Fascioliasis and paragonimiasis, which are caused by liver flukes (Fasciola) and lung flukes (Paragonimus), are emerging public health problems. Several hundred millions of people are at risk of the two diseases that cause considerable morbidity and delay socio-economic development. Triclabendazole, a benzimidazole derivative, has been routinely used since 1983 in veterinary medicine to control infections with Fasciola spp. in domestic herbivorous animals. In 1986, a veterinary formulation of triclabendazole was first administered to two human patients with fascioliasis. Clinical data obtained thus far suggest that triclabendazole is the most efficacious and best tolerated drug for the treatment of fascioliasis. Moreover, the drug holds promise as a useful therapeutic alternative to praziquantel in the treatment of paragonimiasis. This review of triclabendazole includes an overview of the pharmacodynamics and pharmacokinetics, toxicology and efficacy against the major food-borne trematodes in laboratory animals. Data from case reports and clinical trials in humans infected with Fasciola spp. and Paragonimus spp. are summarised and the current state of triclabendazole regarding treatment of human fascioliasis and paragonimiasis is described. Efforts to facilitate broader registration of this drug should go hand-in-hand with research and development on novel drugs against food-borne trematodiasis, better access to improved sanitation, sound health education and the development of new technologies for assuring food safety.

Tabanids were collected in an area in northern Germany, where pastured cattle were abundant. Trypanosomatidae were identified in 14% of tabanids examined. Twelve cattle became infected with Trypanosoma theileri after applying usually 2-5 infected tabanids, to the intact oral mucosa. Haematopota pluvialis, Haematopota italica, Hybomitra micans and Tabanus bromius were identified as vectors. Infective stages of Trypanosoma theileri were identified in the gut and in the faeces of tabanids by transmission experiments. The minimum prepatent period was less than 4 days. No apparent signs of disease were observed in the infected cattle.

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