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Kern P, Menezes da Silva A, Akhan O, Müllhaupt B, Vizcaychipi KA, Budke C, Vuitton DA. The Echinococcoses: Diagnosis, Clinical Management and Burden of Disease. ADVANCES IN PARASITOLOGY 2017; 96:259-369. [PMID: 28212790 DOI: 10.1016/bs.apar.2016.09.006] [Citation(s) in RCA: 310] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The echinococcoses are chronic, parasitic diseases that are acquired after ingestion of infective taeniid tapeworm eggs from certain species of the genus Echinococcus. Cystic echinococcosis (CE) occurs worldwide, whereas, alveolar echinococcosis (AE) is restricted to the northern hemisphere, and neotropical echinococcosis (NE) has only been identified in Central and South America. Clinical manifestations and disease courses vary profoundly for the different species of Echinococcus. CE presents as small to large cysts, and has commonly been referred to as 'hydatid disease', or 'hydatidosis'. A structured stage-specific approach to CE management, based on the World Health Organization (WHO) ultrasound classification of liver cysts, is now recommended. Management options include percutaneous sterilization techniques, surgery, drug treatment, a 'watch-and-wait' approach or combinations thereof. In contrast, clinical manifestations associated with AE resemble those of a 'malignant', silently-progressing liver disease, with local tissue infiltration and metastases. Structured care is important for AE management and includes WHO staging, drug therapy and long-term follow-up for at least a decade. NE presents as polycystic or unicystic disease. Clinical characteristics resemble those of AE, and management needs to be structured accordingly. However, to date, only a few hundreds of cases have been reported in the literature. The echinococcoses are often expensive and complicated to treat, and prospective clinical studies are needed to better inform case management decisions.
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Affiliation(s)
- P Kern
- University Hospital of Ulm, Ulm, Germany
| | | | - O Akhan
- Hacettepe University, Ankara, Turkey
| | - B Müllhaupt
- University Hospital of Zurich, Zürich, Switzerland
| | - K A Vizcaychipi
- National Institute of Infectious Diseases, Buenos Aires, Argentina
| | - C Budke
- Texas A&M University, College Station, TX, United States
| | - D A Vuitton
- Université de Franche-Comté, Besançon, France
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102
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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: 626] [Impact Index Per Article: 78.3] [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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103
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Grüner B, Kern P, Mayer B, Gräter T, Hillenbrand A, Barth TEF, Muche R, Henne-Bruns D, Kratzer W, Kern P. Comprehensive diagnosis and treatment of alveolar echinococcosis: A single-center, long-term observational study of 312 patients in Germany. GMS INFECTIOUS DISEASES 2017; 5:Doc01. [PMID: 30671323 PMCID: PMC6301735 DOI: 10.3205/id000027] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Alveolar echinococcosis (AE) is the most Iethal human helminthic infection. The malignancy-like disease is rare, but morbidity and treatment costs are high. Objective of the study was to identify factors at baseline and during specific AE therapy influencing the long-term outcome of the disease. All patients with AE seen at the specialized treatment unit in Ulm between January 1992 and December 2011 were included in the analysis. The data of 312 patients were analyzed; 108 were diagnosed before 2000 (series A), 204 since 2000 (series B); 290 received specific AE treatment. Patients of series B were more often symptom-free at diagnosis (44.1% vs. 21.3%), had lower disease stages (50.0% vs. 34.2%) and more complete resections (57.7% vs. 20.0%), but higher rates of side effects and drug toxicity (54.1% vs. 40.8%). In series B, more patients remained relapse- or progression-free after 5 years (90.5% vs. 82.8%); after 10 years, the ratio of relapses converged (70.3% vs. 66.9%, p=0.0507). Relapses or progression occurred more often after incomplete surgery or long treatment pauses. The 5-year and 10-year survival rates were 96.9% and 90.6%, respectively, and 17% of the patients were cured. We observed a shift towards early diagnosis, earlier initiation of specific therapy and more complete resections after 2000. Although diagnosis and treatment of AE pose a challenge, with an individual interdisciplinary management 88.8% of the patients have a favorable outcome.
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Affiliation(s)
- Beate Grüner
- Department of Internal Medicine III, University Hospital Ulm, Germany
| | - Petra Kern
- Institute of Epidemiology and Medical Biometry, University of Ulm, Germany
| | - Benjamin Mayer
- Institute of Epidemiology and Medical Biometry, University of Ulm, Germany
| | - Tilmann Gräter
- Department of Interventional and Diagnostic Radiology, University Hospital Ulm, Germany
| | | | | | - Rainer Muche
- Institute of Epidemiology and Medical Biometry, University of Ulm, Germany
| | | | - Wolfgang Kratzer
- Department of Internal Medicine I, University Hospital Ulm, Germany
| | - Peter Kern
- Department of Internal Medicine III, University Hospital Ulm, Germany
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104
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Pascal G, Azoulay D, Belghiti J, Laurent A. Hydatid disease of the liver. BLUMGART'S SURGERY OF THE LIVER, BILIARY TRACT AND PANCREAS, 2-VOLUME SET 2017:1102-1121.e3. [DOI: 10.1016/b978-0-323-34062-5.00074-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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105
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Abstract
Human cystic echinococcosis (CE) has been eliminated or significantly reduced as a public health problem in several previously highly endemic regions. This has been achieved by the long-term application of prevention and control measures primarily targeted to deworming dogs, health education, meat inspection, and effective surveillance in livestock and human populations. Human CE, however, remains a serious neglected zoonotic disease in many resource-poor pastoral regions. The incidence of human alveolar echinococcosis (AE) has increased in continental Europe and is a major public health problem in parts of Eurasia. Better understanding of wildlife ecology for fox and small mammal hosts has enabled targeted anthelmintic baiting of fox populations and development of spatially explicit models to predict population dynamics for key intermediate host species and human AE risk in endemic landscapes. Challenges that remain for echinococcosis control include effective intervention in resource-poor communities, better availability of surveillance tools, optimal application of livestock vaccination, and management and ecology of dog and wildlife host populations.
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106
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Echinococcosis. Infect Dis (Lond) 2017. [DOI: 10.1016/b978-0-7020-6285-8.00120-9] [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: 11/18/2022] Open
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107
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Hints for control of infection in unique extrahepatic vertebral alveolar echinococcosis. Infection 2016; 45:365-368. [DOI: 10.1007/s15010-016-0974-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 12/07/2016] [Indexed: 10/20/2022]
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108
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Liu H, Ji X, Sun L, Xiao T, Xie H, Fu Y, Zhao Y, Liu W, Zhang X, Lin R. Visualization and Pathological Characteristics of Hepatic Alveolar Echinococcosis with Synchrotron-based X-ray Phase Sensitive Micro-tomography. Sci Rep 2016; 6:38085. [PMID: 27897249 PMCID: PMC5126691 DOI: 10.1038/srep38085] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 11/03/2016] [Indexed: 11/16/2022] Open
Abstract
Propagation-based phase-contrast computed tomography (PPCT) utilizes highly sensitive phase-contrast technology applied to X-ray micro-tomography, especially with the extensive use of synchrotron radiation (SR). Performing phase retrieval (PR) on the acquired angular projections can enhance image contrast and enable quantitative imaging. We employed the combination of SR-PPCT and PR for the histopathological evaluation of hepatic alveolar echinococcosis (HAE) disease and demonstrated the validity and superiority of PR-based SR-PPCT. A high-resolution angular projection data set of a human postoperative specimen of HAE disease was acquired, which was processed by graded ethanol concentration fixation (GECF). The reconstructed images from both approaches, with the projection data directly used and preprocessed by PR for tomographic reconstruction, were compared in terms of the tissue contrast-to-noise ratio and density spatial resolution. The PR-based SR-PPCT was selected for microscale measurement and the 3D visualization of HAE disease. Our experimental results demonstrated that the PR-based SR-PPCT technique is greatly suitable for the discrimination of pathological tissues and the characterization of HAE. In addition, this new technique is superior to conventional hospital CT and microscopy for the three-dimensional, non-destructive microscale measurement of HAE. This PR-based SR-PPCT technique has great potential for in situmicroscale histopathological analysis and diagnosis, especially for applications involving soft tissues and organs.
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Affiliation(s)
- Huiqiang Liu
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumchi 830011, China
| | - Xuewen Ji
- Hepatobiliary &Echinococcosis Surgery, FirstAffiliated Hospital, Xinjiang Medical University, Urumchi 830054, China
| | - Li Sun
- State Key Laboratory Incubation Base of Xinjiang Major Diseases Research, FirstAffiliated Hospital, Xinjiang Medical University, Urumchi 830054, China
| | - Tiqiao Xiao
- SSRF, Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - Honglan Xie
- SSRF, Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - Yanan Fu
- SSRF, Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800, China
| | - Yuan Zhao
- Imaging Center, First Affiliated Hospital, Xinjiang Medical University, Urumchi 830054, China
| | - Wenya Liu
- Imaging Center, First Affiliated Hospital, Xinjiang Medical University, Urumchi 830054, China
| | - Xueliang Zhang
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumchi 830011, China
| | - Renyong Lin
- State Key Laboratory Incubation Base of Xinjiang Major Diseases Research, FirstAffiliated Hospital, Xinjiang Medical University, Urumchi 830054, China
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Abstract
Cystic and alveolar echinococcosis are severe chronic helminthic diseases caused by the cystic growth or the intrahepatic tumour-like growth of the metacestode of Echinococcus granulosus or Echinococcus multilocularis, respectively. Both parasites have evolved sophisticated strategies to escape host immune responses, mainly by manipulating and directing this immune response towards anergy and/or tolerance. Recent research studies have revealed a number of respective immunoregulatory mechanisms related to macrophages and dendritic cell as well as T cell activities (regulatory T cells, Tregs). A better understanding of this complex parasite-host relationship, and the elucidation of specific crucial events that lead to disease, represents targets towards the development of novel treatment strategies and options.
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110
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Knapp J, Combes B, Umhang G, Aknouche S, Millon L. Could the domestic cat play a significant role in the transmission of Echinococcus multilocularis? A study based on qPCR analysis of cat feces in a rural area in France. ACTA ACUST UNITED AC 2016; 23:42. [PMID: 27739398 PMCID: PMC5782850 DOI: 10.1051/parasite/2016052] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 09/28/2016] [Indexed: 11/19/2022]
Abstract
Echinococcus multilocularis, a cestode parasite responsible for alveolar echinococcosis in humans, is often reported in Europe. It involves red foxes, domestic dogs, and domestic and wild cats as definitive hosts. The parasite infects small mammals and accidentally humans as intermediate hosts and develops in a similar way to a tumor, usually in the liver. Domestic animals are suspected of playing a role in parasite transmission, but this is rarely proven. Moreover, the role of domestic cats is thought to be small, because of experimental studies showing incomplete development of the parasite observed in their intestines. In the present study, we investigated copro-sampling performed in a rural and highly endemic area in Eastern France, on carnivore feces (n = 150). From these samples, the parasite was detected and identified by DNA analysis using quantitative PCR targeting part of a mitochondrial gene (Em-qPCR). Taeniid eggs were isolated from positive-Em-qPCR samples by flotation, and species identification was confirmed by sequencing on DNA extracts. From a total of 43 copro-samples from cats, four tested positive for E. multilocularis by the Em-qPCR. In two of these, we found parasite eggs that were identified as E. multilocularis. This finding was confirmed by sequencing, while one dog stool out of 61 collected was found to be positive, no egg was detectable. At the same time, 34% of fox stools tested positive for the parasite. The present study challenges the current idea that cats are only of minor significance in the E. multilocularis life cycle.
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Affiliation(s)
- Jenny Knapp
- Chrono-Environnement Laboratory, UMR UBFC/CNRS 6249 aff. INRA, University of Bourgogne Franche-Comté, 25030 Besançon, France - Department of Parasitology-Mycology, University Hospital of Besançon, 25030 Besançon, France
| | - Benoît Combes
- Entente for the Control of Zoonoses, 54220 Malzéville, France
| | - Gérald Umhang
- ANSES Nancy Laboratory for Rabies and Wildlife, National Reference Laboratory for Echinococcus spp., Wildlife Surveillance and Eco-Epidemiology Unit, Technopole Agricole et Vétérinaire, 54220 Malzéville, France
| | - Soufiane Aknouche
- Chrono-Environnement Laboratory, UMR UBFC/CNRS 6249 aff. INRA, University of Bourgogne Franche-Comté, 25030 Besançon, France
| | - Laurence Millon
- Chrono-Environnement Laboratory, UMR UBFC/CNRS 6249 aff. INRA, University of Bourgogne Franche-Comté, 25030 Besançon, France - Department of Parasitology-Mycology, University Hospital of Besançon, 25030 Besançon, France
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111
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Abstract
Echinococcosis is a zoonosis whose history dates back to antiquity. This article provides an overview on the general history of echinococcosis, including the elucidation of Echinococcus life cycles and the long controversy on the aetiology of the cystic and alveolar forms of echinococcosis (CE and AE), lasting about 100years since the middle of the 19th century. Furthermore, selected historical aspects of some fields of echinococcosis research are discussed and compared with our current knowledge, such as geographic distribution and epidemiology of CE (Echinococcus granulosus) and AE (Echinococcus multilocularis), clinical aspects and pathology, diagnosis in humans and animals, treatment (with focus on chemotherapy), control and basic research. A short paragraph is devoted to the neotropical forms of echinococcosis, caused by Echinococcus vogeli and Echinococcus oligarthrus. In this context the achievements of some ancestral pioneers of echinococcosis research are particularly highlighted and appreciated. Finally, the role of associations, international organizations (World Health Organization and others) and international working groups in echinococcosis research and control is briefly outlined. The retrospective reveals both the admirable achievements of our ancestors and the scientific progress of more recent times. But, it also shows the gaps in our knowledge, skills and resources that we need to control or even eradicate echinococcosis.
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Affiliation(s)
- J Eckert
- University of Zurich, Zurich, Switzerland
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112
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Oksanen A, Siles-Lucas M, Karamon J, Possenti A, Conraths FJ, Romig T, Wysocki P, Mannocci A, Mipatrini D, La Torre G, Boufana B, Casulli A. The geographical distribution and prevalence of Echinococcus multilocularis in animals in the European Union and adjacent countries: a systematic review and meta-analysis. Parasit Vectors 2016; 9:519. [PMID: 27682156 PMCID: PMC5039905 DOI: 10.1186/s13071-016-1746-4] [Citation(s) in RCA: 130] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 08/10/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND This study aimed to provide a systematic review on the geographical distribution of Echinococcus multilocularis in definitive and intermediate hosts in the European Union (EU) and adjacent countries (AC). The relative importance of the different host species in the life-cycle of this parasite was highlighted and gaps in our knowledge regarding these hosts were identified. METHODS Six databases were searched for primary research studies published from 1900 to 2015. From a total of 2,805 identified scientific papers, 244 publications were used for meta-analyses. RESULTS Studies in 21 countries reported the presence of E. multilocularis in red foxes, with the following pooled prevalence (PP): low (≤ 1 %; Denmark, Slovenia and Sweden); medium (> 1 % to < 10 %; Austria, Belgium, Croatia, Hungary, Italy, the Netherlands, Romania and the Ukraine); and high (> 10 %; Czech Republic, Estonia, France, Germany, Latvia, Lithuania, Poland, Slovakia, Liechtenstein and Switzerland). Studies from Finland, Ireland, the United Kingdom and Norway reported the absence of E. multilocularis in red foxes. However, E. multilocularis was detected in Arctic foxes from the Arctic Archipelago of Svalbard in Norway. CONCLUSIONS Raccoon dogs (PP 2.2 %), golden jackals (PP 4.7 %) and wolves (PP 1.4 %) showed a higher E. multilocularis PP than dogs (PP 0.3 %) and cats (PP 0.5 %). High E. multilocularis PP in raccoon dogs and golden jackals correlated with high PP in foxes. For intermediate hosts (IHs), muskrats (PP 4.2 %) and arvicolids (PP 6.0 %) showed similar E. multilocularis PP as sylvatic definitive hosts (DHs), excluding foxes. Nutrias (PP 1.0 %) and murids (PP 1.1 %) could play a role in the life-cycle of E. multilocularis in areas with medium to high PP in red foxes. In areas with low PP in foxes, no other DH was found infected with E. multilocularis. When fox E. multilocularis PP was >3 %, raccoon dogs and golden jackals could play a similar role as foxes. In areas with high E. multilocularis fox PP, the wolf emerged as a potentially important DH. Dogs and cats could be irrelevant in the life-cycle of the parasite in Europe, although dogs could be important for parasite introduction into non-endemic areas. Muskrats and arvicolids are important IHs. Swine, insectivores, murids and nutrias seem to play a minor or no role in the life-cycle of the parasite within the EU and ACs.
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Affiliation(s)
- Antti Oksanen
- Finnish Food Safety Authority Evira (FINPAR), Elektroniikkatie 3, FI-90590 Oulu, Finland
| | - Mar Siles-Lucas
- Department of Parasitic Zoonoses, IRNASA, CSIC, Cordel de Merinas, 40-52, 37008 Salamanca, Spain
| | - Jacek Karamon
- Department of Parasitology, National Veterinary Research Institute, 57 Partyzantów Avenue, 24-100, Puławy, Poland
| | - Alessia Possenti
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanitá, Viale Regina Elena, 299, 00161 Rome, Italy
- European Reference Laboratory for Parasites (EURLP), Rome, Italy
| | - Franz J. Conraths
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Epidemiology, Südufer 10, 17493 Greifswald-Insel Riems, Germany
| | - Thomas Romig
- Universität Hohenheim, FG Parasitologie 220 B, 70599 Stuttgart, Germany
| | - Patrick Wysocki
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Epidemiology, Südufer 10, 17493 Greifswald-Insel Riems, Germany
| | - Alice Mannocci
- Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza University of Roma, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Daniele Mipatrini
- Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza University of Roma, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Giuseppe La Torre
- Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza University of Roma, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Belgees Boufana
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanitá, Viale Regina Elena, 299, 00161 Rome, Italy
- European Reference Laboratory for Parasites (EURLP), Rome, Italy
- World Health Organization Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar echinococcosis (in humans and animals), Rome, Italy
| | - Adriano Casulli
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanitá, Viale Regina Elena, 299, 00161 Rome, Italy
- European Reference Laboratory for Parasites (EURLP), Rome, Italy
- World Health Organization Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar echinococcosis (in humans and animals), Rome, Italy
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Singh A, Sharma R, Garg A, Nanda NC, Elsayed M, Taher A, Bulur S. Usefulness of bubble study in echocardiographic diagnosis of contained rupture of hydatid cyst in the right ventricular outflow tract. Echocardiography 2016; 33:1402-8. [PMID: 27650224 DOI: 10.1111/echo.13317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We describe an adult female presenting with dyspnea in whom both transthoracic and transesophageal echocardiography detected a mobile sac-like structure in the right ventricular outflow tract (RVOT) containing a heterogenous echogenic mass. This sac-like structure markedly changed its shape and size during the cardiac cycle. These findings and the fact that the patient lived in a rural area raised the possibility that this was a hydatid cyst. A bubble study using normal saline was useful in detecting a contained rupture of the cyst. Bubble echoes were noted within the sac-like structure but did not penetrate the inner wall of the cyst which contained echogenic material, indicating that the rupture was confined only to the outer layers. At surgery, a 0.5 cm communication was noted between the cyst and the RVOT and pathology confirmed the diagnosis of hydatid cyst.
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Affiliation(s)
- Amitoj Singh
- Department of Cardiology, St. Luke's University Health Network, Bethlehem, Pennsylvania
| | - Ravindra Sharma
- Santokba Durlabhji Memorial Hospital, Jaipur, Rajasthan, India
| | - Ashok Garg
- Jaipur Heart Institute, Jaipur, Rajasthan, India
| | - Navin C Nanda
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Mahmoud Elsayed
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama
| | - Ahmed Taher
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama
| | - Serkan Bulur
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama
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114
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Davidson RK, Lavikainen A, Konyaev S, Schurer J, Miller AL, Oksanen A, Skírnisson K, Jenkins E. Echinococcus across the north: Current knowledge, future challenges. Food Waterborne Parasitol 2016. [DOI: 10.1016/j.fawpar.2016.08.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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115
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Lass A, Szostakowska B, Myjak P, Korzeniewski K. Fresh fruits, vegetables and mushrooms as transmission vehicles for Echinococcus multilocularis in highly endemic areas of Poland: reply to concerns. Parasitol Res 2016; 115:3637-42. [PMID: 27249964 PMCID: PMC4980413 DOI: 10.1007/s00436-016-5149-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 05/20/2016] [Indexed: 11/26/2022]
Abstract
Echinococcus multilocularis is a tapeworm that may cause alveolar echinococcosis (AE), one of the most dangerous parasitic zoonoses. As in the case of other foodborne diseases, unwashed fruits and vegetables, contaminated with dispersed forms of E. multilocularis, may serve as an important transmission route for this parasite. In this article, we reply to the incorrect interpretation of results of our study concerning the detection of E. multilocularis DNA in fresh fruit, vegetable and mushroom samples collected from the highly endemic areas of the Warmia-Masuria Province, Poland, to dispel any doubts. The accusations formulated by the commentators concerning our paper are unfounded; moreover, these commentators demand information which was beyond the purview of our study. Making generalisations and drawing far-reaching conclusions from our work is also unjustified. The majority of positive samples were found in only a few hyperendemic communities; this information corresponds with the highest number of both infected foxes and AE cases in humans recorded in this area. Our findings indicate that E. multilocularis is present in the environment and may create a potential risk for the inhabitants. These people should simply be informed to wash fruits and vegetables before eating. No additional far-reaching conclusions should be drawn from our data. We believe these commentators needlessly misinterpreted our results and disseminated misleading information. Nevertheless, we would like to encourage any readers simply to contact us if any aspects of our study are unclear.
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Affiliation(s)
- Anna Lass
- Department of Tropical Parasitology, Institute of Maritime and Tropical Medicine in Gdynia, Medical University of Gdansk, 9b Powstania Styczniowego Str., 81-519, Gdynia, Poland.
| | - Beata Szostakowska
- Department of Tropical Parasitology, Institute of Maritime and Tropical Medicine in Gdynia, Medical University of Gdansk, 9b Powstania Styczniowego Str., 81-519, Gdynia, Poland
| | - Przemysław Myjak
- Department of Tropical Parasitology, Institute of Maritime and Tropical Medicine in Gdynia, Medical University of Gdansk, 9b Powstania Styczniowego Str., 81-519, Gdynia, Poland
| | - Krzysztof Korzeniewski
- Epidemiology and Tropical Medicine Department in Gdynia, Military Institute of Medicine in Warsaw, Grudzińskiego St. 4, 81-103, Gdynia, Poland
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Atalan G, Sivrioglu AK, Sönmez G, Celik M, Simsek B. A Case of Alveolar Echinococcosis Presenting as Cerebral and Spinal Intradural Metastases. Eurasian J Med 2016; 48:149-52. [PMID: 27551181 DOI: 10.5152/eurasianjmed.2015.15003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Alveolar echinococcosis is a chronic and serious, even lethal, parasitic infection caused by the helminth Echinococcus multilocularis. The involvement of Central Nervous System is reported to be 1-3% in literature. Brain involvement is considered a sign of the terminal phase of alveolar echinococcosis. We here in reported a 67-year-old female who had liver alveolar hydatid disease with brain and spinal intradural metastases.
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Affiliation(s)
- Guneri Atalan
- Clinic of Anesthesiology and Reanimation, Medical Park Hospital, Elazığ, Turkey
| | | | - Güner Sönmez
- Clinic of Radiology, GATA Haydarpaşa Training and Research Hospital, İstanbul, Turkey
| | - Mahir Celik
- Clinic of Anesthesiology and Reanimation, Harput State Hospital, Elazığ, Turkey
| | - Berksan Simsek
- Clinic of Microbiology, Kasımpaşa Military Hospital, İstanbul, Turkey
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Kolářová L, Matějů J, Hrdý J, Kolářová H, Hozáková L, Žampachová V, Auer H, Stejskal F. Human Alveolar Echinococcosis, Czech Republic, 2007-2014. Emerg Infect Dis 2016; 21:2263-5. [PMID: 26583699 PMCID: PMC4672410 DOI: 10.3201/eid2112.150743] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Autochthonous human alveolar echinococcosis in a Hungarian patient. Infection 2016; 45:107-110. [PMID: 27352256 DOI: 10.1007/s15010-016-0918-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 06/23/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Alveolar echinococcosis is a zoonotic parasitic disease causing a severe clinical condition and is known as the most deadly of all helminth infections. Moreover, this disease is also an increasing concern in Northern and Eastern Europe due to its spread in the wildlife animal host. CASE PRESENTATION An asymptomatic 70-year-old woman from south-western Hungary was diagnosed with multiple liver lesions. Imaging techniques (ultrasound, computed tomography and magnetic resonance imaging), serology (ELISA, indirect hemagglutination and Western blot), and conventional staining methods (hematoxylin-eosin and periodic acid-Schiff) were used for the detection of the disease. A histopathological re-evaluation of formalin-fixed paraffin block by immunohistochemical staining with the monoclonal antibody Em2G11 definitively confirmed the diagnosis of alveolar echinococcosis. CONCLUSIONS To our knowledge, this is the first confirmed autochthonous case of human alveolar echinococcosis in Hungary. To what extent diagnostic difficulties may contribute to underestimate this zoonosis in Eastern Europe is unknown. Differential diagnosis with alveolar echinococcosis should be considered for patients with multiple, tumor-like cystic lesions of the liver, in countries where this parasite is emerging.
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Rossi P, Tamarozzi F, Galati F, Pozio E, Akhan O, Cretu CM, Vutova K, Siles-Lucas M, Brunetti E, Casulli A. The first meeting of the European Register of Cystic Echinococcosis (ERCE). Parasit Vectors 2016; 9:243. [PMID: 27126135 PMCID: PMC4850717 DOI: 10.1186/s13071-016-1532-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 04/24/2016] [Indexed: 01/09/2023] Open
Abstract
Cystic echinococcosis (CE) is a zoonotic parasitic disease endemic in southern and eastern European countries. The true prevalence of CE is difficult to estimate due to the high proportion of asymptomatic carriers who never seek medical attention and to the underreporting of diagnosed cases, factors which contribute to its neglected status. In an attempt to improve this situation, the European Register of Cystic Echinococcosis (ERCE), was launched in October 2014 in the context of the HERACLES project. ERCE is a prospective, observational, multicentre register of patients with probable or confirmed CE. The first ERCE meeting was held in November 2015 at the Italian National Institute of Health (Istituto Superiore di Sanita, ISS) in Rome, to bring together CE experts currently involved in the Register activities, to share and discuss experiences, and future developments.Although the Register is still in its infancy, data collected at the time of writing this report, had outnumbered the total of national cases reported by the European endemic countries and published by the European Centre for Disease Prevention and Control in 2015. This confirms the need for an improved reporting system of CE at the European level. The collection of standardized clinical data and samples is expected to support a more rational, stage-specific approach to clinical management, and to help public authorities harmonize reporting of CE. A better understanding of CE burden in Europe will encourage the planning and implementation of public health policies toward its control.
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Affiliation(s)
- Patrizia Rossi
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanita, Rome, Italy
- European Reference Laboratory for Parasites, Istituto Superiore di Sanita, Rome, Italy
| | - Francesca Tamarozzi
- Department of Clinical Surgical Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
- WHO Collaborating Centre for the Clinical Management of Cystic Echinococcosis, Pavia, Italy
| | - Fabio Galati
- SIDBAE, Information Technology, Istituto Superiore di Sanita, Rome, Italy
| | - Edoardo Pozio
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanita, Rome, Italy
- European Reference Laboratory for Parasites, Istituto Superiore di Sanita, Rome, Italy
| | - Okan Akhan
- Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Carmen Michaela Cretu
- University of Medicine and Pharmacy, Colentina Clinical Hospital - Parasitology, Bucharest, Romania
| | - Kamenna Vutova
- Specialised Hospital of Infectious and Parasitic Diseases "Prof. Ivan Kirov", Department of Infectious, Parasitic and Tropical Diseases, Medical University, Sofia, Bulgaria
| | - Mar Siles-Lucas
- Instituto de Recursos Naturales y Agrobiología de Salamanca, CSIC, Salamanca, Spain
| | - Enrico Brunetti
- Department of Clinical Surgical Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
- WHO Collaborating Centre for the Clinical Management of Cystic Echinococcosis, Pavia, Italy
- Division of Tropical and Infectious Diseases, San Matteo Hospital Foundation, Pavia, Italy
| | - Adriano Casulli
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanita, Rome, Italy.
- European Reference Laboratory for Parasites, Istituto Superiore di Sanita, Rome, Italy.
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Cadavid Restrepo AM, Yang YR, McManus DP, Gray DJ, Giraudoux P, Barnes TS, Williams GM, Soares Magalhães RJ, Hamm NAS, Clements ACA. The landscape epidemiology of echinococcoses. Infect Dis Poverty 2016; 5:13. [PMID: 26895758 PMCID: PMC4759770 DOI: 10.1186/s40249-016-0109-x] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 02/15/2016] [Indexed: 12/29/2022] Open
Abstract
Echinococcoses are parasitic diseases of major public health importance globally. Human infection results in chronic disease with poor prognosis and serious medical, social and economic consequences for vulnerable populations. According to recent estimates, the geographical distribution of Echinococcus spp. infections is expanding and becoming an emerging and re-emerging problem in several regions of the world. Echinococcosis endemicity is geographically heterogeneous and over time it may be affected by global environmental change. Therefore, landscape epidemiology offers a unique opportunity to quantify and predict the ecological risk of infection at multiple spatial and temporal scales. Here, we review the most relevant environmental sources of spatial variation in human echinococcosis risk, and describe the potential applications of landscape epidemiological studies to characterise the current patterns of parasite transmission across natural and human-altered landscapes. We advocate future work promoting the use of this approach as a support tool for decision-making that facilitates the design, implementation and monitoring of spatially targeted interventions to reduce the burden of human echinococcoses in disease-endemic areas.
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Affiliation(s)
- Angela M Cadavid Restrepo
- Research School of Population Health, The Australian National University, Canberra, New South Wales, Australia.
| | - Yu Rong Yang
- Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, P. R. China.
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
| | - Donald P McManus
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
| | - Darren J Gray
- Research School of Population Health, The Australian National University, Canberra, New South Wales, Australia.
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
| | - Patrick Giraudoux
- Chrono-environment lab, UMR6249, University of Bourgogne Franche-Comté/CNRS, Besançon, France.
- Institut Universitaire de France, Paris, France.
| | - Tamsin S Barnes
- The University of Queensland, School of Veterinary Science, Gatton, Queensland, Australia.
- The University of Queensland, Queensland Alliance for Agriculture and Food Innovation, Gatton, Queensland, Australia.
| | - Gail M Williams
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
| | - Ricardo J Soares Magalhães
- The University of Queensland, School of Veterinary Science, Gatton, Queensland, Australia.
- Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia.
| | - Nicholas A S Hamm
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, The Netherlands.
| | - Archie C A Clements
- Research School of Population Health, The Australian National University, Canberra, New South Wales, Australia.
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Bourgeois B, Marguet P, Gbaguidi-Haore H, Knapp J, Said-Ali Z, Demonmerot F, Bresson-Hadni S, Millon L, Bellanger AP. Alveolar echinococcosis: how knowledgeable are primary care physicians and pharmacists in the Franche-Comté region of France? Acta Parasitol 2015; 60:682-90. [PMID: 26408591 DOI: 10.1515/ap-2015-0097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 05/25/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Alveolar echinococcosis (AE) is a parasitic disease resulting from the intrahepatic growth of Echinococcus multilocularis larva. This zoonotic helminthic disease is rare but, if left untreated or treated too late, can be severe or even fatal. In France, endemic areas containing infected foxes have become larger, spreading towards western regions of the country and leading to an increased risk of environmental contamination. An observational survey was undertaken in 2014 to assess the level of knowledge of AE among primary care physicians (PCPs) and pharmacists in the Franche-Comté region. METHODS Standardized questionnaires were sent to a random sample of 183 PCPs and 236 pharmacists practicing in the Franche-Comté region (eastern France), requesting their voluntary and anonymous participation. The questionnaires collected socio-demographic details, self-evaluation and asked multiple choice questions (MCQs) about epidemiology, prevention, diagnosis and management of AE. RESULTS The crude response rate was 37.5% of the PCPs and pharmacists questioned. Responses to MCQs showed that most of the participating PCPs and pharmacists had acceptable basic knowledge of AE, especially concerning epidemiology and prevention of the disease. However, a serious lack of knowledge was observed concerning the management of AE. CONCLUSION PCPs are often the first health professionals to suspect latent AE, which is still a rural disease in France. Both PCPs and pharmacists play an important role in informing and referring patients potentially exposed to AE. This study shows that although AE is rare, PCPs and pharmacists of the Franche-Comté region have a satisfactory level of knowledge of AE.
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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: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Alveolar echinococcosis: correlation between hepatic MRI findings and FDG-PET/CT metabolic activity. ACTA ACUST UNITED AC 2015; 40:56-63. [PMID: 24970734 DOI: 10.1007/s00261-014-0183-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To correlate the appearance of alveolar echinococcosis (AE) hepatic lesions in magnetic resonance imaging (MRI) as defined by Kodama, to the metabolic activity visualized in 18-fluoro-deoxyglucose positron emission tomography combined with computed tomography (PET/CT). MATERIALS AND METHODS Forty-two patients diagnosed with AE and who underwent both MRI and PET/CT were included. The forty-two hepatic lesions were divided into five types according to Kodama's classification by three independent readers blinded with regard to the PET/CT information. Concerning PET/CT, two independent readers, unaware of the MRI information, considered the results as positive when an increased FDG-uptake was observed at 1 or 3 h after FDG-injection, and as negative when no increased uptake was noted. Inter-observer agreement was assessed by using κ statistics. RESULTS Forty-two lesions were counted and the mean diameter of overall evaluated lesions was 6.3 cm. One lesion (2.4%) was categorized as type 1, 11 (26.2%) as type 2, 24 (57.1%) as type 3, 3 (7.1%) as type 4, and 3 (7.1%) as type 5. The inter-observer analysis found a κ coefficient of 0.96. All type-1, 90.9% of type-2 and 87.5% of type-3 lesions showed an increased FDG-uptake on PET/CT images. All non-microcystic AE liver lesions (types 4 and 5) showed no abnormal increased FDG-uptake on PET/CT images. The inter-observer analysis at 1 and 3 h found a κ coefficient of 0.95 and 0.92, respectively. CONCLUSIONS In patients with AE liver lesions, the absence of microcysts on MRI is strongly correlated to a metabolically inactive disease.
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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: 9.9] [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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Brunet J, Regnard P, Pesson B, Abou-Bacar A, Sabou M, Pfaff AW, Candolfi E. Description of vertebral and liver alveolar echinococcosis cases in Cynomolgus monkeys (Macaca fascicularis). BMC Vet Res 2015; 11:198. [PMID: 26263896 PMCID: PMC4534023 DOI: 10.1186/s12917-015-0520-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 07/31/2015] [Indexed: 11/11/2022] Open
Abstract
Background Echinococcus multilocularis, the causative agent of alveolar echinococcosis, is a fox tapeworm widely distributed in Europe with an increase of endemic area in recent years. Many mammal species including humans and non-human primates can be infected by accidental ingestion of eggs. Case presentation In March 2011, a 5-year-old zoo-raised male cynomolgus macaque (Macaca fascicularis) presented a paresis of the lower limbs which evolved into paralysis. Lesions in liver and vertebra were observed on tomography scan. E. multilocularis infection was diagnosed post-mortem by morphological and histological examination and detection of Em DNA by polymerase chain reaction. Serodiagnosis of other primates of the colony using enzyme-linked immunosorbent assay (ELISA) was negative. In June 2013, at necroscopy, a hepatic and a paravertebral masses were detected in a second cynomolgus macaque of the same colony. Serology and DNA isolated from hepatic and abdominal cysts confirmed E. multilocularis infection. Conclusions We described hear vertebral and liver localization of alveolar echinococcosis in non-human primates. The animals lived in an indoor/outdoor housing facility, where the probable mode of contamination is by ingestion of food foraging around the enclosure which could be contaminated with fox feces. Serological survey in the facility should allow us to estimate the risk of human contamination and the zoonotic risk of monkey infection due to environmental contamination.
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Affiliation(s)
- Julie Brunet
- Institut de Parasitologie et Pathologie Tropicale, EA 7292, Fédération de Médecine Translationelle, Université de Strasbourg, 3 rue Koeberlé, 67000, Strasbourg, France.
| | - Pierrick Regnard
- Centre de Primatologie UdS - SILABE (Simian Laboratory Europe) ADUEIS, Fort Foch, 67207, Niederhausbergen, France.
| | - Bernard Pesson
- Institut de Parasitologie et Pathologie Tropicale, EA 7292, Fédération de Médecine Translationelle, Université de Strasbourg, 3 rue Koeberlé, 67000, Strasbourg, France.
| | - Ahmed Abou-Bacar
- Institut de Parasitologie et Pathologie Tropicale, EA 7292, Fédération de Médecine Translationelle, Université de Strasbourg, 3 rue Koeberlé, 67000, Strasbourg, France.
| | - Marcela Sabou
- Institut de Parasitologie et Pathologie Tropicale, EA 7292, Fédération de Médecine Translationelle, Université de Strasbourg, 3 rue Koeberlé, 67000, Strasbourg, France.
| | - Alexander W Pfaff
- Institut de Parasitologie et Pathologie Tropicale, EA 7292, Fédération de Médecine Translationelle, Université de Strasbourg, 3 rue Koeberlé, 67000, Strasbourg, France.
| | - Ermanno Candolfi
- Institut de Parasitologie et Pathologie Tropicale, EA 7292, Fédération de Médecine Translationelle, Université de Strasbourg, 3 rue Koeberlé, 67000, Strasbourg, France.
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Aydinli B, Ozturk G, Arslan S, Kantarci M, Tan O, Ahıskalioglu A, Özden K, Colak A. Liver transplantation for alveolar echinococcosis in an endemic region. Liver Transpl 2015; 21:1096-102. [PMID: 26074280 DOI: 10.1002/lt.24195] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 06/10/2015] [Accepted: 06/11/2015] [Indexed: 12/13/2022]
Abstract
Alveolar echinococcosis (AE) is a chronic disease caused by ingestion of the eggs of the parasitic cestode Echinococcosis multilocularis (EM). In severe cases, liver transplantation (LT) may represent the only possibility of survival and cure. Patients undergoing LT associated with hepatic AE at our institution between April 2011 and October 2014 were investigated retrospectively. The clinical findings of the 27 patients who participated in the study were noted. Kaplan-Meier and chi-square tests were used to investigate the effect of these characteristics on survival and mortality. Living donor LT was performed on 20 patients (74.1%), and deceased donor LT was performed on 7 patients (25.9%). Hilar invasion was the most common indication (14 patients, 51.9%) for transplantation. The patient follow-up was 16.1 ± 11.4 months, and the overall survival rate was 77.8%. Primary nonfunction developed only in 2 patients in the posttransplantation period. Six patients died during monitoring, the most common cause of death being sepsis (3 patients). The relationship between the mortality rate of the patients and the invasion of the bile duct and/or portal vein by alveolar lesions was found to be statistically significant (P = 0.024 and P = 0.043, respectively). According to PNM staging, when the AE disease exceeds the resectability limits, the only alternative for the treatment of the disease is LT. However, different from LT due to cirrhosis, it is extremely difficult to perform a transplantation for AE disease because of the invasive characteristics of it. In order to decrease the difficulty of the operation and the postoperative mortality, the intracystic abscess and cholangitis which occur because of AE must be treated via medical and percutaneous methods before transplantation.
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Affiliation(s)
- Bulent Aydinli
- Departments of General Surgery, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Gurkan Ozturk
- Departments of General Surgery, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Sukru Arslan
- Departments of General Surgery, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Mecit Kantarci
- Radiology, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Onder Tan
- Plastic Reconstructive and Aesthetic Surgery, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Ali Ahıskalioglu
- Anesthesiology and Reanimation, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Kemalettin Özden
- Infectious Disease, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Abdurrahim Colak
- Department of Cardiovascular Surgery, School of Medicine, Ataturk University, Erzurum, Turkey
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Knapp J, Gottstein B, Saarma U, Millon L. Taxonomy, phylogeny and molecular epidemiology of Echinococcus multilocularis: From fundamental knowledge to health ecology. Vet Parasitol 2015; 213:85-91. [PMID: 26260408 DOI: 10.1016/j.vetpar.2015.07.030] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Alveolar echinococcosis, caused by the tapeworm Echinococcus multilocularis, is one of the most severe parasitic diseases in humans and represents one of the 17 neglected diseases prioritised by the World Health Organisation (WHO) in 2012. Considering the major medical and veterinary importance of this parasite, the phylogeny of the genus Echinococcus is of considerable importance; yet, despite numerous efforts with both mitochondrial and nuclear data, it has remained unresolved. The genus is clearly complex, and this is one of the reasons for the incomplete understanding of its taxonomy. Although taxonomic studies have recognised E. multilocularis as a separate entity from the Echinococcus granulosus complex and other members of the genus, it would be premature to draw firm conclusions about the taxonomy of the genus before the phylogeny of the whole genus is fully resolved. The recent sequencing of E. multilocularis and E. granulosus genomes opens new possibilities for performing in-depth phylogenetic analyses. In addition, whole genome data provide the possibility of inferring phylogenies based on a large number of functional genes, i.e. genes that trace the evolutionary history of adaptation in E. multilocularis and other members of the genus. Moreover, genomic data open new avenues for studying the molecular epidemiology of E. multilocularis: genotyping studies with larger panels of genetic markers allow the genetic diversity and spatial dynamics of parasites to be evaluated with greater precision. There is an urgent need for international coordination of genotyping of E. multilocularis isolates from animals and human patients. This could be fundamental for a better understanding of the transmission of alveolar echinococcosis and for designing efficient healthcare strategies.
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Affiliation(s)
- Jenny Knapp
- Department of Chrono-environnement, UMR UFC/CNRS 6249 aff. INRA, University of Franche-Comté, Besançon, France; Department of Parasitology-Mycology, University Hospital of Besançon, Besançon, France.
| | - Bruno Gottstein
- Institute of Parasitology, Faculty Vetsuisse, University of Berne, Berne, Switzerland
| | - Urmas Saarma
- Department of Zoology, Institute of Ecology and Earth Sciences, University of Tartu, Tartu, Estonia
| | - Laurence Millon
- Department of Chrono-environnement, UMR UFC/CNRS 6249 aff. INRA, University of Franche-Comté, Besançon, France; Department of Parasitology-Mycology, University Hospital of Besançon, Besançon, France
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Lass A, Szostakowska B, Myjak P, Korzeniewski K. The first detection of Echinococcus multilocularis DNA in environmental fruit, vegetable, and mushroom samples using nested PCR. Parasitol Res 2015. [PMID: 26208943 PMCID: PMC4577536 DOI: 10.1007/s00436-015-4630-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this study was to estimate the presence of Echinococcus multilocularis DNA in fruits, vegetables, and mushrooms in rural areas of Varmia-Masuria Province, Poland, which is the region with the highest number of human alveolar echinococcosis (AE) cases in this country. Recovery tests showed that E. multilocularis DNA is detectable in samples contaminated with at least 100 eggs of this tapeworm. In total, 103 environmental fruit, vegetable, and mushroom samples collected in forests, plantations, and kitchen gardens were analyzed using nested PCR assay based on the mitochondrial 12S ribosomal RNA (rRNA) gene. The parasite DNA was detected in 23.3 % of the samples. Sequencing confirmed that the obtained PCR products represented E. multilocularis. This study is the first environmental survey of the presence of E. multilocularis DNA in fruits, vegetables, and mushrooms intended for consumption. The results clearly demonstrate that it may be a direct source of human infections and shows the need to educate the public about the threat, especially people living in at-risk areas.
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Affiliation(s)
- Anna Lass
- Department of Tropical Parasitology, Institute of Maritime and Tropical Medicine in Gdynia, Medical University of Gdansk, 9b Powstania Styczniowego Str., 81-519, Gdynia, Poland.
| | - Beata Szostakowska
- Department of Tropical Parasitology, Institute of Maritime and Tropical Medicine in Gdynia, Medical University of Gdansk, 9b Powstania Styczniowego Str., 81-519, Gdynia, Poland
| | - Przemysław Myjak
- Department of Tropical Parasitology, Institute of Maritime and Tropical Medicine in Gdynia, Medical University of Gdansk, 9b Powstania Styczniowego Str., 81-519, Gdynia, Poland
| | - Krzysztof Korzeniewski
- Epidemiology and Tropical Medicine Department in Gdynia, Military Institute of Medicine in Warsaw, Grudzińskiego St. 4, 81-103, Gdynia, Poland
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Sokouti M, Sokouti B, Shokouhi B, Rahimi-Rad MH. Multi-vesicular pulmonary hydatid cyst, the potent underestimated factor in the formation of daughter cysts of pulmonary hydatid disease. Lung India 2015; 32:375-7. [PMID: 26180389 PMCID: PMC4502204 DOI: 10.4103/0970-2113.159583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Pulmonary multi-vesicular hydatid disease (HD) with Echinococcus granulosus is rare. A 28-year-old woman presented to our center with cough and respiratory distress. Chest x-ray and computerized tomography scan revealed bilateral giant cysts with water-lily sign (ruptured hydatid cysts). The left cyst was in vicinity of heart. With thoracotomy cysts of both lungs were removed. Thousands of translucent, homogenized small daughter cysts were discovered from the left side cyst. Pathologic examinations revealed the ruptured hydatid cysts of both lungs with daughter cysts on the left lung cyst. To best of our knowledge probably this is the first report of multi-vesicular HD in lung. We suppose that the heart pulsation was effective in the formation of daughter cysts.
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Affiliation(s)
- Mohsen Sokouti
- Department of Cardiothoracic Surgery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Babak Sokouti
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behrooz Shokouhi
- Department of Pathology, Tabriz University of Medical Sciences, Tabriz, Iran
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Richter PJ, Holtfreter M, Orhun A, Müller-Stöver I, Kubitz R, Hillenbrand A, Kratzer W, Gräter T, Grüner B. Echinokokkose-Erkrankungen. MMW Fortschr Med 2015; 157:56-63. [PMID: 26099410 DOI: 10.1007/s15006-015-2727-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Pisa Joachim Richter
- Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinikum Düsseldorf, Heinrich-Heine-Unversität, Moorenstr. 5, D-40225, Düsseldorf, Deutschland,
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Tamarozzi F, Rossi P, Galati F, Mariconti M, Nicoletti GJ, Rinaldi F, Casulli A, Pozio E, Brunetti E. The Italian registry of cystic echinococcosis (RIEC): the first prospective registry with a European future. Euro Surveill 2015; 20. [DOI: 10.2807/1560-7917.es2015.20.18.21115] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Cystic echinococcosis (CE), a worldwide zoonosis, is highly endemic in southern and eastern Europe. Its actual prevalence is unknown due to the lack of efficient reporting systems designed to take into account the particular features of the disease. Neglect of CE makes diagnosis and clinical management difficult outside referral centres, with inconsistencies in clinical practice and often unnecessary procedures carried out that have associated risks and costs. The Italian registry of CE (RIEC) is a prospective multicentre registry of CE patients seen from January 2012 in Italian health centres; data are voluntarily submitted to the registry. Its aims are to show the prevalence of CE in Italy, bring the importance of this infection to the attention of health authorities, encourage public health policies towards its control, and stimulate biological, epidemiological and clinical research on CE. From January 2012 to February 2014, a total 346 patients were enrolled in 11 centres, outnumbering national reports of many CE-endemic European countries. We discuss preliminary data and challenges of the RIEC, template for the European registry of CE, which has been implemented within the Seventh Framework Programme project HERACLES (Human cystic Echinococcosis ReseArch in CentraL and Eastern Societies) since September 2014.
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Affiliation(s)
- F Tamarozzi
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy
| | - P Rossi
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - F Galati
- SIDBAE, Information Technology, Istituto Superiore di Sanità, Rome, Italy
| | - M Mariconti
- Division of Infectious and Tropical Diseases, San Matteo Hospital Foundation, University of Pavia, WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy
| | - G J Nicoletti
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy
| | - F Rinaldi
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy
| | - A Casulli
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - E Pozio
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - E Brunetti
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy
- Division of Infectious and Tropical Diseases, San Matteo Hospital Foundation, University of Pavia, WHO Collaborating Centre for Clinical Management of Cystic Echinococcosis, Pavia, Italy
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Piarroux M, Gaudart J, Bresson-Hadni S, Bardonnet K, Faucher B, Grenouillet F, Knapp J, Dumortier J, Watelet J, Gerard A, Beytout J, Abergel A, Wallon M, Vuitton DA, Piarroux R. Landscape and climatic characteristics associated with human alveolar echinococcosis in France, 1982 to 2007. Euro Surveill 2015; 20:21118. [PMID: 25990231 DOI: 10.2807/1560-7917.es2015.20.18.21118] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2025] Open
Abstract
Human alveolar echinococcosis (AE) is a severe hepatic disease caused by Echinococcus multilocularis. In France, the definitive and intermediate hosts of E. multilocularis (foxes and rodents, respectively) have a broader geographical distribution than that of human AE. In this two-part study, we describe the link between AE incidence in France between 1982 and 2007 and climatic and landscape characteristics. National-level analysis demonstrated a dramatic increase in AE risk in areas with very cold winters and high annual rainfall levels. Notably, 52% (207/401) of cases resided in French communes (smallest French administrative level) with a mountain climate. The mountain climate communes displayed a 133-fold (95% CI: 95-191) increase in AE risk compared with communes in which the majority of the population resides. A case-control study performed in the most affected areas confirmed the link between AE risk and climatic factors. This arm of the study also revealed that populations residing in forest or pasture areas were at high risk of developing AE. We therefore hypothesised that snow-covered ground may facilitate predators to track their prey, thus increasing E. multilocularis biomass in foxes. Such climatic and landscape conditions could lead to an increased risk of developing AE among humans residing in nearby areas.
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Affiliation(s)
- M Piarroux
- Aix-Marseille University, INSERM-IRD-AMU UMR 912, Marseille, France
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Graeter T, Ehing F, Oeztuerk S, Mason RA, Haenle MM, Kratzer W, Seufferlein T, Gruener B. Hepatobiliary complications of alveolar echinococcosis: A long-term follow-up study. World J Gastroenterol 2015; 21:4925-4932. [PMID: 25945006 PMCID: PMC4408465 DOI: 10.3748/wjg.v21.i16.4925] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 12/17/2014] [Accepted: 02/05/2015] [Indexed: 02/06/2023] Open
Abstract
AIM To determine the long-term hepatobiliary complications of alveolar echinococcosis (AE) and treatment options using interventional methods. METHODS Included in the study were 35 patients with AE enrolled in the Echinococcus Multilocularis Data Bank of the University Hospital of Ulm. Patients underwent endoscopic intervention for treatment of hepatobiliary complications between 1979 and 2012. Patients' epidemiologic data, clinical symptoms, and indications for the intervention, the type of intervention and any additional procedures, hepatic laboratory parameters (pre- and post-intervention), medication and surgical treatment (pre- and post-intervention), as well as complications associated with the intervention and patients' subsequent clinical courses were analyzed. In order to compare patients with AE with and without history of intervention, data from an additional 322 patients with AE who had not experienced hepatobiliary complications and had not undergone endoscopic intervention were retrieved and analyzed. RESULTS Included in the study were 22 male and 13 female patients whose average age at first diagnosis was 48.1 years and 52.7 years at the time of intervention. The average time elapsed between first diagnosis and onset of hepatobiliary complications was 3.7 years. The most common symptoms were jaundice, abdominal pains, and weight loss. The number of interventions per patient ranged from one to ten. Endoscopic retrograde cholangiopancreatography (ERCP) was most frequently performed in combination with stent placement (82.9%), followed by percutaneous transhepatic cholangiodrainage (31.4%) and ERCP without stent placement (22.9%). In 14.3% of cases, magnetic resonance cholangiopancreatography was performed. A total of eight patients received a biliary stent. A comparison of biochemical hepatic function parameters at first diagnosis between patients who had or had not undergone intervention revealed that these were significantly elevated in six patients who had undergone intervention. Complications (cholangitis, pancreatitis) occurred in six patients during and in 12 patients following the intervention. The average survival following onset of hepatobiliary complications was 8.8 years. CONCLUSION Hepatobiliary complications occur in about 10% of patients. A significant increase in hepatic transaminase concentrations facilitates the diagnosis. Interventional methods represent viable management options.
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Jordanova DP, Harizanov RN, Kaftandjiev IT, Rainova IG, Kantardjiev TV. Cystic echinococcosis in Bulgaria 1996–2013, with emphasis on childhood infections. Eur J Clin Microbiol Infect Dis 2015; 34:1423-8. [DOI: 10.1007/s10096-015-2368-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 03/23/2015] [Indexed: 10/23/2022]
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Abstract
Cystic echinococcosis (CE) remains an important health problem in many areas of the world, including the Mediterranean region. We performed a retrospective study of cases reported from 1998 to 2012 in order to review and update the epidemiology of this disease in a highly endemic area situated in western Spain. A total of 471 patients were diagnosed with hydatid disease. Of these cases, 55·8% were male, with an average age of 62·3 ± 19·5 years. More importantly, 1·5% of patients were children, and 20·5% were aged <45 years. An active therapeutic approach was implemented for 92·6% of the CE patients with primary diagnoses; however, a 'watch and wait' strategy was used in 59·3% of all secondary CE diagnoses. The incidence rate of hydatid disease was significantly higher compared to the incidence described in the Notifiable Disease System in this area. Furthermore, a significant decrease in hydatid incidence during the years included in the study was observed (β = -0·4357, P < 0·001). CE incidence has diminished in recent years, although active transmission remains in paediatric cases. Additionally, CE incidence remains high in our region despite public health plans for its control. The documented incidence of CE disease clearly underestimates the real numbers.
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Gendron K, Goepfert C, Linon E, Posthaus H, Frey CF. Pulmonary Echinococcus multilocularis metastasis in a dog. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2015; 56:267-271. [PMID: 25750447 PMCID: PMC4327139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A young adult Labrador retriever dog was presented for surgical debulking of hepatic alveolar echinococcosis. Computed tomography detected hepatomegaly with multiple large cavitary masses with extension of tissue from a lesion wall into the caudal vena cava and numerous nodules in all lung lobes. Following euthanasia, histology confirmed parasitic vesicles with granulomatous reaction in all lesions, and polymerase chain reaction (PCR) established the causative agent to be Echinococcus multilocularis. This report is the first to present imaging features of pulmonary E. multilocularis granulomata in a dog.
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MESH Headings
- Animals
- Anthelmintics/therapeutic use
- Dog Diseases/parasitology
- Dog Diseases/pathology
- Dogs
- Echinococcosis, Hepatic/complications
- Echinococcosis, Hepatic/drug therapy
- Echinococcosis, Hepatic/pathology
- Echinococcosis, Hepatic/surgery
- Echinococcosis, Hepatic/veterinary
- Echinococcosis, Pulmonary/complications
- Echinococcosis, Pulmonary/drug therapy
- Echinococcosis, Pulmonary/pathology
- Echinococcosis, Pulmonary/surgery
- Echinococcosis, Pulmonary/veterinary
- Echinococcus multilocularis/physiology
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Affiliation(s)
- Karine Gendron
- Address all correspondence to Dr. Karine Gendron; e-mail:
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138
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Bîrluţiu V, Bîrluţiu RM. The management of abdominal hydatidosis after the rupture of a pancreatic hydatid cyst: a case report. J Med Case Rep 2015; 9:27. [PMID: 25972120 PMCID: PMC4429723 DOI: 10.1186/1752-1947-9-27] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 12/15/2014] [Indexed: 11/13/2022] Open
Abstract
Introduction Echinococcosis or hydatidosis is a zoonosis caused by cestodes from the genus Echinococcus; its habitat is the small intestine of the definitive host, represented by dogs/carnivorous animals, where it produces eggs which are eliminated in the environment. Cystic echinococcosis represents more than 95% of the hydatidosis cases registered annually. The most frequent localization is the hepatic one, followed by the pulmonary localization with a ratio of 2.5:1. A pancreatic localization represents 0.2% of hydatidosis cases with a higher possibility of disseminating intra-abdominally. The incidence of hydatidosis in Romania has not been investigated yet through national studies. Case presentation We present the case of a 54-year-old Caucasian man who underwent emergency surgery in 1989 for symptoms suggestive for an acute abdomen. He was diagnosed intraoperatively with rupture of a pancreatic hydatid cyst, having a caudal localization and complicated by necrotic acute pancreatitis. Our objective is to describe a patient with hydatidosis, with unfavorable evolution after two surgical interventions, with intra-abdominal dissemination, for whom we considered the best therapeutic choice to be long-term anti-parasite drugs. Conclusions He has been treated with albendazole for 6 years and he shows a very good tolerance; praziquantel (600mg/week) was also administered and he is under clinical and biological screening. There is no general consensus on the duration of anti-parasite treatments. Electronic supplementary material The online version of this article (doi:10.1186/1752-1947-9-27) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Victoria Bîrluţiu
- Faculty of Medicine Sibiu, Academic Emergency Hospital SIBIU - Chief of the Infectious Diseases Clinic, "Lucian Blaga" University Sibiu, Sibiu, Romania.
| | - Rareş Mircea Bîrluţiu
- Faculty of Medicine Sibiu, "Lucian Blaga" University Sibiu, Alba-Iulia Str. No.79 23/8, Sibiu, 550052, Romania.
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Liu W, Delabrousse É, Blagosklonov O, Wang J, Zeng H, Jiang Y, Wang J, Qin Y, Vuitton DA, Wen H. Innovation in hepatic alveolar echinococcosis imaging: best use of old tools, and necessary evaluation of new ones. ACTA ACUST UNITED AC 2014; 21:74. [PMID: 25531446 PMCID: PMC4273719 DOI: 10.1051/parasite/2014072] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 12/11/2014] [Indexed: 12/12/2022]
Abstract
Hepatic Alveolar Echinococcosis (HAE), caused by larvae of Echinococcus multilocularis, is a rare but potentially lethal parasitic disease. The first diagnostic suspicion is usually based on hepatic ultrasound exam performed because of abdominal symptoms or in the context of a general checkup; HAE diagnosis may thus also be an incidental finding on imaging. The next step should be Computed Tomography (CT) or Magnetic Resonance Imaging (MRI). They play an important role in the initial assessment of the disease; with chest and brain imaging, they are necessary to assess the PNM stage (parasite lesion, neighboring organ invasion, metastases) of a patient with AE. Performed at least yearly, they also represent key exams for long-term follow-up after therapeutic interventions. Familiarity of radiologists with HAE imaging findings, especially in the endemic regions, will enable earlier diagnosis and more effective treatment. Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) is currently considered to be the only noninvasive, albeit indirect, tool for the detection of metabolic activity in AE. Delayed acquisition of images (3 hrs after FDG injection) enhances its sensitivity for the assessment of lesion metabolism and its reliability for the continuation/withdrawal of anti-parasite treatment. However, sophisticated equipment and high cost widely limit PET/CT use for routine evaluation. Preliminary studies show that new techniques, such as contrast-enhanced ultrasound (US), Dual Energy CT or Spectral CT, and Diffusion-Weighted MRI, might also be useful in detecting the blood supply and metabolism of lesions. However, they cannot be recommended before further evaluation of their reliability in a larger number of patients with a variety of locations and stages of AE lesions.
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Affiliation(s)
- Wenya Liu
- Imaging Center, First Affiliated Hospital, Xinjiang Medical University Hospital, No. 1 Liyushan road, Urumqi 830011, PR China
| | - Éric Delabrousse
- Department of Visceral Radiology, University Hospital Jean Minjoz, 25030 Besançon, France - WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis, University of Franche-Comté and University Hospital, 25030 Besançon, France
| | - Oleg Blagosklonov
- WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis, University of Franche-Comté and University Hospital, 25030 Besançon, France - Department of Nuclear Medicine, University Hospital Jean Minjoz, 25030 Besançon, France
| | - Jing Wang
- Imaging Center, First Affiliated Hospital, Xinjiang Medical University Hospital, No. 1 Liyushan road, Urumqi 830011, PR China
| | - Hongchun Zeng
- Department of Ultrasonography, First Affiliated Hospital, Xinjiang Medical University Hospital, No. 1 Liyushan road, Urumqi 830011, China
| | - Yi Jiang
- Imaging Center, First Affiliated Hospital, Xinjiang Medical University Hospital, No. 1 Liyushan road, Urumqi 830011, PR China
| | - Jian Wang
- Imaging Center, First Affiliated Hospital, Xinjiang Medical University Hospital, No. 1 Liyushan road, Urumqi 830011, PR China
| | - Yongde Qin
- Imaging Center, First Affiliated Hospital, Xinjiang Medical University Hospital, No. 1 Liyushan road, Urumqi 830011, PR China
| | - Dominique Angèle Vuitton
- WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis, University of Franche-Comté and University Hospital, 25030 Besançon, France
| | - Hao Wen
- Department of Hepatic surgery, First Affiliated Hospital, Xinjiang Medical University Hospital, No. 1 Liyushan road, Urumqi 830011, China
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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: 1.5] [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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Fooks AR, Johnson N. Jet set pets: examining the zoonosis risk in animal import and travel across the European Union. VETERINARY MEDICINE (AUCKLAND, N.Z.) 2014; 6:17-25. [PMID: 30101093 PMCID: PMC6067792 DOI: 10.2147/vmrr.s62059] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Ownership of companion animals or pets is popular throughout the world. Unfortunately, such animals are susceptible to and potential reservoirs of zoonotic pathogens. Close proximity to and contact with pets can lead to human infections. The distribution of zoonotic diseases associated with companion animals such as dogs and cats is not uniform around the world, and moving animals between regions, countries, and continents carries with it the risk of relocating the pathogens they might harbor. Critical among these zoonotic diseases are rabies, echinococcosis, and leishmania. In addition, the protozoan parasites, Toxoplasma gondii and Giardia duodenalis, are also significant agents for human disease of pet origin. Considerable effort is applied to controlling movements of companion animals, particularly dogs, into the European Union. However, free movement of people and their pets within the European Union is a risk factor for the translocation of diseases and their vectors. This review considers the current distribution of some of these diseases, the risks associated with pet travel, and the controls implemented within Europe to prevent the free movement of zoonotic pathogens.
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Affiliation(s)
- Anthony R Fooks
- Wildlife Zoonoses and Vector-Borne Diseases Research Group, Animal and Plant Health Agency, Addlestone, Surrey,
- Department of Clinical Infection, University of Liverpool, Liverpool, UK
| | - Nicholas Johnson
- Wildlife Zoonoses and Vector-Borne Diseases Research Group, Animal and Plant Health Agency, Addlestone, Surrey,
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Auer H, Aspöck H. Helminths and helminthoses in Central Europe: diseases caused by cestodes (tapeworms). Wien Med Wochenschr 2014; 164:414-23. [PMID: 25354487 DOI: 10.1007/s10354-014-0315-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 09/15/2014] [Indexed: 12/01/2022]
Abstract
The second part of the overview "Helminths and helminthoses in Central Europe" is dedicated to the cestodes (tapeworms) and the diseases caused by cestodes. The overview comprises the spectrum of the most relevant species, describes their incidence, geographic distribution and the most important clinical symptoms and highlights the possibilities of diagnosis, treatment and prophylaxis of cestode-caused diseases.
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Affiliation(s)
- Herbert Auer
- Department of Medical Parasitology, Institute of Specific Prophylaxis and Tropical Medicine, Center of Pathophysiology, Infectiology and Immunology, Medical University Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria,
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143
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Chauchet A, Grenouillet F, Knapp J, Richou C, Delabrousse E, Dentan C, Millon L, Di Martino V, Contreras R, Deconinck E, Blagosklonov O, Vuitton DA, Bresson-Hadni S. Increased incidence and characteristics of alveolar echinococcosis in patients with immunosuppression-associated conditions. Clin Infect Dis 2014; 59:1095-1104. [PMID: 25034426 DOI: 10.1093/cid/ciu520] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2025] Open
Abstract
BACKGROUND An increased incidence of alveolar echinococcosis (AE) in patients with immunosuppression (IS) has been observed; our aim was to study this association and its characteristics. METHODS Fifty AE cases with IS-associated conditions (ISCs) before or at AE diagnosis were collected from the French AE registry (1982-2012, 509 cases). There were 30 cancers, 9 malignant hematological disorders, 14 chronic inflammatory diseases, 5 transplants, and 1 case of AIDS; 9 patients had ≥2 ISCs. Characteristics of the 42 IS/AE cases and the 187 non-IS/AE cases diagnosed during the period 2002-2012 were statistically compared. RESULTS There was a significant increase in IS/AE cases over time. Risk factors did not differ between IS/AE and non-IS/AE patients. However, AE was more frequently an incidental finding (78% vs 42%) and was diagnosed at earlier stages (41% vs 23%) in IS/AE than in non-IS/AE patients. Serology was more often negative (14% vs 1%) and treatment efficacy was better (51% regression after 1-year treatment vs 27%) in IS/AE patients. All IS/AE patients but 7 took IS drugs; 7 received biotherapeutic agents. When not concomitant, AE occurred in IS patients within a 48-month median time period. Atypical presentation and abscess-, hemangioma-, and metastasis-like images delayed AE diagnosis in 50% of IS/AE patients, resulting in inappropriate treatment. Liver images obtained for 15 patients 1-5 years before diagnosis showed no AE lesions. Albendazole efficacy was good, but 19 of 48 treated patients experienced side effects. CONCLUSIONS Patients with immunosuppression are at increased risk for occurrence, delayed diagnosis, and progression of AE.
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Affiliation(s)
- Adrien Chauchet
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis, and French National Reference Centre on Alveolar Echinococcosis, Franche-Comté University and University Hospital Department of Hematology, University Hospital, Besançon
| | - Frédéric Grenouillet
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis, and French National Reference Centre on Alveolar Echinococcosis, Franche-Comté University and University Hospital UMR 6249 'Chrono-environment,'
| | - Jenny Knapp
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis, and French National Reference Centre on Alveolar Echinococcosis, Franche-Comté University and University Hospital UMR 6249 'Chrono-environment,'
| | - Carine Richou
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis, and French National Reference Centre on Alveolar Echinococcosis, Franche-Comté University and University Hospital
| | - Eric Delabrousse
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis, and French National Reference Centre on Alveolar Echinococcosis, Franche-Comté University and University Hospital
| | | | - Laurence Millon
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis, and French National Reference Centre on Alveolar Echinococcosis, Franche-Comté University and University Hospital UMR 6249 'Chrono-environment,'
| | - Vincent Di Martino
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis, and French National Reference Centre on Alveolar Echinococcosis, Franche-Comté University and University Hospital EA 4266 'Pathogens and inflammation,'
| | - Remy Contreras
- Department of Pharmacy, Hospital of Belfort-Montbéliard, Belfort
| | - Eric Deconinck
- Department of Hematology, University Hospital, Besançon UMR 1098 'Graft-tumor-host interactions and cell and tissue engineering,'
| | - Oleg Blagosklonov
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis, and French National Reference Centre on Alveolar Echinococcosis, Franche-Comté University and University Hospital EA 4662 'Nanomedicine, imagery, therapeutics,'
| | - Dominique A Vuitton
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis, and French National Reference Centre on Alveolar Echinococcosis, Franche-Comté University and University Hospital EA 3181 'Epithelial carcinogenesis; preventive and predictive factors,' Franche-Comté University, Besançon, France
| | - Solange Bresson-Hadni
- WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis, and French National Reference Centre on Alveolar Echinococcosis, Franche-Comté University and University Hospital UMR 6249 'Chrono-environment,'
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144
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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: 1.5] [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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145
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Knapp J, Sako Y, Grenouillet F, Bresson-Hadni S, Richou C, Gbaguidi-Haore H, Ito A, Millon L. Comparison of the serological tests ICT and ELISA for the diagnosis of alveolar echinococcosis in France. ACTA ACUST UNITED AC 2014; 21:34. [PMID: 25058754 PMCID: PMC4111071 DOI: 10.1051/parasite/2014037] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 07/04/2014] [Indexed: 01/31/2023]
Abstract
Serological diagnosis of alveolar echinococcosis (AE) is a key element for efficient patient treatment management. A rapid immunochromatography test kit (ICT) using the recombinant Em18 antigen (rEm18) was recently developed. The aim of our study was to assess this test on a panel of sera from French patients with alveolar echinococcosis and control patients. In a blind test, a total of 112 serum samples were tested including samples of AE (n = 30), cystic echinococcosis [CE] (n = 15), and polycystic echinococcosis [PE] (n = 1). For the comparison, 66 sera from patients with hepatocarcinoma, fascioliasis, toxocariasis, Caroli’s disease, or autoimmune chronic active hepatitis were used. The diagnostic test sets we used were the rEm18-ICT and two validated ELISAs with rEm18 and Em2-Em18 antigens, respectively. For the ICT, 27/30 sera from AE patients, 4/15 sera from CE patients and the PE patient serum were positive. One serum from the control panel (toxocariasis) was positive for the ICT. The rEm18-ICT sensitivity (90.0%) and specificity (92.7%) for detection of Em18-specific antibodies confirmed it as a relevant tool for AE diagnosis. The rEm18-ELISA had a sensitivity of 86.7% and specificity of 91.5%, and the Em2-Em18-ELISA had a sensitivity of 96.7% and specificity of 87.8%. However, when AE patient sera are recorded as weak in intensity with the ICT, we recommend a double reading and use of a reference sample if the ICT is used for patient follow-up.
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Affiliation(s)
- Jenny Knapp
- Laboratory of Chrono-environnement, UMR/CNRS 6249, Faculty of Medicine and Pharmacy, Besançon, France - WHO Collaborating Centre for prevention and treatment of human echinococcosis, Besançon, France
| | - Yasuhito Sako
- Department of Parasitology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Frédéric Grenouillet
- Laboratory of Chrono-environnement, UMR/CNRS 6249, Faculty of Medicine and Pharmacy, Besançon, France - WHO Collaborating Centre for prevention and treatment of human echinococcosis, Besançon, France - Laboratory of Parasitology-Mycology, University Hospital of Besançon, France
| | - Solange Bresson-Hadni
- WHO Collaborating Centre for prevention and treatment of human echinococcosis, Besançon, France - Department of Hepatology, University Hospital of Besançon, France
| | - Carine Richou
- WHO Collaborating Centre for prevention and treatment of human echinococcosis, Besançon, France - Department of Hepatology, University Hospital of Besançon, France
| | - Houssein Gbaguidi-Haore
- Laboratory of Chrono-environnement, UMR/CNRS 6249, Faculty of Medicine and Pharmacy, Besançon, France - Laboratory of Hospital Hygiene, University Hospital of Besançon, France
| | - Akira Ito
- Department of Parasitology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Laurence Millon
- Laboratory of Chrono-environnement, UMR/CNRS 6249, Faculty of Medicine and Pharmacy, Besançon, France - WHO Collaborating Centre for prevention and treatment of human echinococcosis, Besançon, France - Laboratory of Parasitology-Mycology, University Hospital of Besançon, France
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146
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Kumar S, Nanjappa B, Gowda KK. Laparoscopic management of a hydatid cyst of the adrenal gland. Korean J Urol 2014; 55:493-5. [PMID: 25045450 PMCID: PMC4101121 DOI: 10.4111/kju.2014.55.7.493] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 09/27/2012] [Indexed: 12/25/2022] Open
Abstract
Hydatid disease is endemic in parts of India, yet genitourinary involvement is rare. Laparoscopic management of such cases is uncommonly reported. We present a case of an adrenal hydatid and its management by laparoscopic aspiration, instillation of scolicidal solution, and partial excision of the cyst.
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Affiliation(s)
- Santosh Kumar
- Department of Urology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Bhuvanesh Nanjappa
- Department of Urology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Kiran Krishne Gowda
- Department of Pathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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147
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Nourrisson C, Mathieu S, Beytout J, Cambon M, Poirier P. Lésion ostéolytique chez une patiente splénectomisée : à propos d’un cas d’échinococcose alvéolaire vertébrale. Rev Med Interne 2014; 35:399-402. [DOI: 10.1016/j.revmed.2013.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 04/15/2013] [Accepted: 06/18/2013] [Indexed: 10/26/2022]
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148
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Szostakowska B, Lass A, Kostyra K, Pietkiewicz H, Myjak P. First finding of Echinococcus multilocularis DNA in soil: Preliminary survey in Varmia-Masuria Province, northeast Poland. Vet Parasitol 2014; 203:73-9. [DOI: 10.1016/j.vetpar.2014.02.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 02/10/2014] [Accepted: 02/12/2014] [Indexed: 11/16/2022]
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149
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Tolnai Z, Széll Z, Sréter T. Environmental determinants of the spatial distribution of Echinococcus multilocularis in Hungary. Vet Parasitol 2013; 198:292-7. [DOI: 10.1016/j.vetpar.2013.09.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 09/02/2013] [Accepted: 09/08/2013] [Indexed: 10/26/2022]
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150
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Piarroux M, Piarroux R, Knapp J, Bardonnet K, Dumortier J, Watelet J, Gerard A, Beytout J, Abergel A, Bresson-Hadni S, Gaudart J. Populations at risk for alveolar echinococcosis, France. Emerg Infect Dis 2013; 19:721-8. [PMID: 23647623 PMCID: PMC3647496 DOI: 10.3201/eid1905.120867] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
During 1982–2007, alveolar echinococcosis (AE) was diagnosed in 407 patients in France, a country previously known to register half of all European patients. To better define high-risk groups in France, we conducted a national registry-based study to identify areas where persons were at risk and spatial clusters of cases. We interviewed 180 AE patients about their way of life and compared responses to those of 517 controls. We found that almost all AE patients lived in 22 départements in eastern and central France (relative risk 78.63, 95% CI 52.84–117.02). Classification and regression tree analysis showed that the main risk factor was living in AE-endemic areas. There, most at-risk populations lived in rural settings (odds ratio [OR] 66.67, 95% CI 6.21–464.51 for farmers and OR 6.98, 95% CI 2.88–18.25 for other persons) or gardened in nonrural settings (OR 4.30, 95% CI 1.82–10.91). These findings can help sensitization campaigns focus on specific groups.
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