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Schneider C, Kratzer W, Binzberger A, Schlingeloff P, Baumann S, Romig T, Schmidberger J. Echinococcus multilocularis and other zoonotic helminths in red foxes (Vulpes vulpes) from a southern German hotspot for human alveolar echinococcosis. Parasit Vectors 2023; 16:425. [PMID: 37980538 PMCID: PMC10657614 DOI: 10.1186/s13071-023-06026-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/19/2023] [Indexed: 11/20/2023] Open
Abstract
BACKGROUND We describe the spatial distribution of Echinococcus multilocularis in its main definitive host, the red fox, and the distribution of human cases of alveolar echinococcosis (AE) within a highly endemic focus in southern Germany (13.7-19.9/100,000 in 1992-2018). Human cases were unequally distributed within the endemicity focus. The purpose of the study was to test whether this is reflected in the small-scale distribution of E. multilocularis in foxes. METHODS Three areas with contrasting numbers of human cases were selected within the counties of Ravensburg and Alb-Donau, Baden-Württemberg, Germany. From 2018 to 2020, a total of 240 fox carcasses were obtained from traditional hunters in these areas. Carcasses were necropsied and examined for the presence of intestinal helminths. The statistical analysis was performed with SAS version 9.4, and the geo-mapping with QGIS version 3.16.0 Hannover. RESULTS The prevalence of E. multilocularis in foxes was 44/106 (41.5%) in area I (commune Leutkirch and environs), 30/59 (50.8%) in area II (commune Isny and environs), and 31/75 (41.3%) in area III (commune Ehingen and environs). From 1992 to 2018, a total of nine human cases of alveolar echinococcosis were recorded in area I, five cases were recorded in study area III, and no cases were recorded in area II. No statistically significant differences between the areas were observed (P > 0.05) for intestinal infections with E. multilocularis, and no apparent spatial correlation with the small-scale distribution of human cases was found. Concerning other zoonotic helminths, Toxocara spp. were equally common, with prevalence of 38.7%, 47.4% and 48.0%, respectively, while the frequency of Alaria alata varied among the study areas (0.0-9.4%), probably reflecting the specific habitat requirements for the establishment of its complex life cycle. CONCLUSIONS Echinococcus multilocularis is highly prevalent in foxes in all the studied areas. The varying number of human AE cases within these areas should therefore be caused by factors other than the intensity of parasite transmission in foxes.
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Affiliation(s)
- Carina Schneider
- Department of Parasitology, Hohenheim University, 70599, Stuttgart, Germany
| | - Wolfgang Kratzer
- Klinik Für Innere Medizin I, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
| | - Andreas Binzberger
- Klinik Für Innere Medizin I, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Patrycja Schlingeloff
- Klinik Für Innere Medizin I, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Sven Baumann
- Klinik Für Innere Medizin I, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Thomas Romig
- Department of Parasitology, Hohenheim University, 70599, Stuttgart, Germany
| | - Julian Schmidberger
- Klinik Für Innere Medizin I, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany
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Kwiedor I, Kratzer W, Schlingeloff P, Schmidberger J. [Spread and Development of Alveolar Echinococcosis in Germany, 1992-2018]. DAS GESUNDHEITSWESEN 2023; 85:258-265. [PMID: 34872118 PMCID: PMC11248785 DOI: 10.1055/a-1670-7485] [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] [Indexed: 10/19/2022]
Abstract
GOAL OF THE STUDY Alveolar echinococcosis (AE) is a rare parasitosis caused by the pathogen Echinococcus multilocularis. There is an increase in the number of cases in many countries. The aim of the study was to investigate the current prevalence and the change in the geographical distribution pattern. METHODOLOGY Data were collected retrospectively for the period 1992-2018 using the registered cases in the national disease register for AE in Germany. Statistical analysis was performed using the SAS statistical analysis system version 9.4 (SAS Institute, Cary, N.C., USA). RESULTS The study population of n=569 patients included n=322 (56,59%) women and n=247 (43,40%) men. The mean average age of patients with alveolar echinococcosis at first presentation was 53,90±17,54 years (median: 56,00 years). The Moran's I test statistic showed a positive spatial autocorrelation for the period 1992-2018 corresponding to a heterogeneous distribution of disease cases in Germany (I=0,4165; Z=10,9591, p=0,001). An increase in age- and sex-specific prevalence could be determined for the entire study period (1992-2018). The overall prevalence in the period 1992-2018 was 0,71 cases per 100,000 population. The determination of the prevalence for the period 1992-2018 resulted in 0,31 cases for men and 0,40 cases for women per 100,000 population. In the period 1992-1996, no AE cases had been registered in 11/16 (68,8%) federal states (Berlin, Brandenburg, Bremen, Hamburg, Mecklenburg-Vorpommern, Rheinland-Pfalz, Saarland, Sachsen, Sachsen-Anhalt, Schleswig-Holstein und Thüringen). The evaluation recently shows an increased occurrence of cases in the federal states of Hessen, Rheinland-Pfalz and Nordrhein-Westfalen. CONCLUSIONS The analysis shows a rise in prevalence and an increasing number of cases outside the classic endemic areas of Baden-Württemberg and Bavaria.
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Affiliation(s)
- Isabelle Kwiedor
- Klinik für Innere Medizin I, Universitätsklinikum Ulm,
Ulm, Deutschland
| | - Wolfgang Kratzer
- Klinik für Innere Medizin I, Universitätsklinikum Ulm,
Ulm, Deutschland
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Bagó F, Hoelzl F, Knauer F, Kübber-Heiss A, Smith S. Rapid and Reliable Detection of Echinococcus multilocularis from Faeces Using Droplet Digital PCR. Acta Parasitol 2021; 66:553-559. [PMID: 33346906 PMCID: PMC8166707 DOI: 10.1007/s11686-020-00325-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 12/02/2020] [Indexed: 11/29/2022]
Abstract
Purpose Alveolar echinococcosis is a severe helminthic disease in humans caused by larvae of the fox tapeworm Echinococcus multilocularis. Austria is considered an endemic area with hotspots having up to 45% prevalence (Bagó et al. in Proceedings of the Zoo and Wildlife Health Conference 2019, Berlin, p. 91, 2019). At our facility, we have registered a notifiable increase of animals submitted for the diagnosis of E. multilocularis since 2016. Therefore, we investigated high throughput diagnostic methods to provide rapid and reliable results in comparison with our current method. Methods We have developed and compared a novel method of detection using droplet digital PCR (ddPCR) combined with previous target specific extraction according to Maas et al. (Vet Parasitol 230:20–24, 2016), with our current macroscopic method “Shaking in a Vessel Technique” (SVT) by Duscher et al. (Parasitol Res 95(1):40–42, 2005). We investigated 77 wild canids (72 red foxes, 5 golden jackals) using both methods. The data were analyzed using a non-Bayesian approach, applying bootstrapping to create confidentiality intervals. Results Sensitivity for droplet digital PCR was 90.51% with the 95% credibility interval ranging from 82.50 to 96.92%, whereas mean sensitivity for SVT was 92.04% with a 95% credibility interval ranging from 84.75% to 98.36%. Additionally, a non-linear regression similar to R2 could be pointed out between the counted worms and the results gathered from ddPCR. Conclusion Magnetic capture extraction followed by ddPCR shows strong potential as a high throughput method for diagnosing E. multilocularis prevalence in diverse canid populations as well as infection intensities of individual animals, giving valuable epidemiological insights of the distribution amongst wild canids as an alternative to conventional qPCR or macroscopic methods.
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Affiliation(s)
- Fabian Bagó
- Research Institute of Wildlife Ecology, Department for Interdisciplinary Life Sciences, Vetmeduni Vienna, Savoyenstraße 1, 1160, Vienna, Austria.
| | - Franz Hoelzl
- Konrad Lorenz Institute of Ethology, Department for Interdisciplinary Life Sciences, Vetmeduni Vienna, Savoyenstraße 1, 1160, Vienna, Austria
| | - Felix Knauer
- Conservation Medicine Unit, Research Institute of Wildlife Ecology, Department for Interdisciplinary Life Sciences, Vetmeduni Vienna, Savoyenstraße 1, 1160, Vienna, Austria
| | - Anna Kübber-Heiss
- Research Institute of Wildlife Ecology, Department for Interdisciplinary Life Sciences, Vetmeduni Vienna, Savoyenstraße 1, 1160, Vienna, Austria
| | - Steve Smith
- Konrad Lorenz Institute of Ethology, Department for Interdisciplinary Life Sciences, Vetmeduni Vienna, Savoyenstraße 1, 1160, Vienna, Austria
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Spatial distribution and incidence trend of human alveolar echinococcosis in southwest Germany: increased incidence and urbanization of the disease? Infection 2020; 48:923-927. [PMID: 32676946 PMCID: PMC7674360 DOI: 10.1007/s15010-020-01479-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 07/03/2020] [Indexed: 11/05/2022]
Abstract
Ecology and epidemiology of Echinococcus multilocularis and human alveolar echinococcosis (AE) are changing in Central Europe. Our data from a regional referral center for AE in southwest Germany suggest rising regional incidence for AE (annual incidence per 100,000 population 2004–2011: 0.12; 2012–2019: 0.20) and emerging urban AE (of 7 cases of AE in Freiburg city dwellers none was diagnosed before 2012) calling for an intensification of E. multilocularis and AE surveillance and of AE prevention measures.
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Schmidberger J, Baumann S, Kratzer W, Schlingeloff P, Lachmann R, Stark K, Peters L, Gruener B, Ramharter M, Hoepffner PJ, Strohäker J, Blum A, Müllhaupt B, Lagler H. [An Update on the Epidemiological Situation of Alveolar Echinococcosis: Recording and Reporting Structures in Austria, Switzerland and Germany]. DAS GESUNDHEITSWESEN 2020; 83:e51-e56. [PMID: 32512599 DOI: 10.1055/a-1138-0692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Alveolar echinococcosis (AE) is a rare disease in Austria, Switzerland and Germany (DACh) caused by an infection with the parasite Echinococcus multilocularis. The aim of the study was to describe differences in the detection and reporting systems of alveolar echinococcosis in Austria, Switzerland and Germany and to describe epidemiological trends. METHODOLOGY As part of an epidemiological update on 6th September 2019 in Ulm, Germany, experts and representatives discussed differences in the reporting and recording systems as well as the current epidemiological situation. RESULTS Since 2004, Austria has had an obligation to report suspected cases, diseases and deaths of alveolar echinococcosis by name in accordance with §1 Para. 1 of the Epidemiegesetz 1950 (EpidemieG) and the Ordinance on Notifiable Communicable Diseases. According to §7 Para. 3 of the German Infection Protection Act (IfSG), Germany has also been subject to a reporting obligation since 2001, but not by name. In addition, national registers are available in both countries, which can be used to answer scientific questions. In Switzerland, there is no obligation to report human alveolar echinococcosis since 1997. Efforts are currently being made to implement a national register for alveolar echinococcosis in Switzerland. Despite different reporting and recording systems, a similar epidemiological trend can be observed for DACh. CONCLUSIONS In Austria, Switzerland and Germany there is a slightly increasing trend of human cases with alveolar echinococcosis. The direct comparability is limited due to different reporting obligations. The structures often do not allow a joint answering of scientific questions concerning diagnostics, treatment and care.
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Affiliation(s)
| | - Sven Baumann
- Klinik für Innere Medizin I, Universitätsklinikum Ulm, Ulm
| | | | | | - Raskit Lachmann
- Abteilung für Infektionsepidemiologie, Robert Koch Institut, Berlin
| | - Klaus Stark
- Abteilung für Infektionsepidemiologie, Robert Koch Institut, Berlin
| | - Lynn Peters
- Klinik für Innere Medizin III, Universitätsklinikum Ulm, Ulm
| | - Beate Gruener
- Klinik für Innere Medizin III, Universitätsklinikum Ulm, Ulm
| | - Michael Ramharter
- Department of Tropical Medicine, Bernhard Nocht Institute of Tropical Medicine, Hamburg, Germany.,I. Dep of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg
| | | | - Jens Strohäker
- Allgemeine, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen, Tubingen
| | - Anna Blum
- Arztpraxis Dr. B. Beck, Tropen- und Reisemedizin am Bellevue, Zürich
| | - Beat Müllhaupt
- Klinik für Gastroenterologie und Hepatologie, UniversitätsSpital Zürich, Zurich, Switzerland
| | - Heimo Lagler
- Klinische Abteilung für Infektionen und Tropenmedizin, Medizinische Universität Wien Universitätsklinik für Innere Medizin I, Wien, Austria
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Kołodziej-Sobocińska M, Dvorožňáková E, Hurníková Z, Reiterová K, Zalewski A. Seroprevalence of Echinococcus spp. and Toxocara spp. in Invasive Non-native American Mink. ECOHEALTH 2020; 17:13-27. [PMID: 31989366 PMCID: PMC7109198 DOI: 10.1007/s10393-020-01470-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 11/20/2019] [Accepted: 12/15/2019] [Indexed: 06/09/2023]
Abstract
Invasive non-native species can become reservoirs of zoonotic pathogens and cause their spread during colonization, increasing the risk of zoonoses transmission to both wild hosts and humans. American mink (Neovison vison) are considered an important invasive mammal species responsible for carrying endoparasites. The aim of our study was to evaluate the role of feral American mink as a possible transmission vector of Echinococcus spp. and Toxocara spp. in wildlife. We analysed the frequency of American mink exposure to both parasites, the spatial distribution in Poland, and the variability over time on the basis of specific antibody presence using ELISA and Western blot. Alimentary tract analyses revealed that American mink do not serve as definitive hosts for these parasites. Altogether, 1100 American mink were examined. The average seropositivity for American mink was 14.2% for echinococcosis and 21.7% for toxocarosis; dual-seropositivity was detected in only 6.0%. Seroprevalence of both parasites differed between study sites and significantly increased over time in Toxocara spp. Thus, our study revealed that free-living American mink are exposed to parasites and likely to be involved in the maintenance of both Echinococcus spp. and Toxocara spp. in the wild as paratenic hosts.
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Affiliation(s)
| | - Emília Dvorožňáková
- Institute of Parasitology, Slovak Academy of Sciences, Hlinkova 3, 040 01, Kosice, Slovak Republic
| | - Zuzana Hurníková
- Institute of Parasitology, Slovak Academy of Sciences, Hlinkova 3, 040 01, Kosice, Slovak Republic
| | - Katarína Reiterová
- Institute of Parasitology, Slovak Academy of Sciences, Hlinkova 3, 040 01, Kosice, Slovak Republic
| | - Andrzej Zalewski
- Mammal Research Institute, Polish Academy of Sciences, Stoczek 1, 17-230, Białowieża, Poland
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Baumann S, Shi R, Liu W, Bao H, Schmidberger J, Kratzer W, Li W. Worldwide literature on epidemiology of human alveolar echinococcosis: a systematic review of research published in the twenty-first century. Infection 2019; 47:703-727. [PMID: 31147846 PMCID: PMC8505309 DOI: 10.1007/s15010-019-01325-2] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 05/20/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE Human alveolar echinococcosis (AE) is a potentially lethal zoonosis caused by the cestode Echinococcus multilocularis. The aim of this systematic review is to establish a comprehensive global AE literature overview taking into account the epidemiologically relevant AE research of the twenty-first century. METHODS We systematically searched the global literature published from 2001 through 2018 via MEDLINE, EMBASE, the Russian databases eLIBRARY.RU, CyberLeninka, the Chinese databases CNKI, VIP, Journals. RESEARCH ac.ir (Farsi language-based), Jordan E-Library (Arab language-based) and supplementary Google Scholar, in accordance with the PRISMA guidelines. QGIS software was used for the mapping of the affected countries. RESULTS We have listed 154 relevant publications in the final literature synopsis in consideration of our quality assessment. Including non-autochthonous cases, human AE was reported in 36 countries within the northern hemisphere from 2001 to 2018. The first publication of AE in Tajikistan, Pakistan, South Korea, Belgium, the Netherlands, Slovakia, Hungary, Lithuania, Latvia, Slovenia and Morocco occurred in this century; further first cases in Taiwan, Thailand, and Denmark were considered to be non-autochthonous by the authors. The highest total case numbers (n ≥ 100 in a single article) were reported in France, Germany, Switzerland, Poland, and Lithuania, including China and Kyrgyzstan with by far the highest prevalence figures. CONCLUSIONS Our paper emphasises the increasing spread of reported cases and the rise in its numbers in the literature of the twenty-first century, especially in western, northern and eastern Europe, as well as in central Asia. Epidemiological studies on human infections are lacking in many parts of the world.
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Affiliation(s)
- Sven Baumann
- Department of Internal Medicine I, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Rong Shi
- Department of Diagnostic and Interventional Radiology, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Wenya Liu
- Xinjiang Medical University, First Affiliated Hospital, WHO Collaborating Centre on Prevention and Care Management of Echinococcosis, Urumqi, 830000, Xinjiang Uyghur Autonomous Region, People's Republic of China
| | - Haihua Bao
- Qinghai University Affiliated Hospital, Qinghai University, Xining, 810001, Qinghai, People's Republic of China
| | - Julian Schmidberger
- Department of Internal Medicine I, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Wolfgang Kratzer
- Department of Internal Medicine I, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
| | - Weixia Li
- Qinghai University Affiliated Hospital, Qinghai University, Xining, 810001, Qinghai, People's Republic of China
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Koutsoumanis K, Allende A, Alvarez-Ordóñez A, Bolton D, Bover-Cid S, Chemaly M, Davies R, De Cesare A, Herman L, Hilbert F, Lindqvist R, Nauta M, Peixe L, Ru G, Simmons M, Skandamis P, Suffredini E, Cacciò S, Chalmers R, Deplazes P, Devleesschauwer B, Innes E, Romig T, van der Giessen J, Hempen M, Van der Stede Y, Robertson L. Public health risks associated with food-borne parasites. EFSA J 2018; 16:e05495. [PMID: 32625781 PMCID: PMC7009631 DOI: 10.2903/j.efsa.2018.5495] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Parasites are important food‐borne pathogens. Their complex lifecycles, varied transmission routes, and prolonged periods between infection and symptoms mean that the public health burden and relative importance of different transmission routes are often difficult to assess. Furthermore, there are challenges in detection and diagnostics, and variations in reporting. A Europe‐focused ranking exercise, using multicriteria decision analysis, identified potentially food‐borne parasites of importance, and that are currently not routinely controlled in food. These are Cryptosporidium spp., Toxoplasma gondii and Echinococcus spp. Infection with these parasites in humans and animals, or their occurrence in food, is not notifiable in all Member States. This Opinion reviews current methods for detection, identification and tracing of these parasites in relevant foods, reviews literature on food‐borne pathways, examines information on their occurrence and persistence in foods, and investigates possible control measures along the food chain. The differences between these three parasites are substantial, but for all there is a paucity of well‐established, standardised, validated methods that can be applied across the range of relevant foods. Furthermore, the prolonged period between infection and clinical symptoms (from several days for Cryptosporidium to years for Echinococcus spp.) means that source attribution studies are very difficult. Nevertheless, our knowledge of the domestic animal lifecycle (involving dogs and livestock) for Echinoccocus granulosus means that this parasite is controllable. For Echinococcus multilocularis, for which the lifecycle involves wildlife (foxes and rodents), control would be expensive and complicated, but could be achieved in targeted areas with sufficient commitment and resources. Quantitative risk assessments have been described for Toxoplasma in meat. However, for T. gondii and Cryptosporidium as faecal contaminants, development of validated detection methods, including survival/infectivity assays and consensus molecular typing protocols, are required for the development of quantitative risk assessments and efficient control measures.
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Alveolar echinococcosis in Germany, 1992-2016. An update based on the newly established national AE database. Infection 2017; 46:197-206. [PMID: 29090421 DOI: 10.1007/s15010-017-1094-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 10/26/2017] [Indexed: 12/28/2022]
Abstract
PURPOSE Alveolar echinococcosis is a rare disease caused by the parasite Echinococcus multilocularis. The newly established national database should enable us to determine high-risk areas and evaluate the endemic levels. METHODS The national database was implemented using SQL Workbench. We used EpiInfo™ software to display the prevalence of disease. Moran's I geodata analysis according to cluster and high risk areas was performed with GeoDa™. SAS Version 9.2 was used for the statistical analysis of the cases (n = 523). RESULTS The analysis showed a concentration of cases in Baden-Württemberg and Bavaria. Moran's I showed a heterogeneous case distribution throughout Germany (I = 0.208815, Z = 32.6175, p < 0.001). In the period from 1992 to 2016, the prevalence was 0.64/100,000 inhabitants in the whole of Germany, 2.18/100,000 inhabitants in Baden-Württemberg and 1.48/100,000 inhabitants in Bavaria. The analysis also revealed a difference between men and women, with a prevalence of 0.58/100,000 and 0.69/100,000, respectively. The analysis of spatial autocorrelation and possible risk areas showed that the southeast regions of Baden-Württemberg (I = 0.188514, Z = 11.3197, p < 0.001) and the southwest part of Bavaria (I = 0.176953, Z = 13.5144, p < 0.001) constitute the high risk areas. CONCLUSIONS The prevalence of disease is noticeably high in the Swabian Jura, the Bavarian Alps and the Alpine foothills. Raising awareness and educating doctors in high risk areas may prevent new cases and assist in earlier diagnosis.
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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: 559] [Impact Index Per Article: 79.9] [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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Vuitton D, Demonmerot F, Knapp J, Richou C, Grenouillet F, Chauchet A, Vuitton L, Bresson-Hadni S, Millon L. Clinical epidemiology of human AE in Europe. Vet Parasitol 2015; 213:110-20. [DOI: 10.1016/j.vetpar.2015.07.036] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Threat of alveolar echinococcosis to public health – a challenge for Europe. Trends Parasitol 2015; 31:407-12. [DOI: 10.1016/j.pt.2015.06.001] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 06/02/2015] [Accepted: 06/04/2015] [Indexed: 02/02/2023]
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Abstract
AbstractKazakhstan is highly endemic for echinococcosis. Both Echinococcus granulosus and E. multilocularis are widely distributed in the country. Official records of human cystic echinococcosis over the past 5–10 years suggest a stable incidence of approximately 800–1000 cases per year, which is 5 cases per 100,000 per year. This followed a rapid increase in the incidence following the dissolution of the Soviet Union. Between 2007 and 2013, 5949 cases were reported in the national surveillance data. The prevalence in sheep, based on slaughterhouse studies, suggests that between 30 and 50% of sheep are infected with hydatid cysts, while cattle have a prevalence of approximately 7%. Rural dogs have a high prevalence of infection of between 5 and 10%, with shepherd dogs having prevalences of over 20%. G1 and G6/7 strains of E. granulosus have been isolated from dogs in Kazakhstan. Wolves are also infected, with one prevalence estimate of approximately 20%. The incidence of human alveolar echinococcosis is less clear, although estimates from Kazakhstani expatriates living in Germany and the hospital records of a single referral centre in Almaty suggest 34 or 130 cases per year (or an annual incidence of 0.20 or 0.76 cases per 100,000), respectively, could be occurring in Kazakhstan. Studies suggest that in some rural dog populations the prevalence may be about 5%. The parasite is widely distributed in foxes and small mammals through much of Kazakhstan.
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Hemphill A, Stadelmann B, Rufener R, Spiliotis M, Boubaker G, Müller J, Müller N, Gorgas D, Gottstein B. Treatment of echinococcosis: albendazole and mebendazole--what else? ACTA ACUST UNITED AC 2014; 21:70. [PMID: 25526545 PMCID: PMC4271654 DOI: 10.1051/parasite/2014073] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 12/11/2014] [Indexed: 01/14/2023]
Abstract
The search for novel therapeutic options to cure alveolar echinococcosis (AE), due to the metacestode of Echinococcus multilocularis, is ongoing, and these developments could also have a profound impact on the treatment of cystic echinococcosis (CE), caused by the closely related Echinococcus granulosus s.l. Several options are being explored. A viable strategy for the identification of novel chemotherapeutically valuable compounds includes whole-organism drug screening, employing large-scale in vitro metacestode cultures and, upon identification of promising compounds, verification of drug efficacy in small laboratory animals. Clearly, the current focus is targeted towards broad-spectrum anti-parasitic or anti-cancer drugs and compound classes that are already marketed, or that are in development for other applications. The availability of comprehensive Echinococcus genome information and gene expression data, as well as significant progress on the molecular level, has now opened the door for a more targeted drug discovery approach, which allows exploitation of defined pathways and enzymes that are essential for the parasite. In addition, current in vitro and in vivo models that are used to assess drug efficacy should be optimized and complemented by methods that give more detailed information on the host-parasite interactions that occur during drug treatments. The key to success is to identify, target and exploit those parasite molecules that orchestrate activities essential to parasite survival.
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Affiliation(s)
- Andrew Hemphill
- Vetsuisse Faculty, Institute of Parasitology, University of Berne, Länggass-Strasse 122, 3012 Berne, Switzerland
| | - Britta Stadelmann
- Vetsuisse Faculty, Institute of Parasitology, University of Berne, Länggass-Strasse 122, 3012 Berne, Switzerland
| | - Reto Rufener
- Vetsuisse Faculty, Institute of Parasitology, University of Berne, Länggass-Strasse 122, 3012 Berne, Switzerland
| | - Markus Spiliotis
- Vetsuisse Faculty, Institute of Parasitology, University of Berne, Länggass-Strasse 122, 3012 Berne, Switzerland
| | - Ghalia Boubaker
- Vetsuisse Faculty, Institute of Parasitology, University of Berne, Länggass-Strasse 122, 3012 Berne, Switzerland
| | - Joachim Müller
- Vetsuisse Faculty, Institute of Parasitology, University of Berne, Länggass-Strasse 122, 3012 Berne, Switzerland
| | - Norbert Müller
- Vetsuisse Faculty, Institute of Parasitology, University of Berne, Länggass-Strasse 122, 3012 Berne, Switzerland
| | - Daniela Gorgas
- Department of Clinical Veterinary Medicine, Clinical Radiology, Bremgartenstrasse 109a, 3012 Berne, Switzerland
| | - Bruno Gottstein
- Vetsuisse Faculty, Institute of Parasitology, University of Berne, Länggass-Strasse 122, 3012 Berne, Switzerland
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Charbonnier A, Knapp J, Demonmerot F, Bresson-Hadni S, Raoul F, Grenouillet F, Millon L, Vuitton DA, Damy S. A new data management system for the French National Registry of human alveolar echinococcosis cases. ACTA ACUST UNITED AC 2014; 21:69. [PMID: 25526544 PMCID: PMC4271653 DOI: 10.1051/parasite/2014075] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 12/12/2014] [Indexed: 01/18/2023]
Abstract
Alveolar echinococcosis (AE) is an endemic zoonosis in France due to the cestode Echinococcus multilocularis. The French National Reference Centre for Alveolar Echinococcosis (CNR-EA), connected to the FrancEchino network, is responsible for recording all AE cases diagnosed in France. Administrative, epidemiological and medical information on the French AE cases may currently be considered exhaustive only on the diagnosis time. To constitute a reference data set, an information system (IS) was developed thanks to a relational database management system (MySQL language). The current data set will evolve towards a dynamic surveillance system, including follow-up data (e.g. imaging, serology) and will be connected to environmental and parasitological data relative to E. multilocularis to better understand the pathogen transmission pathway. A particularly important goal is the possible interoperability of the IS with similar European and other databases abroad; this new IS could play a supporting role in the creation of new AE registries.
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Affiliation(s)
- Amandine Charbonnier
- Laboratoire Chrono-Environnement, UMR/CNRS 6249 University of Franche-Comté, 25000 Besançon, France - OSU THETA Franche-Comté Bourgogne, 25000 Besançon, France
| | - Jenny Knapp
- Laboratoire Chrono-Environnement, UMR/CNRS 6249 University of Franche-Comté, 25000 Besançon, France - National Reference Centre of Alveolar Echinococcosis - FrancEchino Network - WHO Collaborating Centre for Prevention and Treatment of Human Alveolar Echinococcosis, University Hospital Centre of Besançon, 25000 Besançon, France
| | - Florent Demonmerot
- Laboratoire Chrono-Environnement, UMR/CNRS 6249 University of Franche-Comté, 25000 Besançon, France - National Reference Centre of Alveolar Echinococcosis - FrancEchino Network - WHO Collaborating Centre for Prevention and Treatment of Human Alveolar Echinococcosis, University Hospital Centre of Besançon, 25000 Besançon, France
| | - Solange Bresson-Hadni
- Laboratoire Chrono-Environnement, UMR/CNRS 6249 University of Franche-Comté, 25000 Besançon, France - National Reference Centre of Alveolar Echinococcosis - FrancEchino Network - WHO Collaborating Centre for Prevention and Treatment of Human Alveolar Echinococcosis, University Hospital Centre of Besançon, 25000 Besançon, France
| | - Francis Raoul
- Laboratoire Chrono-Environnement, UMR/CNRS 6249 University of Franche-Comté, 25000 Besançon, France - National Reference Centre of Alveolar Echinococcosis - FrancEchino Network - WHO Collaborating Centre for Prevention and Treatment of Human Alveolar Echinococcosis, University Hospital Centre of Besançon, 25000 Besançon, France
| | - Frédéric Grenouillet
- Laboratoire Chrono-Environnement, UMR/CNRS 6249 University of Franche-Comté, 25000 Besançon, France - National Reference Centre of Alveolar Echinococcosis - FrancEchino Network - WHO Collaborating Centre for Prevention and Treatment of Human Alveolar Echinococcosis, University Hospital Centre of Besançon, 25000 Besançon, France
| | - Laurence Millon
- Laboratoire Chrono-Environnement, UMR/CNRS 6249 University of Franche-Comté, 25000 Besançon, France - National Reference Centre of Alveolar Echinococcosis - FrancEchino Network - WHO Collaborating Centre for Prevention and Treatment of Human Alveolar Echinococcosis, University Hospital Centre of Besançon, 25000 Besançon, France
| | - Dominique Angèle Vuitton
- Laboratoire Chrono-Environnement, UMR/CNRS 6249 University of Franche-Comté, 25000 Besançon, France - National Reference Centre of Alveolar Echinococcosis - FrancEchino Network - WHO Collaborating Centre for Prevention and Treatment of Human Alveolar Echinococcosis, University Hospital Centre of Besançon, 25000 Besançon, France
| | - Sylvie Damy
- Laboratoire Chrono-Environnement, UMR/CNRS 6249 University of Franche-Comté, 25000 Besançon, France
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Gottstein B, Wang J, Blagosklonov O, Grenouillet F, Millon L, Vuitton DA, Müller N. Echinococcus metacestode: in search of viability markers. ACTA ACUST UNITED AC 2014; 21:63. [PMID: 25429386 PMCID: PMC4245873 DOI: 10.1051/parasite/2014063] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 11/11/2014] [Indexed: 12/27/2022]
Abstract
Epidemiological studies have demonstrated that most humans infected with Echinococcus spp. exhibit resistance to disease. When infection leads to disease, the parasite is partially controlled by host immunity: in case of immunocompetence, the normal alveolar echinococcosis (AE) or cystic echinococcosis (CE) situation, the metacestode grows slowly, and first clinical signs appear years after infection; in case of impaired immunity (AIDS; other immunodeficiencies), uncontrolled proliferation of the metacestode leads to rapidly progressing disease. Assessing Echinococcus multilocularis viability in vivo following therapeutic interventions in AE patients may be of tremendous benefit when compared with the invasive procedures used to perform biopsies. Current options are F18-fluorodeoxyglucose-positron emission tomography (FDG-PET), which visualizes periparasitic inflammation due to the metabolic activity of the metacestode, and measurement of antibodies against recEm18, a viability-associated protein, that rapidly regresses upon metacestode inactivation. For Echinococcus granulosus, similar prognosis-associated follow-up parameters are still lacking but a few candidates may be listed. Other possible markers include functional and diffusion-weighted Magnetic Resonance Imaging (MRI), and measurement of products from the parasite (circulating antigens or DNA), and from the host (inflammation markers, cytokines, or chemokines). Even though some of them have been promising in pilot studies, none has been properly validated in an appropriate number of patients until now to be recommended for further use in clinical settings. There is therefore still a need to develop reliable tools for improved viability assessment to provide the sufficient information needed to reliably withdraw anti-parasite benzimidazole chemotherapy, and a basis for the development of new alternative therapeutic tools.
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Affiliation(s)
- Bruno Gottstein
- Institute of Parasitology, Vetsuisse Faculty and Faculty of Medicine, University of Bern, Switzerland
| | - Junhua Wang
- Institute of Parasitology, Vetsuisse Faculty and Faculty of Medicine, University of Bern, Switzerland - WHO-Collaborating Centre for the Prevention and Treatment of Human Echinococcosis, University of Franche-Comté and University Hospital, Besançon, Franche-Comté, France
| | - Oleg Blagosklonov
- Department of Nuclear Medicine, University of Franche-Comté and Jean Minjoz University Hospital, Besançon, Franche-Comté, France - WHO-Collaborating Centre for the Prevention and Treatment of Human Echinococcosis, University of Franche-Comté and University Hospital, Besançon, Franche-Comté, France
| | - Frédéric Grenouillet
- Laboratory of Parasitology-Mycology, Centre Hospitalier Universitaire, Université de Franche Comté, Besançon, France - WHO-Collaborating Centre for the Prevention and Treatment of Human Echinococcosis, University of Franche-Comté and University Hospital, Besançon, Franche-Comté, France
| | - Laurence Millon
- Laboratory of Parasitology-Mycology, Centre Hospitalier Universitaire, Université de Franche Comté, Besançon, France - WHO-Collaborating Centre for the Prevention and Treatment of Human Echinococcosis, University of Franche-Comté and University Hospital, Besançon, Franche-Comté, France
| | - Dominique A Vuitton
- WHO-Collaborating Centre for the Prevention and Treatment of Human Echinococcosis, University of Franche-Comté and University Hospital, Besançon, Franche-Comté, France
| | - Norbert Müller
- Institute of Parasitology, Vetsuisse Faculty and Faculty of Medicine, University of Bern, Switzerland
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Antolová D, Miterpáková M, Radoňák J, Hudačková D, Szilágyiová M, Žáček M. Alveolar echinococcosis in a highly endemic area of northern Slovakia between 2000 and 2013. Euro Surveill 2014. [DOI: 10.2807/1560-7917.es2014.19.34.20882] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Long-term surveillance of Echinococcus multilocularis occurrence in red foxes in Slovakia revealed the existence of highly endemic areas, with an overall prevalence rate of 41.6 % in the northern part of the country. Between 2000 and 2013, 26 human cases of alveolar echinococcosis were detected and only three of them were not in endemic localities in northern Slovakia. Remarkable is the occurrence of the disease in eight people younger than 35 years, including three patients aged eight, 14 and 19 years. Occurrence of E. multilocularis in red foxes throughout the country and high incidence of alveolar echinococcosis in young people indicate high infectious pressure in the environment of northern Slovakia. It can be assumed that the real incidence of alveolar echinococcosis is significantly higher than recorded by official data due to the lack of existing registration and reporting system. For effective management of prevention and control strategies for this disease improvement of the national surveillance system and engagement of specialists outside the medical community are necessary. Our study presents a comprehensive picture of the epidemiological situation of E. multilocularis in northern Slovakia. In addition, we report the first list of confirmed human cases of this serious parasitosis in Slovakia.
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Affiliation(s)
- D Antolová
- Institute of Parasitology, Slovak Academy of Sciences, Košice, Slovakia
| | - M Miterpáková
- Institute of Parasitology, Slovak Academy of Sciences, Košice, Slovakia
| | - J Radoňák
- First Department of Surgery, University Hospital Košice, Košice, Slovakia
| | - D Hudačková
- Childrens’ Faculty Hospital Košice, Department of Infectious Diseases, Košice, Slovakia
| | - M Szilágyiová
- Clinic of Infectious Diseases and Travel Medicine, University Hospital Martin, Martin,
| | - M Žáček
- Department of Surgery, University Hospital Žilina, Žilina, Slovakia
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19
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Abstract
Austria is part of the classical area of central Europe to which alveolar echinococcosis (AE) is endemic. Annual incidences in Austria were 2.4 and 2.8 cases/100,000 population during 1991–2000 and 2001–2010, respectively. Hence, the registration of 13 new AE patients in 2011 was unexpected. Increasing fox populations and past AE underreporting might have caused this increase.
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20
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Abstract
Recent changes in the epidemiology of alveolar echinococcosis (AE) in Eurasia have led to increasing concerns about the risk of human AE and the need for a thorough evaluation of the epidemiological situation. The aim of this study was to explore the use of a National Register to detect complex distribution patterns on several scales. The data were human AE cases from the FrancEchino register, diagnosed in France from 1982 to 2011. We used the Kulldorff spatial scan analysis to detect non-random locations of cases. We proposed an exploratory method that was based on the successive detection of nested clusters inside each of the statistically significant larger clusters. This method revealed at least 4 levels of disease clusters during the study period. The spatial variations of cluster location over time were also shown. We conclude that National Human AE registers, although not exempted from epidemiological biases, are currently the best way to achieve an accurate representation of human AE distribution on various scales. Finally, we confirm the multi-scale clustered distribution of human AE, and we hypothesize that our study may be a reasonable starting point from which to conduct additional research and explore the processes that underlie such distributions.
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21
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Atanasov G, Benckert C, Thelen A, Tappe D, Frosch M, Teichmann D, Barth TFE, Wittekind C, Schubert S, Jonas S. Alveolar echinococcosis-spreading disease challenging clinicians: A case report and literature review. World J Gastroenterol 2013; 19:4257-4261. [PMID: 23864792 PMCID: PMC3710431 DOI: 10.3748/wjg.v19.i26.4257] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Revised: 03/09/2013] [Accepted: 04/04/2013] [Indexed: 02/06/2023] Open
Abstract
Human alveolar echinococcosis (AE) is a potentially deadly disease; recent studies have shown that the endemic area of Echinococcus multilocularis, its causative agent, is larger than previously known. This disease has low prevalence and remains underreported in Europe. Emerging clinical data show that diagnostic difficulties are still common. We report on a 76-year old patient suffering from AE lesions restricted to the left lobe of the liver who underwent a curative extended left hemihepatectomy. Prior to the resection a liver biopsy under the suspicion of an atypical malignancy was performed. After the intervention he developed a pseudoaneurysm of the hepatic artery that was successfully coiled. Surprisingly, during surgery, the macroscopic appearance of the tumour revealed a growth pattern that was rather typical for cystic echinococcosis (CE), i.e., a gross tumour composed of multiple large vesicles with several centimeters in diameter. In addition, there were neither extensive adhesions nor infiltrations of the neighboring pancreas and diaphragm as was expected from previous imaging results. The unexpected diagnosis of AE was confirmed by definite histopathology, specific polymerase chain reaction and serology results. This is a rare case of unusual macroscopic presentation of AE that posed immense diagnostic challenges and had an eventful course. To our knowledge this is the first case of an autochthonous infection in this particular geographic area of Germany, the federal state of Saxony. This report may provide new hints for an expanding area of risk for AE and emphasizes the risk of complications in the scope of diagnostic procedures and the limitations of modern radiological imaging.
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22
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Denzin N, Schliephake A, Fröhlich A, Ziller M, Conraths FJ. On the Move?Echinococcus multilocularisin Red Foxes of Saxony-Anhalt (Germany). Transbound Emerg Dis 2012; 61:239-46. [DOI: 10.1111/tbed.12026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Indexed: 11/30/2022]
Affiliation(s)
- N. Denzin
- Department 4, Veterinary Medicine; State Office for Consumer Protection Saxony-Anhalt; Stendal Germany
| | - A. Schliephake
- Department 4, Veterinary Medicine; State Office for Consumer Protection Saxony-Anhalt; Stendal Germany
| | - A. Fröhlich
- Institute of Epidemiology; Friedrich-Loeffler Institut; Federal Research Institute for Animal Health; Wusterhausen Germany
| | - M. Ziller
- Biomathematics Working Group; Friedrich-Loeffler Institut; Federal Research Institute for Animal Health; Greifswald Insel Riems Germany
| | - F. J. Conraths
- Institute of Epidemiology; Friedrich-Loeffler Institut; Federal Research Institute for Animal Health; Wusterhausen Germany
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Küster T, Lense N, Barna F, Hemphill A, Kindermann MK, Heinicke JW, Vock CA. A new promising application for highly cytotoxic metal compounds: η6-areneruthenium(II) phosphite complexes for the treatment of alveolar echinococcosis. J Med Chem 2012; 55:4178-88. [PMID: 22489925 DOI: 10.1021/jm300291a] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Two series of η(6)-areneruthenium(II) phosphite complexes were prepared, characterized, and evaluated in vitro for their toxic potential against Echinococcus multilocularis metacestodes. Neutral complexes of general formula [(η(6)-p-cymene)RuCl(2){P(OR)(3)}] (R = Et, (i)Pr, Ph) with two easily exchangable chloride ligands showed only minor toxicity, whereas the substitution of these moieties against a β-diketonate (2,2,6,6-tetramethylheptanedionate) ligand led to hydrolytically stable complex salts of type [(η(6)-p-cymene)Ru(β-diketonate){P(OR)(3)}][BF(4)] (R = Et, (i)Pr, Ph) with comparable in vitro toxicity (50% PGI release at c = 1.4 - 4.7 μM) to the reference drug nitazoxanide (50% PGI release at c = 1.2 μM). In addition, the latter complexes were highly toxic against rat hepatoma cells (IC(50) = 0.40-2.0 μM) and less toxic against human foreskin fibroblasts (IC(50) = 1.1-2.9 μM) and Vero cells (IC(50) = 1.2-8.9 μM). The measured cytotoxicities against mammalian cells are, to the best of our knowledge, among the highest ever observed for ruthenium-based complexes. In conclusion, complex salts of type [(η(6)-p-cymene)Ru(β-diketonate){P(OR)(3)}][BF(4)] might be interesting candidates for further development toward anthelmintic drugs and/or highly cytotoxic metal compounds.
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Affiliation(s)
- Tatiana Küster
- Institute of Parasitology, Vetsuisse Faculty, University of Berne, Länggass-Strasse 122, CH-3012 Berne, Switzerland
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24
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Srinivasa Rao ASR. Understanding theoretically the impact of reporting of disease cases in epidemiology. J Theor Biol 2012; 302:89-95. [PMID: 22410318 DOI: 10.1016/j.jtbi.2012.02.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2011] [Revised: 02/27/2012] [Accepted: 02/28/2012] [Indexed: 11/27/2022]
Abstract
In conducting preliminary analysis during an epidemic, data on reported disease cases offer key information in guiding the direction to the in-depth analysis. Models for growth and transmission dynamics are heavily dependent on preliminary analysis results. When a particular disease case is reported more than once or alternatively is never reported or detected in the population, then in such a situation, there is a possibility of existence of multiple reporting or under reporting in the population. In this work, a theoretical approach for studying reporting error in epidemiology is explored. The upper bound for the error that arises due to multiple reporting is higher than that which arises due to under reporting. Numerical examples are provided to support the arguments. This paper mainly treats reporting error as deterministic and one can explore a stochastic model for the same.
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Affiliation(s)
- Arni S R Srinivasa Rao
- Bayesian and Interdisciplinary Research Unit, Indian Statistical Institute, 203 B.T. Road, Calcutta 700108, India.
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Abstract
PURPOSE OF REVIEW Human alveolar echinococcosis is caused by the larval stage of Echinococcus multilocularis, occurring in at least 42 countries of the northern hemisphere. Recent studies in Europe and Asia have shown that the endemic area of E. multilocularis is larger than previously known and the parasite has regionally expanded from rural to urban areas. Diagnosis of alveolar echinococcosis is supported by results from imaging studies, histopathology and/or nucleic acid detection, and serology. The present review summarizes current understanding of clinical features, knowledge on appropriate treatment, and discusses ways to improve standards of care. RECENT FINDINGS High prevalences of this deadly disease have been discovered in surveys in parts of China. Clinical manifestations, diagnostic tools and the burden of disease were described, and are based on high case numbers. In Europe, excellent tools have been introduced, which improve disease management. Long-term observations in Switzerland provide an optimistic view, as the infection can be well controlled, if patients are cared for in specialized centres. An expert consensus summarizes the current recommendation for diagnosis and treatment of alveolar echinococcosis by the Informal Working Group on Echinococcosis of the WHO. SUMMARY Diagnosis and treatment of alveolar echinococcosis remains a challenge for clinicians. The updated WHO-recommendations aim to support decisions on diagnosis and treatment of alveolar echinococcosis. Anti-infective therapy is the backbone of treatment; surgery should be restricted to patients at an early stage of the disease. For the majority of cases continuous chemoprophylaxis with benzimidazoles is cost-effective and leads to a good quality of life for patients with this chronic disease.
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26
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Torgerson PR, Keller K, Magnotta M, Ragland N. The global burden of alveolar echinococcosis. PLoS Negl Trop Dis 2010; 4:e722. [PMID: 20582310 PMCID: PMC2889826 DOI: 10.1371/journal.pntd.0000722] [Citation(s) in RCA: 309] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Accepted: 04/29/2010] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Human alveolar echinococcosis (AE) is known to be common in certain rural communities in China whilst it is generally rare and sporadic elsewhere. The objective of this study was to provide a first estimate of the global incidence of this disease by country. The second objective was to estimate the global disease burden using age and gender stratified incidences and estimated life expectancy with the disease from previous results of survival analysis. Disability weights were suggested from previous burden studies on echinococcosis. METHODOLOGY/PRINCIPAL FINDINGS We undertook a detailed review of published literature and data from other sources. We were unable to make a standardised systematic review as the quality of the data was highly variable from different countries and hence if we had used uniform inclusion criteria many endemic areas lacking data would not have been included. Therefore we used evidence based stochastic techniques to model uncertainty and other modelling and estimating techniques, particularly in regions where data quality was poor. We were able to make an estimate of the annual global incidence of disease and annual disease burden using standard techniques for calculation of DALYs. Our studies suggest that there are approximately 18,235 (CIs 11,900-28,200) new cases of AE per annum globally with 16,629 (91%) occurring in China and 1,606 outside China. Most of these cases are in regions where there is little treatment available and therefore will be fatal cases. Based on using disability weights for hepatic carcinoma and estimated age and gender specific incidence we were able to calculate that AE results in a median of 666,434 DALYs per annum (CIs 331,000-1.3 million). CONCLUSIONS/SIGNIFICANCE The global burden of AE is comparable to several diseases in the neglected tropical disease cluster and is likely to be one of the most important diseases in certain communities in rural China on the Tibetan plateau.
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Affiliation(s)
- Paul R Torgerson
- Ross University School of Veterinary Medicine, St. Kitts, West Indies.
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27
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Takekawa JY, Newman SH, Xiao X, Prosser DJ, Spragens KA, Palm EC, Yan B, Li T, Lei F, Zhao D, Douglas DC, Muzaffar SB, Ji W. Migration of waterfowl in the East Asian flyway and spatial relationship to HPAI H5N1 outbreaks. Avian Dis 2010; 54:466-76. [PMID: 20521681 PMCID: PMC4878034 DOI: 10.1637/8914-043009-reg.1] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Poyang Lake is situated within the East Asian Flyway, a migratory corridor for waterfowl that also encompasses Guangdong Province, China, the epicenter of highly pathogenic avian influenza (HPAI) H5N1. The lake is the largest freshwater body in China and a significant congregation site for waterfowl; however, surrounding rice fields and poultry grazing have created an overlap with wild waterbirds, a situation conducive to avian influenza transmission. Reports of HPAI H5N1 in healthy wild ducks at Poyang Lake have raised concerns about the potential of resilient free-ranging birds to disseminate the virus. Yet the role wild ducks play in connecting regions of HPAI H5N1 outbreak in Asia is hindered by a lack of information about their migratory ecology. During 2007-08 we marked wild ducks at Poyang Lake with satellite transmitters to examine the location and timing of spring migration and identify any spatiotemporal relationship with HPAI H5N1 outbreaks. Species included the Eurasian wigeon (Anas penelope), northern pintail (Anas acuta), common teal (Anas crecca), falcated teal (Anas falcata), Baikal teal (Anas formosa), mallard (Anas platyrhynchos), garganey (Anas querquedula), and Chinese spotbill (Anas poecilohyncha). These wild ducks (excluding the resident mallard and Chinese spotbill ducks) followed the East Asian Flyway along the coast to breeding areas in northern China, eastern Mongolia, and eastern Russia. None migrated west toward Qinghai Lake (site of the largest wild bird epizootic), thus failing to demonstrate any migratory connection to the Central Asian Flyway. A newly developed Brownian bridge spatial analysis indicated that HPAI H5N1 outbreaks reported in the flyway were related to latitude and poultry density but not to the core migration corridor or to wetland habitats. Also, we found a temporal mismatch between timing of outbreaks and wild duck movements. These analyses depend on complete or representative reporting of outbreaks, but by documenting movements of wild waterfowl, we present ecological knowledge that better informs epidemiological investigations seeking to explain and predict the spread of avian influenza viruses.
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Affiliation(s)
- John Y Takekawa
- U.S. Geological Survey, Western Ecological Research Center, San Francisco Bay Estuary Field Station, Vallejo, CA 94592, USA.
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28
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Abstract
New information has become available on the epidemiological situation of Echinococcus multilocularis in Europe. Additional endemic areas have been identified, and, in some areas, prevalences in foxes have drastically increased. In addition, some neozootic mammals may by now be involved in the lifecycle. The parasite is now widespread in urban and suburban areas in central Europe. The number of human cases of alveolar echinococcosis is small, but still underreported, and is likely to increase in the near future. Trials to counteract the spread of this parasite have been performed by application of anthelmintics to foxes via baits, and gave encouraging results on different spatial scales.
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Mörk MJ, Wolff C, Lindberg A, Vågsholm I, Egenvall A. Validation of a national disease recording system for dairy cattle against veterinary practice records. Prev Vet Med 2009; 93:183-92. [PMID: 19819035 DOI: 10.1016/j.prevetmed.2009.09.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2009] [Revised: 09/03/2009] [Accepted: 09/15/2009] [Indexed: 10/20/2022]
Abstract
In Sweden, morbidity in dairy cattle is monitored through a national disease recording system. This system gives valuable information for research as well as advisory work and genetic evaluation. Our main objective was to evaluate the completeness in the disease recording system. Farm copies of veterinary records (n=851) from 112 herds, from March 2003 to April 2004, were compared with the information registered in the recording system. The evaluation of completeness was performed at two stages: (i) in the raw data transferred from the Swedish Board of Agriculture (SBA) to the Swedish Dairy Association (for records, cases and diagnostic events) and (ii) in the dairy disease database (DDD) at the Swedish Dairy Association (for diagnostic events). The evaluation was stratified by record type: manual and computerized records from state-employed veterinarians and private veterinarians, respectively. The completeness was high both for records (95-100%) and cases (90-99%) except manual records from private veterinarians (76% for records and 74% for cases). The overall completeness for diagnostic events was 75% in the DDD, with significant differences between record types. For all record types other than manual records from private veterinarians, the majority of diagnostic events lost disappeared after registration in the raw data from the SBA. The reasons for loss found suggest that there is potential for improvement. A multilevel logistic regression analysis showed that the completeness of diagnostic events in the DDD depended on region, diagnosis and veterinary employment. The random effect of veterinarian accounted for 35% of the modeled variation. Future studies are needed to assess how the differential misclassification affect estimates based on the data, and how to account for it.
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Affiliation(s)
- M Jansson Mörk
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, P.O. Box 7019, SE-750 07 Uppsala, Sweden.
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Abstract
Echinococcus granulosus and Echinococcus multilocularis are cestode parasites, of which the metacestode (larval) stages cause the neglected diseases cystic echinococcosis (CE) and alveolar echinococcosis (AE), respectively. The benzimidazoles albendazole and mebendazole are presently used for the chemotherapeutical treatment, alone or prior to and after surgery. However, in AE these benzimidazoles do not appear to be parasiticidal in vivo. In addition, failures in drug treatments as well as the occurrence of side-effects have been reported, leading to discontinuation of treatment or to progressive disease. Therefore, new drugs are needed to cure AE and CE. Strategies that are currently employed in order to identify novel chemotherapeutical treatment options include in vitro and in vivo testing of broad-spectrum anti-infective drugs or drugs that interfere with unlimited proliferation of cancer cells. The fact that the genome of E. multilocularis has recently been sequenced has opened other avenues, such as the selection of novel drugs that interfere with the parasite signalling machinery, and the application of in silico approaches by employing the Echinococcus genome information to search for suitable targets for compounds of known mode of action.
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Echinococcus multilocularis infections in domestic dogs and cats from Germany and other European countries. Vet Parasitol 2008; 157:244-53. [DOI: 10.1016/j.vetpar.2008.07.030] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2008] [Revised: 07/16/2008] [Accepted: 07/18/2008] [Indexed: 11/23/2022]
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