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Casulli A, Massolo A, Saarma U, Umhang G, Santolamazza F, Santoro A. Species and genotypes belonging to Echinococcus granulosus sensu lato complex causing human cystic echinococcosis in Europe (2000-2021): a systematic review. Parasit Vectors 2022; 15:109. [PMID: 35346335 PMCID: PMC8962544 DOI: 10.1186/s13071-022-05197-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/12/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND This study aimed to fill a gap of knowledge by providing a quantitative measure of molecularly identified species and genotypes belonging to Echinococcus granulosus sensu lato (s.l.) causing human cystic echinococcosis (CE) in Europe during the period 2000-2021. As these species and genotypes are characterized by genetic, animal host and geographical differences, studying the E. granulosus s.l. complex is epidemiologically relevant. METHODS A systematic review (SR) was conducted on the basis of both scientific and grey literature considering primary studies between 2000 and 2021 in four databases. From a total of 1643 scientific papers, 51 records were included in the SR. The main inclusion criterion for this study was the molecular confirmation of E. granulosus s.l. at the genotype/species level as a causative agent of human CE cases in selected European countries. RESULTS Relevant data were obtained from 29 out of 39 eligible European countries. This SR identified 599 human molecularly confirmed echinococcal cysts: 460 (76.8%) identified as E. granulosus sensu stricto (s.s.), 130 (21.7%) as E. canadensis cluster (G6/7 and G10), 7 (1.2%) as E. ortleppi (G5), and 2 as E. vogeli (0.3%). Three geographical hotspots of human CE caused by different species of the E. granulosus s.l. complex were identified: (1) E. granulosus s.s. in Southern and South-eastern Europe (European-Mediterranean and Balkan countries); (2) E. canadensis (G6/7) in Central and Eastern Europe; (3) E. ortleppi in Central and Western Europe. This SR also identified data gaps that prevented a better definition of the geographical distribution of the Echinococcus granulosus s.l. species complex in Europe: western Balkan countries, part of Central Europe, and Baltic countries. CONCLUSIONS These results mandate longitudinal, multi-centre, intersectoral and transdisciplinary studies which consider both molecular and clinical epidemiology in animals and humans. Such studies would be valuable for a better understanding of the transmission of the E. granulosus s.l. species complex and their potential clinical impact on humans.
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Affiliation(s)
- Adriano Casulli
- WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy.
- European Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy.
| | - Alessandro Massolo
- Department of Biology, Ethology Unit, University of Pisa, Pisa, Italy
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
- UMR CNRS 6249 Chrono-Environnement, Université Bourgogne Franche-Comté, Besancon, France
| | - Urmas Saarma
- Department of Zoology, Institute of Ecology and Earth Sciences, University of Tartu, Tartu, Estonia
| | - Gérald Umhang
- Anses LRFSN, National Reference Laboratory for Echinococcus Spp, Malzéville, France
| | - Federica Santolamazza
- WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
- European Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
| | - Azzurra Santoro
- WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
- European Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore Di Sanità, Rome, Italy
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Molecular Characterization of Echinococcus granulosus sensu lato from Humans in Slovenia. Pathogens 2020; 9:pathogens9070562. [PMID: 32664693 PMCID: PMC7400081 DOI: 10.3390/pathogens9070562] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 12/19/2022] Open
Abstract
The larval form of tapeworms of the Echinococcus granulosus sensu lato species cluster cause an important zoonotic infection, cystic echinococcosis (CE). Molecular characterization of the cluster’s isolates from different hosts greatly contributes to a better understanding of its transmission dynamics. To date, no genetic information is available on CE in Slovenia. In this work, we characterized isolates from human CE cases. Parasite samples from 18 patients were collected, together with the patients’ demographic and clinical data. Genomic DNA was analyzed by conventional PCR and sequencing at four mitochondrial loci (cytochrome c oxidase subunit 1, cox1; NADH dehydrogenase subunit 1, nad1; NADH dehydrogenase subunit 5, nad5; and small ribosomal RNA, rrnS). Thirteen isolates were successfully amplified and sequenced. Seven (58.8%) patients were infected with E. granulosus sensu stricto (s.s.) G1, five (38.5%) with E. canadensis G7 and one (7.7%) with E. granulosus s.s. G3. Echinococcus canadensis G7, the pig genotype, was identified exclusively in autochthonous Slovenes, while the patients originating from the Western Balkans were all infected with E. granulosus s.s. Our findings suggest that pigs are important intermediate hosts for human CE in Slovenia.
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First Report of Echinococcus ortleppi in Human Cases of Cystic Echinococcosis in Poland. BIOMED RESEARCH INTERNATIONAL 2019; 2019:2474839. [PMID: 31080812 PMCID: PMC6476137 DOI: 10.1155/2019/2474839] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 03/09/2019] [Accepted: 03/18/2019] [Indexed: 11/17/2022]
Abstract
Cystic echinococcosis is considered as an emerging zoonosis that can develop asymptomatically for years, clinically nonpathognomic. The disease is of public health importance due to often late, difficult diagnostics, uncertain results of treatment, the need to remove hydatid cysts surgically in advanced cases, and poor prognosis in untreated patients. Six Polish female patients with diagnosed cystic echinococcosis (CE) were examined. DNA extracted from the liver and lung samples served for amplification of mitochondrial nad1 gene fragment. Sequence alignments of 5 isolates showed identity with the pig strain, Echinococcus canadensis G7. One case was in 100% identical with Echinococcus ortleppi G5, the cattle strain. These data demonstrate first report of E. ortleppi, regarded as extinct species, causing human cystic echinococcosis in Poland, where the most frequent causative agent of human CE is E. canadensis.
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Sałamatin R, Kowal J, Nosal P, Kornaś S, Cielecka D, Jańczak D, Patkowski W, Gawor J, Kornyushin V, Golab E, Šnábel V. Cystic echinococcosis in Poland: genetic variability and the first record of Echinococcus granulosus sensu stricto (G1 genotype) in the country. Parasitol Res 2017; 116:3077-3085. [PMID: 28975403 PMCID: PMC5660138 DOI: 10.1007/s00436-017-5618-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 09/15/2017] [Indexed: 02/04/2023]
Abstract
Cystic echinococcosis is one of the most important zoonotic diseases affecting humans and livestock worldwide, and is endemic in Poland. A set of six isolates on larval stages of Echinococcus granulosus sensu lato tapeworms collected from three humans, two pigs and one sheep from Polish foci of CE was examined by DNA sequencing of two mitochondrial genes (cox1, rrnS). The results demonstrated the presence of E. canadensis and E. granulosus sensu stricto in the investigated hydatid cysts. The former species was found in all five isolates from pigs and humans derived from central Poland. In a sheep hydatid cyst originating from Lesser Poland Voivodeship in southern Poland, E. granulosus s. s. (G1 genotype) was identified. This is the first report of an unambiguously autochthonous infection with E. granulosus s. s. in Poland. The global distribution and host affiliations of the commonly occurring G1 microvariant with nucleotide change 56C/T in cox1, detected here in Polish sheep, are discussed. The finding that sheep harboured E. granulosus s. s. may have important consequences for developing effective hydatid control programmes in Poland due to its longer maturation rate in dogs compared with E. canadensis G7. This may lead to greater expenditures for purchasing anthelmintics to provide an appropriate dosing regime in sheep-raising areas of the country.
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Affiliation(s)
- Rusłan Sałamatin
- Department of General Biology and Parasitology, Medical University of Warsaw, Chałubińskiego 5, 02-004, Warsaw, Poland.
- Department of Parasitology, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791, Warsaw, Poland.
| | - Jerzy Kowal
- Department of Zoology and Ecology, Faculty of Animal Sciences, University of Agriculture in Krakow, al. Mickiewicza 24/28, 30-059, Krakow, Poland
| | - Paweł Nosal
- Department of Zoology and Ecology, Faculty of Animal Sciences, University of Agriculture in Krakow, al. Mickiewicza 24/28, 30-059, Krakow, Poland
| | - Sławomir Kornaś
- Department of Zoology and Ecology, Faculty of Animal Sciences, University of Agriculture in Krakow, al. Mickiewicza 24/28, 30-059, Krakow, Poland
| | - Danuta Cielecka
- Department of General Biology and Parasitology, Medical University of Warsaw, Chałubińskiego 5, 02-004, Warsaw, Poland
| | - Dawid Jańczak
- Department of Parasitology, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791, Warsaw, Poland
| | - Waldemar Patkowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland
| | - Jakub Gawor
- W. Stefański Institute of Parasitology, Polish Academy of Sciences, Twarda 51/55, 00-818, Warsaw, Poland
| | - Vadim Kornyushin
- I. I. Schmalhausen Institute of Zoology, National Academy of Sciences of Ukraine, Khmelnytskoho 15, Kyiv, 01601, Ukraine
| | - Elzbieta Golab
- Department of Parasitology, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791, Warsaw, Poland
| | - Viliam Šnábel
- Institute of Parasitology, Slovak Academy of Sciences, Hlinkova 3, 04001, Košice, Slovakia
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Marinova I, Spiliotis M, Wang J, Muhtarov M, Chaligiannis I, Sotiraki S, Rainova I, Gottstein B, Boubaker G. Molecular characterization of Echinococcus granulosus isolates from Bulgarian human cystic echinococcosis patients. Parasitol Res 2017; 116:1043-1054. [PMID: 28110440 DOI: 10.1007/s00436-017-5386-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 01/16/2017] [Indexed: 02/03/2023]
Abstract
Although cystic echinococcosis (CE) is highly endemic in Bulgaria, there is still scarce information about species and/or genotypes of the Echinococcus granulosus complex that infect humans. Our study tackled the genetic diversity of E. granulosus complex in a cohort of 30 Bulgarian CE patients. Ten animal E. granulosus isolates from neighboring Greece were additionally included. Specimens were comparatively analyzed for partial sequences of five mitochondrial (mt) (cox I, nad I, rrnS, rrnL, and atp6) and three nuclear (nc) genes (act II, hbx 2, and ef-1α) using a PCR-sequencing approach. All 30 Bulgarian isolates were identified as E. granulosus sensu stricto (s.s.) and were showing identical sequences for each of the three examined partial nc gene markers. Based upon concatenated sequences from partial mtDNA markers, we detected 10 haplotypes: 6 haplotypes (H1-H6) clustering with E. granulosus s.s. (G1) and 4 haplotypes (H9-H13) grouping with E. granulosus s.s. (G3), with H1 and H10 being the most frequent in Bulgarian patients. The haplotypes H1, H4, and H11 were also present in Greek hydatid cyst samples of animal origin. In conclusion, E. granulosus s.s. (G1 and G3 genotypes) is the only causative agent found so far to cause human CE in Bulgaria. However, further studies including larger sample sizes and other additional geographic regions in Bulgaria will have to be performed to confirm our results.
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Affiliation(s)
- Irina Marinova
- Institute of Parasitology, Vetsuisse Faculty and Faculty of Medicine, University of Bern, 3012, Bern, Switzerland.,Department of Parasitology and Tropical Medicine, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Markus Spiliotis
- Institute of Parasitology, Vetsuisse Faculty and Faculty of Medicine, University of Bern, 3012, Bern, Switzerland
| | - Junhua Wang
- Institute of Parasitology, Vetsuisse Faculty and Faculty of Medicine, University of Bern, 3012, Bern, Switzerland
| | - Marin Muhtarov
- Department of Parasitology and Tropical Medicine, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria.,Multi-Profile Hospital for Active Treatment "Kardzhali", Gastroenterology Ward, Kardzhali, Bulgaria
| | - Ilias Chaligiannis
- Hellenic Agricultural Organisation-Demeter, Veterinary Research Institute, Thessaloniki, Greece
| | - Smaro Sotiraki
- Hellenic Agricultural Organisation-Demeter, Veterinary Research Institute, Thessaloniki, Greece
| | - Iskra Rainova
- Department of Parasitology and Tropical Medicine, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Bruno Gottstein
- Institute of Parasitology, Vetsuisse Faculty and Faculty of Medicine, University of Bern, 3012, Bern, Switzerland.
| | - Ghalia Boubaker
- Institute of Parasitology, Vetsuisse Faculty and Faculty of Medicine, University of Bern, 3012, Bern, Switzerland.,Department of Clinical Biology B, Laboratory of Medical and Molecular Parasitology-Mycology (LR12ES08), Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
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Deplazes P, Rinaldi L, Alvarez Rojas CA, Torgerson PR, Harandi MF, Romig T, Antolova D, Schurer JM, Lahmar S, Cringoli G, Magambo J, Thompson RCA, Jenkins EJ. Global Distribution of Alveolar and Cystic Echinococcosis. ADVANCES IN PARASITOLOGY 2017; 95:315-493. [PMID: 28131365 DOI: 10.1016/bs.apar.2016.11.001] [Citation(s) in RCA: 568] [Impact Index Per Article: 81.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Alveolar echinococcosis (AE) and cystic echinococcosis (CE) are severe helminthic zoonoses. Echinococcus multilocularis (causative agent of AE) is widely distributed in the northern hemisphere where it is typically maintained in a wild animal cycle including canids as definitive hosts and rodents as intermediate hosts. The species Echinococcus granulosus, Echinococcus ortleppi, Echinococcus canadensis and Echinococcus intermedius are the causative agents of CE with a worldwide distribution and a highly variable human disease burden in the different endemic areas depending upon human behavioural risk factors, the diversity and ecology of animal host assemblages and the genetic diversity within Echinococcus species which differ in their zoonotic potential and pathogenicity. Both AE and CE are regarded as neglected zoonoses, with a higher overall burden of disease for CE due to its global distribution and high regional prevalence, but a higher pathogenicity and case fatality rate for AE, especially in Asia. Over the past two decades, numerous studies have addressed the epidemiology and distribution of these Echinococcus species worldwide, resulting in better-defined boundaries of the endemic areas. This chapter presents the global distribution of Echinococcus species and human AE and CE in maps and summarizes the global data on host assemblages, transmission, prevalence in animal definitive hosts, incidence in people and molecular epidemiology.
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Affiliation(s)
- P Deplazes
- University of Zürich, Zurich, Switzerland
| | - L Rinaldi
- University of Naples Federico II, Napoli, Italy
| | | | | | - M F Harandi
- Research centre of Hydatid Disease in Iran, Kerman University of Medical Sciences, Kerman, Iran
| | - T Romig
- University of Hohenheim, Stuttgart, Germany
| | - D Antolova
- Institute of Parasitology SAS, Kosice, Slovak Republic
| | - J M Schurer
- University of Saskatchewan, Saskatoon, SK, Canada; University of Washington, Seattle, WA, United States
| | - S Lahmar
- National School of Veterinary Medicine, Sidi Thabet, Tunisia
| | - G Cringoli
- University of Naples Federico II, Napoli, Italy
| | - J Magambo
- Meru University of Science and Technology, Meru, Kenya
| | | | - E J Jenkins
- University of Saskatchewan, Saskatoon, SK, Canada
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Ito A, Nakao M, Lavikainen A, Hoberg E. Cystic echinococcosis: Future perspectives of molecular epidemiology. Acta Trop 2017; 165:3-9. [PMID: 27237060 DOI: 10.1016/j.actatropica.2016.05.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 05/24/2016] [Accepted: 05/25/2016] [Indexed: 01/11/2023]
Abstract
Human cystic echinococcosis (CE) has been considered to be caused predominantly by Echinococcus granulosus sensu stricto (the dog-sheep strain). Molecular approaches on CE, however, have revealed that human cases are also commonly caused by another species, Echinococcus canadensis. All indices for classification and standardization of CE pathology including available images, epidemiology, diagnostics and treatment are currently based largely on a mixture of infections which include at least E. granulosus s.s. and E. canadensis. Involvement of other species of Echinococcus in CE including E. ortleppi or otherwise cryptic diversity demonstrated recently in Africa requires further elucidation. Molecular identification of the causative species in CE cases is essential for better understanding of pathogenesis and disease. This article stresses the importance of molecular species identification of human CE as a foundation for re-evaluation of evidence-based epidemiology.
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