A large focus of alveolar echinococcosis in central China

Craig, Philip S.; Deshan, Liu; Macpherson, C. N. L.; Shi, Dongquan; Reynolds, David G.; Barnish, G.; Gottstein, Bruno; Wang, Zhirong

doi:10.1016/0140-6736(92)92693-a

Cited by 147 publications

(130 citation statements)

References 20 publications

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“…In China, the first human cases of AE were reported from western regions in the 1960s but most hospital records still remain fragmented. From the mid-1990s active mass screening surveys using portable ultrasound led to the discovery of the highest documented prevalence rates of human AE (Craig et al, 1992;Li et al, 2005;Yang et al, 2006). However, the application of molecular genetic analysis to human AE isolates in China is rare.…”

Section: Discussionmentioning

confidence: 99%

“…Echinococcus granulosus has the greatest geographic distribution worldwide (Schantz et al, 1995), whereas E. multilocularis is a rare parasitic disease that is restricted to transmission in the northern hemisphere, with distribution from Alaska, across Canada and north central USA, through northern Europe and Eurasia to Japan (Craig, 2003). In China, both cystic and alveolar echinococcosis are highly endemic over large areas of the northwestern provinces and autonomous regions, mainly distributed in Qinghai, Sichuan, Xinjiang, Gansu and Ningxia (Chai, 1995;Craig et al, 1992;Li et al, 2005;Schantz et al, 2003;Yang et al, 2006). Recently, a new species of Echinococcus, E. shiquicus, was described from the Tibetan plateau.…”

Section: Introductionmentioning

confidence: 99%

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Species identification of human echinococcosis using histopathology and genotyping in northwestern China

Itō

Nakaya

et al. 2008

Transactions of the Royal Society of Tropical Medicine and Hygi

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SummaryHuman cystic echinococcosis, caused by infection with the larval stage of Echinococcus granulosus, and alveolar echinococcosis, caused by the larval form of E. multilocularis, are known to be important public health problems in western China. Echinococcus shiquicus is a new species of Echinococcus recently described in wildlife hosts from the eastern Tibetan plateau and its infectivity and/or pathogenicity in humans remain unknown. In the current study, parasite tissues from various organs were collected post-operatively from 68 echinococcosis patients from Sichuan and Qinghai provinces in eastern China. The tissues were examined by histopathology and genotyped using DNA sequencing and PCR-RFLP. Histopathologically, 38 human isolates were confirmed as E. granulosus and 30 as E. multilocularis. Mitochondrial cob gene sequencing and PCR-RFLP with rrnL as the target gene confirmed 33 of 53 of the isolates to have the G1 genotype of sheep/dog strain of E. granulosus as the only source of infection, while the remaining 20 isolates were identified as E. multilocularis. No infections were found to be caused by E. shiquicus. Additionally, 5 of 20 alveolar echinococcosis patients were confirmed to have intracranial metastases from primary hepatic alveolar echinococcosis lesions. All these cases originated from four provinces or autonomous regions but most were distributed in Sichuan and Qinghai provinces, where high prevalence rates of human alveolar echinococcosis and cystic echinococcosis were previously documented. * Corresponding author. Present address: 6 Zhong Xue Lu, Chengdu 610041, Sichuan Province, People's Republic of China. Tel.: +86 28 85589532; fax: +86 28 85589563. E-mail address: litiaoying@sina.com (T. Li). Authors' contributions: TL, AI, PSC and JQ designed the study protocol and drafted the manuscript; TL, PSC, AI and PG performed the analysis and interpretation of data; TL, MN, NX and XW conducted genetic analysis of all specimens; RZ did surgery; KN and MN did histopathology for morphological and molecular analysis; TL, CX and JQ collected tissue samples in the endemic areas. All authors read and approved the final manuscript. TL is guarantor of the paper.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Species identification of human echinococcosis using histopathology and genotyping in northwestern China

Itō

Nakaya

et al. 2008

Transactions of the Royal Society of Tropical Medicine and Hygi

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“…14 The investigators concluded the desirability of combining both methods for screening since 6 of 37 diagnosed cases would have been missed by using only 1 method. Our own results are somewhat ambiguous; while the only case with active AE was detected both by primary ultrasound and serology, 2 of the 3 cases classified as suspected were missed by primary ultrasound and were only found during re-examination of seroreactors.…”

Section: Discussionmentioning

confidence: 99%

“…6,12,13 Ultrasound is accepted to be the most sensitive and appropriate primary screening technique for cystic echinococcosis (CE) caused by E. granulosus, but to date has only been used in one major study in China to screen for AE. 14 In that survey, 16% of the patients FIGURE 1. Map of Baden-Württemberg in southwestern Germany showing the location of the municipality of Römerstein (elevation about 2,400 feet) within the county of Reutlingen, the counties of Baden-Baden and Rastatt, and the high plateau of the Swabian Jura.…”

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confidence: 96%

An epidemiologic survey of human alveolar echinococcosis in southwestern Germany. Römerstein Study Group.

Römig

Kratzer²,

Kimmig³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

102

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Abstract. The inhabitants of a rural community in southwestern Germany were examined for alveolar echinococcosis (AE). The study was prompted by the recent increase of the prevalence of the parasite in foxes and the increase of fox populations: in the study area, 75% of the foxes carried Echinococcus multilocularis. The human population was screened using hepatic ultrasound and serology. All participants were interviewed for demographic and potential risk factors. Of 2,560 participants, one was identified with active AE, while 3 others had suspicious liver lesions. Another 9 participants were seropositive for specific antibodies without detectable lesions. Demographic and behavioral factors were not correlated with active or suspected cases nor with seropositivity. If the prevalence of 40/100,000 (95% confidence interval ϭ 15-295/100,000) for active cases would be representative for the rural population in high endemicity areas, the current number of AE cases in southwestern Germany is considerably higher than previously suspected.

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“…Indeed, highly variable prevalence rates in humans between villages in an area of high endemicity in central China, which could not be explained by landscape contrasts, have already been described. 5,23 High density of grassland species could act by fostering transmission through the prey/predator relationships. Indeed, in periods of high density, foxes become specialized and feed almost exclusively on grassland species (functional response).…”

Section: Discussionmentioning

confidence: 99%

Water Vole (Arvicola Terrestris Scherman) Density as Risk Factor for Human Alveolar Echinococcosis

Viel¹,

Giraudoux²,

Abrial³

1998

Epidemiology

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Abstract. Concern is growing in Europe about alveolar echinococcosis (AE) with the increase in grassland rodent and red fox populations, intermediate and definitive hosts for Echinococcus multilocularis, respectively. The objective of this study was to assess the influence of rodent densities on human AE distribution. Spatial Poisson regression analyses were performed with geomorphologic features, landscape composition, climatic characteristics, and water vole density as independent variables. The outcome consisted of AE cases diagnosed over the period 1980-1992. High vole density yielded a 10-fold risk (relative risk [RR ] ϭ 10.34, 95% confidence interval [CI] ϭ 2.78-38.39), and the first plateau (400-700 m altitude) compared with the plain (200-400 m) was associated with a large increase in risk (RR ϭ 7.10, 95% CI ϭ 1.30-38.63). These results confirm that human AE is strongly influenced by the densities of arvicolid species. Foxes feeding almost exclusively on grassland rodents when the latter expand could mediate this relation.

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A large focus of alveolar echinococcosis in central China

Cited by 147 publications

References 20 publications

Species identification of human echinococcosis using histopathology and genotyping in northwestern China

Species identification of human echinococcosis using histopathology and genotyping in northwestern China

An epidemiologic survey of human alveolar echinococcosis in southwestern Germany. Römerstein Study Group.

Water Vole (Arvicola Terrestris Scherman) Density as Risk Factor for Human Alveolar Echinococcosis

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