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Lallemand S, Oyhenart J, Valot B, Borne R, Bohard L, Umhang G, Karamon J, Konyaev S, Rönnberg C, Gottstein B, Weil-Verhoeven D, Richou C, Bresson-Hadni S, Millon L, Bellanger AP, Knapp J. Challenging the phylogenetic relationships among Echinococcus multilocularis isolates from main endemic areas. Int J Parasitol 2024; 54:569-582. [PMID: 38815855 DOI: 10.1016/j.ijpara.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 04/05/2024] [Accepted: 05/23/2024] [Indexed: 06/01/2024]
Abstract
Alveolar echinococcosis (AE) is a rare but severe disease that affects more than 18,000 people worldwide per year. The complete sequencing of the mitochondrial genome of Echinococcus multilocularis has made it possible to study the genetic diversity of the parasite and its spatial and temporal evolution. We amplified the whole mitochondrial genome by PCR, using one uniplex and two multiplex reactions to cover the 13,738 bp of the mitogenome, and then sequenced the amplicons with Illumina technology. In total, 113 samples from Europe, Asia, the Arctic and North America were analyzed. Three major haplogroups were found: HG1, which clustered samples from Alaska (including Saint-Lawrence Island), Yakutia (Russia) and Svalbard; HG2, with samples from Asia, North America and Europe; and HG3, subdivided into three micro-haplogroups. HG3a included samples from North America and Europe, whereas HG3b and HG3c only include samples from Europe. In France, HG3a included samples from patients more recently diagnosed in a region outside the historical endemic area. A fourth putative haplogroup, HG4, was represented by only one isolate from Olkhon Island (Russia). The increased discriminatory power of the complete sequencing of the E. multilocularis mitogenome has made it possible to highlight four distinct geographical clusters, one being divided into three micro-haplogroups in France.
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Affiliation(s)
- Séverine Lallemand
- UMR CNRS 6249 Chrono-Environnement, University of Franche-Comté, 16 Route de Gray, 25030 Besançon cedex, France
| | - Jorge Oyhenart
- Instituto de Ciencias de la Tierra y Ambientales de La Pampa, Consejo Nacional de Investigaciones Científicas y Técnicas - Facultad de Ciencias Naturales Universidad Nacional de La Pampa, La Pampa, Argentina
| | - Benoit Valot
- UMR CNRS 6249 Chrono-Environnement, University of Franche-Comté, 16 Route de Gray, 25030 Besançon cedex, France
| | - Romain Borne
- UMR CNRS 6249 Chrono-Environnement, University of Franche-Comté, 16 Route de Gray, 25030 Besançon cedex, France
| | - Louis Bohard
- Department of Infectiology, University Hospital of Besançon, 25030 Besançon, France
| | - Gérald Umhang
- INTERFAS Unit, National Reference Laboratory for Echinococcus spp., Rabies and Wildlife Laboratory, ANSES, Malzéville, France
| | - Jacek Karamon
- Department of Parasitology and Invasive Diseases, National Veterinary Research Institute, Puławy, Poland
| | - Sergey Konyaev
- Institute of Systematics and Ecology of Animals, SB RAS, Novosibirsk, Russia
| | - Caroline Rönnberg
- Public Health Agency of Sweden, Department of Microbiology, Unit for Parasitology, Solna, Sweden
| | - Bruno Gottstein
- Institute of Infectious Diseases, Faculty of Medicine, University of Bern, CH-3012 Bern, Switzerland
| | - Delphine Weil-Verhoeven
- Department of Hepatology and Intensive Cares, University Hospital of Besançon, 25030 Besançon, France
| | - Carine Richou
- Department of Hepatology and Intensive Cares, University Hospital of Besançon, 25030 Besançon, France
| | - Solange Bresson-Hadni
- UMR CNRS 6249 Chrono-Environnement, University of Franche-Comté, 16 Route de Gray, 25030 Besançon cedex, France; Department of Parasitology-Mycology, Reference National Centre for Echinococcoses, University Hospital of Besançon, 25030 Besançon, France
| | - Laurence Millon
- UMR CNRS 6249 Chrono-Environnement, University of Franche-Comté, 16 Route de Gray, 25030 Besançon cedex, France; Department of Parasitology-Mycology, Reference National Centre for Echinococcoses, University Hospital of Besançon, 25030 Besançon, France
| | - Anne-Pauline Bellanger
- UMR CNRS 6249 Chrono-Environnement, University of Franche-Comté, 16 Route de Gray, 25030 Besançon cedex, France; Department of Parasitology-Mycology, Reference National Centre for Echinococcoses, University Hospital of Besançon, 25030 Besançon, France
| | - Jenny Knapp
- UMR CNRS 6249 Chrono-Environnement, University of Franche-Comté, 16 Route de Gray, 25030 Besançon cedex, France; Department of Parasitology-Mycology, Reference National Centre for Echinococcoses, University Hospital of Besançon, 25030 Besançon, France.
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Zhao Y, Shi Y, Shen S, Zhang Y, Wei G, Jin X. Plasma Circulating Cell-Free DNA Facilitated the Detection of an Alveolar Echinococcosis Patient Initially Misdiagnosed as Cystic Echinococcosis: A Case Report. Trop Med Infect Dis 2024; 9:88. [PMID: 38668549 PMCID: PMC11054191 DOI: 10.3390/tropicalmed9040088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/09/2024] [Accepted: 04/15/2024] [Indexed: 04/29/2024] Open
Abstract
Echinococcosis, especially alveolar echinococcosis (AE), is becoming an emerging/re-emerging disease with a growing number of cases reported globally. The diagnosis of echinococcosis is based mainly on imaging, which may be challenging when the image presentation is atypical. We reported one patient with suspected cystic echinococcosis (CE) by imaging. The cell-free DNA (cfDNA) obtained from sequencing the patient's plasma before the operation showed that this patient probably had AE with 45 reads mapped to the Echinococcus multilocularis reference genome (Read-Pairs Per Million = 0.24). The patients underwent surgery, and the pathological result showed that the patient had AE. The conventional polymerase chain reaction (PCR) of her lesion sample extraction also indicated that the infection was caused by Echinococcus multilocularis. The follow-up ultrasound after three months indicated no recurrence. We demonstrated that the differentiation of CE and AE by imaging may not be that easy, with further elaboration on the differentiation between AE and CE in different aspects. We demonstrated that it is possible to use patients' plasma cfDNA mapped to Echinococcus references before the operation to obtain the objective clue of the lesion to facilitate diagnosis.
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Affiliation(s)
- Yanping Zhao
- BGI Research, Shenzhen 518083, China; (Y.Z.); (Y.Z.)
- Department of Hepatobiliary Surgery II, The People’s Hospital of Ganzi Tibetan Autonomous Prefecture, Kangding 626000, China;
| | - Yiyang Shi
- Department of Hepatobiliary Surgery II, The People’s Hospital of Ganzi Tibetan Autonomous Prefecture, Kangding 626000, China;
| | - Shu Shen
- Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu 610041, China;
| | - Yan Zhang
- BGI Research, Shenzhen 518083, China; (Y.Z.); (Y.Z.)
| | - Gengfu Wei
- Department of Hepatobiliary Surgery II, The People’s Hospital of Ganzi Tibetan Autonomous Prefecture, Kangding 626000, China;
| | - Xin Jin
- BGI Research, Shenzhen 518083, China; (Y.Z.); (Y.Z.)
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3
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Santoro A, Santolamazza F, Cacciò SM, La Rosa G, Antolová D, Auer H, Bagrade G, Bandelj P, Basso W, Beck R, Citterio CV, Davidson RK, Deksne G, Frey CF, Fuglei E, Glawischnig W, Gottstein B, Harna J, Huus Petersen H, Karamon J, Jansen F, Jarošová J, Jokelainen P, Lundström-Stadelmann B, Maksimov P, Miljević M, Miterpáková M, Moks E, Origgi F, Ozolina Z, Ryser MP, Romig T, Šarkūnas M, Scorrano N, Saarma U, Šnábel V, Sréter T, Umhang G, Vengušt G, Žele Vengušt D, Casulli A. Mitochondrial genetic diversity and phylogenetic relationships of Echinococcus multilocularis in Europe. Int J Parasitol 2024; 54:233-245. [PMID: 38246405 DOI: 10.1016/j.ijpara.2024.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/09/2023] [Accepted: 01/14/2024] [Indexed: 01/23/2024]
Abstract
The cestode Echinococcus multilocularis is the causative agent of alveolar echinococcosis, a fatal zoonotic parasitic disease of the northern hemisphere. Red foxes are the main reservoir hosts and, likely, the main drivers of the geographic spread of the disease in Europe. Knowledge of genetic relationships among E. multilocularis isolates at a European scale is key to understanding the dispersal characteristics of E. multilocularis. Hence, the present study aimed to describe the genetic diversity of E. multilocularis isolates obtained from different host species in 19 European countries. Based on the analysis of complete nucleotide sequences of the cob, atp6, nad2, nad1 and cox1 mitochondrial genes (4,968 bp), 43 haplotypes were inferred. Four haplotypes represented 62.56 % of the examined isolates (142/227), and one of these four haplotypes was found in each country investigated, except Svalbard, Norway. While the haplotypes from Svalbard were markedly different from all the others, mainland Europe appeared to be dominated by two main clusters, represented by most western, central and eastern European countries, and the Baltic countries and northeastern Poland, respectively. Moreover, one Asian-like haplotype was identified in Latvia and northeastern Poland. To better elucidate the presence of Asian genetic variants of E. multilocularis in Europe, and to obtain a more comprehensive Europe-wide coverage, further studies, including samples from endemic regions not investigated in the present study, especially some eastern European countries, are needed. Further, the present work proposes historical causes that may have contributed to shaping the current genetic variability of E. multilocularis in Europe.
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Affiliation(s)
- Azzurra Santoro
- European Union Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
| | - Federica Santolamazza
- European Union Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Simone M Cacciò
- European Union Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Giuseppe La Rosa
- European Union Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Daniela Antolová
- Institute of Parasitology, Slovak Academy of Sciences, Košice, Hlinkova 3, 040 01 Košice, Slovakia
| | - Herbert Auer
- Medical Parasitology, Institute of Specific Prophylaxis and Tropical Medicine, Center of Pathophysiology, Infectiology and Immunology, Medical University Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Guna Bagrade
- Latvian State Forest Research Institute "Silava", Wildlife Management Research Group, Salaspils, Rigas Street 111, LV-2169 Salaspils, Latvia
| | - Petra Bandelj
- Institute of Microbiology and Parasitology, Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000 Ljubljana, Slovenia
| | - Walter Basso
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, CH-3012 Bern, Switzerland
| | - Relja Beck
- Croatian Veterinary Institute, Laboratory for Parasitology, 10000 Zagreb, Croatia
| | - Carlo V Citterio
- Centro Specialistico Fauna Selvatica, SCT2-Belluno, Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe), Via Cappellari 44/A, 32100 Belluno, Italy
| | | | - Gunita Deksne
- Institute of Food Safety, Animal Health and Environment "BIOR", Lejupes Street 3, Riga LV-1076, Latvia; Faculty of Biology, University of Lavia, Jelgavas Street 1, Riga LV-1004, Latvia
| | - Caroline F Frey
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, CH-3012 Bern, Switzerland
| | - Eva Fuglei
- Norwegian Polar Institute, Fram Centre, NO-9296 Tromsø, Norway
| | - Walter Glawischnig
- Institute for Veterinary Disease Control Innsbruck, Austrian Agency for Health and Food Safety, Technikerstraße 70, 6020 Innsbruck, Austria
| | - Bruno Gottstein
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, CH-3012 Bern, Switzerland; Institute of Infectious Diseases, Faculty of Medicine, University of Bern, CH-3012 Bern, Switzerland
| | - Jiří Harna
- State Veterinary Institute Olomouc, Jakoubka ze Stribra 1, 779 00 Olomouc, Czech Republic
| | - Heidi Huus Petersen
- Danish Veterinary and Food Administration, Ministry of Food, Agriculture and Fisheries of Denmark, Stationsparken 31-33 2600, Glostrup, Denmark
| | - Jacek Karamon
- National Veterinary Research Institute, Department of Parasitology and Invasive Diseases, Partyzantow Avenue 57, 24-100 Pulawy, Poland
| | - Famke Jansen
- Institute of Tropical Medicine (ITM), Department of Biomedical Sciences, 155 Nationalestraat, B-2000 Antwerp, Belgium
| | - Júlia Jarošová
- Institute of Parasitology, Slovak Academy of Sciences, Košice, Hlinkova 3, 040 01 Košice, Slovakia
| | - Pikka Jokelainen
- Infectious Disease Preparedness, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark
| | - Britta Lundström-Stadelmann
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, CH-3012 Bern, Switzerland; Multidisciplinary Center for Infectious Diseases, University of Bern, Länggass-Strasse 122, 3012 Bern, Switzerland
| | - Pavlo Maksimov
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Epidemiology, Südufer 10, 17493 Greifswald‑Insel Riems, Germany
| | - Milan Miljević
- Department of Genetic Research, Institute for Biological Research "Siniša Stanković", National Institute of Republic of Serbia, University of Belgrade, Bulevar Despota Stefana 142, 11000 Belgrade, Serbia
| | - Martina Miterpáková
- Institute of Parasitology, Slovak Academy of Sciences, Košice, Hlinkova 3, 040 01 Košice, Slovakia
| | - Epp Moks
- National Centre for Laboratory Research and Risk Assessment, Fr. R. Kreutzwaldi 30, Tartu, Estonia
| | - Francesco Origgi
- Institute for Fish and Wildlife Health (FIWI), Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Längassstrasse 122, 3012 Bern, Switzerland
| | - Zanda Ozolina
- Institute of Food Safety, Animal Health and Environment "BIOR", Lejupes Street 3, Riga LV-1076, Latvia
| | - Marie-Pierre Ryser
- Institute for Fish and Wildlife Health (FIWI), Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Längassstrasse 122, 3012 Bern, Switzerland
| | - Thomas Romig
- Parasitology Unit, Institute of Biology, University of Hohenheim, 70593 Stuttgart, Germany
| | - Mindaugas Šarkūnas
- Department of Veterinary Pathobiology, Veterinary Academy, Lithuanian University of Health Sciences, Tilžės str. 18, 47181 Kaunas, Lithuania
| | - Nathalie Scorrano
- Institute of Parasitology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, CH-3012 Bern, Switzerland
| | - Urmas Saarma
- Department of Zoology, Institute of Ecology and Earth Sciences, University of Tartu, J. Liivi 2, 50409 Tartu, Estonia
| | - Viliam Šnábel
- Institute of Parasitology, Slovak Academy of Sciences, Košice, Hlinkova 3, 040 01 Košice, Slovakia
| | - Tamás Sréter
- National Reference Laboratory of Medical Parasitology, National Public Health Center, Albert Flórián út 2-6, Budapest, Hungary
| | - Gèrald Umhang
- Anses, Nancy Laboratory for Rabies and Wildlife, National Reference Laboratory Echinococcus spp, 54220 Malzéville, France
| | - Gorazd Vengušt
- Institute of Microbiology and Parasitology, Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000 Ljubljana, Slovenia
| | - Diana Žele Vengušt
- Institute of Microbiology and Parasitology, Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000 Ljubljana, Slovenia
| | - Adriano Casulli
- European Union Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
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4
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Raymond S, St Clair CC. Urban Magpies Frequently Feed on Coyote Scats and May Spread an Emerging Zoonotic Tapeworm. ECOHEALTH 2023; 20:441-452. [PMID: 38109036 DOI: 10.1007/s10393-023-01664-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 10/30/2023] [Indexed: 12/19/2023]
Abstract
Allocoprophagy, in which animals feed on the feces of other individuals or species, has been little studied in vertebrates, despite its relevance to parasite transmission. These relationships may be especially important in cities, where animal density, disease incidence, and spatial overlap of humans and wildlife increase. Our goal was to document the incidence and predictors of coprophagy by black-billed magpies (Pica hudsonia) at coyote (Canis latrans) scats in Edmonton, Canada. We detected scats by following coyote trails and recorded whether coprophagy had occurred. We used multiple logistic regression to determine the top contextual and environmental predictors of coprophagy. Of 668 coyote scats, 37.3% had apparently been fed on. Coprophagy was more likely in winter and when scats were not fresh and did not contain vegetation or garbage. Environmental predictors of coprophagy included proximity to other coyote scats and playgrounds, distance from water and maintained trails, abundant natural land cover, and proximity to encampments of people experiencing homelessness. Our results reveal that magpies frequently access coyote scat and often do so near human-use areas. In Edmonton, where > 50% of coyotes are infected with a zoonotic tapeworm, coprophagy likely causes magpies to transport parasites with implications for zoonotic disease risk.
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Affiliation(s)
- Sage Raymond
- Department of Biological Sciences, University of Alberta, 77 University Campus, Edmonton, AB, T6G 2R3, Canada.
| | - Colleen Cassady St Clair
- Department of Biological Sciences, University of Alberta, 77 University Campus, Edmonton, AB, T6G 2R3, Canada
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Santa MA, Umhang G, Klein C, Grant DM, Ruckstuhl KE, Musiani M, Gilleard JS, Massolo A. It's a small world for parasites: evidence supporting the North American invasion of European Echinococcus multilocularis. Proc Biol Sci 2023; 290:20230128. [PMID: 36883278 PMCID: PMC9993045 DOI: 10.1098/rspb.2023.0128] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Echinococcus multilocularis (Em), the causative agent of human alveolar echinococcosis (AE), is present in the Holarctic region, and several genetic variants deem to have differential infectivity and pathogenicity. An unprecedented outbreak of human AE cases in Western Canada infected with a European-like strain circulating in wild hosts warranted assessment of whether this strain was derived from a recent invasion or was endemic but undetected. Using nuclear and mitochondrial markers, we investigated the genetic diversity of Em in wild coyotes and red foxes from Western Canada, compared the genetic variants identified to global isolates and assessed their spatial distribution to infer possible invasion dynamics. Genetic variants from Western Canada were closely related to the original European clade, with lesser genetic diversity than that expected for a long-established strain and spatial genetic discontinuities within the study area, supporting the hypothesis of a relatively recent invasion with various founder events.
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Affiliation(s)
- Maria A. Santa
- Department of Biological Sciences, Faculty of Science, University of Calgary, Calgary, Alberta, Canada
| | - Gerald Umhang
- Nancy Laboratory for Rabies and Wildlife, National Reference Laboratory for Echinococcus spp., Wildlife Surveillance and Eco-epidemiology Unit, ANSES, Technopôle Agricole et Vétérinaire, Malzéville, France
| | - Claudia Klein
- Department of Clinical and Veterinary Clinical Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
- Friedrich-Loeffler-Institut, Bundesforschungsinstitut für Tiergesundheit, Federal Research Institute for Animal Health, Neustadt, Germany
| | - Danielle M. Grant
- Department of Clinical and Veterinary Clinical Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
- NORCE Climate, NORCE Norwegian Research Centre, Bjerknes Centre for Climate Research, Bergen, Norway
| | - Kathreen E. Ruckstuhl
- Department of Biological Sciences, Faculty of Science, University of Calgary, Calgary, Alberta, Canada
| | - Marco Musiani
- Department of Biological Sciences, Faculty of Science, University of Calgary, Calgary, Alberta, Canada
- Dipartimento di Scienze Biologiche, Geologiche e Ambientali (BiGeA), University of Bologna, Italy
| | - John S. Gilleard
- Department of Comparative Biology & Experimental Medicine, Host-Parasite Interactions (HPI) program, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Alessandro Massolo
- Ethology Unit, Department of Biology, University of Pisa, Pisa, Italy
- UMR CNRS 6249 Chrono-environnement, Université Bourgogne Franche-Comté, Besançon, France
- Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
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Polish LB, O'Connell EM, Barth TFE, Gottstein B, Zajac A, Gibson PC, Bah A, Kirchgessner M, Estrada M, Seguin MA, Ramirez-Barrios R. European Haplotype of <i>Echinococcus multilocularis</i> in the United States. N Engl J Med 2022; 387:1902-1904. [PMID: 36383717 PMCID: PMC10072850 DOI: 10.1056/nejmc2210000] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Louis B Polish
- University of Vermont Larner College of Medicine, Burlington, VT
| | | | | | | | - Anne Zajac
- Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA
| | - Pamela C Gibson
- University of Vermont Larner College of Medicine, Burlington, VT
| | - Aissatou Bah
- National Institute of Allergy and Infectious Diseases, Bethesda, MD
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Bradbury RS, Sapp SGH, Potters I, Mathison BA, Frean J, Mewara A, Sheorey H, Tamarozzi F, Couturier MR, Chiodini P, Pritt B. Where Have All the Diagnostic Morphological Parasitologists Gone? J Clin Microbiol 2022; 60:e0098622. [PMID: 36314793 PMCID: PMC9667774 DOI: 10.1128/jcm.00986-22] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Advances in laboratory techniques have revolutionized parasitology diagnostics over the past several decades. Widespread implementation of rapid antigen detection tests has greatly expanded access to tests for global parasitic threats such as malaria, while next-generation amplification and sequencing methods allow for sensitive and specific detection of human and animal parasites in complex specimen matrices. Recently, the introduction of multiplex panels for human gastrointestinal infections has enhanced the identification of common intestinal protozoa in feces along with bacterial and viral pathogens. Despite the benefits provided by novel diagnostics, increased reliance on nonmicroscopy-based methods has contributed to the progressive, widespread loss of morphology expertise for parasite identification. Loss of microscopy and morphology skills has the potential to negatively impact patient care, public health, and epidemiology. Molecular- and antigen-based diagnostics are not available for all parasites and may not be suitable for all specimen types and clinical settings. Furthermore, inadequate morphology experience may lead to missed and inaccurate diagnoses and erroneous descriptions of new human parasitic diseases. This commentary highlights the need to maintain expert microscopy and morphological parasitology diagnostic skills within the medical and scientific community. We proposed that light microscopy remains an important part of training and practice in the diagnosis of parasitic diseases and that efforts should be made to train the next generation of morphological parasitologists before the requisite knowledge, skills, and capacity for this complex and important mode of diagnosis are lost. In summary, the widespread, progressive loss of morphology expertise for parasite identification negatively impacts patient care, public health, and epidemiology.
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Affiliation(s)
| | - Sarah G. H. Sapp
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Idzi Potters
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Blaine A. Mathison
- Institute for Clinical and Experimental Pathology, ARUP Laboratories, Salt Lake City, Utah, USA
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
| | - John Frean
- Parasitology Reference Laboratory, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Abhishek Mewara
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Harsha Sheorey
- Microbiology Department, Royal Melbourne Hospital, Melbourne, Australia
- St. Vincent’s Hospital, Melbourne, Australia
| | - Francesca Tamarozzi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Marc Roger Couturier
- Institute for Clinical and Experimental Pathology, ARUP Laboratories, Salt Lake City, Utah, USA
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
| | - Peter Chiodini
- Hospital for Tropical Diseases, London, United Kingdom
- The London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Bobbi Pritt
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
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Kern P, Grüner B. Rescue treatment of advanced alveolar echinococcosis: The case for a multidisciplinary team. JOURNAL OF LIVER TRANSPLANTATION 2022. [DOI: 10.1016/j.liver.2021.100068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Porter E, Seguin MA, Estrada M, Szlosek D, Massolo A, Visscher DR. Assessing the potential for infections of Echinococcus multilocularis in dogs in a hotspot of human alveolar echinococcosis infections in North America. Vet Parasitol Reg Stud Reports 2022; 29:100704. [PMID: 35256128 DOI: 10.1016/j.vprsr.2022.100704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/23/2021] [Accepted: 02/07/2022] [Indexed: 11/18/2022]
Abstract
Echinococcus multilocularis is a zoonotic tapeworm, whose metacestode larval stage is the etiological agent for alveolar echinococcosis in humans and is a parasite of emerging concern according to the World Health Organization which is difficult to diagnose and has a case mortality rate of >90% when left untreated. Echinococcus multilocularis requires two mammalian hosts to complete its lifecycle: wild and domestic canids as definitive hosts, and small mammals (mostly rodents) as intermediate ones. Because of their close relations with humans, domestic dogs have been indicated as a mean of infection to people. Human alveolar echinococcosis has historically been rare in North America, however, since 2013, at least seventeen diagnoses have been confirmed in Alberta, Canada. Because of this unprecedented series of cases, assessing the frequency of infections in dogs in Alberta is key to estimate risk for dog owners and animal health professionals. This study was carried out in Edmonton to determine the frequency of E. multilocularis infection in domestic dogs and potential risk factors. Fecal samples and corresponding behavior risk surveys were collected from 775 dogs in seven urban off-leash parks within Edmonton city limits during the summer of 2020. A quantitative PCR fecal test was used to diagnose E. multilocularis infection. We found a single case of E. multilocularis infection (1/775) and determined that the overall true prevalence was 0.2% (95% CrI: 0.0-0.7%) corrected for detection sensitivity and specificity. Overall, these findings confirm the presence of E. multilocularis infection in domestic dogs in Edmonton although further work is required to fully understand the risk factors that may contribute to infection and potential transmission to humans.
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Affiliation(s)
- Emilie Porter
- Department of Biology, The King's University, 9125 50 Street NW, Edmonton, AB T6B 2H3, Canada
| | - M Alexis Seguin
- IDEXX Reference Laboratories, Inc, Westbrook, ME 04092, United States of America
| | - Marko Estrada
- IDEXX Reference Laboratories, Inc, Westbrook, ME 04092, United States of America
| | - Donald Szlosek
- IDEXX Reference Laboratories, Inc, Westbrook, ME 04092, United States of America
| | - Alessandro Massolo
- Ethology Unit, Department of Biology, University of Pisa, Via Volta 6, 56126 Pisa, Italy; Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, 2500 University Dr NW, Calgary, Alberta T2N 1N4, Canada; UMR CNRS 6249 Chrono-environnement, Université Bourgogne Franche-Comté, 16 Route de Gray, 25030 Besançon, France
| | - Darcy R Visscher
- Department of Biology, The King's University, 9125 50 Street NW, Edmonton, AB T6B 2H3, Canada; Biological Sciences, University of Alberta, CW405 Biological Sciences Bldg., Edmonton, AB T6G 2E9, Canada; Naturalis Biodiversity Center, Darwinweg 2, 2333CR Leiden, the Netherlands.
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10
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Lightowlers MW, Gasser RB, Hemphill A, Romig T, Tamarozzi F, Deplazes P, Torgerson PR, Garcia HH, Kern P. Advances in the treatment, diagnosis, control and scientific understanding of taeniid cestode parasite infections over the past 50 years. Int J Parasitol 2021; 51:1167-1192. [PMID: 34757089 DOI: 10.1016/j.ijpara.2021.10.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 02/07/2023]
Abstract
In the past 50 years, enormous progress has been made in the diagnosis, treatment and control of taeniid cestode infections/diseases and in the scientific understanding thereof. Most interest in this group of parasites stems from the serious diseases that they cause in humans. It is through this lens that we summarize here the most important breakthroughs that have made a difference to the treatment of human diseases caused by these parasites, reduction in transmission of the taeniid species associated with human disease, or understanding of the parasites' biology likely to impact diagnosis or treatment in the foreseeable future. Key topics discussed are the introduction of anti-cestode drugs, including benzimidazoles and praziquantel, and the development of new imaging modalities that have transformed the diagnosis and post-treatment monitoring of human echinococcoses and neurocysticercosis. The availability of new anti-cestode drugs for use in dogs and a detailed understanding of the transmission dynamics of Echinococcus granulosus sensu lato have underpinned successful programs that have eliminated cystic echinococcosis in some areas of the world and greatly reduced the incidence of infection in others. Despite these successes, cystic and alveolar echinococcosis and neurocysticercosis continue to be prevalent in many parts of the world, requiring new or renewed efforts to prevent the associated taeniid infections. Major advances made in the development of practical vaccines against E. granulosus and Taenia solium will hopefully assist in this endeavour, as might the understanding of the parasites' biology that have come from an elucidation of the nuclear genomes of each of the most important taeniid species causing human diseases.
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Affiliation(s)
- Marshall W Lightowlers
- Department of Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, 250 Princes Highway, Werribee, Victoria 3030, Australia.
| | - Robin B Gasser
- Department of Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Andrew Hemphill
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Länggassstrasse 122, 3012 Bern, Switzerland
| | - Thomas Romig
- University of Hohenheim, Parasitology Unit, Emil-Wolff-Strasse 34, 70599 Stuttgart, Germany
| | - Francesca Tamarozzi
- Department of Infectious Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar di Valpolicella, Verona, Italy
| | - Peter Deplazes
- Institute of Parasitology, Vetsuisse, and Medical Faculty, University of Zürich, Zürich, Switzerland
| | - Paul R Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
| | - Hector H Garcia
- Infectious Diseases Laboratory Research-LID, Faculty of Science and Philosophy, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Perú; Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Perú
| | - Peter Kern
- Ulm University Hospital, Division of Infectious Diseases, Albert-Einstein-Allee 23, 89081 Ulm, Germany
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11
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Gottstein B, Deplazes P. Alveolar echinococcosis: what triggers emergence in North America, Central Europe and Asia? Curr Opin Infect Dis 2021; 34:440-446. [PMID: 34524197 DOI: 10.1097/qco.0000000000000765] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW Infection with the larval (metacestode) stage of Echinococcus multilocularis causes alveolar echinococcosis (AE), a serious hepatic disorder. The parasite has increased its infection extensity in wildlife and domestic dogs, mainly due to urbanization and spatial extension of wildlife hosts in Europe, Asia as well as North America, resulting in emerging infection risk for humans. RECENT FINDINGS In hyperendemic areas such as Kyrgyzstan and China, ecological and socioeconomic changes have been associated with the unpredictable increase of AE cases. In North America, the appearance of the European-like genotype is of concern. In Europe, the annual increase of human case numbers reached a plateau even in hyperendemic situations. Therefore, we conclude that most of the exposed individuals are resistant to parasite invasion and/or to disease development. Thus, AE develops in a few healthy individuals, but preferentially in immunosuppressed patients. SUMMARY In the future, improved diagnostic strategies will allow more precise estimations of transmission routes including the role of food, water and direct dog contact, which should yield improved public health recommendations. Finally, understanding protective innate and acquired immune mechanisms as well as parasite-driven immune-evasion processes will be essential to develop curative therapies in nonoperable patients and, futuristically, appropriate vaccines.
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Affiliation(s)
- Bruno Gottstein
- Institute of Infectious Diseases, Faculty of Medicine, University of Bern, Bern
| | - Peter Deplazes
- Institute of Parasitology, Vetsuisse Faculty and Faculty of Medicine, University of Zurich, Zurich, Switzerland
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12
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Houston S, Belga S, Buttenschoen K, Cooper R, Girgis S, Gottstein B, Low G, Massolo A, MacDonald C, Müller N, Preiksaitis J, Sarlieve P, Vaughan S, Kowalewska-Grochowska K. Epidemiological and Clinical Characteristics of Alveolar Echinococcosis: An Emerging Infectious Disease in Alberta, Canada. Am J Trop Med Hyg 2021; 104:1863-1869. [PMID: 33755579 PMCID: PMC8103444 DOI: 10.4269/ajtmh.20-1577] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 01/26/2021] [Indexed: 01/29/2023] Open
Abstract
Human alveolar echinococcosis (AE) is a zoonotic cestode infection which is usually fatal in the absence of treatment. Treatment involves major surgery or indefinite antiparasitic therapy. The incidence is rising in Europe and Asia, with an increased risk observed in immunocompromised individuals. Previously, AE acquisition in North America was extremely rare, except for one remote Alaskan Island. Recent studies have demonstrated a new European-like strain of Echinococcus multilocularis (Em) in wildlife and in human AE in western Canada. We report the experience of all AE patients diagnosed in Alberta. Each was diagnosed by histopathology, serology, and PCR-confirmed by a reference laboratory. Seventeen cases of human AE, aged 19-78 years, nine females, were diagnosed between 2013 and 2020: all definitely or probably acquired in Alberta. Six lived in urban areas, and 14 had kept dogs. In eight, the lesions were found incidentally on abdominal imaging performed for other indications. Six were immunocompromised to varying degrees. Six were first diagnosed at surgery. All have been recommended benzimidazole therapy. One died of surgical complications. Clinicians should be aware of this diagnostic possibility in patients presenting with focal nonmalignant hepatic mass lesions. Greater urbanization of coyotes, the predominant definitive host of Em in Alberta, and growing numbers of immune suppressed individuals in the human population may lead to increasing recognition of AE in North America.
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Affiliation(s)
- Stan Houston
- University of Alberta, Edmonton, Canada;,Address correspondence to Stan Houston, University of Alberta, 1-124 Clinical Sciences Bldg., 11350 83 Ave., Edmonton T6G 2G3, Canada. E-mail:
| | - Sara Belga
- University of Alberta, Edmonton, Canada;,University of British Columbia, Vancouver, Canada
| | | | | | | | | | - Gavin Low
- University of Alberta, Edmonton, Canada
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Cathomas M, Abitabile P, Dolanc R, Glaser C, Cathomas G. Echinococcal hepatic lesion mimicking metastasis from colon cancer: two case reports. BMC Surg 2021; 21:150. [PMID: 33743666 PMCID: PMC7981815 DOI: 10.1186/s12893-021-01150-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Echinococcus is a worldwide zoonosis, primarily causing liver lesions. Accidentally detected, these lesions enter the differential diagnosis of a tumor, including metastasis. This situation is especially challenging in patients with colorectal cancer, as both diseases affect mainly the liver. CASE PRESENTATION We report two patients with a newly diagnosed colorectal cancer. Pre- and intraoperatively radiological imaging revealed hepatic lesions which were resected on suspicion of colorectal cancer metastasis. Histology showed granulomatous lesions with characteristic parasitic membrane consistent with an echinococcal cyst. The diagnosis was confirmed by specific polymerase chain reaction. CONCLUSIONS Focal hypoechoic liver lesion in patients with colorectal cancer should be primarily considered as a liver metastasis and resected whenever feasible. Other uncommon etiologies, including parasitic lesion as echinococcal cysts, should be taken in consideration, as this could lead to major changes of the management and prognosis of the affected patients.
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Affiliation(s)
- Marionna Cathomas
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, 3010, Bern, Switzerland.
| | | | - Rok Dolanc
- Riva Klinik Rheinfelden, Rheinfelden, Switzerland
| | - Christine Glaser
- Department of Surgery, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Gieri Cathomas
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
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Lundström-Stadelmann B, Rufener R, Hemphill A. Drug repurposing applied: Activity of the anti-malarial mefloquine against Echinococcus multilocularis. INTERNATIONAL JOURNAL FOR PARASITOLOGY-DRUGS AND DRUG RESISTANCE 2020; 13:121-129. [PMID: 32636148 PMCID: PMC7389337 DOI: 10.1016/j.ijpddr.2020.06.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/29/2020] [Accepted: 06/03/2020] [Indexed: 02/06/2023]
Abstract
The current chemotherapeutical treatment against alveolar echinococcosis relies exclusively on benzimidazoles, which are not parasiticidal and can induce severe toxicity. There are no alternative treatment options. To identify novel drugs with activity against Echinococcus multilocularis metacestodes, researchers have studied potentially interesting drug targets (e.g. the parasite's energy metabolism), and/or adopted drug repurposing approaches by undertaking whole organism screenings. We here focus on drug screening approaches, which utilize an in vitro screening cascade that includes assessment of the drug-induced physical damage of metacestodes, the impact on metacestode viability and the viability of isolated parasite stem cells, structure-activity relationship (SAR) analysis of compound derivatives, and the mode of action. Finally, once in vitro data are indicative for a therapeutic window, the efficacy of selected compounds is assessed in experimentally infected mice. Using this screening cascade, we found that the anti-malarial mefloquine was active against E. multilocularis metacestodes in vitro and in vivo. To shed more light into the mode of action of mefloquine, SAR analysis on mefloquine analogues was performed. E. multilocularis ferritin was identified as a mefloquine-binding protein, but its precise role as a drug target remains to be elucidated. In mice that were infected either intraperitoneally with metacestodes or orally with eggs, oral treatment with mefloquine led to a significant reduction of parasite growth compared to the standard treatment with albendazole. However, mefloquine was not acting parasiticidally. Assessment of mefloquine plasma concentrations in treated mice showed that levels were reached which are close to serum concentrations that are achieved in humans during long-term malaria prophylaxis. Mefloquine might be applied in human AE patients as a salvage treatment. Future studies should focus on other repurposed anti-infective compounds (MMV665807, niclosamide, atovaquone), which showed stronger in vitro activity against E. multilocularis than mefloquine.
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Affiliation(s)
- Britta Lundström-Stadelmann
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Längggassstrasse 122, 3012, Bern, Switzerland.
| | - Reto Rufener
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Längggassstrasse 122, 3012, Bern, Switzerland
| | - Andrew Hemphill
- Institute of Parasitology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Längggassstrasse 122, 3012, Bern, Switzerland
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