A review of the global prevalence, molecular epidemiology and economics of cystic echinococcosis in production animals

A pilot study on the epidemiology, diagnosis and characterization of Echinococcus granulosus sensu lato in sheep, goats and dogs in Siirt province of Türkiye revealed remarkable adaptation of Echinococcus canadensis (G6/G7) in goats

Cystic echinococcosis (CE), caused by Echinococcus granulosus sensu lato (s.l.), represents one of the most significant zoonotic diseases globally, affecting both humans and animals. The objective of this study was to ascertain the prevalence of E. granulosus sensu lato in sheep and goats in a pilot region with a one-year slaughterhouse follow-up period and to determine the genetic differences and haplotypes among sheep, goat, and dog isolates. To this end, the prevalence of CE cysts was determined by monitoring the slaughter of sheep and goats at least three days a week at a slaughterhouse in the Siirt province of Türkiye during 2023. Additionally, faecal samples were collected from stray dogs and analysed using both flotation and molecular techniques. The presence of CE cysts was identified in 569 (11.12 %) of the 5119 sheep and 66 (2.31 %) of the 2860 goats after slaughtering. The highest positivity was observed in November (20.39 %), while the lowest was recorded in July (5.62 %). Of the sheep that detected positive, 25 (4.39 %) were less than one year old, while 544 (95.61 %) were older than one year. Of the infected sheep, 26 (4.57 %) were male and 543 (95.43 %) were female. 204 (35.85 %) sheep exhibited fluid-filled CE cysts, 338 (59.40 %) displayed calcification, and 27 (4.75 %) demonstrated the presence of newly developed cysts. The highest positivity was observed in December (5.83 %), while the lowest was recorded in May (0.62 %) in goats. Of the positive goats, two (3 %) were less than one year old, while the remaining 64 (97 %) were older than one year. Of the goats infected with CE cysts, 10 (15.15 %) were male and 56 (84.85 %) were female. Of the cysts, 56.1 % were fluid-filled, 42.4 % were calcified and 1.5 % were newly developed. Following DNA sequence analysis of CE cyst isolates obtained from the slaughterhouse, all 61 sheep sequences were identified as E. granulosus s.s. (G1/G3). Of the 13 goat isolates, seven were identified as E. granulosus s.s. (G1/G3), while the remaining six were classified as E. canadensis (G6/G7). The centrifugal flotation method was employed to detect the presence of Isospora spp. oocysts in eight dogs, Toxocara canis and hookworm eggs in three dogs each, and Dipyllidium caninum eggs in one dog. A total of 54 dog faeces were examined. No Taeniid eggs were observed in any of the dogs. Following PCR analysis of the mt-CO1 gene region in the dog faecal samples, four samples were positive for a 875 bp band. Only one of these bands was suitable for sequence analysis, which confirmed it as E. granulosus s.s. (G1/G3).

A scoping review of evidence of naturally occurring Japanese encephalitis infection in vertebrate animals other than humans, ardeid birds and pigs

Japanese encephalitis virus (JEV) is the leading cause of human encephalitis in Asia. JEV is a vector-borne disease, mainly transmitted by Culex mosquitoes, with Ardeidae birds as maintenance hosts and pigs as amplifying hosts. Other vertebrate animal hosts have been suggested to play a role in the epidemiology of JEV. This scoping review followed PRISMA guidelines to identify species in which evidence of naturally occurring JEV infection was detected in vertebrates other than ardeid birds, pigs and people. Following systematic searches, 4372 records were screened, and data were extracted from 62 eligible studies. Direct evidence (virus, viral antigen or viral RNA) of JEV infection was identified in a variety of mammals and birds (not always identified to the species level), including bats, passerine birds (family Turdidae), livestock (cattle [Bos taurus] and a goat [Capra hircus]), carnivores (two meerkats [Suricata suricatta]), and one horse (Equus caballus). Bat families included Pteropodidae, Vespertilionidae, Rhinolophidae, Miniopteridae, Hipposideridae. Indirect evidence (antibodies) was identified in several mammalian and avian orders, as well as reported in two reptile species. However, a major limitation of the evidence of JEV infection identified in this review was diagnostic test accuracy, particularly for serological testing. Studies generally did not report diagnostic sensitivity or specificity which is critical given the potential for cross-reactivity in orthoflavivirus detection. We hypothesise that bats and passerine birds could play an underappreciated role in JEV epidemiology; however, development of diagnostic tests to differentiate JEV from other orthoflaviviruses will be essential for effective surveillance in these, as well as the companion and livestock species that could be used to evaluate JEV control measures in currently endemic regions.

HLA class II profile in patients with different stages of cystic echinococcosis according to the WHO ultrasound imaging classification

The factors involving in the natural history and determinants of different features of human cystic echinococcosis (CE) are not adequately understood. Several host-related factors including the genetic structure of the host and human leukocyte antigens (HLAs) are believed to be involved in the natural history of CE in humans. The present study was conducted to investigate the association between HLA class II genes and active and inactive stages of hepatic cystic echinococcosis. Echinococcus granulosus cyst samples and patient information were collected from the biobank of the Iranian Hydatid Disease Registry from 2019 to 2022. HLA-DRB and HLA-DQB were characterized by PCR method. CE patients were categorized into three active (CE1 and CE2), inactive (CE4 and CE5), and transitional (CE3) stages according to the WHO ultrasound classification of CE. In total, 77 participants including 38 patients (36.8% men and 63.2% women) with different stages of CE as well as 39 healthy individuals (38.5% men and 61.5% women) were included in the study. Findings of the study showed that the frequency of HLA-DRB1*03 was significantly lower in the patients compared to the healthy individuals. The frequencies of HLA-DQB and HLA-DRB alleles were not differed significantly between active, inactive, and transitional stages of E. granulosus cysts. Findings of this study indicate the potential role of this allele in the susceptibility of human to cystic echinococcosis. Further large-scale studies in different endemic countries are required to document the significance of HLA-DQB and HLA-DRB as a host-related factor in the natural history of CE in human.

Prevalence and associated risk factors of hydatidosis in cattle slaughtered at Wolaita Sodo municipality abattoir

BACKGROUND

Hydatidosis, caused by the larval stage of the tapeworm Echinococcus granulosus, affect cattle by forming hydatid cyst in thier lungs, livers and pose great financial loss in animal production and country's economy by both direct and indirect effect. Despite its great economic and health importance, there is an absence of current information on cystic echinococcosis in cattle slaughtered at Wolaita Sodo municipality abattoir in Ethiopia.

OBJECTIVES

Current investigation determines the prevalence, organ distribution and fertility of hydatid cysts in cattle slaughtered at the Wolaita Sodo municipality abattoir in Ethiopia.

METHODS

A cross-sectional study was conducted from February, 2023, to October, 2023, at Wolaita Sodo municipality abattoir in southern Ethiopia, through regular meat examinations and cyst characterisation to determine the prevalence, organ distribution and fertility of hydatid cysts.

RESULTS

The overall prevalence of hydatidosis recorede in current study was 17.9% (69/384) and has shown a statistically significant association (p < 0.05) with the body condition of cattle. However, there was no statistically significant association (p > 0.05) between the prevalence of hydatidosis and other risk factors such as sex, breed, production system and origin of animals. This study showed that the lungs and liver were the most affected organs in cattle, followed by the spleen and kidneys. On cyst characterisation, the majority of hydatid cysts were found sterile (55.4%) followed by fertile (38.8%) and calcified (8.7%) cysts. Out of 125 fertile hydatid cysts tested for survival, 18.8% (58/321) were viable and 20% (67/321) were nonviable.

CONCLUSION

The finding of this study shows that cystic echinococcus was important health threat of the cattle and widespread in the internal organs of affected cattle causing significant economic loss by condemning edible organs that are not suitable for human consumption. Therefore, urgent and integreted preventive action is needed to disrupt the life cycle of cystic echinococcosis to tackle subsequent financial loss and risk of zoonosis to humans in the study area.

Environmental contamination with feces of free-roaming dogs and the risk of transmission of Echinococcus and Taenia species in urban regions of southeastern Iran

BACKGROUND

Dogs are the most important definitive hosts of zoonotic taeniid helminths worldwide. Different Echinococcus and Taenia species of domestic and wild carnivores pose a potential risk to human population. High populations of free-roaming dogs (FRDs) in urban areas of Iran and widespread contamination of the environment with dog feces is a potential source of infecting people living in the urban regions with cystic echinococcosis (CE). Our knowledge on the risk of CE transmission in the urban settings in the endemic regions is limited. The present study surveyed the species and genotypes of E. granulosus sensu lato and other taeniids by examining feces of free-roaming dogs in the urban areas in the city of Kerman, southeastern Iran.

METHODS

The city was divided into 100 consecutive blocks of which 25 blocks were randomly selected. Fecal samples of FRDs were counted, mapped and fresh samples were collected. Then Zinc chloride flotation, and sequential sieving was performed, and the samples were examined under an inverted microscope. Single individual taeniid eggs were isolated, partial nad1 gene was amplified and sequenced to identify species and genotypes.

RESULTS

In total 5607 fecal samples of dogs were mapped and 83 fresh samples were collected. Taeniid eggs were detected in nine fecal samples (10.8%) from seven out of the 25 city blocks (28.0%). Echinococcus eggs were found in four samples (4.8%) from three city blocks, two samples containing E. granulosus sensu stricto (2.4%), two samples containing E. canadensis G6/7 (2.4%). In addition, three samples contained eggs of Taenia hydatigena (3.6%), and one sample of Taenia serialis (1.2%).

CONCLUSIONS

This study documented the potential risk of CE transmission to humans resulting from the feces of dogs roaming freely in urban areas.

First Case Report of Cystic Echinococcosis Caused by G7 Genotype Echinococcus intermedius Confirmed by Genetic Sequencing - Southern China, December 2023

What is already known about this topic?

Echinococcosis exhibits a global distribution. In China, the primary endemic area is the northwest region. In December 2023, we documented a case of echinococcosis in an individual lacking any travel or residential history in endemic regions.

What is added by this report?

This is the first laboratory-confirmed case of hepatic echinococcosis reported in Guangdong Province, associated with the G7 genotype of Echinococcus granulosus (E. granulosus). The most probable mode of transmission is a local infection resulting from E. granulosus introduced from endemic regions.

What are the implications for public health practice?

As the circulation of agricultural products increases, it is essential to enhance the quarantine and management of livestock from epidemic areas to prevent and control the spread of echinococcosis to non-epidemic regions.

Molecular characterization of cystic echinococcosis cysts isolated from cattle in Shiraz, Iran

Cystic echinococcosis (CE), is one of the common parasitic infections of domestic animals and humans caused by the larval stages of the tapeworm Echinococcus granulosus. This research aimed to identify of CE cysts in cattle isolates from Shiraz slaughterhouse using molecular technique. Thirty CE cysts isolates were collected and total DNA was extracted from protoscolices or the germinal layer of each cyst followed by polymerase chain reaction (PCR) using cytochrome c oxidase I (cox1) and NADH dehydrogenase subunit 1 (NADH-1) mitochondrial genes (~ 450 bp) and sequencing. The sequence results were compared with available reference sequences in GenBank by BLAST system. Phylogenetic analysis was performed using MEGA 5.0 software and the maximum likelihood method. The results showed that all 30 samples examined in this study were identified as E. granulosus sensu stricto (G1-G3 genotypes) with G1 dominant.

Untargeted metabolomics to discriminate liver and lung hydatid cysts: Importance of metabolites involved in the immune response

The Echinococcus granulosus sensu lato species complex is responsible for the neglected zoonotic disease known as cystic echinococcosis (CE). Humans and livestock are infected via fecal-oral transmission. CE remains prevalent in Western China, Central Asia, South America, Eastern Africa, and the Mediterranean. Approximately one million individuals worldwide are affected, influencing veterinary and public health, as well as social and economic matters. The infection causes slow-growing cysts, predominantly in the liver and lungs, but can also develop in other organs. The exact progression of these cysts is uncertain. This study aimed to understand the survival mechanisms of liver and lung CE cysts from cattle by determining their metabolite profiles through metabolomics and multivariate statistical analyses. Non-targeted metabolomic approaches were conducted using quadrupole-time-of-flight liquid chromatography/mass spectrometry (LC-QTOF-MS) to distinguish between liver and lung CE cysts. Data processing to extract the peaks on complex chromatograms was performed using XCMS. PCA and OPLS-DA plots obtained through multiple statistical analyses showed interactions of metabolites within and between groups. Metabolites such as glutathione, prostaglandin, folic acid, and cortisol that cause different immunological reactions have been identified both in liver and lung hydatid cysts, but in different ratios. Considering the differences in the metabolomic profiles of the liver and lung cysts determined in the present study will contribute research to enlighten the nature of the cyst and develop specific therapeutic strategies.

Cystic echinococcosis in cattle and sheep caused by Echinococcus granulosus sensu stricto genotypes G1 and G3 in the USA

BACKGROUND

Endemic domestic dog-ruminant cycles and human cystic echinococcosis caused by Echinococcus granulosus have been sporadically reported in the United States. However, there is a paucity of molecular data describing the genotypes and haplotypes of this important cestode in domestic ruminant hosts.

METHODS

Ninety-four cysts from the lungs and/or livers of slaughtered beef cattle (76 samples), dairy cows (five samples) and sheep (13 samples) were collected from abattoirs in four states of the USA. Samples were genotyped at two mitochondrial loci, cox1 and nad5. Sequences were used to determine species, genotypes and haplotypes using median joining networks and Bayesian phylogenetic analyses. Cyst fertility was assessed in hematoxylin and eosin-stained sections. Additionally, previously reported autochthonous E. granulosus infections in the USA in various hosts were mapped.

RESULTS

Based on cox1 sequences obtained from 94 cysts, 89 (94.7%) were identified as E. granulosus G1/G3, while five (5.3%) were Taenia hydatigena. Taenia hydatigena were only isolated from sheep. Based on nad5 sequences obtained from 89 hydatid cysts, 96.6% and 3.4% belonged to E. granulosus sensu stricto genotypes G1 and G3 respectively. Two haplotypes were found among E. granulosus cox1 sequences, neither of which was geographically unique. Six haplotypes were found among nad5 sequences in genotype G1, of which five were novel, while one haplotype was found in genotype G3. In the concatenated cox1-nad5 dataset, seven haplotypes were identified, of which six were geographically unique. All cysts from cattle were non-fertile. Four cysts from sheep were fertile.

CONCLUSIONS

All genotyped samples belonged to E. granulosus s.s. This is the first study to our knowledge to confirm the presence of genotypes G1 and G3 in domestic cattle and sheep intermediate hosts in the USA and provide data for future diagnostic and epidemiological studies. Sequences have been deposited in GenBank (cox1 sequences: OR398494-OR398496, nad5 sequences: OR400695-OR400702).

Prevalence of cystic echinococcosis among livestock in pastoral and agro-pastoral areas in Uganda

Cystic echinococcosis (CE) remains a significant challenge in Uganda with precise status largely undocumented in most communities. To determine CE prevalence, post-mortem examination was done on 14 937 livestock (5873 goats, 1377 sheep, 3726 zebu cattle and 3054 Ankole cattle) slaughtered in abattoirs in the districts of Moroto in Karamoja region, Kumi in Teso region and Nakasongola and Luwero in Buganda region. The overall CE prevalence was 21.9% in sheep, 15.2% in zebu cattle, 5.5% in goats and 2.1% in Ankole cattle. Moroto district had a higher prevalence of CE than other districts with 31.3% in zebu cattle, sheep 28%, goats 29.1% and (0%) in Ankole cattle. On organ locations, the lungs were the most affected in all livestock in all the study areas. Considering cyst fertility, 33.9, 1.7 and 6.4% of Ankole cattle, sheep and zebu cattle respectively had fertile cysts in the liver while 4.5% of goats and 4% Ankole cattle had fertile cysts in the lungs. In conclusion, CE is widespread and occurs among cattle, sheep and goats in pastoral and agro-pastoral areas in Uganda. Therefore, there is an urgent need to create awareness among the communities on role of livestock in CE epidemiology and transmission.

Gray wolves as sentinels for the presence of Echinococcus spp. and other gastrointestinal parasites in France

Over the past 30 years, the gray wolf population has recovered in France, initially to wolves from Italy passing through the Alps. The population is carefully monitored, but little information is available on their helminth fauna, which includes parasites of public health importance: Echinococcus multilocularis and Echinococcus granulosus sensu lato. Capitalizing on the availability of 911 fecal samples collected for the noninvasive genetic monitoring of French wolf populations, along with the intestines from 15 dead wolves, the presence of Echinococcus species among others helminth species was evaluated in French wolves. A copro-PCR approach amplifying a large spectrum of parasites was used for fecal samples while intestines were analyzed using SCT. The fecal occurrences of E. granulosus sensu stricto (2.4%) and E. multilocularis (0.3%), and indeedother parasitic species, are similar to those of other European wolf populations including Taenia hydatigena (7.2%), Taenia krabbei (2.4%), Uncinaria stenocephala (2.4%), Mesocestoides litteratus (1.9%), Taenia ovis (0.3%), Taenia multiceps (0.1%), and Toxascaris leonina (0.1%). The three most abundant species were also found in the intestines. Infections by E. granulosus sensu stricto are in accordance with the overlap of wolf pack areas and sheep breeding pastoral units. However, the wolf does not appear to play a significant role in the lifecycle of E. granulosus sensu stricto. The availability of this opportunistic fecal sampling of wolves in southeastern France means that they can be used as sentinels for the surveillance of E. multilocularis in the context of its southward expansion observed in recent years.

Prevalence of intestinal parasites in street dogs (Canis lupus familiaris) with highlights on zoonosis in Lalitpur, Nepal

BACKGROUND

The presence of intestinal parasites influences the growth and well-being of canids. Additionally, infected dogs and their faeces with considerably higher eggs/oocysts released per gram (epg/opg) of zoonotic parasites contribute to parasitic spillover to humans, domestic animals and sympatric wildlife.

OBJECTIVES

The current study aimed to reveal the prevalence of intestinal parasites (protozoa and helminths) and to list the zoonotically significant parasites in free-roaming street dogs in Lalitpur Metropolitan City, Nepal.

METHODS

Fresh faecal samples (n = 332) were collected from feral dogs of varying ages and sexes and transported to the research laboratory. The copro microscopic examination was carried out via direct wet mount, formalin ethyl acetate sedimentation, saturated salt flotation, acid-fast staining and sporulation techniques.

RESULTS

Coproscopy revealed an overall 95.7% (318/332) prevalence rate with 23 diverse species of intestinal parasites (10 protozoa and 13 helminths). Among them, 5 protozoa and 11 helminths possessed zoonotic potential, and their overall prevalence was 92.5%. Helminth's overall prevalence was double that of the protozoa (87.7% vs. 43%). Polyparasitism was dominant over mono parasitism (79.5% vs. 16.3%), and co-infection of up to seven species of parasites at a time was recorded.

CONCLUSIONS

Urban street dogs harboured a higher prevalence of intestinal parasites that varied with age and sex. Since most of the reported parasites are zoonotic, dog density and parasitic richness indicate a greater spillover risk to humans and domestic animals. Furthermore, this study also provides appropriate 'baseline' data for assessing effective control measures against parasitic infestations among street dogs and controlling their transmission to humans.

A Novel Designed Sandwich ELISA for the Detection of Echinococcus granulosus Antigen in Camels for Diagnosis of Cystic Echinococcosis

Echinococcus spp. are important cosmopolitan zoonotic parasitic tapeworms that cause a disease called hydatidosis or cystic echinococcosis (CE), which has remarkable economic losses. The objective of our study was to develop a specific IgG polyclonal antigen-based ELISA (Sandwich ELISA; capture ELISA) method for the detection of circulating Echinococcus granulosus (E. granulosus) antigens in camels infected with hydatid cysts before slaughtering and its application in serodiagnosis of CE in animals to assess the positive rate of hydatidosis in camels slaughtered in Giza governorate abattoirs in Egypt. In this study, molecular identification of Echinococcus sp. isolate was performed based on the NADH dehydrogenase subunit 1 (NAD1) gene, revealing the isolate (GenBank: OQ443068.1), which is identical to the G6 E. granulosus sensu lato genotype. The positive rate of hydatid cysts was determined in slaughtered camels' organs (n = 587). The results revealed that hydatid cysts were found in 46.5% (273/587) of the examined camels. Pulmonary echinococcosis was significantly more prevalent in the slaughtered camels (60%, 164/273) than hepatic echinococcosis (39.9%, 109/273), (p = 0.001, Chi Square = 11.081). Cyst fertility rates were higher in hepatic (90.8%, 99/109) than in pulmonary cysts (83.5%, 137/164) and the most viable protoscoleces were recorded from fertile the hepatic cysts (67.85 ± 12.78). In this study, hydatid cyst germinal layer antigen (GlAg) was isolated and used for the immunization of rabbits to raise IgG polyclonal antibodies (anti-Echinococcus GlAb IgG). These IgG polyclonal antibodies were purified by affinity chromatography using a protein A column, then labeled with horseradish peroxidase. Electrophoretic analysis of IgG polyclonal antibodies and crude GlAg was performed in 10% polyacrylamide gels. The SDS-PAGE revealed four bands at molecular weights of 77 kDa, 65 kDa, 55 kDa, and 25 kDa. The Sandwich ELISA was performed to evaluate the sensitivity and specificity and cross-reactivity of the prepared IgG polyclonal antibodies. The circulating hydatid antigen was found in 270 out of the 273 samples with hydatidosis, with a sensitivity of 98.9% (270/273), a specificity of 94.9% (296/312) and a diagnostic efficacy of 96.8%. Regarding the cross reactivity, anti-Echinococcus GlAb IgG showed a low cross-reactivity with Fasciola gigantica infected camel sera (3/8), and Myiasis (Cephalopina titillator larvae; 3/20). No cross-reactivity was recorded with uninfected camel sera (negative sera for E. granulosus), and no cross-reactivity was found with antigens of Eimeria spp., Toxoplasma gondii, Cryptosporidium sp., and Hyalomma dromedarii (ticks' infestation). Then, Sandwich ELISA was conducted again to detect E. granulosus antigen in all the collected camel sera, which resulted in a 48.7% (286/587) positive rate of CE compared to 46.5% (273/587) using a postmortem inspection (PM diagnosis) (p = 0.5, Chi Square = 0.302). In conclusion, the Sandwich ELISA technique introduced in this study appears to be a sufficiently sensitive diagnostic assay for the detection of camels' echinococcosis using anti-Echinococcus GlAb IgG. In addition, it might offer a significant medical and veterinary importance in helping the early detection of hydatidosis, as well as its early treatment.

High species diversity of Echinococcus spp. in wild mammals of Namibia

An opportunistic survey for Echinococcus spp. in wild mammals was conducted in seven distinct study areas throughout Namibia, representing all major ecosystems, between 2012 and 2021. In total, 184 individually attributable faeces and 40 intestines were collected from eight species of carnivores, and 300 carcasses or organs of thirteen species of ungulates were examined for Echinococcus cysts. Nested PCR and sequencing of the mitochondrial nad1 gene led to the identification of five species of the Echinococcus granulosus sensu lato complex. Echinococcus canadensis G6/7 was found throughout Namibia at low frequency in lions, cheetahs, African wild dogs, black-backed jackals and oryx antelopes. Echinococcus equinus was present only in northern Namibia, locally at high frequency in lions, black-backed jackals and plains zebras. Echinococcus felidis was found only in one small area in the north-east of Namibia, but with high frequency in lions and warthogs. Echinococcus granulosus sensu stricto was identified only in two African wild dogs in the north-east of Namibia, and Echinococcus ortleppi occurred in central and southern Namibia in black-backed jackals and oryx antelopes. The development of fertile cysts indicated active intermediate host roles of oryx antelopes for E. canadensis and E. ortleppi, of warthogs for E. felidis, and of plains zebras for E. equinus. Our data support earlier hypotheses of exclusive or predominant wildlife life-cycles for E. felidis involving lions and warthogs, and - in Namibia - for E. equinus involving lions and/or black-backed jackals and plains zebras. Our data further support an interlink of wild and domestic transmission for E. ortleppi. A possible involvement of livestock and domestic dogs in transmission of E. canadensis G6/7 and E. granulosus s.s., the two parasite species with highest zoonotic potential, is uncertain for Namibia and needs further investigation.

The spatial distribution of cystic echinococcosis in Italian ruminant farms from routine surveillance data

Introduction

Cystic echinococcosis (CE) is a zoonotic parasite caused by the cestode Echinococcus granulosus sensu lato (s.l.) which predominantly affects livestock. The disease is endemic in central-southern and insular Italy, with CE particularly infecting sheep, goats, cattle, and water buffalo. The spatial distribution of CE in endemic regions is not widely understood, with surveillance efforts varying across the region.

Methods

In this study, we investigated the spatial distribution of CE in livestock using samples from farms across different livestock species using a Stochastic Partial Differential Equations (SPDE) model. Samples were collected during a survey conducted in the area of central-southern and insular Italy between the years 2019 – 2021.

Results

A total of 3141 animal samples (126 goats, 601 sheep and 2414 cattle and water buffalo) were inspected for Echinococcus s.l. cysts through routine surveillance in abattoirs by postmortem visual examination, palpation and incision of target organs. The geographic location of the farm of origin (a total of 2,878) for each sample was recorded. CE prevalence of 46.0% (1,323/2,878) was estimated at the farm level with 78.3% (462/590) of farms with sheep, 28.6% (36/126) of farms with goats, 36.5% (747/2,049) of farms with cattle, and 23.5% (102/434) of farms with water buffalo infected.

Discussion

The spatial model evaluated the probability of infection in farms across the sampled regions, with the distribution of CE showing high clustering of infected cattle farms in Sardinia and Sicily regions, and sheep farms in Salerno province (Campania region). The output of this study can be used to identify CE hot-spots and to improve surveillance and control programs in endemic areas of Italy.

Genetic diversity and haplotype analysis of yak and sheep echinococcal cysts isolates from the mitochondrial cox1 gene in parts of Tibet, China

Echinococcosis, also known as hydatid disease, is caused by the metacestode stage of the species cluster Echinococcus granulosus sensu lato (E. granulosus s.l.). It is almost widespread worldwide, especially in countries and regions dominated by animal husbandry. It is a major parasitic disease that seriously endangers human health, public health safety, environmental safety, and the development of animal husbandry production in western China. In this study, the mitochondrial cox1 gene was used to analyze the genetic diversity and haplotype of bovine and sheep echinococcal cysts isolated in Tibet. Echinococcus granulosus sensu stricto (E. granulosus s.s., G1, G3) was still the dominant species in the infected samples of yak and sheep in some parts of Tibet. Through haplotype analysis, Hap_1 was deemed the dominant haplotype, 14 of the 20 haplotypes were similar to the reference sequence previously published in Genbank, and the rest of the 6 haplotypes were found for the first time. Through Tajima's D value, neutral test Fu's Fs analysis, and haplotype network map, it can be concluded that Echinococcus population expansion has occurred in Xigaze, Tibet. This study provides basic data for understanding the genetic characteristics, epidemiology, and control of echinococcosis in this area.

Cystic echinococcosis in northern Tanzania: a pilot study in Maasai livestock-keeping communities

Background

There are close similarities between the life-cycles of Echinococcus granulosus sensu lato (E. granulosus s.l.) that causes cystic echinococcosis (CE) in humans and Taenia multiceps/Coenurus cerebralis that causes cerebral coenurosis in small ruminants. Recent evidence highlights that livestock in Maasai communities of northern Tanzania are suffering from increases in the prevalence of cerebral coenurosis, leading to concerns about a possible concurrent increased risk of human CE. The aim of this study was to estimate the prevalence of human abdominal CE and the prevalence and species/genotypes of E. granulosus s.l. in livestock in Maasai communities.

Methods

Human CE was diagnosed by abdominal ultrasound on volunteers aged ≥ 7 years in five villages in the Longido and Ngorongoro Districts in northern Tanzania. Infection in ruminants was evaluated through inspection in local abattoirs, followed by molecular identification of one cyst per animal, with a priority for hepatic cysts, using PCR targeting of the cytochrome c oxidase I gene (COX1), followed by restriction fragment length polymorphism and multiplex PCR, and sequencing of non-E. granulosus s.l. samples.

Results

Ultrasound was performed on 823 volunteers (n = 352 in two villages in Longido District, and n = 471 in three villages of Ngorongoro). Hepatic CE cases were diagnosed only in Ngorongoro (n = 6; 1.3%), of which three had active cysts. Village-level prevalence of CE ranged between 0 and 2.4%. Of the 697 ruminants inspected, 34.4% had parasitic cysts. Molecular identification was achieved for 140 of the 219 (63.9%) cysts sampled. E. granulosus s.l. and T. hydatigena/Cysticercus tenuicollis were identified in 51.4% and 48.6%, respectively, of livestock cysts. E. granulosus s.l. was identified in livestock from both Longido (35.3% of 116 genotyped cysts) and Ngorongoro (91.2% of 34 genotyped cysts). Of the total of 72 E. granuslosus s.l. cysts identified in livestock, 87.5% were E. granulosus sensu stricto (G1–G3 genotypes), 9.7% were E. ortleppi (G5) and one cyst was E. canadensis (G6–10). The three active human cysts, which were removed surgically, were G1–G3 genotypes.

Conclusions

Multiple species/genotypes of E. granulosus s.l. are circulating in Maasai communities of northern Tanzania. Human CE was detected in villages of Ngorongoro District and a high prevalence of echinococcal cysts was observed in livestock in both districts. More precise estimation of the prevalence in this area and a better understanding of the specific risk factors for CE among Maasai communities in northern Tanzania is needed. Interventions targeting transmission routes common to both E. granulosus s.l. and T. multiceps would have dual benefits for preventing both human and livestock disease.

Graphical Abstract

Protection against cystic echinococcosis in sheep using an Escherichia coli-expressed recombinant antigen (EG95) as a bacterin

The EG95 recombinant vaccine is protective against cystic echinococcus in animal intermediate hosts. Preparation of the existing, registered EG95 vaccines involves semi-purification of the vaccine protein, adding to the cost of production. Truncation of the EG95 cDNA, shortening both the amino and carboxy-termini of the protein, leads to high levels of recombinant protein expression. The recombinant EG95 protein was prepared as a bacterin from clarified, whole bacterial lysate, and used in a vaccine trial in sheep against an experimental challenge infection with Echinococcus granulosus eggs. The EG95 bacterin was found to induce 98% protection. Use of this in a new generation EG95 vaccine would simplify production, facilitate new sources of the vaccine and potentially enhance uptake of vaccination in control of E. granulosus transmission.

Genetic diversity of Echinococcus granulosus sensu lato in China: Epidemiological studies and systematic review

Cystic echinococcosis (CE) is a neglected tropical zoonosis caused by Echinococcus granulosus sensu lato (s.l.) and remains a major public health concern globally. Here, CE isolates (n = 3310) with clearly defined genotypes and geographical origins in China were retrieved through our epidemiological survey (2016-2020) and systematic review (1992-2020). Existing known genotypes of Echinococcus granulosus sensu lato (E. granulosus s.l.) except for G4 have been found in China, particularly on the Tibetan Plateau, where their genetic diversity is unique to that part of the world. According to the systematic review, genetic compositions of E. granulosus s.l. in China were as follows: E. granulosus (G1, G3), 98.3%; Echinococcus ortleppi (G5), 0.1%; Echinococcus intermedius (G6, G7), 1.4%; and Echinococcus canadensis (G8, G10), 0.2%. Specifically, G1 was responsible for 97.7% of infections and characterized by the broadest host ranges and geographic distributions. Our epidemiological results showed a relatively stable genetic composition of E. granulosus s.l. in sheep and yaks from three CE hyperendemic provinces (Xinjiang, Sichuan, Qinghai). A higher proportion of fertile cysts were found in sheep (287/406, 70.7%) than in yaks (28/184, 15.2%). During the past 29 years, 51 cox1 haplotypes of E. granulosus s.l. were endemic in China. The ancestral haplotype (Hap_2) remained the most common haplotype, 12 relatively common haplotypes were endemic and nine newly reported haplotypes were found during the survey. Overall, our results demonstrate that the compulsory immunization of sheep and the pilot EG95 vaccination campaign in yaks are well matched with the current genotypic situation. In addition to yaks, we advocate for more surveillance of CE isolates from pigs, cattle, goats and camels, since their roles in the transmission and reservation of E. granulosus s.l. have been largely ignored in China.

Cystic echinococcosis in cattle slaughtered at a slaughterhouse in Gessa, southern Ethiopia

Cystic echinococcosis is caused by the metacestode of the zoonotic flatworm Echinococcus granulosus. A cross-sectional study was conducted from October 2020 to August 2021 at the Gessa municipality abattoir in southern Ethiopia, through regular meat examinations and cyst characterization to determine the prevalence, organ distribution, and fertility of Cystic echinococcosis. The overall prevalence of Echinococcus granulosus sensu lato was 17.9% (69/384) and has shown a statistically significant association (p < 0.05) with the body condition of cattle but not with other putative risk factors (p > 0.05). The odds of poor body condition cattle infected with CE was 1.29 times higher than medium body condition (OR = 0.506; CI = 0.566–2.96). Based on organ distribution of cysts, the lungs and liver were the most affected organs having a statistically significant difference (p < 0.05) with the prevalence of CE. Based on the size of cysts, small (47.9%) size cysts revealed the highest prevalence as compared with large (33.3%) and medium (18.8%) sized cysts. On cyst characterization, the majority of Cystic echinococcosis were sterile cysts (55.4%) followed by fertile (38.8%) and calcified (8.7%) cysts and revealed a statistically significant difference (p < 0.05). Cyst number, organ localization, fertility of cyst, and cyst size have shown a strong positive correlation (r = 0.8686, r = 0.8393, r = 0.9506, and r = 0.9189) with the prevalence of CE, respectively. The presence of an overall high prevalence of Echinococcus granulosus sensu lato in the present study required urgent action to interrupt the life cycle of Cystic echinococcosis and further studies using molecular techniques to characterize the circulating genotypes to prevent the risk of zoonosis in humans in the study area.

Global distribution of Echinococcus granulosus genotypes in domestic and wild canids: a systematic review and meta-analysis

The current systematic review and meta-analysis demonstrate the genotypic distribution of canine echinococcosis worldwide. Studies published from the inception until 21 May 2021 were screened, relevant articles were selected and the random-effect model was used to draw forest plots with 95% confidence intervals (CIs). Totally, 44 articles were included, mostly examined dogs (37 records), followed by wolf (8 records), jackal (7 records), fox (3 records), pump fox (3 records) and coyote (1 record). Echinococcus granulosus sensu stricto (G1–G3) and G6/7 cluster of Echinococcus canadensis were the most common genotypes among canids. Most studies were conducted in Asia and Europe with 17 and 15 datasets, respectively. Exclusively, Iran possessed the highest number of studies (10 records). Meta-analysis showed that the pooled molecular prevalence of echinococcosis was 33.82% (95% CI 24.50–43.83%). Also, the highest and lowest prevalence of canine echinococcosis was calculated for South America (66.03%; 95% CI 25.67–95.85%) and Europe (19.01%; 95% CI 9.95–30.16%). Additionally, there were statistically significant differences between the global prevalence of echinococcosis in canines and publication year, continent, country, sample type, host and molecular test. These findings will elevate our knowledge on the poorly known canine echinococcosis worldwide.

Cystic echinococcosis in slaughtered sheep in Erzurum province, Turkey

Cystic echinococcosis (CE) is an important zoonotic infection caused by the larval stages of the genus Echinococcus. Turkey is a highly endemic region for CE and the disease is one of the major public health problems. The study was aimed to assess the situation of the CE in sheep in Turkey and also to provide data on circulating genotypes in the country. A total of 3319 sheep at slaughter were screened during the study. The prevalence of CE in the study area was 31.7% (1052/3319). The lungs were the most frequently CE infected organ (52.6%, 526/1052). Microscopic examination revealed that overall cyst fertility was 68.1%. Molecular analysis of partial fragments of 12S and COI gene regions were included for 351 selected cyst samples and all of them were identified as E. granulosus sensu stricto. Sequence analysis showed that the predominant genotype in the study areas was G1 (77.1%), and the rest were G3 (22.9%). The prevalence rate of CE in sheep in the study area is lower compared to previous years except for one province. Considering the high cyst fertility rate and the predominance of E. granulosus G1 which is particularly pathogenic to humans, calls for serious control measures like public awareness about the disease, sufficient dog deworming programs, continuity of monitoring the disease should be taken.

Ultrasonography of Parasitic Diseases in Domestic Animals: A Systematic Review

Simple Summary

The aim of this literature review was to summarize the current knowledge on the application of ultrasonography in diagnosis, staging and monitoring of helminthic diseases in domestic animals. We selected and analyzed 122 papers about the application of ultrasonography in parasitic disease in ruminants, equids, swine, and companion animals. Helminths can be recognized in ultrasound images by their morphology, size, and location. In some cases, the parasites are not directly seen by ultrasound, but the lesions caused by them can be easily visualized. Ultrasound imaging is taking on an increasingly important role in veterinary parasitology.

Abstract

The aim of this review was to summarize the current knowledge on the application of ultrasonography in diagnosis, staging and monitoring of helminthic diseases in domestic animals. Only peer reviewed papers written in English language were included in this systematic review. All papers concerning unicellular parasites, wild animals, non-domestic experimental animals, or ex vivo or in vitro applications of ultrasonography were excluded from the review. A total of 122 papers met the inclusion criteria. Among them 47% concerned nematodes, 37% cestodes, and 16% trematodes with the genus Dirofilaria, Echinococcus, and Fasciola the most represented, respectively. Helminths can be recognized in ultrasound images by their morphology, size, and location. In some cases, the parasite stages are not directly seen by ultrasound, but the lesions caused by them can be easily visualized. Ultrasound imaging is taking on an increasingly important role in the diagnosis, staging, monitoring, and control of parasitic diseases in veterinary medicine. However, it cannot replace the clinical approach and the diagnostic tests commonly used in veterinary parasitology.

Prevalence and molecular characterization of cystic hydatidosis in livestock slaughtered in southern Mozambique

Hydatid disease is a parasitic zoonosis caused by genotypes of the genus Echinococcus. This disease inflicts economic loses in livestock and cause public health burden in resource poor mostly in developing countries. The aim of this study was to determine the prevalence and identity of the genotypes responsible for hydatid cysts in cattle, goats and pigs slaughtered at selected abattoirs of southern provinces of Mozambique. Cysts were collected from liver and lungs and hydatid confirmation was made by cystic membrane observation and visualization of protoscoleces by light microscope. Thirty-two hydatid cysts from 817 cattle and two from 68 pigs were collected from local slaughterhouses and slabs. DNA was extracted from protoscoleces of each cyst together with the cystic membrane and amplified based on the mitochondrial subunit 1 of the cox1 and nad1 gene. The overall prevalence of hydatid cysts was 3.9% in cattle, 2.9% in pigs and none of the goats were found with cysts. All cysts collected from cattle and pigs were identified as Echinococcus ortleppi (G5) with a minimum homology of 99% on BLAST analysis. Our results confirm the presence of E. ortleppi in cattle and pigs in southern Mozambique at a low prevalence and further studies are recommended to determine the risk factors favoring the transmission of this zoonotic parasite in the resource-poor livestock farming communities of this region.

Cystic Echinococcosis in Slaughtered Cattle and Sheep from North Macedonia

Cystic echinococcosis is a cosmopolitan zoonotic infection, commonly seen in areas where livestock and dogs are kept together. The objective of this study was to investigate the prevalence of echinococcosis in slaughtered cattle and sheep in North Macedonia and to evaluate the location and fertility/sterility rates of the cysts. A total of 302 slaughtered animals were examined with visual inspection, palpation, and incision of the internal organs in order to detect cysts. Microscopic examination was carried out to determine the presence of protoscoleces. The overall prevalence of echinococcosis in slaughtered cattle and sheep was 60%. The presence of cysts increased with age in cattle. In both cattle and sheep, the most common affected organs were the liver and lungs infected with more than one cyst. The findings showed higher fertility rate in sheep which confirmed their role as the most important intermediate host. This study shows that North Macedonia is an endemic region, and serious control strategies should be implemented, with special emphasis on safety disposal of infected organs and anthelmintic treatment of the dogs.

Findings of a community screening programme for human cystic echinococcosis in a non-endemic area

Cystic Echinococcosis (CE) is a zoonosis caused by infection with the larval stages of the taeniid cestodes of the species complex Echinococcus granulosus sensu lato. It is prevalent among transhumant communities in East Africa, including those residing in northern Kenya. The movement of livestock from these regions of high incidence to areas of low incidence creates an indirect risk of disease spill-over to humans. To assess possible establishment of the CE life cycle outside known endemic regions, we used a portable ultrasound scanner to screen for the presence of human CE in Bungoma County of western Kenya, an area which imports substantial numbers of cattle for slaughter from neighbouring pastoralist regions. Eight sentinel sites were purposively selected based on their proximity to slaughterhouses handling animals introduced from pastoralist regions, and necessary permissions to conduct the study were sought. Regression analyses were conducted to identify risk factors associated with the presence of abdominal and cystic lesions (CL). In total, 1002 participants were screened; of these, 654 (65.3%) were female and the median age was 43. Farming (n = 403; 43.4%) was the most frequent occupation, followed by professional (i.e. on regular salary) (n = 215; 23.1%), and business (n = 207; 22.3%) categories. Sixty-seven participants (6.7%) had abnormal ultrasound findings, of these, 7 (1.1%) had simple liver cysts/CL, as per WHO classification. As such, their outcome was inconclusive and they were not put on treatment but advised to attend follow-up investigations in a referral health facility. Other abnormal findings included splenomegaly (n = 14), ovarian cysts (n = 14), uterine fibroids (n = 10), polycystic kidneys (n = 6), and benign prostatic hyperplasia (n = 6). Age was unconditionally associated with the presence of presumptive CL. These results contribute to CE baseline data while providing insights on the implementation of ultrasound diagnosis in the field, as recommended by the WHO for targeted control of echinococcosis by 2030.

Echinococcus granulosus sensu stricto and E. canadensis are distributed in livestock of highly endemic area in the Peruvian highlands

The prevalence of cystic echinococcosis is high in many livestock areas of Peru, where intermediate hosts such as sheep, cattle, and South American camelids can be infected. Several species of E. granulosus have been described in relation to its genetic diversity and distribution. The aim of this study was to determine the species of E. granulosus sensu lato (s.l.) metacestodes collected from sheep, cattle, swine and camelids at different localities in the department of Puno, in the southern highlands of Peru. One hundred and fifty-two echinococcal cysts were collected from 10 different locations. E. granulosus s.l. species were determined by amplification of the Internal transcribed spacer 1 of the ribosomal DNA using a Nested PCR-RFLP technique. The cytochrome C oxidase 1 gene (450 bp) was also amplified and sequenced in samples with different RFLP patterns. Cysts samples were collected from sheep (39.5%), cattle (32.9%), pigs (15.8%) and alpacas/llamas (11.8%). E. granulosus sensu stricto (G1 genotype) was mainly identified in all animal hosts, while, the E. canadensis (G7) was only identified in cysts from pigs and alpacas. This is the first report of E. granulosus sensu stricto and E. canadensis in llamas and alpacas, respectively. Knowledge of species and molecular epidemiology of E. granulosus s.l. in endemic areas in Peru may help to evaluate preventive programs, understand disease transmission, as well as improve vaccine and chemotherapy effectiveness.

Electronic data collection to enhance disease surveillance at the slaughterhouse in a smallholder production system

Globally, meat inspection provides data for animal health surveillance. However, paper-based recording of data is often not reported through to higher authorities in sufficient detail. We trialled the use of an electronic meat inspection form in Kenyan slaughterhouses, in lieu of the currently used paper-based format. Meat inspectors in two ruminant slaughterhouses completed and submitted an electronic report for each animal slaughtered at their facility. The reports, which captured information on the animal demographics and any eventual condemnations, were stored in a central database and available in real-time. A stakeholder meeting was held towards the end of the study. Over the 2.75 year study period, 16,386 reports were submitted; a downward linear trend in the monthly submissions was noted. There was a week effect, whereby more reports were submitted on the market day. Of the slaughtered animals, 23% had at least a partial condemnation. The most frequently condemned organs were the liver, lungs and intestines; the primary reasons for condemnations were parasitic conditions. Lack of feedback and difficulty capturing animal origin information were the primary challenges highlighted. The study demonstrated that electronic data capture is feasible in such challenging environments, thereby improving the timeliness and resolution of the data collected.

Molecular characterization and immune protection of the 3-hydroxyacyl-CoA dehydrogenase gene in Echinococcus granulosus

BACKGROUND

Cystic echinococcosis (CE) is a serious parasitic zoonosis caused by the larvae of the tapeworm Echinococcus granulosus. The development of an effective vaccine is one of the most promising strategies for controlling CE.

METHODS

The E. granulosus 3-hydroxyacyl-CoA dehydrogenase (EgHCDH) gene was cloned and expressed in Escherichia coli. The distribution of EgHCDH in protoscoleces (PSCs) and adult worms was analyzed using immunofluorescence. The transcript levels of EgHCDH in PSCs and adult worms were analyzed using quantitative real-time reverse transcription PCR (RT-qPCR). The immune protective effects of the rEgHCDH were evaluated.

RESULTS

The 924-bp open reading frame sequence of EgHCDH, which encodes a protein of approximately 34 kDa, was obtained. RT-qPCR analysis revealed that EgHCDH was expressed in both the PSCs and adult worms of E. granulosus. Immunofluorescence analysis showed that EgHCDH was mainly localized in the tegument of PSCs and adult worms. Western blot analysis showed that the recombinant protein was recognized by E. granulosus-infected dog sera. Animal challenge experiments demonstrated that dogs immunized with recombinant (r)EgHCDH had significantly higher serum IgG, interferon gamma and interleukin-4 concentrations than the phosphate-buffered saline (PBS) control group. The rEgHCDH vaccine was able to significantly reduce the number of E. granulosus and inhibit the segmental development of E. granulosus compared to the PBS control group.

CONCLUSIONS

The results suggest that rEgHCDH can induce partial immune protection against infection with E. granulosus and could be an effective candidate for the development of new vaccines.

A One-Health evaluation of the burden of cystic echinococcosis and its prevention costs: Case study from a hypo-endemic area in Italy

An integrated model, based on a One Health approach, was implemented to estimate the epidemiological and economic outcomes of cystic echinococcosis (CE) in Veneto region, an hypo-endemic area of Northern Italy, and the costs for its prevention. Data and information needed to populate the model were retrieved from published literature, official statistics, expert opinions, or actively searched through data mining (i.e., Hospital and slaughterhouse data), when fundamental data were not available. Human-health and animal-health costs, both public and private, were considered. The overall impact of CE in the study area was estimated in an yearly cost of about 0.5 million €, due to an average of 19.5 human hospitalized cases and about 200 infected animals among cattle and sheep, per year. The human:animal costs ratio was about 8:1. Most of the infected animals were autochthonous, while the identification of an autochthonous source of the infection for the human cases was extremely difficult, and unlikely in most cases. No specific action resulted to be in place for human surveillance, while veterinary surveillance accounted for a yearly cost of about 22,000 €. Sheepherders were found to pay privately an overall amount of around 2000 € for the preventive treatment of their dogs every year, but the applied protocol proved to be sub-optimal. The source of most of the human cases was likely external to the study area, and their economic impact accounts for a cost that is far exceeding that of surveillance and preventive actions in place in the veterinary sector. Although autochthonous human cases appeared to be very rare, the strengthening of preventive actions and surveillance systems can reduce the risk of their increment.

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The study integrated epidemiology and economic aspects in a One Health perspective.

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The research estimates in detail the overall impact of CE in a hypo-endemic region in Italy.

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The study provided data for evidence-based actions to control CE in the study area.

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The investigated case study represents a reproducible model for zoonotic diseases evaluation.

Echinococcoses in Iran, Turkey, and Pakistan: Old Diseases in the New Millennium

Echinococcosis is considered a cosmopolitan zoonosis caused by different species of small taeniid tapeworms of the genus Echinococcus and is regarded as a neglected zoonosis. Cystic and alveolar echinococcoses are endemic diseases of Tibetan, Pamir, and Iranian plateaus. All of the countries within the Iranian plateau are affected by echinococcosis. Pakistan, Turkey, and Iran are the three most populous countries of the region, in which echinococcosis is highly endemic. The three neighboring countries share strong cultural and socioeconomic ties. The present study aimed to provide a broad review of the status of cystic and alveolar echinococcosis, summarizing the current knowledge about geographical distribution, molecular epidemiology, and transmission dynamics of Echinococcus granulosus sensu lato and Echinococcus multilocularis in this region. Additionally, we aimed to understand disease burden and risk factors as basic requirements for establishing a surveillance system and planning prevention and control programs. A considerable body of information is available on different aspects of echinococcosis in this region; however, several information and research gaps need to be filled before planning control programs. None of the countries in the region have an elaborate echinococcosis control program. Effective control programs require multi/intersectoral coordination within a One Health approach with a long-term political and administrative commitment and enhanced international collaboration among the three countries.

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.

Exploring Risk for Echinococcosis Spillover in Northern Minnesota Tribal Communities

Echinococcus spp. are zoonotic cestode parasites with a worldwide distribution and a complex, two-host life cycle involving carnivore definitive hosts and small mammal or ungulate intermediate hosts. Surveillance for Echinococcus spp. in the Midwestern United States (USA) is rare. Using a mixed-methods approach, we examined Echinococcus infection risks in wildlife and domestic dogs in four Minnesota Tribal Nations. We hypothesized that the spillover of Echinococcus spp. into domestic dogs would vary with the presence or absence of suspected wildlife host species and certain behaviors associated with domestic dog ownership, like feeding wildlife host carcasses or frequency of veterinary care. Among 83 dogs tested, three (3.6%) were positive for Echinococcus spp. Despite low prevalence, pet owner survey and focus group findings indicated that dogs encounter peri-domestic wildlife most often when they roam freely or consume wildlife carcasses. This study demonstrates a need for further research into spillover potential of endemic zoonotic Echinococcus spp. in the Midwest USA.

Human and animal cystic echinococcosis in Konya, Turkey: molecular identification and the first report of E. equinus from human host in Turkey

Cystic echinococcosis is a neglected, zoonotic disease in Turkey. The disease is commonly seen in rural areas where the local population is in close contact with livestock and dogs. This research aimed to molecularly identify of hydatid cysts in cattle and human isolates from Konya, Turkey. Following sample collection, direct microscopy was performed. After direct examination, total DNA was extracted, and positive PCR products of cox 1 mitochondrial gene (~ 875 bp) were sequenced. A total of 83 hydatid cysts (cattle n = 57 and human n = 26), 82 were identified as Echinococcus granulosus sensu stricto (G1–G3 genotypes), and one human isolate was characterized as Echinococcus equinus (G4 genotype). Fertility rates of cysts belonging to cattle for liver and lung cysts were 93.3% and 80%, respectively. Out of 26 human originated isolates, 18 (69.2%) of cysts were found to be fertile. To the best of our knowledge, this is the first report of E. equinus from human host in Turkey.

Echinococcus granulosus sensu lato and Echinococcus multilocularis: A review

Echinococcus spp. have a global distribution and are found on every continent except Antarctica. Infections with these parasites are considered extremely serious, contributing to significant morbidity and mortality in addition to substantial economic losses to the livestock industry. Echinococcus granulosus sensu lato (s.l.) and Echinococcus multilocularis, causing cystic echinococcosis (CE) and alveolar echinococcosis (AE) respectively, are the two main species of interest from a human and veterinary perspective. This review collates the current state-of-the-art understanding of these two parasites within four key areas of relevance to human and veterinary professionals: transmission and epidemiology, clinical signs and pathogenesis, diagnosis, and treatment and prevention. This review should serve as a broad introduction to the most important Echinococcus spp. The reader is advised to seek out specific literature on individual diseases and their causative parasites for a deeper understanding.

Echinococcus ortleppi and Echinococcus canadensis G6/7 affect domestic animals in western Zambia

Cystic echinococcosis (CE) is endemic in many parts of sub-Saharan Africa. In contrast to the eastern part of the continent, very little data exists on the current disease situation in southern Africa including Zambia. This study determined frequency and species identity of Echinococcus spp. circulating in livestock and dogs in the Western Province of Zambia. Cysts were collected in slaughterhouses at meat inspection (cattle) and during examination of home slaughtered pigs, while dog faecal samples were collected per-rectum and examined microscopically for the presence of taeniid eggs. Individual taeniid eggs from faecal samples and individual protoscoleces from cysts were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and/or sequencing of the NADH-dehydrogenase subunit 1 (nad1) and cytochrome C oxidase 1 (cox1) gene. Fifty-four of 2000 cattle (2.7%) were found infected with a total of 65 cysts, predominantly fertile lungs cysts; all cysts were identified as Echinococcus ortleppi. Two out of 52 home-slaughtered pigs (3.8%) were infected with a fertile lung cyst each; both cysts were also identified as E. ortleppi. Microscopic examination revealed 10/289 dog faecal samples to contain taeniid eggs, of which four samples (two each) contained Echinococcus canadensis (G6/7) or Taenia hydatigena, respectively. This is the first insight in the Echinococcus species circulating in Zambia providing premises for further studies into transmission dynamics of CE in the southern African region.

Spatial epidemiology of cystic echinococcosis in livestock from a hyper-endemic region in southern Chile

Cystic echinococcosis (CE) is a parasitic zoonosis, caused by the larval stage of Echinococcus granulosus. This disease has a worldwide distribution and is considered an important zoonosis in Chile, especially in regions where raising livestock dominates. We aimed to describe the spatial distribution and risk factors for CE in cattle and sheep slaughtered in the Aysén Region, Chile between 2015 and 2016, to inform disease control in this hyper-endemic region. Clustering and hotspot analyses of CE at the farm-level were performed (Moran's global index, local indicator of spatial autocorrelation (LISA), and the scan statistic Poisson model), and we used spatial interpolation to display areas with a higher risk of CE. Mixed effects logistic regression models were fit to assess the association between municipality of origin and age of animals and CE detected at slaughter, with the farm of origin included as a random effect. Overall, data from 1532 cattle farms (1078 geocoded) and 30,805 cattle were analyzed, with a 64 % and 39 % CE prevalence at the farm and animal-level, respectively. For sheep farms, data from 381 (296 geocoded) farms and 58,223 sheep were analyzed, with a 71 % and 18 % CE prevalence at the farm and animal-level, respectively. Globally, the CE prevalence in both cattle and sheep farms was not clustered. However, we found 14 cattle and 23 sheep farms with high prevalence that were locally clustered. We also detected 6 and 11 clusters in cattle and sheep farms, respectively. Risk of reported CE varied according to municipalities of origin, and the age of animals. This study confirms that the Aysén region is a hyper-endemic region for CE. It demonstrates the usefulness of the traceability of animals slaughtered for understanding the epidemiology of CE. The results suggest that in this hyper-endemic region in which there are limited financial resources available, that intervention activities - at the beginning of a control program - should be focused on farms with high prevalence and identified disease clusters.

Cystic Echinococcosis of Camels: 12S rRNA Gene Variation Revealed Changing Pattern of Genetic Diversity Within Echinococcus granulosus sensu lato in the Middle East and North/Sub-Saharan Africa

Cystic echinococcosis (CE) is one of the most widespread zoonotic diseases, with considerable public health and economic importance. Camels play a significant role in transmission cycle of Echinococcus granulosus especially, in the Middle East and North Africa (MENA). The present study aimed to identify the genetic variation and haplotype distribution of camel isolates of E. granulosus sensu lato using all existing E. granulosus mitochondrial DNA data from camels in different parts of the world. Sequence data from 1,144 camel isolates of E. granulosus s.l. available in the NCBI GenBank including 57 camel hydatid cysts collected in central Iran were used to analyze the nature of genetic variation within the camel isolates of E. granulosus s.l. in MENA region. Fifty-seven camel isolates were also PCR-sequenced on mitochondrial 12S rRNA gene. Haplotype network analysis revealed seven different haplotypes clustered into four major groups. E. intermedius G6 was identified as the most commonly represented genotype in camels followed by G1. Mitochondrial 12S rRNA gene sequence analysis on 57 camel isolates identified three different genotypes, including E. intermedius/G6 (35/57, 61.4%), E. granulosus sensu stricto/G1-G3 (21/57, 36.8%) as well as one isolate identified as E. ortleppi/G5 (1/57, 1.8%). The number of base substitutions per site over 420 positions of partial 12S rRNA gene sequences were shown as 0.000 and 0.004 for E. intermedius (G6) corresponding to the Middle East and sub-Saharan isolates, respectively. Camel isolates of E. granulosus in the MENA region present moderate genetic diversity (Hd = 0.5540–0.6050). The Middle East isolates demonstrated a more diverse population than the North/sub-Saharan isolates, where six out of seven 12S rRNA haplotypes were identified in the former region. E. intermedius (G6 genotype) was shown to be the most common species in the world camel population. In conclusion, camels showed to be an important intermediate host species in the MENA region with different patterns of genetic variation between the Middle East and Africa.

Epidemiological distribution of Echinococcus granulosus s.l. infection in human and domestic animal hosts in European Mediterranean and Balkan countries: A systematic review

Cystic echinococcosis (CE) is a neglected zoonosis caused by infection with the cestode Echinococcus granulosus sensu lato. We carried out a systematic literature review on E. granulosus s.l. human and animal (cattle, sheep, dog) infection in European Mediterranean and Balkan countries in 2000–2019, to provide a picture of its recent epidemiology in this endemic area. MEDLINE, EMBASE, Scopus, Google Scholar and Open Grey databases were searched. Included cases were: i) for humans, data from hospital records and imaging studies; ii) for dogs, data from necropsy and coprological studies; iii) for ruminants, cases based on slaughter inspection. The NUTS (Nomenclature of Territorial Units for Statistics) classification was used to categorize extracted data in epidemiological units, defined as data referred to one NUTS2 (basic region) in one year time. Data were then aggregated to NUTS1 level (major regions), calculating the average incidence value of included epidemiological units. For prevalence studies covering different epidemiological units, the pooled prevalence was estimated. Data were extracted from 79 publications, 25 on human infection (covering 437 epidemiological units), and 54 on animal infection (52 epidemiological units for cattle, 35 for sheep and 25 for dogs). At NUTS1 level, average annual incidence rates of human CE ranged from 0.10–7.74/100,000; pooled prevalence values ranged from 0.003–64.09% in cattle, 0.004–68.73% in sheep, and 0–31.86% in dogs. Southern and insular Italy, central Spain, Romania and Bulgaria reported the highest values. Bovine data showed a more similar pattern to human data compared to sheep and dogs. Limitation of evidence included the paucity of human prevalence studies, data heterogeneity, and the patchy geographical coverage, with lack of data especially for the Balkans. Our results confirm Italy, Spain, and Eastern Europe being the most affected areas, but data are extremely heterogeneous, geographical coverage very patchy, and human prevalence studies extremely scant. Results also highlight the notorious problem of underreporting of E. granulosus s.l. infection in both humans and animals.

Cystic echinococcosis (CE) is a neglected zoonosis caused by infection with the parasite Echinococcus granulosus sensu lato, naturally transmitted between canids and livestock; CE in humans can be a serious condition. In endemic areas, CE is responsible for significant health and economic losses, but its real burden is difficult to estimate. E. granulosus s.l. is especially present in areas where livestock breeding is practiced, including European Mediterranean and Balkan countries. We carried out a systematic literature review on the epidemiology of E. granulosus s.l. human and animal infection in this area in 2000–2019. Data were extracted from 79 publications, and referred to Nomenclature of Territorial Units for Statistics (NUTS) levels per year. Average annual incidence rates of human CE ranged from 0.10–7.74/100,000; pooled prevalences ranged from 0.003–64.09% in cattle, 0.004–68.73% in sheep, and 0–31.86% in dogs. Bovine data showed a more similar pattern to human data compared to sheep and dogs. Our results confirm that Italy, Spain, and Eastern Europe are the most affected areas, but data are extremely heterogeneous, geographical coverage very patchy, and human prevalence studies extremely scant. Results also highlight the well-known problem of underreporting of E. granulosus s.l. infection in both humans and animals.

Atypical parasitic lesions in slaughtered cattle in Southern Brazil

In this study, we described the morphological features and unusual presentations of hydatidosis, fasciolosis, and eosinophilic myositis caused by Sarcocystis species diagnosed at the slaughterhouse lines. Twenty-seven samples of atypical parasitic lesions from distinct cattle were evaluated, of which 12 corresponded to hydatidosis, 11 to fasciolosis, and 4 to eosinophilic sarcocystosis. Hydatid cysts were observed mainly in the heart, with all cases involving the left ventricle. Fasciolosis lesions involved mainly the lungs, and were characterized by a focal nodular elevated area involving the edges of the lobes. Intralesional trematodes were observed in three cases. Sarcocystosis lesions were observed in four cases, and lesions were primarily located in the skeletal and cardiac muscles. Grossly, they presented as focal or focally extensive streaks, patches, or numerous nodules that were greenish to mildly yellowish. Histologically, all the cases had intralesional ruptured cysts of Sarcocystis that were associated with severe eosinophilic myositis and myocarditis. Parasitic lesions in atypical locations and/or with aberrant responses should be promptly identified because it may mistakenly diagnosed as other potentially zoonotic diseases, such as cysticercosis and tuberculosis.

Microsatellite Investigations of Multiple Echinococcus Granulosus Sensu Stricto Cysts in Single Hosts Reveal Different Patterns of Infection Events between Livestock and Humans

Cystic echinococcosis (CE) caused by the cestode Echinococcus granulosus sensu lato (s.l.) is a worldwide zoonosis and E. granulosus sensu stricto (s.s.) is the most common species associated with animal and human diseases. The objective of this study was to obtain a better understanding of CE infection in livestock and humans from very low and high endemic areas—France and Tunisia—by studying the genetic diversity of E. granulosus s.s. at the intra-individual host level. This genetic diversity was studied using EgSca6 and EgSca11 microsatellite profiles in 93 sheep from France and Tunisia, and in 12 cattle and 31 children from Tunisia only, all presenting multiple CE cysts (2 to 10 cysts). Overall, 96% of sheep, 92% of cattle, and 48% of children had at least two cysts with different microsatellite profiles. Inversely, 35% of sheep, 17% of cattle, and 65% of children had at least two cysts with the same microsatellite profile. The genotyping results for the CE samples highlight high and similar genetic diversity in France and Tunisia, suggesting that the probability of being successively infected by CE of the same microsatellite profile was rare in both countries. Therefore, our results suggest that in rare cases, several eggs of the same microsatellite profile, from two to seven in our data, can be ingested simultaneously in a single infection event and develop into several cysts in livestock and children. They also indicate that multiple infection events are frequent in livestock, even in a low endemic country such as France, and are less frequent but not negligible in children in a high endemic country such as Tunisia. Moreover, this is the first time that genetic evidence of secondary CE has been found. Further studies are needed to better assess the pattern of infection events in livestock and humans, especially by studying the genetic diversity of adult worms in definitive hosts.

Molecular characterization of human lung and liver cystic echinococcosis isolates in Van Province, Turkey

Cystic echinococcosis (CE) is a zoonotic infection and could lead to significant public health problems. The genetic diversity of CE includes five species: E. granulosus sensu stricto (s.s.) (G1-G3), Echinococcus equinus (G4), Echinococcus ortleppi (G5), Echinococcus canadensis genotypic cluster (G6, G7, G8 and G10, with the doubtful G9) and the Echinococcus felidis (lion strain). The species are important in epidemiology, pathology, control, prevention measures and vaccine/drug designs. The aim of the present study was to determine the E. granulosus genotypes in humans in the Van province in east of Turkey. In total, 102 echinococcal cysts were collected from operated patients. Genomic analyses were conducted with PCR-RFLP of the rDNA internal transcribed spacer 1 (ITS1) fragment and partial PCR sequencing of the cytochrome c oxidase subunit 1 (cox1) mitochondrial DNA gene region. In total, DNAs of 96 isolates could be extracted, unfortunately six extractions failed. The PCR-RFLP analysis findings were identical in all isolates. Two bands were observed at approximately 300 bp and 600 bp. All profiles corresponded to the G1-G3 strain. Also, 446 bp amplified gene regions were observed for cox1. Out of 20 samples, alignment of 16 sequences exhibited a total identification (100%) of granulosus sensu stricto (G1/G3). Of 16 samples, 8 were obtained in the lung and 12 were obtained in the liver; 8 belonged to male and 12 belonged to female patients. Other four samples exhibited one nucleotide substitution at different positions. Four samples had one nucleotide substitution at different positions. We detected single nucleotide variations in TRH1, TRH67, TRH85 and TRH89 isolates at the positions C240T; G330T; G211A and T157C, respectively. In conclusion, the present study was the first comprehensive molecular investigation on genetic characterization of human CE isolates in Van region. The findings demonstrated that E. granulosus s.s. was the dominant species, which indicated that the sheep-dog cycle was the source in human infections. And, probably, it would be possible to describe these mutations as "Turkey" or "lung" variants. In addition to contributing molecular epidemiological data, the present results should be considered when designing and implementing E. granulosus control programs.

Complete mitochondrial genome analysis confirms the presence of Echinococcus granulosus sensu lato genotype G6 in Nigeria

Cystic echinococcosis (CE) is common in Africa especially in northern and eastern countries where it is highly prevalent and mainly caused by Echinococcus granulosus sensu stricto and Echinococcus granulosus sensu lato (G6/7). In a recent epidemiological survey in Nigeria, the G6/7 genotype was reportedly responsible for the majority of CE infection. In this study, considering the taxonomic challenges of the G6/7 genotype and the limitation of the cox1/nad1 genes in resolving the differences, we sequenced the complete mitochondrial (mt) genome of seven larval isolates of E. granulosus s.l. G6/7 haplotypes recently reported in Nigeria to correctly assign them to either (G6/7) genotype and to understand the mt genome variation with isolates from other geographical regions. On analysis, a total of 13,731 bp in a covalently closed circular molecule were realized. The total mt length was ≥10 bp than previously reported G6 and G7 mt genome sequences. Also, the median-joining network and phylogeny based on the 12 protein-coding sequences correctly identified them as G6 genotype. Since longer mt genome sequences have shown some advantage over individual genes in resolving taxonomic challenges, we confirm that the genotype responsible for the majority of CE infection in livestock in Nigeria is the G6 genotype and the availability of the complete mt genome from different Nigerian intermediate hosts will prove useful in future genetic population studies across the country and the West African sub-region.

Cystic echinococcosis in the Eastern Mediterranean region: Neglected and prevailing!

Cystic echinococcosis (CE) is distributed worldwide, extending from China to the Middle East and from Mediterranean countries to the sub-Saharan Africa and South America. According to WHO, one million people around the world are suffering from CE with an estimated burden of 183,573 DALYs. The annual monetary burden of the disease due to treatment costs and CE-related livestock losses has been estimated at US$ 3 billion. CE is endemic in all countries within the WHO Eastern Mediterranean Regional Office (EMRO). The region, which includes most of the Middle East and North Africa, is one of the most ancient foci of the domestic cycle of CE and is recognized as one of the major hotspots of CE. There are 22 countries in the EMRO, where about 688 million people are living at risk of CE. In many EMRO countries, little is known about CE epidemiology and transmission. WHO included echinococcosis in a list of 17 neglected tropical diseases (NTDs) and 12 neglected zoonotic diseases (NZDs). Accordingly, different regional offices of WHO organized several initiatives for CE control and prevention. WHO’s Western Pacific regional office considered echinococcosis as one of the region’s major health topics, and several preventive measures have been implemented in the American region with the support of Pan American Health Organization (PAHO) in Argentina, Peru, Uruguay, and Chile. Although CE is endemic in all 22 EMRO countries, surprisingly, CE is absent from the health topics list of diseases and conditions in this region. Therefore, CE clearly requires further attention in the WHO EMRO agenda, and the need for elaboration of specific measures for CE control is becoming apparent in EMRO countries, where substantial collaborations among the member states and WHO EMRO is of paramount importance. Major topics of collaborative activities include training programs and health communication on different aspects of CE control, analysis of CE burden, national and international surveillance and disease registry systems, technical support to promote epidemiological studies for collecting baseline data, cost–benefit analysis of control interventions, and intersectoral cooperation among the agriculture, veterinary, medical, and health sectors.

Comprehensive Account on Prevalence and Characteristics of Hydatid Cysts in Livestock from Pakistan

Pakistan is at intersection of hyperendemic regions for hydatidosis. Current study aimed to determine the prevalence of hydatid cysts and cyst characteristics in different intermediate hosts (sheep, goats, cattle and buffaloes) across the 4 provinces of Pakistan. A total of 991 sheep, 1,478 goats, 1,602 cattle and 1,343 buffaloes were examined for presence of hydatid cysts during 2 years (January 2016–December 2018). Differences in frequency of hydatidosis were observed with highest overall prevalence in buffaloes (11.9%) and sheep (11.5%). Highest prevalence and burden of infection were observed in older age animals (23.8%, 9.78±0.49) and females (26.5%, 12.53±0.67). Data for seasonal prevalence alluded to year-round presence of disease with non-significant statistical difference. Organ predilection indicated liver as the most preferred site of cyst localization followed mainly by lungs. An over-dispersion pattern was observed in all infected animals as majority of cysts belonged <10 cysts per infected host category. Highest percentage of fertile cysts was observed in liver of sheep. Interestingly, solitary form of cysts had higher fertility rate than multiple form. Amid lack of data and wide gap of knowledge, this study would try to fill up the lacunae regarding this neglected tropical disease. Extensive rearing of livestock, unregulated official slaughter and home slaughtering have played role in adaptability of E. granulosus in Pakistan.

Molecular Characterization of Echinococcus multilocularis and Echinococcus granulosus from Cysts and Formalin-Fixed Paraffin-Embedded Tissue Samples of Human Isolates in Northeastern Turkey

Erzurum province of Turkey is known to be highly endemic for alveolar echinococcosis (AE) and cystic echinococcosis (CE). In this study, we confirmed Echinococcus multilocularis cases, searched genetic variations of the isolates, and-for the first time-determined the genotypes of Echinococcus granulosus s.l. infecting humans in the province. A total of 5 alveolar and 106 hydatid cysts as well as 23 formalin-fixed paraffin-embedded (FFPE) samples that were diagnosed as AE were collected from hospitals between 2015 and 2017. Partial sequences of two mitochondrial genes were amplified to detect E. multilocularis and E. granulosus sensu lato with conventional polymerase chain reactions (PCRs) and genotypes confirmed by sequencing. PCR amplification of a partial 12S rRNA gene on an alveolar cyst and FFPE tissue samples yielded the expected bp in 5 cysts and 19 of 23 FFPE samples; all Erzurum E. multilocularis isolates were confirmed by sequencing. Phylogenetic analysis of the isolates indicated that some of them were identical to European isolates, whereas some of them were identical to Asian isolates. Off all hydatid cyst samples, 101 (95.2%) yielded the expected bp (94 with 12S rRNA-PCR and 7 with COI-PCR). Sequence analysis showed that 98 (97%) of them corresponded to the G1 genotype, whereas 3 (3%) corresponded to the G3 genotype. Results of the study emphasize that E. multilocularis isolates of Erzurum, based on short sequencing, are similar to both European and Asian isolates, and the G1 genotype of E. granulosus is the main causative agent of human CE in Erzurum.

Echinococcus granulosus sensu stricto, Echinococcus ortleppi; and E. intermedius (G7) are present in Bolivia

Cystic echinococcosis (CE) is a zoonotic disease caused by a complex of species known as Echinococcus granulosus sensu lato. CE is endemic in Argentina, Chile, Peru, Uruguay and the South part of Brazil. In contrast, little is known regarding the presence of CE in Bolivia. In this study, 35 cysts isolated from livestock (mostly from the Department of La Paz) and 3 from humans (La Paz, Oruro and Potosi) were genetically characterized analysing the sequence of the cox1 gene (1609 bp). In total, 30 cysts (from La Paz, Cochabamba and Beni) were characterized as E. granulosus sensu stricto (3 fertile and 4 non-fertile cysts from sheep, 8 fertile and 12 non-fertile cysts from cattle and 3 fertile cysts from humans). A detailed analysis of the cox1 haplotypes of E. granulosus s.s. is included. Echinococcus ortleppi (G5) was found in 5 fertile cysts from cattle (from La Paz and Cochabamba). Echinococcus intermedius (G7) was identified in 3 fertile cysts from pigs (from Santa Cruz). Additionally, E. granulosus s.s. was detected in 4 dog faecal samples, while E. ortleppi was present in other two dog faecal samples. The implications of these preliminary results in the future implementation of control measures are discussed.

Multiplex cytokine and antibody profile in cystic echinococcosis patients during a three-year follow-up in reference to the cyst stages

Background

Cystic echinococcosis (CE) is a worldwide parasitic zoonosis caused by infection of the larval stage of tapeworm Echinococcus granulosus. In human CE, the parasites develop and form cysts in internal organs. The differentiated cysts can be classified into five types based on WHO-IWGE standard CE1-5 representing different developmental stages. Infection with E. granulosus triggers hosts’ humoral and cellular response, displaying elevated serum antibodies and Th1 and Th2 cytokines, which are presumed to be in association with the disease outcome. Identification of immunological markers for evaluation of disease progression has been a growing concern. However, the distinctive profile of cytokines and antibodies associated with the cyst progression has not been ascertained.

Methods

To better understand the interaction between host immune response and disease outcome, the present study followed-up four CE patients over three years by yearly measuring serum level of 27 cytokines, total IgG and isotypes, and ultrasound scanning, beginning in year 1 for all patients with CE1 and CE2 cysts before treatment and continued in year 2 with CE4 and in year 3 with CE3-CE5 post-treatment.

Results

Nine cytokines including Th1-type IL-2, Th17-type IL-17A, and inflammatory cytokines IL-1β, IL-1Rα and TNF-α, chemokines IL-8, MIP-1α, MIP-1β, and growth factor G-CSF were significantly elevated in patients with cyst type CE1, compared to the normal controls, and then declined to a normal level at CE4 and CE5. Examining the antibody production, we found that serum specific IgG was significantly increased in patients with active and transitional cysts, specifically the total IgG at CE1/CE3/CE4-CE5, IgG4 at CE1 and IgG1 at CE1/CE3 cyst status, in comparison with the normal controls, but showed no significant changes between the cyst stages.

Conclusions

Our findings provide new information on the profile of multiplex cytokines and serum antibodies associated with cyst stages in cystic echinococcosis patients through a three-year follow-up, implying that further studies using an approach combining cyst-associated immune parameters may aid in identifying immunological markers for differentiation of disease progression.