[Echinococcus multilocularis in Grisons: distribution in foxes and presence of potential intermediate hosts]

The southern border of the European endemic area of Echinococcus multilocularis runs along the alpine crest. This endemic transition area was analysed in the canton Grisons on a small spatial scale. A total of 543 foxes originating from 10 areas north and 4 areas south of the main alpine divide were investigated. Parasites were isolated using the sedimentation and counting technique on intestinal contents. The mean prevalence of E. multilocularis was 6.4% with significant differences between different areas. In the southern valleys, only foxes from the Val Müstair were infected (14.3%). On the northern side of the main alpine divide, prevalences varied between 0 and 40%. The predation habits of foxes on potential intermediate hosts was investigated by means of stomach content analyses (n=530). Rodents of the genera Microtus/Pitymys were found in 19.6% of fox stomachs, Clethrionomys glareolus in 8.0% and Arvicola terrestris in 0.4%. A small scale analysis based on a 10 x 10 km grid suggested that the predation rate on the genera Microtus/Pitymys significantly correlated with the prevalence of E. multilocularis in foxes (Spearman's r = 0.51). Hence, E. multilocularis appears to occur in the alpine study area on a very small spatial scale. These local sources of infection may persist for decades. This may partly explains why, during the last 34 years, some human cases of alveolar echinococcosis occurred in areas of the Canton Grisons where the parasite is presently endemic in foxes. No such human cases have been recorded in other areas free of E. multilocularis.

Spatial spreading of Echinococcus multilocularis in Red foxes (Vulpes vulpes) across nation borders in Western Europe

The occurrence of the fox tapeworm Echinococcus multilocularis in Red foxes was studied in Belgium and a neighbouring region in The Netherlands. A total number of 1202 foxes were analysed (1018 in Belgium and 184 in The Netherlands) of which 179 were infected with E. multilocularis (164 in Belgium and 15 in The Netherlands). Further, the spatial distribution of infection among sampled foxes was analysed with an ellipsoidal gradient, demonstrating a decreasing prevalence in northwestern direction. Using this gradient, we showed that the spatial patterns of infection in Belgium and the neighbouring region in The Netherlands correspond, indicating a continuous distribution of E. multilocularis across the nation borders. Part of the Belgian data allowed investigating temporal changes in the spatial distribution of E. multilocularis. This revealed a northwestern spread of E. multilocularis.

Echinococcus granulosus in northern Queensland

OBJECTIVE

To determine the prevalence and geographical distribution of hydatidosis and investigate factors that might be expected to influence the prevalence of hydatids in cattle in Queensland north of the Tropic of Capricorn. To determine the effect of natural levels of infection on carcase weight and subsequent economic loss.

PROCEDURE

An abattoir survey conducted in 1981 provided information on the distribution, prevalence and viability of hydatid cysts in cattle from all shires north of the Tropic of Capricorn in Queensland. Livers, lungs and spleens from 10,382 cattle were palpated at abattoirs in Cairns, Townsville and Rockhampton to detect hydatid cysts. Prevalence of infection in cattle in each shire was estimated from results of the abattoir study together with reports of infection in a further 22,185 cattle obtained from abattoir records. Linear modelling was used to define the effect of geographical origin, age, breed and sex on prevalence of infection. Differences in the weights of carcases between infected and non-infected cattle of the same age, sex, breed and property of origin were examined. The economic loss to the beef industry in the region surveyed was estimated.

RESULTS

Cattle infected with hydatids originated almost entirely from regions to the east of the Great Dividing Range. The mean prevalence inside this zone was 28% compared with 3% in other areas. Viable protoscoleces were found in 0.7% of cysts. Geographical origin and age of the cattle were the most significant factors influencing prevalence. Infection with hydatids had no effect on carcase weight. Economic loss was limited to that associated with condemnations of organs at meat inspection, estimated to be 0.5 million dollars per annum in 1981 and 6 million dollars in 2004. The distribution of hydatids in Queensland north of the Tropic of Capricorn corresponded most closely with the distribution of small wallabies such as Macropus dorsalis (black-striped wallaby), M parryi (whiptail wallaby) and M rufogriseus (red-necked wallaby).

CONCLUSIONS

It was concluded that cattle are not an important part of maintaining the life-cycle of E granulosus in Queensland north of the Tropic of Capricorn. Within the endemic zone, which is almost all to the east of the Great Dividing Range, the local pattern of bovine echinococcosis is most likely to be determined by the presence or absence of small species of wallaby such as M dorsalis, M parryi and M rufogriseus.

Echinococcus granulosus in northern Queensland

OBJECTIVE

To provide information on possible ecological determinants of infection with Echinococcus granulosus in a beef pastoral area of northern Queensland.

PROCEDURE

An ecological study was carried out on the prevalence and viability of infection with Echinococcus granulosus in definitive and potential intermediate hosts, and their predator prey relationships. Seven adjacent extensive beef properties 100 km south of Townsville, that included areas of savannah, open woodland and dense closed scrub, were selected for the study. Infection with E granulosus in dingoes was determined at post mortem, and in domestic dogs by examining duodenal mucus after purging with arecoline hydrobromide. Cattle, wild pigs and macropods were examined at post mortem for viable hydatid cysts. The diet of dingoes was investigated by identifying the hair of prey species found in their stomach and colon, and that of domestic dogs by questioning their owners.

RESULTS

Prevalence of hydatidosis in adult cattle ranged from 41% in animals from properties with large areas of dense closed scrub, to 3% on properties with little or no scrub. Hydatid cysts were found in 21.8% of black-striped wallabies (Macropus dorsalis), 9.4% of feral pigs, 1.5% of wallaroos (Macropus robustus), and 1.4% of eastern grey kangaroos (Macropus giganteus). No rufous rat kangaroos (Aepyprymnus rufescens) or swamp wallabies (Wallabia bicolor) were infected. Most cysts in macropods were viable, whereas in pigs about half were viable and in cattle only 0.7% contained viable protoscoleces. Infection with E granulosus was detected in 76% of dingoes, whereas no infection was detected in domestic dogs in the study area.

CONCLUSIONS

It was concluded that the sylvatic cycle of E granulosus in the study area was maintained mainly through predation of black-striped wallabies by dingoes, and that the verges of dense scrub were the main nidus of infection.

Canid immunity to Echinococcus spp.: impact on transmission

The canid intestinal immune system recognizes the cestode parasite Echinococcus following infection, but it is still unclear the extent to which protection against reinfection occurs. An increasing number of studies have shown that there are convex age-related abundance or prevalence rates in naturally infected populations of dogs with E. granulosus and foxes infected with E. multilocularis. Data from dogs naturally infected with E. granulosus give a better fit to a model that incorporates herd immunity compared to competing models of age-related changes in infection pressure. A theoretical framework suggests that such herd immunity will act as a stabilizing force for Echinococcus populations. Hence a decrease in infection pressure to dogs or foxes will not result in a corresponding decrease in infection pressure to intermediate hosts or to humans. In addition the age structure of the canid population could affect transmission.

Ecology and epidemiology of Echinococcus multilocularis in Europe

Human alveolar echinococcosis (AE), caused by the larval stage of Echinococcus multilocularis has a high mortality rate in untreated patients. The life-cycle of E. multilocularis in Europe predominantly involves foxes as definitive hosts. However, experimental studies demonstrated a comparable biotic potential of E. multilocularis in dogs and raccoon dogs but an insignificant potential in cats. AE occurs in central and eastern Europe at low incidence rates. Recent studies in foxes have shown that E. multilocularis has a wider geographic range (including Italy) than previously thought. In recent years, increases in fox populations have been observed in many European countries, especially in urban areas. As a result, the E. multilocularis cycle is now established in the urban environment. This presents an increased risk of infection for a large human population. Based on these facts and new epidemiological data, possible intervention strategies are presented.

Emergence/re-emergence of Echinococcus spp.--a global update

This review provides an update of the biological aspects of the genus Echinococcus and focuses on newly recognized endemic areas. Infection with the intermediate cystic stage of all species of Echinococcus causes disease and incapacity in animals and humans, and in the most serious cases, death of the host. Transmission of Echinococcus to new continents has occurred during European colonisation and the parasite has often taken advantage of Echinococcus-naive wildlife populations in these new environments, incorporating them into its transmission pattern. Echinococcus granulosus consists of a complex of 10 strains. Host specificities of these strains have important implications for transmission and control. As a result of human behaviour and/or political instability in a number of countries Echinococcus is re-emerging as an important public health issue. The importance of wildlife reservoirs in perpetuating transmission and as a source of infection for domestic animals and humans is addressed. The review also refers to the transmission pattern of a recently described new species, Echinococcus shiquicus, from China.

Implications of increased susceptibility to predation for managing the sylvatic cycle of Echinococcus multilocularis

The ability to increase the chances that infectious prey are taken by predators is an observed feature of many parasites that rely on one or more predator-prey relationships to complete their life-cycle. In the sylvatic life-cycle of Echinococcus multilocularis - the causative agent of human alveolar echinococcosis-- foxes are the final host, with voles acting as intermediate hosts. Here we review the evidence that E. multilocularis causes increased susceptibility to predation and present a general mathematical model for the sylvatic life-cycle. The ability to increase susceptibility to predation in the intermediate host reduces the sensitivity of the parasite population to adverse conditions. For example, there is no critical density of foxes below which the parasite is expected to die out, even if the effect of the parasite on infected prey is very small. We suggest that increased susceptibility to predation is a plausible explanation for the observed resilience of E. multilocularis during and following field trials of praziquantel baiting.

Control of hydatidosis

Control of hydatidosis is less effective without the support of dog-owners, and this support can only be obtained if the people have a clear understanding of the life-cycle of the hydatid parasite(s) and what risk factors contribute to human infections. Dissemination of this information is the biggest challenge for hydatid control. Participatory planning between dog-owners and community leaders should evaluate the possible control technologies, and should enable a choice of those aspects that suit the sociology and economic status of the particular community. Collection of baseline data is essential, as is on-going surveillance. Hydatid control should be mainly self-funded, which again requires the support of the dog-owner. A pilot hydatid control program for Tibetan herdsmen is described.

Echinococcus granulosus in Australia, widespread and doing well!

Echinococcus granulosus is the only member of the Genus Echinococcus to occur in Australia. The major biomass of E. granulosus occurs in wildlife. The wildlife transmission cycle is predominantly perpetuated via a predator/prey interaction between wild dogs (dingoes and dingo/domestic dog hybrids) and macropodid marsupials (wallabies and kangaroos). Other wildlife hosts include foxes, wombats and feral pigs. This wildlife reservoir for E. granulosus "spills over" to help maintain a domestic cycle through E. granulosus-infected wild dogs defecating on pasture, transmitting infection to livestock and some farmers and hunters feeding hydatid-infected offal of macropodids or feral pigs to domestic dogs. The potential transmission risk to humans using public picnic and camping areas in parks and forests, especially in the southeastern Australia, could be substantially reduced through regular distribution of baits containing praziquantel. Encroachment of wild dogs and foxes into urban centers presents a new potential path of transmission from wildlife to humans.

Spatial modelling and ecology of Echinococcus multilocularis transmission in China

Recent research in central China has suggested that the most likely transmission mechanism for Echinococcus multilocularis to humans is via domestic dogs which are allowed to roam freely and hunt (infected) small mammals within areas close to villages or in areas of tented pasture. This assertion has led to the hypothesis that there is a landscape control on transmission risk since the proximity of suitable habitat for susceptible small mammals appears to be the key. We have tested this hypothesis in a number of endemic areas in China, notably south Gansu Province and the Tibetan region of western Sichuan Province. The fundamental landscape control is its effect at a regional scale on small mammal species assemblages (susceptible species are not ubiquitous) and, at a local scale, the spatial distributions of small mammal populations. To date the research has examined relationships between landscape composition and patterns of human infection, landscape and small mammal distributions and recently the relationships between landscape and dog infection rates. The key tool to characterize landscape is satellite remote sensing and these data are used as inputs to drive spatial models of transmission risk. This paper reviews the progress that has been made so far in spatial modeling of the ecology of E. multilocularis with particular reference to China, outlines current research issues, and describes a framework for building a spatial-temporal model of transmission ecology.

Transmission ecology of Echinococcus multilocularis: what are the ranges of parasite stability among various host communities in China?

A striking feature of the transmission ecology of Echinococcus multilocularis in China is the diversity of hosts that contribute to the parasite cycle. Considering the population dynamics of key reservoir intermediate hosts and the ratio of their preferred habitat in a landscape (ROMPA) is essential to understanding transmission, but the numerous communities in which the parasite cycles and the extent of those communities is currently far from being fully documented. On the Tibetan plateau grassland management influences intermediate host species populations and the sheer size of the area could be a major contributing factor to sustaining transmission in the region. In Southern Gansu and Southern Ningxia the processes of deforestation have temporarily provided optimal habitat for key reservoir intermediate hosts of E. multilocularis, resulting in high transmission and human disease, however currently the parasite may be extinct locally. Faced with this pattern of potentially transient transmission in a diversity of communities the question of the dispersal potential of the parasite arises. The reforestation program currently active across much of Western China has the potential to give rise to a massive increase in habitat favourable to suitable intermediate hosts and emergence or re-emergence of the zoonosis alveolar echinococcosis in many areas. This potential epidemic could be mitigated by both natural and human induced parasite dispersal mechanisms including fox migration and the sale of infected dogs originating from stable endemic foci on the Tibetan plateau. However, currently the degree of genetic exchange between discrete transmission foci is unknown and it is expected that genetic techniques could provide crucial information regarding this important question.

Mathematical modeling of Echinococcus multilocularis transmission

A mathematical model for the transmission cycle of Echinococcus multilocularis would be useful for estimating its prevalence, and the model simulation can be instrumental in designing various control strategies. This review focuses on the epidemiological factors in the E. multilocularis transmission cycle and the recent advances of mathematical models for E. multilocularis transmission.

Hydatid control in Australia: where it began, what we have achieved and where to from here

Echinococcus granulosus was imported into Australia with domestic livestock about 200 years ago. It spread rapidly through domestic animals and quickly became a public health problem in the new colony. Control was hampered by ignorance of the transmission pattern. The association between metacestodes and tapeworms was not elucidated until 63 years after the arrival of the First Fleet. Australian wildlife were highly susceptible to infection with E. granulosus and wildlife/domestic animal interaction facilated rapid infiltration of wildlife by E. granulosus. The wildlife reservoir has hampered hydatid control campaigns on mainland Australia but successful eradication has been achieved in the island state of Tasmania where there was no wildlife reservoir. The application of a new recombinant vaccine for sheep in control campaigns and the use of praziquantel baits for controlling infection in dingoes around bush campsites and picnic areas is discussed.

Transmission dynamics of Echinococcus multilocularis; its reproduction number, persistence in an area of low rodent prevalence, and effectiveness of control

On the basis of high prevalences of Echinococcus multilocularis in the growing fox populations in Central Europe, its total biomass may have increased significantly in the past 20 years. E. multilocularis is now also found in areas outside the known endemic area in Central Europe. Therefore, E. multilocularis, the causative agent of a serious parasitic zoonosis, might be of major concern for public health and a challenge to control. Some experimental field trials to control E. multilocularis using an anti-worm drug reduced parasite burden in a contaminated region during the control campaign, but failed to eradicate the parasite completely. It was our aim to develop a mathematical model describing the biomass of egg, larval, and adult worm stages of the E. multilocularis life-cycle, and simulate a hypothetical control campaign. Additionally, we derived the reproduction number of this parasite and explored conditions for the persistence of the parasite's life-cycle. Our model shows that while control campaigns rapidly reduce the worm burden in the definitive host, and consequently eggs in the environment, the pool of larvae in the intermediate host remains large. The parasite's life-cycle persists in a region where prevalence in the intermediate host is low (∼1%). Therefore, we conclude that the parasite is likely to re-emerge if control is discontinued on the basis of reduced worm population. Continued treatment of the definitive host is required to eradicate the larval stage of the parasite from the intermediate host population.

Modified Sugar Centrifugal Flotation Technique for Recovering Echinococcus multilocularis Eggs From Soil

Among soil-transmitted parasitic diseases, alveolar hydatidosis due to the ingestion of Echinococcus multilocularis eggs is becoming a serious problem in Hokkaido, the northern most island of Japan. Dissemination of the infection far from the endemic areas can occur if motor vehicles transmit soil contaminated with eggs. No appropriate and validated method for recovering the taeniid eggs from soil is available. A modified sugar centrifugal flotation technique, using a sucrose solution of specific gravity 1.27 and 0.05% Tween-80, was evaluated as a method to successfully recover eggs from soil. Contamination levels as low as 10 eggs per gram could be detected. This method may be useful to determine the prevalence of E. multilocularis, its transmission, and the potential for by monitoring soil contamination with eggs.

Modeling the transmission of Echinococcus granulosus and Echinococcus multilocularis in dogs for a high endemic region of the Tibetan plateau

Echinococcus granulosus and Echinococcus multilocularis abundance and prevalence data, for domestic dogs of Shiqu County, Sichuan Province, People's Republic of China, were fitted to mathematical models to evaluate transmission parameters. Abundance models, assuming the presence and absence of immunity, were fit for both E. granulosus and E. multilocularis using Bayesian priors, maximum likelihood, and Monte Carlo sampling techniques. When the models were compared, using the likelihood ratio test for nested models, the model assuming the presence of immunity was the best fit for E. granulosus infection, with a purgation based prevalence of 8% (true prevalence interval of 8-19% based on the sensitivity of purgation) and a mean abundance of 80 parasites per dog, with an average infection pressure of 560 parasites per year. In contrast, the model assuming the absence of immunity was the best fit for E. multilocularis infection, with a purgation based prevalence of 12% (true prevalence interval of 13-33% based on the sensitivity of purgation) and a mean abundance of 131 parasites per dog, with an average infection pressure of 334 or 533 parasites per year assuming a 5 or 3 month parasite life expectancy, respectively. The prevalence data for both parasites was then fit to a set of differential equations modeling the transition between infection states in order to determine number of infectious insults per year. Infection pressure was 0.21, with a 95% credibility interval of 0.12 to 0.41, infections per year for E. granulosus and 0.52, with a 95% credibility interval of 0.29-0.77, infections per year for E. multilocularis assuming a 5 month parasite lifespan or 0.85, with a 95% credibility interval of 0.47-1.25 infections per year, assuming a 3 month E. multilocularis lifespan in dogs.

New Distribution Records of Echinococcus multilocularis in the Brown Lemming from Barrow, Alaska, USA

We identified Echinococcus multilocularis for the first time in brown lemmings (Lemmus trimucronatus) from Barrow, Alaska, USA. Of 467 brown lemmings trapped between 1995 and 2000, two males and two females (0.9%; 95% confidence interval=0.9+/-0.9%) were found to be infected with metacestodes of E. multilocularis. No metacestodes were found in 17 collared lemmings (Dicrostonyx rubricatus) also trapped at Barrow. In humans, E. multilocularis causes alveolar echinococcosis, which is potentially fatal. Knowledge of the distribution of this parasite is important to protect the public health.

Canine gastrointestinal parasitic zoonoses in India

Although well recognized and studied in developed countries, canine parasitic zoonoses pose a lowly prioritized public health problem in developing countries such as India, where conditions are conducive for transmission. A study of the most recent parasite survey determining prevalence and epidemiology of canine parasitic zoonoses among tea-growing communities of northeast India demonstrated the endemicity of the problem. This particular study serves as a model using conventional, as well as molecular parasitological, tools to provide novel insights into the role of dogs as mechanical transmitters of human parasites such as Ascaris and Trichuris, and discusses the risks dogs pose with regards to zoonotic transmission of hookworms and Giardia.

Echinococcus granulosus in the wolf in Italy

During the period 1987-1999, 119 wolf cadavers were examined and checked for the presence of Echinococcus granulosus. All the animals were retrieved along the whole Apennines range of distribution of the species in Italy and most of them were illegally killed. Eighteen wolves resulted positive (15%). The mean intensity was 697.5. The force of infection for prevalence was 8.2 year(-1). The prevalence of the parasite was significantly and positively influenced by the local prevalence of cystic echinococcosis (CE) in sheep. Mean intensity was significantly and positively influenced by both the age of the wolf and the prevalence of CE in sheep. A deterministic model was used in order to simulate a purely theoretical sylvatic cycle of the parasites having the wolf as the only definitive host with 15% of prevalence. The expected prevalence of CE in wild intermediate species ranges between 10% and 25%. This prevalence overlaps the one observed in sheep. Even if both the wolf and the wild ungulate populations are increasing, the wolf still acts as a part of the main dog-sheep cycle of the parasite.

Notes on cystic echinococcosis in the Mediterranean

Cystic Echinococcosis (CE), caused by Echinococcus granulosus, is present from the beginning of history and in the Mediterranean it is linked to the dog-sheep cycle. The Mediterranean area possesses many features favouring CE. Positive and negative influences derived from the action of the European Community and from recent developments. The control measures of CE have political, economic, public health and environmental implications. Dog population and dog-transmitted zoonoses control, improvement of slaughtering procedures and the destruction of infected viscera, health education, interprofessional cooperation are able individually to constitute a contraposition to CE and combined to compose a control program. Epidemiological surveillance and control of CE in the Mediterranean are coordinated by the WHO Mediterranean Zoonoses Control Centre of Athens.

Cystic echinococcosis in Italy from the 1950s to present

In Italy the epidemiological pattern of cistic echinococcosis (CE) is incomplete and the information for most regions is out of date, contradictory, and almost exclusively limited to the intermediate hosts. The disease is found most frequently in particular social and economic conditions: widespread use of extensive or semi-extensive sheep farming, illegal slaughtering, and high numbers of sheepdogs and other types of dogs. The highest incidence in sheep is found in Sardinia (70.6-92.8%), Sicily (6.5-36.5%), Basilicata (5-28%), Abruzzo (22%) and Tuscany (47%). It North Italy, it is never higher than 0.5% in slaughtered sheep. No data are available on the biomolecular characterization of the strains of E. granulosus in Italy, apart from Sardinia and recently Lazio. G1 (Sheep strain), G7 (Pig strain) G2 (Tasmanian sheep strain) have been identified in Sardinia and G1 and G3 (Buffalo strain) have been recently isolated in Lazio. In Italy, CE has was also found in buffaloes (2.63-9.8%) and horses (<1%). However, further epidemiological surveys and genotyping study are necessary. The small quantity of up to date information on the diffusion of E. granulosus in dogs (Abruzzo 4%, Sardinia 6-10% and Sicily 19.3%) highlights the need for modern, fast, sensitive and low risk diagnostic methods which would provide a true picture of the pattern of the infection in this host.