Cystic Echinococcosis in Sardinia: Farmers’ knowledge and dog infection in sheep farms

Hydatid cyst of the brainstem: The rarest of the rare locations for echinococcosis

Hydatidosis, caused by the larval stage of Echinococcus granulosus, is a zoonotic disease typically affecting the liver and lungs. Cerebral localizations are rare, especially in the brainstem. We present a case of a 9-year-old boy with a brainstem hydatid cyst. The patient exhibited progressive walking difficulties and limb impairment. MRI revealed a brainstem mass consistent with a hydatid cyst. Due to the lesion's size and location, surgical intervention was necessary. The cyst was decompressed and removed without complications, followed by albendazole treatment. Postoperative recovery was uneventful, and the patient showed no signs of recurrence after 2 years. This case highlights the importance of early diagnosis, precise surgical techniques, and thorough postoperative care in managing rare cerebral hydatid cysts.

Epidemiological update of cystic echinococcosis in livestock and assessment of practices related to its control in the Mediterranean area

Cystic echinococcosis (CE), caused by the tapeworm Echinococcus granulosus, is a zoonotic parasitic disease that still represents a serious threat to human and animal health worldwide. The Mediterranean basin is recognized as one of the major hotspots of CE due to several factors, including the presence of diverse intermediate host species as well as socio-economic and cultural conditions of local communities. This study aims to take a closer look at epidemiological data on CE in the Mediterranean area and assess the knowledge attitudes and practices of shepherds towards this disease in four countries (Algeria, Greece, Italy and Tunisia), highly endemic for CE, with the final goal of identifying highly endemic risk areas and practices in use which might potentially allow the persistence of E. granulosus infection in these areas. To update the epidemiological scenario of CE in Mediterranean areas, a comprehensive review of peer-reviewed literature on CE prevalence data published during the 2017-2023 period was carried out and, through a geographical information system (GIS), a map displaying the current CE distribution in the Mediterranean area was generated. In addition, a questionnaire survey was conducted through in-depth interviews of the farmers to collect information on their management system as well as knowledge attitudes and practices towards CE. From the farmer-participatory survey some risky practices emerged including the non-regular deworming of dogs or the use of ineffective drugs or dosing, as well as the provision of uncooked animal viscera to dogs. Finally, lower levels of knowledge and awareness of the disease was observed among farmers from North Africa compared with those of European countries. In conclusion, the results obtained highlight that CE is still a very serious problem in Mediterranean areas and increased efforts are needed to promote awareness among farmers and to turn research results into policy in order to reduce the spread of this disease, according to the One Health perspective.

Knowledge, awareness and practice regarding cystic echinococcosis in Algeria: A cross-sectional survey among the general population

Cystic echinococcosis (CE) is a parasitic zoonotic disease with a widespread occurrence, particularly in developing countries. Known as a neglected disease, it is highly prevalent in Algeria with a significant public health concern and substantial financial losses. The objectives of this study was to explore knowledge and awareness and practice of the Algerian population regarding this disease. A cross-sectional online-based survey was conducted between July 15 and September 25, 2022 using a self-administered questionnaire targeting all Algerian people of more than 18 years of age. Out of the total respondents, 87.7% have ever heard of CE with livestock rearing connection (OR:2.550, CI 95% OR: 1.108-5.870) and educational level (OR:3.826, CI 95% OR: 1.599-9.156) as the main factors associated with the level of awareness. Regarding their knowledge, results showed dispersing notions about the disease. The majority (84.8%) were aware of the zonnotic nature of the disease while only 49.6% knew that CE is caused by parasitic disease. Also, 83.3% were knowledgeable of the role of contaminated offal in the contamination of dogs which are considered as the main source of contamination of humans (65.19%). Regarding their practices, even home slaughtering was common (92.96%), some positive attitudes were prevalent where most of the participants declared washing vegetable before consumption (97.41%) and washing their hands after touching a dog (91.11%). Also, 68.29% among the dog owners declared that deworming their pets. This study has revealed that despite the high level of awareness and some positive attitudes, the level of knowledge about CE among the Algerian public has shown some gaps related to the epidemiology of the disease. These results could be helpful for the awareness campaigns programmers in their missions through focusing their efforts on raising the level of knowledge for the items that have shown a lack of understand which will be of great importance in the strategy of CE elimination.

Immunological Profile of Serum Antibodies, Multiplex Cytokines, and Complement Proteins in Cystic Echinococcosis Patients

Background:

Cystic echinococcosis (CE) is a zoonotic parasite disease that affects people globally and causes cysts to develop in internal organs.

Objectives:

This study aimed to examine the effects of E. granulosus infection on the level of some immunological cytokines such as IL-2, IL-4, and IL-6 and the level of IgM and IgG antibodies as well as to investigate the effects of hydatid cysts disease on complement proteins.

Materials and Methods:

This case–control study was carried out on 46 individuals whose ages ranged between 20 and 70. The study extended from September 2021 to May 2022. Forty-six blood samples were collected from patients infected with hydatidosis and 10 blood samples from non-infected as a control group. The blood samples were used to obtain the desired sera for immunological detection: immunoglobulins (IgM and IgG); interleukins (IL-2, IL-4, and IL-6) by using enzyme-linked immunosorbent assay and complement proteins (by using radial immnodiffusion plate).

Results:

The level of anti-echinococcosis IgM (304.7 ± 73.4 mg/dL) was higher in infected than uninfected persons (161.8 ± 14.2 mg/dL). Anti-echinococcosis IgG level in an infected individual (1587.3 ± 449.4 mg/dL) was higher when compared with control (1136 ± 25.4 mg/dL). The highest number of cases (19, 41.30%) was observed in age 41–50 years, followed by the age 31–40 years (11, 17.18%). The results showed a high increase in the incidence of infection with hydatid cyst among men (58.69%) in comparison to women (41.30%). The patients most at risk are those living in intimate association with animals’ environments. Three cytokines including (IL-6, IL-4, and IL-2) were significantly elevated (474.8 ± 116, 6.86 ± 0.6, and 7.01 ± 2.89 pg/mL) in patients with hydatidosis disease in comparison with the normal controls (118.4 ± 14.3, 6.11 ± 0.3, and 4.54 ± 0.4 pg/mL). Examining the complement protein production, we found that C3 and C4 were significantly higher (159.5 ± 51.6 and 36.15 ± 6.13 mg/dL) in patients with hydatidosis than those of controls (117.7 ± 8.1 and 26.4 ± 3.1).

Conclusions:

Our findings provide information on the effects of E. granulosis parasite on the profile of serum antibodies, multiplex cytokines, and complement proteins in cystic echinococcosis patients.

An Epidemiological Survey to Investigate the Prevalence of Cystic Echinococcosis in Slaughtered Bovine Hosts in Punjab, Pakistan

Cystic echinococcosis (CE) is a neglected zoonotic disease of worldwide geographical distribution. CE is most common in underdeveloped and herding communities where people survive on animal husbandry and agricultural activities. The prevalence of CE in livestock and its risk factors are widely underreported, because of inefficient surveillance systems. The aim of this study was to evaluate the epidemiological characteristics and prevalence of CE in cattle in Punjab, Pakistan. Data were collected from slaughterhouses from September 2021 to February 2022. Ante- and postmortem examination and cyst characterization were performed. Epidemiological, demographic, and one health data were collected. A total of 8877 animals (8096 buffalo, 781 cattle) were examined, and the prevalence of CE was 6.22% (n = 552) in all animals, with a higher prevalence in cattle (15.20% vs. buffalo 5.83%). Prevalence was not significantly different in males and females. Of the 23 districts studied, the highest prevalence was in the Haripur district of KP (20.85%). The majority of animals studied were older than 3 years. Most cysts were found in animals older than 5 years. Lungs and liver were the predominant sites for the presence of cysts (65.58% and 31.34%, respectively. Of the collected cysts, 29.71% were fertile. The findings may be useful in estimating the eco-epidemiology of CE and improving surveillance and prevention programs in Pakistan.

Morphometry and genetic diversity pattern of Cysticercus tenuicollis, an important food-borne taeniid metacestode in goats in Bangladesh

Cysticercus tenuicollis is a larval stage of Taenia hydatigena resulting in cysticercosis, and responsible for enormous economic loses, especially in livestock production. Here, we planned to determine the prevalence and explore genetic variation of C. tenuicollis isolated from goats based on small subunit ribosomal RNA (rrnS) and cytochrome oxidase subunit 1 (cox1). To do this, samples were collected from different slaughter houses of municipal areas such as Bramhapalli slaughterhouse, Jubileeghat slaughterhouse and Mesuabazar slaughterhouse at Mymensingh sadar, and tentatively identified by morphological and morphometrical analysis. To study genetic variation, DNA was extracted from C. tenuicollis, and amplified rrnS and cox1 genes using specific primers, and were sequenced. Among 1372 examined animals, 177 (12.9%) were infected with C. tenuicollis. Cysts were recovered from peritoneum (7.9%), liver (4.4%) and urinary bladder (0.6%) of the infected animals. Females (18.9%) and adults (20.7%) were significantly more susceptible than male (8.8%) and young (9.3%), respectively. Genetic analysis defined 8 distinct rrnS genotypes and 9 unique cox1 haplotypes among 20 C. tenuicollis isolates. The nucleotide diversities were 0.00283 and 0.00434 for rrnS and cox1 genes, respectively. Neighbor joining (NJ) trees of rrnS and cox1 gene were constructed and the studied sequences were clustered with reference sequences of T. hydatigena with strong nodal support (100%). To compare Bangladeshi isolates, a median joining network was constructed with the population from other geographical regions and hosts. This led to a clustering pattern, but the clusters were not built with unique geographical regions or hosts. In conclusion, this is the first study that describes the genetic variation of T. hydatigena population and suggests the existence of host-specific variants. Therefore, it is fundamental to dispose infected viscera, restrict dog movement and proper management of slaughter house for the prevention and control of cysticercosis.

Oxidative stress markers, immune-regulating cytokines, and the pathological evaluation of sheep co-infected with Oestrus ovis and Coenuruscerebralis

This study aimed to evaluate the immune response using the immune-regulating cytokines as (IL-1β; MHC-I and MHC-II) associated with co-infected sheep Oestrusovis and Coenurus cerebralisas well as oxidative stress markers (malondialdehyde "MDA" and nitric oxide "NO"). So; sheep samples from different regions in Egypt showed different neurological signs, were examined for detection of the cause of the nervous manifestations. Moreover, the O. ovis and C. cerebralis cysts were collected and identified using scanning electron microscopy. The brain tissues were evaluated for different immunological genes such as MHC-I, MHC-II, and Interleukin-1β activity using quantitative real-time PCR (qRT-PCR) techniques, where the infected sheep showed higher MHC-I gene expression (10-fold), higher MHC-II gene expression (peaked at 25-fold), and higher IL-1β gene expression (14-fold) than the control group. The MDA level was significantly increased. Also, stress marker (nitric oxide) levels were significantly higher in infectedsheep than in negative control one. During gross pathology, migrating larvae of O. ovis andC. cerebralis were noticed In such areas, hemorrhages and patches of clotted blood were noticed. cysts with prominent protoscolices were also observed and were attached to the caudal region near the cerebellum.

Environmental Contamination by Echinococcus spp. Eggs as a Risk for Human Health in Educational Farms of Sardinia, Italy

Cystic Echinococcosis (CE) is a severe zoonosis caused by the larval stage of the tapeworm Echinococcus granulosus. These parasites are naturally transmitted between canid definitive hosts that harbour the adult stage in the intestine, and mainly ungulate intermediate hosts, with larval cysts developing in their internal organs. The close coexistence between dog and sheep with incorrect hygiene management are the most important factors for the persistence of this parasitic pathology. The Educational Farms (EF) are farms and agritourisms suitably equipped to carry out training activities for people interested in farm practices and agricultural processing, in particular student groups. Public attendance of farms represents a new potential risk factor for the zoonoses transmission. Consumption of contaminated food and water in combination with contact or playing with domestic dogs (Canis familiaris) are possible routes of zoonoses human infection. In fact, Echinococcus spp. eggs may persist in the environment up to several months at low temperatures and moist conditions, having the chance of contaminating different matrices and surfaces. The aim of this investigation was to study environmental contamination by parasitic elements as a risk for zoonoses, such as Echinococcus spp. A total of 116 samples (35 of water, 33 of soil, 23 of vegetables, 25 of dog faeces) were collected in 30 EF in Sardinia. Samples were subjected to biomolecular investigation for the research of specific gene sequences of Echinococcus granulosus, Echinococcus multilocularis and Taenia spp. The study allowed to identify eight positive EF due to the presence of Echinococcusgranulosus in eight dog faeces samples and one positive EF due to the presence of Taenia spp. in a water sample. The work has allowed to develop and harmonise the diagnostic methods and operating protocols essential for controlling the spread of the CE to create “One Health” intervention plans in high endemic areas through the implementation of SOP (standard operating procedures) for monitoring the pathology in animals, humans and environment.

Molecular identification of Taenia hydatigena from domestic and free-living animals in Slovakia, Central Europe

Taenia hydatigena is a cosmopolitan tapeworm that uses canids or felines as definitive hosts, while the larval stage (metacestode), formerly referred to as cysticercus tenuicollis, infects a wide variety of intermediate hosts, in particular ruminants. In the present study, we used partial nucleotide sequences of the cox1 and nad1 genes of T. hydatigena from different animal species to analyse the intraspecies genetic diversity of this economically important parasite. Twenty-four samples of metacestodes or adults of T. hydatigena from infected sheep, chamois, roe deer, fallow deer, wild boar, and dogs from Slovakia were collected and further analysed. Several haplotypes of T. hydatigena were identified with unique mutations that have not been previously recorded in Slovakia. Analysis of nucleotide polymorphism revealed the existence of 9 and 13 haplotypes, with relatively low nucleotide pairwise divergence ranging between 0.3-1.3 and 0.2-1.8% for the Hcox and Hnad haplotypes, respectively. In general, low nucleotide and high haplotype diversities in the overall population of T. hydatigena from the study indicate a high number of closely related haplotypes within the explored population; nucleotide diversity per site was low for cox1 (Pi = 0.00540) and slightly higher for nad1 (Pi = 0.00898). A molecular study confirmed the existence of genetic variation within T. hydatigena isolates from Slovakia. However, further investigations with more samples collected from different intermediate and definitive hosts are required in order to investigate the epidemiological significance of the apparent genetic differences observed in this study.

Taenia multiceps coenurosis: a review

Taenia multiceps is a taeniid cestode that inhabits the small intestines of both wild and domestic carnivores. The larval stage, Coenurus cerebralis, is typically found in the central nervous system (CNS) of a wide range of livestock and, to a lesser extent, in the extra-cerebral tissues of sheep and goats. This review covers all aspects of the life cycle of T. multiceps and its epidemiology, molecular characterization, pathogenesis, diagnosis, therapy, control and zoonotic potential. Coenurosis caused by the larval stage of T. multiceps has a worldwide distribution and is often fatal in intermediate hosts, which can result in substantial economic losses in livestock farming. Molecular characterization using the mitochondrial genes cytochrome c oxidase subunit 1 and nicotinamide adenine dinucleotide dehydrogenase subunit 1 of different T. multiceps populations has revealed significant genetic variation and the presence of three major haplotypes. The disease mostly affects young sheep and is referred to as either acute or chronic coenurosis. Acute coenurosis occurs as a result of oncospheres migrating through the CNS, while chronic coenurosis occurs as a consequence of the coenurus maturing, which causes displacement and pressure atrophy of brain tissue. Non-cerebral coenurosis has been most commonly reported in goats. The best diagnostic method for cerebral coenurosis involves the interpretation of clinical signs with accurate localization of the cyst using diagnostic imaging techniques. A vaccine based on recombinant oncosphere antigens has proved to be an effective tool against T. multiceps infection in sheep. Additionally, use of anthelmintics during the parasite's migration stages reduces the development of cysts in the sheep brain. Surgery is considered the most effective method for the treatment of cerebral coenurosis in small ruminants, but is often not carried out because of the limited finances of many sheep and goat breeders. However, coenurosis can also be controlled effectively through preventative measures, such as anthelmintic treatment of dogs and the proper disposal of intermediate host carcasses. The parasite is also zoonotic, and cases of coenurosis have been reported in humans with coenuri located in the brain, spinal cord and eyes.

Human Cystic Echinococcosis in Lebanon: A Retrospective Study and Molecular Epidemiology

Purpose

Human cystic echinococcosis (CE) is a zoonotic parasitic disease that constitutes a public health challenge and a socio-economic burden in endemic areas worldwide. No specific surveillance system of CE infections in humans exists in Lebanon. The incidence and trends over time have not been documented. The current study aimed to assess the demographic and epidemiologic features of human CE surgical cases over a 14-year period in the five main regions of Lebanon.

Methods

From 2005 to 2018, a total of 894 surgically confirmed cases of hydatidosis were recorded from five anatomy and pathology laboratories.

Results

The mean annual surgical incidence was 1.23/100,000 inhabitants. Over the span of these years, the incidence increased from 0.53 to 1.94 cases/100,000 inhabitants in 2005 and 2018, respectively. CE is present in Lebanon with an uneven distribution from one region to the other with higher prevalence in Bekaa (29.0%), a rural area where sheep raising is widespread. Human CE cases were more common in females (60.1%) than in males (39.9%) and a high burden of infection was reported for the age group of 30–39 years. Besides, 66.7% of the cases expressed only liver complications whereas, 20.5% showed predilection towards lungs. The 7.8% of cases presented cysts in other organs, and 1.3% showed multiple localizations. Additionally, predominant involvement of Echinococcus granulosus sensu stricto was recorded in human infections. Comparison of Echinococcus granulosus s.s. populations from different Mediterranean countries also revealed high gene flow among this region and sharing of alleles.

Conclusion

The current study is a step forward to fill the gap of knowledge for the hydatidosis in Lebanon where the lack of epidemiological data and control measures have resulted in higher incidence of human CE.

Graphic Abstract

Epidemiological aspects of echinococcosis of the liver and other organs in the Republic of Uzbekistan

Introduction

Recently, in international medical organizations, more and more interest is shown towards diseases in humans, among which the cystic form of echinococcosis (CE) is given special importance. As a zoonotic parasitic disease caused by the larval stage of cestodes belonging to the genus Echinococcus and the Taeniidae family, CE in 2014 was recognized globally by the UN Food and Agriculture Organization (FAO) and WHO as the second most important foodborne parasitic pathology. In the 2018, the European Food Safety Authority (EFSA) considered CE among the food-borne parasites of highest relevance in Europe.

Purpose

to study the actual epidemiology of human echinococcosis lesion in the Republic of Uzbekistan for 2015–2019 to highlight the mean annual incidence of this pathology in all regions of the country, as well as the extensive value of the proportion of echinococcosis of the liver (EL), lungs (LE) and other localizations.

Material and methods

The officially registered data for all regions of the country for 2015–2019 were studied. An ultrasound screening of the abdominal organs of the population of the Khorezm region was carried out during 2019 to determine the effectiveness of early diagnosis of EL. A total of 104,284 inhabitants were examined, of which 38,660 were children and 65,624 were adults.

Results

According to the processed statistical data for all regions of the Republic of Uzbekistan for 2015–2019 on average, 2105.0 ± 43.3 patients with echinococcosis of various localizations were diagnosed. The mean annual incidence was 6.5 ± 0.09 per 100,000 inhabitants. The extensive value of the EL share was 79.4 ± 0.9% (1672.2 ± 35.6 on average per year), high-level rate - 5.2 ± 0.08 per 100,000 inhabitants; the proportion of LE was 14.0 ± 0.8% (295.2 ± 17.8), the prevalence was 0.9 ± 0.06 per 100,000 inhabitants; the proportion of echinococcosis of other localizations was 6.5 ± 0.5% (137.6 ± 13.4), the high-level value was 0.4 ± 0.03 per 100,000 inhabitants. The frequency of detection of the liver or other abdominal organs echinococcosis during screening ultrasound in the Khorezm region was 0.009%, in turn, the examination of family members of these patients increased this indicator to 0.011%.

Help from the sky: Can vultures contribute to Cystic Echinococcosis control in endemic areas?

Cystic echinococcosis (CE) is endemic in Sardinia and constitutes a serious public health concern due to high prevalence in livestock and humans. Despite sustained efforts, control of the disease had been unsuccessful in the region. Problematic carcass disposal due to soaring incineration costs and free access of dogs to infected carrion are dominant factors, fueling endemicity among other. As sole obligate scavenger, griffon vultures (Gyps fulvus) are uniquely specialized to eliminate carcasses swiftly and efficiently, saving on unnecessary environmental and economic costs for carrion disposal. However, following drastic population declines across Europe, griffon vultures practically went extinct in Italy. A conservation expansion program in Sardinia successfully reinforced the last remaining Italian vulture population by mitigating the main threats to its survival; food shortage. Through the establishment of supplementary feeding stations, permanent supply of livestock cadavers was provided. In this research, the management and conservation implications on the controlled disposal of carcass disposal through vulture feeding stations on the control of CE in Sardinia were assessed. During the course of the project, vultures scavenged a total of 81,361 kg of biomass, saving €90,041 in incineration costs and € 1,054 in CO₂ emission. Through extrapolation of these results, a total of 5,304 kg of suspected CE infected sheep carcasses (65.3%) was calculated to have been disposed by griffons, considerably reducing the CE risk and burden in Sardinia. A quantification of the amount of biomass that could be eliminated by griffon in a succeeding conservation project was also made. These calculations implied that 162,722 kg of biomass, including 10,608 kg of infected biomass from sheep, would be consumed over a period of 5 years, further lowering the CE burden in Sardinia. Our results, driven under one health approach, emphasize the crucial and direct role of griffons in breaking the lifecycle of CE as well as their indirect role in rendering multiple ecosystem and economic services through the elimination of carcasses. Please view a video Abstract here: https://youtu.be/Tm820nPq5KE.

Cystic echinococcosis (CE), is a major parasitic disease of animal and public health significance due to high morbidity and mortality. The infection is caused by the larval stage of the dog tapeworm Echinococcus granulosus, frequently reported in rural pastoral regions. In Sardinia, CE is very abundant in livestock, especially in sheep (65.3%). Several control strategies were attempted to limit the spread of CE, however, it turns out that the elimination of disease requires long lasting efforts. High prevalence of CE in Sardinia is due to multiple factors, but the cost of carcass incineration and free access of dogs to unattended carcasses are major points in the persistency of the infection. Griffon vultures as sole obligate scavengers, are highly specialized in removing the animal carcasses swiftly and efficiently, but have suffered severe population declines in the last decade. A wildlife conservation project in Sardinia envisioned to expand the griffon population by utilizing animal carcasses of animals as feed for vultures. We aimed to investigate these natural scavenging habits of vultures and the use of such “vulture restaurants” in relation to the control of CE. Our results show that the vultures remove a significant quantity of infected biomass, simultaneously saving high cost for incineration and carbon emission. The study is one of the pioneer investigations in the biological control of CE along with its estimation of ecosystem and economic services provided by the griffons.

Molecular characterization of Cysticercus tenuicollis isolates from sheep in the Nile Delta, Egypt and a review on Taenia hydatigena infections worldwide

The predator–prey-transmitted cestode Taenia hydatigena infects a wide range of definitive and intermediate hosts all over the world. Domestic and sylvatic cycles of transmission are considered as well. The parasite has considerable economic importance, particularly in sheep. Here, the molecular characters of T. hydatigena cysticerci in sheep from the Nile Delta, Egypt were investigated for the first time. For this purpose, 200 sheep carcasses and their offal were inspected at the municipal abattoir, Dakahlia governorate, Egypt. Cysticerci of T. hydatigena were collected and molecularly characterized employing the mitochondrial 12S rRNA gene. Cysticerci were found in 42 (21%) sheep, mostly attached to the omenti, mesenteries and livers. After molecular confirmation, nine isolates were sequenced displaying six different haplotypes. Analysis of the T. hydatigena 12S rRNA nucleotide sequences deposited in GenBank revealed 55 haplotypes out of 69 isolates, displaying high haplotype (0.797) and low nucleotide (0.00739) diversities. For the Tajima D neutrality index, a negative value (−2.702) was determined, indicating the population expansion of the parasite. Additionally, global data summarized in this study should be useful to set up effective control strategies against this ubiquitous parasite.

First Report of Echinococcus ortleppi in Free-Living Wild Boar (Sus scrofa) from Portugal

Cystic echinococcosis (CE) is a zoonosis that is prevalent worldwide. It is considered endemic in Portugal but few studies have been performed on Echinococcus granulosus sensu lato and their hosts. In this study, CE cysts are reported for the first time in a free-living wild boar (Sus scrofa) in Portugal. The presence of the metacestodes in the liver of the wild boar was identified by morphological features, microscopic examination and molecular analysis. The sequencing of part of the DNA nuclear ribosomal internal transcribed spacer-1 (ITS-1) region revealed a G5 genotype that presently corresponds to Echinococcus ortleppi. This is the first report of E. ortleppi in Portugal and to the best of the authors’ knowledge, in Europe. These results suggest that wild boar may be a host of CE, namely, crossing the livestock–wildlife interface, which has important public health implications. Wildlife reservoirs must be taken into account as CE hosts and surveillance of game as well as health education for hunters should be implemented using a One Health approach, with implementation of feasible and tailor-made control strategies, namely, proper elimination of byproducts in the field.

Evaluation of fecal immunoassays for canine Echinococcus infection in China

Human echinococcosis is present worldwide but it is in China that disease prevalence is the highest. In western China, especially in the Tibetan Plateau, the burden of echinococcosis is the most important. Dogs are a major definitive host of Echinococcus and monitoring the presence of Echinococcus worms in dogs is therefore essential to efficiently control the disease. Detection kits based on three different technologies including sandwich ELISA, (indirect) ELISA, and gold immunodiffusion, are currently marketed and used in China. The objective of this work was to assess the efficacy of these kits, in particular with respect to sensitivity and specificity. Four fecal antigen detection kits for canine infection reflecting the three technologies were obtained from companies and tested in parallel on 220 fecal samples. The results indicate that the performance is lower than expected, in particular in terms of sensitivity. The best results were obtained with the sandwich ELISA technology. The gold immunofiltration yielded the poorest results. In all cases, further development is needed to improve the performance of these kits which are key components for the control of echinococcosis.

Although present worldwide, human echinococcosis is at its highest prevalence in western China and particularly in the Tibetan Plateau. Controlling echinococcosis is a national priority and routine monitoring must be established. Dogs are the main infection source in China and surveying Echinococcus worms in dogs is therefore a research priority. Commercial detection kits are currently in use in China to monitor the presence of Echinococcus in dogs. The kits are based on three different technologies including sandwich ELISA with two monoclonal antibodies, (indirect) ELISA, and gold immunodiffusion. National survey programmes are essential for the control of echinococcosis and it is thus very important to assess the efficacy of these kits for the programmes. This work was therefore undertaken to assess efficacy of the kits, in particular with respect to sensitivity and specificity. Four fecal antigen detection kits for canine infection reflecting the three technologies were obtained from companies and tested in parallel on 220 fecal samples. The performance was lower than expected, in particular for their sensitivity which ranged between 51.5% and 83.9% with only two samples displaying a worm burden lower than 100. Three out of four kits showed non-specific cross-reactions with other parasites. The best results were obtained with the sandwich ELISA technology, whereas gold immunofiltration yielded the poorest results. However, in all cases, further development is strongly needed to improve the performance of these kits which are key components for the control of echinococcosis.

In-silico Analysis of Mt-CO1 Gene of Taenia Hydatigena Sheep Isolates

Taenia hydatigena is a tapeworm that affects herbivores in different regions of the world. Cysticercus tenuicollis (larvae of T. hydatigena), is prevalent in ruminants and pigs. In the current study, phylogenetic analysis of the published mt-CO1 gene of C. tenuicollis sheep isolates was analyzed using in-silico method and vertical and horizontal transmission at the global level by using a meta-analysis approach. A total of 82 mt-CO1 nucleotide sequences (339 bp) of C. tenuicollis sheep isolates from the NCBI database (Italy -Sardinia-, Iran, Palestine, Iraq, Finland, India and China) were used to investigate haplotype and genetic relationships. Tajima's D (-2,2984) value was negative for the mt-CO1 sequences signifying the population expansion and/or purifying selection. The highly negative Fu's Fs (-60,528) values determined for the sequences reflecting the existence of uncommon haplotypes. The mt-CO1 of C. tenuicollis haplotype network had 47 haplotypes arranged within a star-like configuration with a main haplotype, which encompassed 25.6 % of the total isolates. In the mt-CO1 haplotype network analyzed, there were 80.5 % unique single haplotype and highest ratio was observed in C. tenuicollis from sheep originating from Iran, followed by Sardinia, Palestine and Finland. If the current condition continues, genetic differences in T. hydatigena will be able to rise, and possible new strains and/or genotypes that may influence the host adaptation and life cycle of the parasite may emerge.

Environmental Contamination by Dog Feces in Touristic Areas of Italy: Parasitological Aspects and Zoonotic Hazards

Public spaces are common sites of fecal contamination which is concerning considering the prevalence rates of gastrointestinal pathogens carried by pets. Multiple pet-bound parasite species capable of infecting humans have previously been reported in fecal samples collected from urban areas around the globe, including Italy. In addition, the presence of gastrointestinal parasites has recently been shown in pets from the island of Sardinia, a well-known touristic destination. For these reasons, this study aims to evaluate the level of fecal contamination of two of the most important cities on Sardinia. Furthermore, the presence of endoparasites in fecal samples collected was also investigated to assess the parasitological risks associated with such contamination. A grid approach using a geographical information system was applied, followed by transect counting and sampling. A total of 956 and 220 dog feces with an average feces count of 4.7 and 2.6 per 100 linear meters were found for Sassari and Alghero, respectively. In Sassari 15.6% (52/333) and in Alghero 6.8% (6/88) of the samples tested positive for parasitic elements. Hookworms, Strongyloides stercoralis, Toxocara sp., and Trichuris vulpis were among the parasites most identified. This study showed significant urban contamination of both Sassari and Alghero with dog feces and the parasites within them, including potentially zoonotic species. The general public as well as tourists visiting the island should be aware of the risks associated with this and appropriate measures taken.

Αcute visceral cysticercosis caused by Taenia hydatigena in lambs: ultrasonographic findings

Background

Cysticercosis caused by cysticercus tenuicollis is a metacestode infection that affects several species of ungulates. It is caused by the larval stage of Taenia hydatigena, an intestinal tapeworm in dogs and wild canids. In the intermediate host, the mature cysticerci are usually found in the omentum, mesentery, and peritoneum, and less frequently in the pleura and pericardium. The migrating larvae can be found mostly in the liver parenchyma causing traumatic hepatitis in young animals. Most infections are chronic and asymptomatic, and are diagnosed at the abattoir. The acute form of infection is unusual in sheep and reports of death in lambs are rare.

Methods

In March 2018, fifteen female lambs presented anorexia, weakness, lethargy, and death secondary to acute visceral cysticercosis. Twelve of them underwent hepatic ultrasonography. Examinations were performed on standing or left lateral recumbent animals.

Results

Livers of affected animals presented rounded margins and a thickened, irregular and hyperechoic surface. Hepatic parenchyma appeared to be wholly or partially affected by lesions characterized by heterogeneous areas crossed by numerous, irregular, anechoic tracts ranging from 1 to 2 cm in length and 0.1 to 0.2 cm in width. Superficial and intraparenchymal cystic structures were also visualized. The presence of lesions was confirmed by anatomopathological examination, and T. hydatigena cysticerci was identified by morphological and molecular characterization of isolates.

Conclusions

Our results highlighted that hepatic ultrasonography is effective for an intra-vitam diagnosis of acute cysticercosis in lambs.

New Insights Into the Peculiar World of the Shepherd-Dog Parasites: An Overview From Maremma (Tuscany, Italy)

Several developments have been recently achieved to understand pet-dog parasites and their relationship with hosts; however, parasites' presence and distribution in shepherd-dog have been mainly neglected; this knowledge gap is of critical sanitary importance, as shepherd-dogs could harbor zoonotic helminths including Echinococcus granulosus sensu lato. The related human disease, cystic echinococcosis, is a worldwide neglected disease, with high endemicity in the Mediterranean Basin. To evaluate the presence of E. granulosus and other parasites, a sheep-dog population from the province of Grosseto (Tuscany, Italy) has been investigated. Overall, 648 dog fecal samples obtained from 50 modern sheep farms, having a total of 216 dogs, were collected. Specimens were analyzed using a standardized centrifugal flotation method (specific gravity = 1.3). Taeniid eggs detected were further isolated using a sieving/flotation technique. DNA was isolated from eggs for PCR and sequence analyses for species identification (gene target: 12S rRNA and nad1). Thirty-nine (78%) farms tested positive for at least one parasite species or genus. The most represented intestinal helminths were Toxocara spp. in 64% of farms, followed by Ancylostomatidae (58%), Trichuris vulpis (50%), Capillaria spp. (34%), and taeniids (32%). Sequence analyses confirmed the presence of Taenia hydatigena in seven farms, Taenia (syn. Multiceps) multiceps in five farms, and T. pisiformis in one farm. No DNA was extracted from four previously taeniid egg-positive farms. No amplification of amplicon corresponding to E. granulosus was achieved in the investigated farms. Although not entirely expected, Spearman's test showed a positive correlation between flock size and the number of dogs per farm (ρ = 0.588, P < 0.001). The quantitative analysis reported that the home slaughter practice was affected neither by the flock size nor by the number of dogs per farm. The probability to diagnose farms positive for taeniids had been increased by about 35% for each dog unit increase [odds ratio (OR) = 1.35, P = 0.012]. In conclusion, the wide distribution of T. hydatigena and T. multiceps detected in the present study clearly reveals that dogs have still access to raw offal, a major risk for the transmission of E. granulosus. Home slaughtering is an unavoidable practice, and more efforts must be undertaken by the public health system to prevent and control potential zoonotic taeniids.

Taenia hydatigena cysticercosis in wild boar (Sus scrofa) from southern Italy: an epidemiological and molecular survey

Taenia hydatigena cysticercosis is a widespread parasitic disease of wild and domestic animals. In Europe, the increase in wild boar population may potentially contribute to the spread of this parasitic infection. To determine the occurrence of cysticerci (metacestodes) in wild boar population from southern Italy, carcasses were inspected during three hunting seasons (2016-2018). Out of 3363 wild boar examined, 229 (6.8%) harboured cysticerci with 188 (82.1%) infected by a single cyst, vs 41 (17.9%) boars having more than one. Most of the positive animals (187; 81.7%) showed cysts on the liver, whereas a multiple localization of cysticerci was reported in 10 (4.4%) wild boar. The total number of cysts retrieved from positive animals was 301 (average 1.3). Molecular analysis revealed the occurrence of a common haplotype (Hap 8) shared between wild boar and domestic animals. Our findings suggest the presence of a T. hydatigena semi-domestic life cycle in which wild boar may play an important role, due to a large number of offal available to hunting dogs, wolves and foxes during hunting seasons. Hunters may be players in the management of wildlife species to control and prevent the circulation of parasitic diseases.

Cystic echinococcosis in the endemic island of Sardinia (Italy): has something changed?

Cystic echinococcosis (CE) is a disease of livestock and humans caused by the larval stage of the Echinococcus granulosus sensu lato (s.l.) species complex and occurs especially in areas where sheep breeding is widespread. This survey evaluates, after more than a decade since the last epidemiological survey, the current situation and trend of CE in sheep of the highly endemic island of Sardinia (Italy). From 2012 to 2018, out of a total of 1416 sheep, 65.3% were found positive for CE. Cyst fertility has increased slightly from 10.3% in 2006 (Scala et al. 2006) to 11.7% in the present survey (χ2 = 1.07; P = 0.30018) with a peak of 14.0% in the province of Sassari. Overall, 6815 hydatids were found and classified as sterile (26.2%), fertile (14.4%), caseous (5.3%), or calcified (54.1%) based on their morphology. All isolates were identified as E. granulosus sensu stricto (former G1/G3, strains). Results shown as the implementation of new European Council Regulations and in particular of 21/2004 that established a system for the individual identification and tracking of sheep could be a step forward towards a better control of animal movement, preventing illegal slaughtering on the island as well as in other countries experiencing similar problems. Even if at first sight the general situation of Sardinia regarding CE seems a little better compared with the past, our findings indicate that in some Provinces the epidemiological situation is not improved since 2006.

Infection rate and biochemical characterization of Cysticercus tenuicollis from sheep in Minoufiya governorate, Egypt

Cysticercus tenuicollis, the larval stage of Taenia hydatigenia, infects sheep and causes economic losses due to condemnation of infected organs. This study was designed to report the infection rate, risk factors, biochemical, and molecular characterization of Cysticercus tenuicollis in sheep from Ashmoun, Minoufiya, Egypt. The infection rate was 18%. The age was a risk factor for infection where there was a significant difference in infection rate between sheep more than 3 years and sheep under 3 years of age. There was no significant difference between infection in male and female groups. The liver had the highest organ distribution followed by omentum. Biochemical analysis of the cyst fluid showed some variations in the levels of ALT, AST, triglycerides, cholesterol, total protein, urea nitrogen, calcium, sodium, chromium, potassium than the levels identified in Algeria, Iraq, and Iran. PCR and sequence analysis of cox1 and ssrRNA showed that the sequences from Minoufiya, Egypt were highly identical to the related ones from several countries and confirmed the cyst is Cysticercus tenuicollis. This study reported the infection rate, risk factors, biochemical analysis, and molecular characterization of Cysticercus tenuicollis in sheep from Minoufiya, Egypt.

Control of cystic echinococcosis: Background and prospects

Cystic echinococcosis (CE), caused by Echinococcus granulosus, is a chronic and debilitating zoonotic larval cestode infection in humans, which is principally transmitted between dogs and domestic livestock, particularly sheep. Human CE occurs in almost all pastoral communities and rangeland areas of the underdeveloped and developed world. Control programmes against CE have been implemented in several endemic countries to reduce or eliminate the disease. New Zealand and Tasmania are examples of some of the first programmes to be undertaken (in insular territories) and which were very successful in the elimination of CE. The advent and proven effectiveness of praziquantel, plus the experience of insular models, produced high expectations for rapid advances in a second generation of control programmes undertaken in continental areas (Argentina, Uruguay and Chile). Nevertheless, only moderate gains in CE control have been made and the impact on prevalence among humans has been slight. A major impediment to the adoption of procedures that were successful in New Zealand and Tasmania has been the requirement to administer praziquantel to dogs in rural areas eight times per year over numerous years. In addition, there have been clear technological improvements made in the diagnosis of canine echinococcosis for surveillance, the genetic characterization of parasite strains and in vaccination against CE infection in livestock. In order to establish new paradigms and appropriate combinations of control strategies, we have carried out a review and discussion of the available control tools and control models. Control strategies must be suitable and sustainable to benefit the Echinococcosis-endemic areas primarily, which at the same time are the poorest regions of the world.

Cystic echinococcosis in wild boars (Sus scrofa) from southern Italy: Epidemiological survey and molecular characterization

Cystic Echinococcosis (CE) caused by Echinococcus granulosus sensu lato (s.l.) is one of the most important parasitic zoonotic diseases in the world and it represents an important public health and socio-economic concern. In the Mediterranean basin, CE is widespread and it is endemic in Italy, with major prevalence in southern areas. Several studies have investigated CE in domestic pigs, however, such data in wild boars are scant. In the last decades the wild boar population in Italy has increased and this ungulate could play an important role in the spreading of CE in the wild. Here we report on the prevalence and fertility rate of hydatid cysts in wild boars that were shot during two hunting seasons (2016-2017) in the Campania region of southern Italy. For each animal, a detailed inspection of the carcass and organs (lungs, liver and spleen) was performed and when cysts were found, their number, morphology and fertility were determined by visual and microscopic examination. Cysts were classified morphologically as fertile, sterile, caseous and calcified. Protoscoleces and germinal layers were collected from individual cysts and DNA was extracted to identify different strains/genotypes of E. granulosus s.l. Out of a total of 2108 wild boars 93 (4.4%) were found positive for CE. Infected animals were 45 males and 48 females, aged between 1 and 8 years. The average number of cysts per wild boar was 1.3 (min 1 - max 13). The total number of cysts collected was 123, of which 118 (95.9%) in the liver, 4 (3.3%) in the lungs and 1 (0.8%) in the spleen. Of all analyzed cysts, 70 (56.9%) were fertile and 53 (43.1%) sterile/acephalous. The presence of fertile cysts in 19.4% of CE-positive animals is noteworthy. Overall, molecular diagnosis showed 19 wild boars infected with the pig strain (G7).

Dicrocoeliosis in extensive sheep farms: a survey

Background

This study investigated the epidemiological and molecular aspects of dicrocoeliosis in extensive sheep farms.

Methods

From 2013 to 2014, copromicroscopical analyses in 190 dairy sheep farms and anatomo-pathological inspections in six slaughterhouses were carried in Sardinia, Italy. Rectal faecal samples were analyzed using the FLOTAC® method, and anatomo-pathological examinations were based on detecting thickened terminal bile ducts (TTBDs). In addition, genetic analyses were conducted on representative DNA samples of adult Dicrocoelium spp.

Results

Ninety-seven (51.1%) out of 190 sheep farms were coprologically positive for Dicrocoelium spp. In the liver, on the surface and cut surface, TTBDs were reported in 40.1% (309/770) and 15.3% (118/770) of the animals examined, respectively, with an overall prevalence of 25.5% (196/770). No intraspecific genetic variation was observed among the Dicrocoelium dendriticum isolates.

Conclusions

Our survey reveals the widespread presence of D. dendriticum in Sardinia, although seasonal, geographical and climatic conditions might be key factors in modulating the infection prevalence. Examining typical lesions due to D. dendriticum in the liver in abattoirs can be used as a marker for tracking chronic dicrocoeliosis infection.

First detection of zoonotic tapeworm Echinococcus granulosus sensu lato genotype G7 in continental Italy

The larval stage of the species complex Echinococcus granulosus sensu lato (s.l.) is the cause of a widespread zoonotic disease known as cystic echinococcosis (CE). The disease is highly prevalent in southern Italy and represents a serious public health issue. The main aim of this study was to characterize E. granulosus s.l. genotypes from wild boar on a continental area of Italy (Campania region), using recently developed mtDNA markers of nad2 and nad5 for reliable identification of different genotypes. Here, nad5 (680 bp) allowed for a clear identification of G1 and G3, whereas a combination of nad2 (714 bp) and nad5 (1394 bp in total) did the same for genotype G7 and its haplogroups G7a and G7b. The results of this study revealed for the first time the presence of genotype G7 in continental Italy. While haplogroup G7b was previously shown to be restricted to the islands of Corsica and Sardinia, here we demonstrate that haplogroup G7b is also present on the mainland of Italy. This work has implications in designing future strategies to reduce CE in Italy.

Molecular phylodiagnosis of Echinococcus granulosus sensu lato and Taenia hydatigena determined by mitochondrial Cox1 and SSU-rDNA markers in Iranian dogs: Indicating the first record of pig strain (G7) in definitive host in the Middle East

Unawareness of canine parasitic diseases among at-risk hosts and an uncontrolled program of stray dog population have caused that zoonotic parasites received great attention in endemic regions of the Middle East. A total of 552 faecal samples were collected between December 2016 to January 2018 from stray (n = 408) and domestic (n = 144) dogs of Iran. All specimens were coproscopically observed following concentration and flotation techniques. Subsequently, the DNAs of taeniid eggs were extracted, amplified, and sequenced by targeting of mitochondrial cytochrome oxidase subunit 1 and small-subunit ribosomal DNA markers. The overall prevalence of canine intestinal parasites found 53.6%. The following parasites and their total frequencies were identified: taeniid (10.5%), Dicrocoelium dendriticum (0.7%), Trichuris vulpis (1.2%), Capillaria spp. (2.3%), Blastocystis spp. (5.2%), Ancylostoma spp. (2%), Eimeria spp. (13.2%), Dipylidium caninum (2.3%), Toxocara canis (3.8%), Giardia spp. (8.5%), and Toxascaris leonina (3.6%). Stray dogs were characterized more likely to be poliparasitized and indicated a higher prevalence of taeniid (10.9%), T. canis (4.4%) Giardia spp. (10.1%) than domestic dogs (P > 0.05). Phylogenetic and sequence analysis of Cox1 and SSU-rDNA indicated a low genetic diversity (Haplotype diversity; 0 to 0.495) in E. granulosus sensu lato G1, G3, G7 genotypes, and Taenia hydatigena. The pairwise sequence distances between G7 isolates showed an intra-diversity of 0.7%-1.5% and identity of 98.5%-100%. The first occurrence of pig strain (G7) from Iranian dogs might have substantial implications in the drug treatment of infected dogs due to the shorter maturation time of G7 compared with G1 genotype. Thus, the preventive strategies should be noticed to determine the risk factors, the importance of applying the hygienic practices, and well adjusting deworming programs for the Iranian dogs and at-risk individuals.

Ultrasonography for early diagnosis of Toxocara canis infection in puppies

Toxocara canis is one of the most common intestinal parasites in dogs and represents a highly infectious zoonotic parasite worldwide. Adult worms live in the bowel of dogs, and infections in puppies are commonly acquired transplacentally. The biology of the parasite and the commonly used diagnostic method, based on faecal examination, often prevent an early diagnosis of toxocariasis in puppies. Ultrasonographic diagnosis of intestinal ascariasis could be a feasible alternative method to diagnose T. canis infection in puppies during the prepatent period. The present study evaluated the diagnostic accuracy of ultrasonography for the diagnosis of intestinal toxocariasis in new-born puppies during the prepatent period. Fifty-four new-born puppies were prospectively recruited in the study. Each dog underwent intestinal ultrasonography and copro-microscopic examination every 5 days, starting from the 10th day post-birth. Intestinal ultrasonography visualized adult T. canis nematodes in the puppies' small intestine from the 10th day post-birth. On the 15th day after birth, ultrasonography showed 100% specificity and 85.4% sensitivity in diagnosing T. canis infection, despite negative results deriving from the copro-microscopic examination performed at the same time point. Our results showed that ultrasonography can be used as test for early diagnosis of T. canis infection in new-born puppies during the prepatent period. Early ultrasonographic diagnosis of T. canis infection in puppies could help control the disease in dogs and reduce the zoonotic risk for the human population.

Epidemiological survey on cystic echinococcosis in wild boar from Central Italy

Despite the wide distribution of wild boar populations in Italy and the increase of its diffusion in urbanized areas, only one case report has described the occurrence of Echinococcus granulosus s.l. in a wild boar from Marche (Central Italy). The present study investigated the presence of E. granulosus sensu lato with an epidemiological survey on wild boars from central Italy that had been killed during hunting season. Seven hundred sixty-five (765) adult wild boars were examined during the 2016-2017 hunting season. Of these animals, 1.0% (8/765) were positive to E. granulosus s.l. with a fertility of 0.3% (2/765), and 2.9% animals (22/765) were positive for the metacestode stage of Taenia hydatigena (Cysticercus tenuicollis), while 0.5% (4/765) showed mixed infection (E. granulosus s.l. + T. hydatigena). Sixteen hydatids were found, of which 12.5% were fertile, 37.5% were sterile, 31.3% were caseous, and 18.8% were calcified. Eight hydatids (two fertile and six sterile cysts) were molecularly characterized by analysis of the mitochondrial gene, cytochrome c oxidase subunit 1 (cox1), and the NADH dehydrogenase subunit 1 (ND1). Hydatids found in wild boars were characterized as E. granulosus sensu stricto (G1 genotype). The present survey represents the first epidemiological study on cystic echinococcosis in wild boar in Italy which highlights the need for more extensive epidemiological investigations to determine the causal factors, economic impact, and public health importance of the disease in this livestock-wildlife setting.

Incidence, Risk Factors, and Epidemiology of Cystic Echinococcosis: A Complex Socioecological Emerging Infectious Disease in Khyber Pakhtunkhwa, Province of Pakistan

Cystic echinococcosis is a serious zoonotic disease caused by Echinococcus granulosus species complex. The current study is the first attempt to determine the level of infection in domestic livestock and to explore the CE-related knowledge and awareness among livestock farmers in different districts of Khyber Pakhtunkhwa, province of Pakistan. A total of 1297 animals were examined for hydatid cysts including 538 cows, 428 buffaloes, 208 sheep, and 123 goats, at different slaughter houses in different districts of Khyber Pakhtunkhwa in 2 years from September 2015 to September 2017. For epidemiological investigations, prevalence in association with various factors (climate, age, and gender), organ specificity, types of cysts (fertile, sterile, or calcified), and viability of cysts parameters was recorded. Basing on the results obtained, areas with high prevalence were selected for further follow-ups and administration of questionnaires to the farmers and dog owners, to provide baseline data about this parasitic disease and to identify potential areas of emergence with correspondence animal and of public health significance. The finding of this study revealed the presence of CE in livestock of KP, Pakistan. The prevalence of hydatid cysts was the highest in buffaloes (15.88%) followed by cows (15.79%), sheep (15.38%), and goats (3.25%). Our investigation revealed close relationship between prevalence and animal age and gender in different months of the year. These findings also showed the highest prevalence of hydatid cysts in liver (63.49%), followed by lungs (23.80%) and mesentery (2.64%). Fertile and viable cysts were observed in all animal species except goats. The highest percentage of fertile and viable cysts was reported from the liver and lungs of sheep. For evaluation of risk factors, a total of 384 respondents were investigated. The results of current study revealed that 97.9% of farmers are not familiar with CE and transmission of this infection from dogs to human and livestock. The present study shows that CE will continue to be of medical and veterinary importance in Pakistan.

Innovative tools for the diagnosis of Echinococcus granulosus in definitive hosts

The aim of this study was to develop and validate an innovative protocol for the diagnosis of Echinococcus granulosus and other Taeniidae in dogs. For this purpose, three experiments were performed, using faecal samples from naturally infected dogs. Firstly, the FLOTAC technique was calibrated with five flotation solutions: saturated sodium chloride (specific gravity, s.g. = 1.20), zinc sulphate (s.g. = 1.35), zinc chloride (s.g. = 1.45), Breza (s.g. = 1.30) and modified Breza (s.g. = 1.40). Then, FLOTAC was compared with four techniques of flotation in centrifuge using: zinc sulphate (s.g. = 1.20), Breza (s.g. = 1.30), modified Breza (s.g. = 1.40), and zinc chloride (s.g. = 1.45). Finally, four different protocols of DNA extraction were compared for Taeniidae identification: QIAamp Tissue Kit and QIAamp Stool from eggs; QIAamp Stool and Wizard Magnetic Purification System for Food from faeces. FLOTAC with zinc sulphate was the most efficient method to detect Taeniidae eggs, showing highest mean of eggs per gram (EPG) of faeces. The QIAamp Stool, using eggs concentrated by FLOTAC, was the best method for DNA extraction. The combination of these protocols provided the highest number of positive samples with PCR, i.e., 47/50 (94.0%). The three negative samples showed a low faecal egg count (2 EPG) below the detection limit (4 EPG) of the protocol. From sequencing of the 47 positive samples: 6 samples were identified as E. granulosus sensu stricto (s.s.), 28 as Taenia hydatigena and 6 as T. pisiformis. A co-infection between different genera of Taeniidae was found in 7 samples.

Global phylogeography and genetic diversity of the zoonotic tapeworm Echinococcus granulosus sensu stricto genotype G1

Echinococcus granulosus sensu stricto (s.s.) is the major cause of human cystic echinococcosis worldwide and is listed among the most severe parasitic diseases of humans. To date, numerous studies have investigated the genetic diversity and population structure of E. granulosus s.s. in various geographic regions. However, there has been no global study. Recently, using mitochondrial DNA, it was shown that E. granulosus s.s. G1 and G3 are distinct genotypes, but a larger dataset is required to confirm the distinction of these genotypes. The objectives of this study were to: (i) investigate the distinction of genotypes G1 and G3 using a large global dataset; and (ii) analyse the genetic diversity and phylogeography of genotype G1 on a global scale using near-complete mitogenome sequences. For this study, 222 globally distributed E. granulosus s.s. samples were used, of which 212 belonged to genotype G1 and 10 to G3. Using a total sequence length of 11,682 bp, we inferred phylogenetic networks for three datasets: E. granulosus s.s. (n = 222), G1 (n = 212) and human G1 samples (n = 41). In addition, the Bayesian phylogenetic and phylogeographic analyses were performed. The latter yielded several strongly supported diffusion routes of genotype G1 originating from Turkey, Tunisia and Argentina. We conclude that: (i) using a considerably larger dataset than employed previously, E. granulosus s.s. G1 and G3 are indeed distinct mitochondrial genotypes; (ii) the genetic diversity of E. granulosus s.s. G1 is high globally, with lower values in South America; and (iii) the complex phylogeographic patterns emerging from the phylogenetic and geographic analyses suggest that the current distribution of genotype G1 has been shaped by intensive animal trade.

Genetic diversity and phylogeography of the elusive, but epidemiologically important Echinococcus granulosus sensu stricto genotype G3

Cystic echinococcosis (CE) is a severe parasitic disease caused by the species complex Echinococcus granulosus sensu lato. Human infections are most commonly associated with E. granulosus sensu stricto (s.s.), comprising genotypes G1 and G3. The objective of the current study was to provide first insight into the genetic diversity and phylogeography of genotype G3. Despite the epidemiological importance of the genotype, it has remained poorly explored due to the ambiguity in the definition of the genotype. However, it was recently demonstrated that long sequences of mitochondrial DNA (mtDNA) provide a reliable method to discriminate G1 and G3 from each other. Therefore, we sequenced near-complete mtDNA of 39 G3 samples, covering most of the known distribution range and host spectra of the genotype. The phylogenetic network revealed high genetic variation within E. granulosus s.s. G3 and while G3 is significantly less prevalent worldwide than G1, the genetic diversity of both of the genotypes is equally high. We also present the results of the Bayesian phylogeographic analysis, which yielded several well-supported diffusion routes of genotype G3 originating from Turkey and Iran, suggesting the Middle East as the origin of the genotype.

Histopathological, immunohistochemical, and parasitological studies on pathogenesis of Coenurus cerebralis in sheep

Introduction

This study consisted in histopathological and immunohistochemical examinations of the central nervous system of 15 sheep suspected of infection with Coenurus cerebralis. The sheep displayed compulsive circling and were submitted for necropsy in 2012–2016.

Material and Methods

Species identification was made on the basis of the PCR analysis and parasitological examination of the cysts.

Results

Coenurus cerebralis cysts were detected only in the cerebral tissue of 13 sheep and in the cerebral and cerebellar tissues of 2 animals. Out of the 33 parasite cysts, most (21.21%) were located in the right and left frontal lobes of the cerebrum. The largest cyst measured 6 × 5 cm and the smallest cyst was 2 × 2 cm in size. The highest and lowest numbers of scolices were 55 and 21, and the number of rostellar hooks ranged between 22 and 30. Histopathological examination revealed the presence of typical parasitic granulomatous inflammatory foci. Immunohistochemical staining showed that most common in the periphery of the parasite cysts were, in descending order by cell number, GFAP, CD163, CD3, and CD79α-positive cells.

Conclusion

The study confirms the role of cellular defence mechanisms in the pathogenesis of Coenurus cerebralis infection in sheep.

A study to assess the awareness of risk factors of cystic echinococcosis in Turkey

OBJECTIVES

To determine the knowledge, attitudes, practices, and awareness for risk factors associated with cystic echinococcosis (CE) among animal breeders, nurses, nursing students, dietitians, food professionals and other public groups in Turkey. Methods: Questionnaire forms were prepared in compliance with the individuals' diversity, and a survey was created about agents, transmission modes, epidemiology, treatment, and risk factors for CE. The descriptive survey was performed between May 2015 and May 2016 by face-to-face communication. Data were collected from a total of 647 individuals, including 95 animal breeders, 92 nurses, 249 nursing students, 49 dietitians, 28 food professionals and 134 people from other public groups from Turkey. Survey data were evaluated in terms of percentages and means and analyzed by the Pearson's chi-square test and Mann-Whitney U test to determine the relationships between questionnaire answers and socio-demographic attributes, such as age, gender, educational level, and profession. Non-categorical variables were compared via Spearman's rho correlation analysis with statistical significance set at the 0.05 level. Results: We determined low awareness for vegetable washing, raw vegetables and offal consumption, informative courses, contact with dogs, and administration of antiparasitic drugs to dogs. Conclusion: The participants of this survey were found to be with insufficient knowledge regarding risk factors of CE. We advocate the implementation of training programs to improve public awareness on this important disease.

Histopathological, Immunohistochemical, and Parasitological Studies on Pathogenesis of Coenurus Cerebralis in Sheep

INTRODUCTION

This study consisted in histopathological and immunohistochemical examinations of the central nervous system of 15 sheep suspected of infection with Coenurus cerebralis. The sheep displayed compulsive circling and were submitted for necropsy in 2012-2016.

MATERIAL AND METHODS

Species identification was made on the basis of the PCR analysis and parasitological examination of the cysts.

RESULTS

Coenurus cerebralis cysts were detected only in the cerebral tissue of 13 sheep and in the cerebral and cerebellar tissues of 2 animals. Out of the 33 parasite cysts, most (21.21%) were located in the right and left frontal lobes of the cerebrum. The largest cyst measured 6 × 5 cm and the smallest cyst was 2 × 2 cm in size. The highest and lowest numbers of scolices were 55 and 21, and the number of rostellar hooks ranged between 22 and 30. Histopathological examination revealed the presence of typical parasitic granulomatous inflammatory foci. Immunohistochemical staining showed that most common in the periphery of the parasite cysts were, in descending order by cell number, GFAP, CD163, CD3, and CD79α-positive cells.

CONCLUSION

The study confirms the role of cellular defence mechanisms in the pathogenesis of Coenurus cerebralis infection in sheep.

Knowledge, Awareness and Practices Regarding Cystic Echinococcosis among Livestock Farmers in Basrah Province, Iraq

Cystic echinococcosis (CE) is an endemic neglected parasitic zoonosis in many of the countries of the Middle East. The disease poses a remarkable economic burden for both animals and humans. In this study, we conducted a questionnaire survey among livestock farmers in Basrah province, southern Iraq, in order to evaluate their knowledge and awareness about CE, and to understand some of the risky practices that could contribute to spread and persistence of such disease. Of the interviewed participants (N = 314), 27.4% owned dogs on their farms. Among farmers owning dogs, 76.7% (66/86) never tied up their dogs, and 43% (37/86) indicated feeding uncooked animal viscera to their dogs. The majority (96.5%) of the farmers indicated that they did not de-worm their dogs at all. Only 9.8% (31/314) of the respondents indicated eating raw leafy vegetables without washing. Added to that, 32% of the interviewees indicated that they source water for domestic use from a river; meanwhile 94.3% (296/314) of them do not boil water before using it for domestic purposes. Half of the interviewed livestock farmers in Basrah were not aware about how humans get infected with CE disease, and 41.4% (130/314) did not even realize that CE is a dangerous disease to human health. Almost one in three of the respondents who owned dogs on their farms viewed de-worming of their dogs as a low priority practice. This study highlights the gap in knowledge and awareness about CE among the study population. Risky practices associated with dog keeping management and food and water handling practices were identified. The insight from this research could be used to improve the delivery of a health education message relevant to cystic echinococcosis control at the human-animal interface in Iraq.

Identification of non-cerebral cyst: Zoonotic Taenia multiceps in domestic goat in Bangladesh

AIM

This study was performed to identify the non-cerebral Taenia multiceps cyst through molecular phylogeny of the 12S rRNA gene.

MATERIALS AND METHODS

Eight cyst samples were collected from 385 examined slaughtered goats during October 2015-September 2016 from three slaughterhouses in Chittagong City Corporation. Cysts were removed from the thigh muscle, and scolices were collected for light microscopic examination and molecular identification. The DNA was extracted and analyzed by polymerase chain reaction using 12S rRNA gene primers. Cyst samples were also preserved in 10% buffered formalin for histopathological study.

RESULTS

T. multiceps non-cerebral cyst is 2.1% prevalent in goat in this area. Under light microscopic examination, scolex was found with four suckers and a rostellum with the double crown of 32 hooks and hooklets. Molecularly, all the samples were amplified with 12S rRNA gene fragments yielded 270 base pair amplicon. Zenker's necrosis with focal to diffuse infiltration of lymphocytes and eosinophil was also found around the cyst wall in histopathological examination.

CONCLUSION

Although the non-cerebral form of the cysts produced by T. multiceps is genetically identical with the cerebral cyst, previously published data indicated that cerebral T. multiceps cyst is predominant in other parts of the world as well as in Bangladesh. This study showed that non-cerebral cyst is also prevalent in this country which is very important for public health concern. This study depicts an idea of non-cerebral form of zoonotic T. multiceps cyst which will be helpful in taenia cyst control and prevention.

Endoparasites detected in faecal samples from dogs and cats referred for routine clinical visit in Sardinia, Italy

This study aimed to update data on the prevalence of intestinal and lung parasitic infections in owned dogs and cats in Sardinia, Italy. Examinations on faecal samples from 619 dogs and 343 cats routinely referred to the Veterinary Teaching Hospital of the University of Sassari were performed between the years of 2011 and 2015. Individual faecal samples were analysed using the Wisconsin technique for copro-microscopic examination and the Baermann technique for the presence of lungworm larvae. Endoparasites were found in 34.9% and 43.4% of examined dogs and cats, respectively. Helminthic infections (21.2% in dogs and 32.6% in cats) occurred more frequently than protozoan infections (17.9% in dogs and 17.8% in cats). In both dogs and cats, the most common parasites were ascarids (12.1% and 15.7%), Cystoisospora spp. (10.2% and 10.8%), Giardia duodenalis (9.4% and 8.5%), and hookworms (7.9% and 5.5%). Evidence of bronchopulmonary nematode infections were found in 0.8% of examined dogs and in 15.8% of examined cats. Age was identified as a risk factor, with animals younger than 6months more frequently infected than older animals, while no significant association was observed for gender. This study demonstrated that endoparasites in owned dogs and cats of Sardinia have considerably high prevalence. Veterinary practitioners and pet owners should be more aware of these infections and should adopt more effective and standardized control practices.

Global Distribution of Alveolar and Cystic Echinococcosis

Alveolar echinococcosis (AE) and cystic echinococcosis (CE) are severe helminthic zoonoses. Echinococcus multilocularis (causative agent of AE) is widely distributed in the northern hemisphere where it is typically maintained in a wild animal cycle including canids as definitive hosts and rodents as intermediate hosts. The species Echinococcus granulosus, Echinococcus ortleppi, Echinococcus canadensis and Echinococcus intermedius are the causative agents of CE with a worldwide distribution and a highly variable human disease burden in the different endemic areas depending upon human behavioural risk factors, the diversity and ecology of animal host assemblages and the genetic diversity within Echinococcus species which differ in their zoonotic potential and pathogenicity. Both AE and CE are regarded as neglected zoonoses, with a higher overall burden of disease for CE due to its global distribution and high regional prevalence, but a higher pathogenicity and case fatality rate for AE, especially in Asia. Over the past two decades, numerous studies have addressed the epidemiology and distribution of these Echinococcus species worldwide, resulting in better-defined boundaries of the endemic areas. This chapter presents the global distribution of Echinococcus species and human AE and CE in maps and summarizes the global data on host assemblages, transmission, prevalence in animal definitive hosts, incidence in people and molecular epidemiology.

First molecular identification of Echinococcus vogeli and Echinococcus granulosus (sensu stricto) G1 revealed in feces of domestic dogs (Canis familiaris) from Acre, Brazil

Background

Echinococcus granulosus (sensu lato) (s.l.) and Echinococcus vogeli are causative agents of chronic zoonotic diseases such as cystic and polycystic echinococcosis, respectively. In Brazil, polycystic echinococcosis has a restricted geographical distribution in the North Region, while cystic echinococcosis is observed in the South Region. Domestic dogs (Canis familiaris) fed with raw viscera represent a risk factor for E. granulosus (s.l.) infection in the South Region. Although this practice is frequent, it remains unclear whether domestic dogs are infected with E. vogeli in the state of Acre, located in the Amazon basin in the North Region of Brazil. The aim of this study was to investigate this gap in the polycystic echinococcosis epidemiology.

Methods

Sixty-five fecal samples were collected from the ground in five municipalities (Sena Madureira, n = 14; Rio Branco, n = 06; Bujari, n = 06; Xapuri, n = 30; and Epitaciolândia, n = 09) located in the state of Acre, northern Brazil. The samples were screened for parasites by copro-PCR using the cox1 gene associated with automated sequencing.

Results

Echinococcus vogeli was molecularly confirmed in a sample from Sena Madureira and E. granulosus (sensu stricto) (s.s.) (G1) in a sample from Rio Branco.

Conclusions

These findings indicate that molecular assays are useful in typing Echinococcus taxa from fecal samples of dogs in northern Brazil. The present study is the first molecular record of E. vogeli in domestic dogs found in the state of Acre, reinforcing their role as a source of infection for humans. Because E. granulosus (s.s.) (G1) was detected for the first time in the North Region, from the epidemiological standpoint this finding is highly relevant, because it expands the known geographical distribution, which was previously restricted to the South Region of Brazil.

Echinococcosis: Control and Prevention

Human cystic echinococcosis (CE) has been eliminated or significantly reduced as a public health problem in several previously highly endemic regions. This has been achieved by the long-term application of prevention and control measures primarily targeted to deworming dogs, health education, meat inspection, and effective surveillance in livestock and human populations. Human CE, however, remains a serious neglected zoonotic disease in many resource-poor pastoral regions. The incidence of human alveolar echinococcosis (AE) has increased in continental Europe and is a major public health problem in parts of Eurasia. Better understanding of wildlife ecology for fox and small mammal hosts has enabled targeted anthelmintic baiting of fox populations and development of spatially explicit models to predict population dynamics for key intermediate host species and human AE risk in endemic landscapes. Challenges that remain for echinococcosis control include effective intervention in resource-poor communities, better availability of surveillance tools, optimal application of livestock vaccination, and management and ecology of dog and wildlife host populations.

Limited Knowledge About Hydatidosis Among Farmers in Northwest Portugal: A Pressing Need for a One Health Approach

Hydatidosis is a re-emerging disease. Farmers are a vulnerable population; however, little is known about their awareness of this disease. The purpose of this study was two-fold: (1) to assess sheep and goat farmers' awareness of, perceptions of, and attitudes towards parasitic zoonoses and hydatidosis and (2) to identify the preferred means for promotion of information about hydatidosis. A cross-sectional study was conducted. An in-person questionnaire was constructed and administered to 279 individuals. A coprological survey in shepherd dogs was performed using 88 faecal samples. SPSS version 18.0 was used for statistical analysis. Farmers reported several risk practices (69% practice home slaughtering, 46% do not deworm the dogs, 58% of these dogs have contact with other animals) and very little knowledge about hydatidosis (97% have never heard about it). Nevertheless, 75% of the farmers demonstrated interest in receiving information, mainly from a veterinarian. A wide diversity of potentially zoonotic parasites (Trichuris spp., Ancylostomatidae, Toxocara spp., Taeniidae) was found in 61% of the dogs. This survey revealed farmers' lack of knowledge in relation to hydatidosis and a high prevalence of potentially zoonotic parasites in dogs, thus pointing to the need for health education and a closer collaboration between veterinarian and public health professionals.

High-resolution phylogeography of zoonotic tapeworm Echinococcus granulosus sensu stricto genotype G1 with an emphasis on its distribution in Turkey, Italy and Spain

Echinococcus granulosus is the causative agent of cystic echinococcosis. The disease is a significant global public health concern and human infections are most commonly associated with E. granulosus sensu stricto (s. s.) genotype G1. The objectives of this study were to: (i) analyse the genetic variation and phylogeography of E. granulosus s. s. G1 in part of its main distribution range in Europe using 8274 bp of mtDNA; (ii) compare the results with those derived from previously used shorter mtDNA sequences and highlight the major differences. We sequenced a total of 91 E. granulosus s. s. G1 isolates from six different intermediate host species, including humans. The isolates originated from seven countries representing primarily Turkey, Italy and Spain. Few samples were also from Albania, Greece, Romania and from a patient originating from Algeria, but diagnosed in Finland. The analysed 91 sequences were divided into 83 haplotypes, revealing complex phylogeography and high genetic variation of E. granulosus s. s. G1 in Europe, particularly in the high-diversity domestication centre of western Asia. Comparisons with shorter mtDNA datasets revealed that 8274 bp sequences provided significantly higher phylogenetic resolution and thus more power to reveal the genetic relations between different haplotypes.

ZOONOTIC ENCOUNTERS AT THE SLAUGHTERHOUSE: PATHWAYS AND POSSIBILITIES FOR THE CONTROL OF CYSTIC ECHINOCOCCOSIS IN NORTHERN MOROCCO

This study traces the biosocial dynamics of Echinococcus granulosus – a zoonotic tapeworm spread between dogs, livestock and people – at slaughterhouses in Morocco. One of the most important parasitic zoonoses worldwide, this neglected cestode is responsible for a debilitating, potentially life-threatening, human disease and significant livestock production losses. Transmission can be interrupted, among other ways, by restricting dogs from eating cyst-infected livestock viscera. Recent epidemiological studies in Sidi Kacem province, northern Morocco, found that government-operated slaughterhouses were ‘hotspots’ for hydatid cysts in livestock and infection in dogs. An ethnographic approach was used to compliment these studies, exploring ‘how’ and ‘why’ cysts were being openly discarded. All seven visited slaughterhouses had low levels of hygiene, oversight and infrastructure. This was described locally as perpetuating a sense of ‘chaos’ that normalized (un)hygienic practices and justified the ignoring of state rules and regulations. However deference to ‘poor’ infrastructure, both physically and symbolically, served to under-emphasize local institutional logics, which were mediated by prevailing risk perceptions, economic practices and local socio-political norms. These included inter-departmental government relationships, the motivation of veterinary technicians, the political lobbying of butchers and market-based mitigation strategies. The study shows the importance of understanding E. granulosus from a biosocial perspective, and the need for more long-term, participatory and integrated ‘One Health’ approaches for neglected zoonotic diseases.

A study of morphological aspects of cystic echinococcosis in sheep in Sardinia

We have investigated the morphological and structural aspects of hydatid cysts recovered from sheep raised in southern Sardinia during two surveys conducted over the 20 years since the last control attempt at the end of the 1980s. In the first study carried out during 1995-1997, a few years after the last control attempt, a total of 10,334 cysts were examined, recovered from 1029 infected sheep out of a total of 1375 inspected (prevalence 74.84%). In the second survey, conducted ten years later during the period 2005-2010 in the absence of specific control measures, a total of 6249 cysts were recovered from 916 parasitized sheep out of the 1414 examined (prevalence 64.78%). Cysts were grouped into 5 different types: "Unilocular", "Multisepted", "Calcified", "Caseous", "Hyperlaminated". Unilocular: fertile, consist of a single fluid-filled cavity; multisepted: generally sterile, fluid filled, with cavity divided into spheroidal chambers (3-dozen); calcified: sterile, small, with internal chambers almost virtual due to the thickening of internal septa; caseous: sterile, the cavity filled with a thick yellowish matrix; hyperlaminated: sterile, with a virtual cavity filled with extensively folded and overlapping sheets of hyperproduced laminated tissue. A thorough knowledge and the precise characterization of each type of lesion, making it possible to establish detailed parameters for cyst classification, appears very useful for the harmonization of data collection. From a surveillance and control perspective it is proposed that, in addition to other relevant epidemiological information, data from meat inspection be further improved, including morpho-functional indications about cyst type.