Advertisement

Langenbeck's Archives of Surgery

, Volume 388, Issue 4, pp 209–217 | Cite as

Epidemiology of echinococcosis

  • Thomas RomigEmail author
Current Concepts in Clinical Surgery

Abstract

Background

Various species and infraspecific forms of the cestode genus Echinococcus are causative agents of human echinococcosis. Pathology, epidemiology and geographical occurrence vary widely between the different Echinococcus taxa. As a general rule, those forms of echinococcosis that are transmitted mainly by wild animals are rather rare, due to limited contact between humans and wildlife. This is the case with alveolar echinococcosis (AE) caused by Echinococcus multilocularis, the 'fox tapeworm' (except in regions where domestic dogs are heavily involved in the lifecycle), and for the South American endemic species E. oligarthrus and E. vogeli. On the other hand, most forms of cystic echinococcosis (CE) are transmitted in domestic lifecycles involving dogs and livestock and constitute an emerging public health problem, especially in regions with extensive livestock husbandry and non-supervised slaughter.

Method

This review focuses on two fields where a wealth of new information became available in recent years.

Results and conclusions

New data demonstrate that 'E. granulosus', the causative agent of CE, is an assembly of several, rather diverse, species and genotypes that show fundamental differences, not only in their epidemiology, but also in their pathogenicity to humans. This fact may explain the unequal distribution of high-endemicity areas for human CE on regional scales, which previously, has been attributed to differences in human behaviour. In addition, new data suggest that E. multilocularis is expanding its geographical range in the northern hemisphere, and its transmission is intensifying, e.g. in central Europe. Moreover, the lifecycle (involving wild foxes and rodents) is rapidly becoming 'urbanised' due to the recent establishment of fox populations in cities and towns. This shift from sylvatic to synanthropic occurrence is likely to result in an increased pressure on the human population of infection from AE.

Keywords

Echinococcosis Hydatid disease Epidemiology 

References

  1. 1.
    Macpherson CNL (1983) An active intermediate host role for man in the life cycle of Echinococcus granulosus in Turkana, Kenya. Am J Trop Med Hyg 32:397–404Google Scholar
  2. 2.
    Pawlowski Z (1997) Terminology related to Echinococcus and echinococcosis. Acta Trop 67:1–5Google Scholar
  3. 3.
    Pawlowski ZS, Eckert J, Vuitton DA, Ammann RW, Kemp P, Craig PS, Dar KF, De Rosa F, Filice C, Gottstein B, Grimm F, Macpherson CNL, Sato N, Todorov T, Uchino J, von Sinner W, Wen H (2001) Echinococcosis in humans: clinical aspects, diagnosis and treatment. In: Eckert J, Gemmell MA, Meslin FX, Pawlowski ZS (eds) WHO/OIE Manual on echinococcosis in humans and animals: a public health problem of global concern. Office International des Epizooties, Paris, pp 20–66Google Scholar
  4. 4.
    Thompson RCA, McManus D (2001) Aetiology: parasites and life-cycles. In: Eckert J, Gemmell MA, Meslin FX, Pawlowski ZS (eds) WHO/OIE Manual on echinococcosis in humans and animals: a public health problem of global concern. Office International des Epizooties, Paris, pp 1–16Google Scholar
  5. 5.
    Thompson RCA, McManus D (2002) Towards a taxonomic revision of the genus Echinococcus. Trends Parasitol 18:452–457CrossRefPubMedGoogle Scholar
  6. 6.
    Rausch RL (1995) Life cycle patterns and geographic distribution of Echinococcus species. In: Thompson RCA, Lymbery AJ (eds) Echinococcus and hydatid disease. CAB International, Wallingford, pp 89–134Google Scholar
  7. 7.
    Schantz PM, Chai J, Eckert J, Jenkins DJ, Macpherson CNL, Thakur A (1995) Epidemiology and control of hydatid disease. In: Thompson RCA, Lymbery AJ (eds) Echinococcus and hydatid disease. CAB International, Wallingford, pp 233–331Google Scholar
  8. 8.
    Jenkins DJ, Morris B (2003) Echinococcus granulosus in wildlife in and around the Kosciuszko National Park, south-eastern Australia. Aust Vet J 81:81–85Google Scholar
  9. 9.
    Gemmell MA, Roberts MG, Beard TC, Campano Diaz S, Lawson JR, Nonnemaker JM (2001) Control of Echinococcus granulosus. In: Eckert J, Gemmell MA, Meslin FX, Pawlowski ZS (eds) WHO/OIE Manual on echinococcosis in humans and animals: a public health problem of global concern. Office International des Epizooties, Paris, pp 195–204Google Scholar
  10. 10.
    Eckert J, Schantz PM, Gasser RB, Torgerson PR, Bessonov AS, Movsessian SO, Thakur A, Grimm F, Nikogossian MA (2001) Geographic distribution and prevalence. In: Eckert J, Gemmell MA, Meslin FX, Pawlowski ZS (eds) WHO/OIE Manual on echinococcosis in humans and animals: a public health problem of global concern. Office International des Epizooties, Paris, pp 100–142Google Scholar
  11. 11.
    Macpherson CNL, Wachira TWM (1997) Cystic echinococcosis in Africa south of the Sahara. In: Andersen FL, Ouhelli H, Kachani M (eds) Compendium of cystic echinococcosis in Africa and in middle eastern countries with special reference to Morocco. Brigham Young University, Provo, pp 245–277Google Scholar
  12. 12.
    Macpherson CNL, Spoerry A, Zeyhle E, Romig T, Gorfe M (1989) Pastoralists and hydatid disease: an ultrasound scanning prevalence survey in East Africa. Trans R Soc Trop Med Hyg 80:196–200Google Scholar
  13. 13.
    Thompson RCA, Lymbery AJ, Constantine CC (1995) Variation in Echinococcus: towards a taxonomic revision of the genus. Adv Parasitol 35:145–176PubMedGoogle Scholar
  14. 14.
    Thompson RCA (1995) Biology and systematics of Echinococcus. In: Thompson RCA, Lymbery AJ (eds) Echinococcus and hydatid disease. CAB International, Wallingford, pp 1–50Google Scholar
  15. 15.
    Bowles J, van Knapen F, McManus DP (1992) Cattle strain of Echinococcus granulosus and human infection. Lancet 339:1358Google Scholar
  16. 16.
    Dinkel A, Njoroge EM, Zimmermann A, Romig T, Zeyhle E, McManus D, Mackenstedt U (2001) A PCR-based approach for specific detection of Echinococcus granulosus strains in East Africa. Abstracts, XXth International Congress of Hydatidology, 3–8 June 2001, KusadasiGoogle Scholar
  17. 17.
    Scott JC, Stafaniak J, Pawlowski ZS, McManus DP (1997) Molecular genetic analysis of human cystic hydatid cases from Poland: identification of a new genotypic group (G9) of Echinococcus granulosus. Parasitology 114:37–43CrossRefPubMedGoogle Scholar
  18. 18.
    Wilson JF, Diddams AC, Rausch RL (1968) Cystic hydatid disease in Alaska—a review of 101 autochthonous cases of Echinococcus granulosus infection. Am Rev Respir Dis 98:1–15PubMedGoogle Scholar
  19. 19.
    Eckert J (1996) Der 'gefährliche Fuchsbandwurm' (Echinococcus multilocularis) und die alveoläre Echinokokkose des Menschen in Europa. Berl Munch Tierarztl Wochenschr 109:202–210Google Scholar
  20. 20.
    Deplazes P, Alther P, Tanner I, Thompson RC, Eckert J (1999). Echinococcus multilocularis coproantigen detection by enzyme-linked immunosorbent assay in fox, dog and cat populations. J Parasitol 85:115–121PubMedGoogle Scholar
  21. 21.
    Thompson RCA, Eckert J (1983) Observations on Echinococcus multilocularis in the definitive host. Z Parasitenkd 69:335–345Google Scholar
  22. 22.
    Jenkins DJ, Romig T (2000) Efficacy of DroncitR spot-on (praziquantel) 4% w/v against immature and mature Echinococcus multilocularis in cats. Int J Parasitol 30:959–962Google Scholar
  23. 23.
    Henttonen H, Fuglei E, Gower CN, Haukisalmi V, Ims RA, Niemimaa J, Yoccoz NG (2001) Echinococcus multilocularis on Svalbard: introduction of an intermediate host has enabled the local life-cycle. Parasitology 123:547–552Google Scholar
  24. 24.
    Sydler T, Mathis A, Deplazes P (1998) Echinococcus multilocularis lesions in the livers of pigs kept outdoors in Switzerland. Eur J Vet Pathol 4:43–46Google Scholar
  25. 25.
    Deplazes P, Eckert J (2001) Veterinary aspects of alveolar echinococcosis—a zoonosis of public health significance. Vet Parasitol 98:65–87PubMedGoogle Scholar
  26. 26.
    Romig T, Kratzer W, Kimmig P, Frosch M, Gaus W, Flegel WA, Gottstein B, Lucius R, Beckh K, Kern P (1999) An epidemiologic survey of human alveolar echinococcosis in southwestern Germany. Am J Trop Med Hyg 61:566–573Google Scholar
  27. 27.
    Bresson-Hadni S, Laplante JJ, Lenys D, Rohmer P, Gottstein B, Jacquier P, Mercet P, Meyer JP, Miguet JP, Vuitton DA (1994) Seroepidemiologic screening of Echinococcus multilocularis infection in a European area endemic for alveolar echinococcosis. Am J Trop Med Hyg 51:837–846PubMedGoogle Scholar
  28. 28.
    Kern P, Bardonnet K, Renner E, Auer H, Pawlowski Z, Ammann RW, Vuitton DA, Kern P (2003) European Echinococcosis Registry: human alveolar echinococcosis, Europe, 1982–2000. Emerg Infect Dis 9:343–349PubMedGoogle Scholar
  29. 29.
    Romig T (2002) Spread of Echinococcus multilocularis in Europe? In: Craig P, Pawlowski Z (eds) Cestode zoonoses: echinococcosis and cysticercosis. IOS Press, Amsterdam, pp 65–80Google Scholar
  30. 30.
    Giraudoux P, Delattre P, Takahashi K, Raoul F, Quere JP, Craig P, Vuitton DA (2002) Transmission ecology of Echinococcus multilocularis in wildlife: what can be learned from comparative studies and multiscale approaches? In: Craig P, Pawlowski Z (eds) Cestode zoonoses: echinococcosis and cysticercosis. IOS Press, Amsterdam, pp 251–266Google Scholar
  31. 31.
    Romig T, Bilger B, Dinkel A, Merli M, Mackenstedt U (1999) Echinococcus multilocularis in animal hosts: new data from western Europe. Helminthologia 36:185–191Google Scholar
  32. 32.
    Deplazes P, Gloor S, Hegglin D, Romig T (2003) Wilderness in the city—the urbanization of Echinococcus multilocularis. Trends Parasitol (in press)Google Scholar
  33. 33.
    Hofer S, Gloor S, Müller U, Mathis A, Hegglin D, Deplazes P (2000) High prevalence of Echinococcus multilocularis in urban red foxes (Vulpes vulpes) and voles (Arvicola terrestris) in the city of Zurich, Switzerland. Parasitology 120:135–142CrossRefPubMedGoogle Scholar
  34. 34.
    Stieger C, Hegglin D, Schwarzenbach G, Mathis A, Deplazes P (2002) Spatial and temporal aspects of urban transmission of Echinococcus multilocularis. Parasitology 124:631–640Google Scholar
  35. 35.
    Altintas N (1997) Alveolar echinococcosis in Turkey and middle-east countries. Arch Int Hydatidol 32:150–154Google Scholar
  36. 36.
    Craig PS, Giraudoux P, Shi D, Bartholomot B, Garnish G, Delattre P, Quere JP, Harraga S, Bao G, Wang W, Lu F, Ito A, Vuitton DA (2000) An epidemiological and ecological study of human alveolar echinococcosis transmission in south Gansu, China. Acta Trop 77:167–177Google Scholar
  37. 37.
    Ito A, Romig T, Takahashi K (2003) Perspective on control options for Echinococcus multilocularis with particular reference to Japan. Parasitology (in press)Google Scholar
  38. 38.
    Hildreth MB, Sriram S, Gottstein B, Wilson M, Schantz PM (2000) Failure to identify alveolar echinococcosis in trappers from South Dakota in spite of high prevalence of Echinococcus multilocularis in wild canids. J Parasitol 86:75–77Google Scholar
  39. 39.
    Storandt ST, Virchow DR, Dryden MW, Hugnstorom SE, Kazacos KR (2002). Distribution and prevalence of Echinococcus multilocularis in wild predators in Nebraska, Kansas, and Wyoming. J Parasitol 88:420–422Google Scholar
  40. 40.
    D'Alessandro A (1997) Polycystic echinococcosis in tropical America: Echinococcus vogeli and E. oligarthrus. Acta Trop 67:43–65Google Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  1. 1.Department of ParasitologyUniversity of HohenheimStuttgartGermany
  2. 2.Section Infectiology University Clinic of UlmUlmGermany

Personalised recommendations