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Flatworm and Flukes


Flatworm fascinate me, especially the blood fluke.  Blood flukes are parasitic right from the word ‘Go’ and remain parasitic throughout their entire life cycles As free-swimming larvae, they are released into freshwater by infected snails.  They either penetrate the skin of a human host or are ingested with vegetables, fish or crustaceans.  Once inside us they’re resident in our veins for 20 to 30 years.

Let’s look at the overall picture first.  The three main classes of flatworm are:

1.   Tapeworms:  only in the adult stage are tapeworms parasitic, lodged in the digestive tracts of animals and humans.  We covered tapeworm in some detail in our February 2007 newsletter so I won’t repeat anything here.

2.   Planarians:  these are aquatic, free-living and non-parasitic.  Although soft, very thin and delicate, planarian flatworms are active carnivores eating other living, as well as dead, invertebrates and decaying organic matter.  The worms can quickly glide along sea or river bed by using the fine hair-like cilia which cover their body. When disturbed they can swim for a considerable period of time by throwing the sides of their body into undulating waves.

We often think of animals hunting and fighting for food, but flatworms appear to hunt and fight for mates. Each worm is hermaphroditic, containing both ovaries with eggs and testes with sperm. Some even have two penises and one or more genital pores for receiving a two-tailed sperm delivered during copulation.

Flatworms have both male and female sex organs in the one animal. If you think about it, that's a great way to be. If you're rare and you're looking for a mate and you're traveling alone, you don't have to meet another female or another male. You just have to meet another one”.  Leslie Newman

Using new camera technology, Marine Biologist Leslie Newman of Australia's Southern Cross University participated in filming two marine flatworms engaging in some odd reproductive behaviour -- referred to as ‘penis fencing’.  During penis fencing, each flatworm tries to pierce the skin of the other using one of its penises.  For flatworms the contest is serious business. The winner becomes the male, delivering its sperm into the other which becomes female, expending considerable energy caring for the developing eggs.  At the end of the film clip the narrator says the losing flatworm has to ‘….bear the burden of motherhood’.  “A typical male perspective!” my wife tells me, adding “The true winner is the one who nurtures and creates the next generation.”

Penis Fencing Film Clip

3.   Flukes are parasitic in various parts of different humans and animals. It is the blood fluke that we are focusing on here.

There are several types of fluke - blood flukes, liver flukes, oriental lung flukes, sheep liver flukes and intestinal flukes, tissue flukes, zoonotic flukes, lancet flukes and a host of others.  The differences vary in where and how you become infected, as well as where and how they will damage you internally.   

Liver, oriental lung, sheep liver, and intestinal flukes are transmitted via food; blood flukes are transmitted in swimming or bathing water.  If you live in the UK, Europe, North America or Canada it is likely that any fluke contamination you have will have been picked up on holiday in somewhere  tropical.  Areas such as Africa (especially Egypt), South America, the Caribbean and China are worst affected.   Please don’t think that by enjoying your annual holidays somewhere local, you are completely safe from blood flukes.  They can be brought right to your table in food imported from abroad.  The symptoms you might encounter include urinary problems, liver problems, hepatitis, abdominal pain, liver abscesses, fibrosis, diabetes, diarrhoea, and vomiting.

Blood Flukes or Schistosomes: The dangers of travelling in countries like Africa are not only restricted to lions, snakes and crocodiles. If you bathe, wade or swim in fresh water you could become infested with blood flukes that cause a disease called Schistosomaiasis (you may be more familiar with its other name - Bilharzia).  This produces fevers and chills but elevates the number of white fighter cells causing abdominal pains with enlargement of the liver and spleen.

Animal Planet has created a great animated cartoon that shows the life-cycle of the blood fluke - click here 

Blood flukes break some of their own cardinal rules. Not only do they skip a larval developmental stage that other flatworms go though, but flukes are not hermaphrodites.  Flukes have separate male and female sexes, the male being larger than the female (normally in parasites, the female is larger because eggs take up more room than sperm). They can also be mistaken forroundworm – their apparently cylindrical body is unlike that of any other fluke.

On closer examination this "round" body is really the flat fluke's body curled up like a tube of paper. The reason for this body shape is that the blood fluke lives in the blood vessels of its host - a wide flat body is not good for moving through cylindrical tubes. The groove created by the fold in the male fluke provides a place for the female worm to sit during mating. Once mature, flukes stay attached and mating for life.

What exactly is inside our veins?

There are three major species of blood flukes infecting humans: Schistosoma mansoni and Schistosoma haematobium are found in Africa.  Schistosoma mansoni lives in the veins draining the intestines, so infection with this species results in intestinal upset and produces eggs in the faeces.  Schistosoma haematobium lives in the veins draining the bladder and causes cystitis and blood in the urine, with eggs passed out with the urine as well.  Schistosoma japonicum (Oriental Blood Fluke) is found in Asia, and lives in the veins draining the intestines, resulting in similar symptoms to Schistosoma mansoni although somewhat more acute in presentation.

Once inside the hosts portal and mesenteric veins, they attach themselves to the walls by means of their suckers and, after mating, lay their eggs into the blood stream. The eggs pass down the blood vessels until they become too large to proceed.  Most blood fluke eggs have a spine or knob which shears through the wall of the blood vessel like a can-opener. Helped by muscle movement from the host, the egg works its way through the tissue until it passes out with the faeces or urine. 


Schistosomiasis is not easy to diagnose.  The female worms produce very few eggs, and these eggs are not easy to find using routine stool tests.  Because the worms are found deep in the tissues, conventional drugs used to treat them must be capable of reaching them, and frequently have nasty side effects on the human host. In rare cases, the blood fluke may lodge in sensitive spots - in a recent case, schistosomiasis caused paraplegia after the worms lodged in the spine.

To evidence the presence of flukes a blood test will reveal an elevated white blood cell (eosiniphil) count. This is only a general indcator that the host may have other parasites such as roundworm, hookworm, toxocara, pinworms and strongyloides.  Even certain drugs will raise the white blood cell count. Many doctors dismiss the elevated eosiniphil count as being caused by allergies, not realizing that the primary allergen is the parasite itself.  Urine testing will also evidence blood fluke eggs in the urine sediment.  Since the female adult fluke lays her eggs around the anal area, the application of clear scotchtape to the anal area first thing in the morning will recover the eggs of the blood fluke as well as those from beef and pork tapeworm.

Diagnostic Laboratories – Dr Omar Amin Ph.D

If you feel you have any parasitic infestation at all my recommendation would be to contact Dr Omar Amin in Tempe, Arizona.  Google him.  Dr Amin is highly regarded in the industry and does an enormous amount of charity work in Africa and Mexico.  His identification of parasite infestation is far greater, and he is considerably less expensive than many of the better known diagnostic labs in the UK or North America.

When travelling abroad (particularly to Africa and Asia) please heed the warnings and avoid swimming in bodies of freshwater. Every now and then a sports team on a tour ignores this advice, and comes back with something to keep the local doctors guessing.


Cattle, sheep, goats, pigs and occasionally rabbits, become infected when they graze low-lying, marshy pastures that have been contaminated by the fluke, which in turn have been released by host snails.  Flukes can only be picked up where snails are present, but, because flukes take many weeks to mature inside cattle, adverse effects may not be apparent until long after stock have left the infective pastures.  After ingestion by grazing cattle, the young fluke make their way to the liver and browse through the tissue until at about 8 weeks of age they penetrate the bile ducts, where they spend the rest of their adult lives. 

Harmful effects

The liver is such a fundamentally important organ in the body.  Fluke damage can lead to a variety of different problems including reduced weight gain, poor nutrition conversion, reduced milk production and poor fertility.  Cattle with fluke infestation may be more susceptible to a variety of other infections, such as Black disease and salmonellosis.

The Global Impact

Around 200 million people are infected with blood flukes of which some 20 million are severely ill and many more just show symptoms.  The impact of flukes can play havoc with economic development, especially in tropical developing countries. Schistosomiasis is at present the world's second most prevalent infectious disease - second only to malaria.  Hulda Clark, Ph.D, maintains that parasites and pollution cause all illness, and that intestinal flukes are the worst parasite in existence.  So the fluke is a true heavyweight in terms of disease.

Irrigated agriculture which creates permanent shallow freshwater channels has been a major factor promoting the spread of schistosomiasis, although measures are in place to reduce the numbers of water plants and snails, treat sewage effectively and keep it out of irrigation water.

Blood flukes have a complex effect on the immune system of the people they infect, some of which may be the direct result of substances secreted by the worms. It has been suggested that these make people more susceptible to diseases such as HIV and tuberculosis.  Death from infection is rare and is usually observed only in patients with a heavy worm burden. Flukes can affect both children and adults, but children are affected more severely.

We often have questions about a statement I made in the November 2006 newsletter on how parasites can manipulate the behaviour of their host.  To show how this works within the animal kingdom I’ll finish with the Lancet Fluke.

Lancet Flukes start life as eggs found in the dung of cattle. This dung is fed upon by snails which allow the eggs to enter the snail's intestine. Once inside, the eggs hatch and burrow into the digestive gland of the snail. The flukes reproduce in this gland and are expelled from the snail in slime trails.

Ants happen upon the slime and consume it as a source of moisture thus taking the new flukes into their system. Once inside, the parasite shows an interesting tactic. By controlling nerve centers of the ant they are able to control its behaviour. When the sun sets and temperatures drop the ant is compelled to attach itself to a tall blade of grass by its mandibles. Here it waits to be ingested by some grazing animal. If the ant survives the night the sun prompts it to return to the colony and live its life normally, until the next night.  Flukes living within ants are eaten by cattle while grazing. The flukes will enter the digestive system and force their way into the cow's liver, where they will grow to adults capable of producing eggs.  These eggs are then expelled in the dung of cattle to begin their life cycle.

Here are two final clips.  The first shows how parasites influence the behaviour of their snail host….. 

Watch this film on a parasites life cycle using snails and birds.

If you’d like to see a variety of parasite images go to Duncan Griffiths website.  He does a great website on Koi Carp and has a movie section where there are several clips to download

We have what we know to be the most broad spectrum herbal formula that helps eliminate parasites: Natural Balance has been used for over 100 years to eliminate toxins; similarly Natural Cleanse her been used for over 500 years to eliminate parasites.  Both have their origins in Ancient Phoenician recipes.

Customer Feedback:

With Natural Cleanse I find that the parasites are starting to come out of me.  One white worm was 2 1/2 in long.  This morning I must have removed 50 to 100 worms from my stomach. It’s looking good Graeme – keep the good work up. I think there’s an angel helping you with these wonderful herbs.  Also I am telling all my friends about this wonderful herbal treatment for worms we cannot see with our eyes.  Must clean from the inside out – not the other way. 

A.R.  Lincolnshire

With my thanks to Leslie Newman, The Wellcome Foundation, Carl Zimmer, Duncan Griffiths and Anne Louise Gittelman.

Graeme Dinnen 



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