICU or previous parasite infection. Foreign country MUST be identified on requisition.
○ Stool: Parasitology Kit (3 each of SAF yellow top vial, white top sterile vial)
○ Whole blood/serum: Serum separator tube (clotted blood) (min volume 5 mL)

Stool
○ Collect stool immediately after bowel movement in a dry, clean container (e.g. Chamber pot, wide-mouth jar, pie plate, newspaper, or saran wrap on toilet seat). Follow instructions below to add specimen to BOTH yellow and white capped containers. Specimen should not be contaminated with urine or toilet water.
Container 1 SAF (Yellow top) vial:
○ Use plastic spork attached to lid to add sample (from beginning, middle and end of stool) to yellow capped bottle so that the preservative fluid level is approximately ¾ full. Mix thoroughly by shaking. Ratio should be 1 part solid stool to 3 parts SAF or 1 part liquid faeces to 1 part SAF.

Container 2 Sterile (White top) vial:
○ Using plastic spork, Add stool directly to sterile white capped container.

Whole blood/serum
○ Decontaminate skin with 70% alcohol followed by iodine or chlorhexidine, collect at least 5 mL of blood into appropriate container

Refer to section Sample Processing / Delivery
PHOL
○ Microscopy: Up to 5 days from receipt at PHOL
○ Serology: Up to 42 days from receipt at PHOL
416-586-4800 extension 4595
NO
○ Label specimen container. Place specimens in biohazard bag and seal.. Transport specimen to the laboratory within 72 hours.

○ Specimens should be stored at room temperature (20-25˚C) and transported to the UHN/SH Microbiology Laboratory ASAP after collection. For stool, keep Yellow top tube (SAF vial) at room temperature while the White-top vial should be refrigerated (2-8˚C) prior to transport.

○ The specimen will be referred to the Public Health Ontario Laboratory for testing. PHOL will refer serology samples to NRCP