Human Alveolar Echinococcosis in Poland: 1990–2011

Abstract

BackgroundAlveolar echinococcosis (AE) caused by Echinococcus multilocularis infections is a dangerous old disease in the Northern Hemisphere. The aim of the paper was to collect and analyze data on human AE in Poland in the last two decades.Methodology/Principal FindingsThe sources of data were both the cases officially registered and detected by an active field and laboratory surveillance. The cases were verified by clinical, epidemiological, and laboratory criteria. Altogether 121 human cases of AE were detected. Among these 83 (68,6%) cases were classified as confirmed, 16 as probable and 22 as possible. During the two decades a continuous increase in detection rate was noticed. The cases were 6–82 years old at the time of diagnosis (mean - 47.7 years). Sex ratio M/F was 0.86/1.0. The AE was fatal in 23 (19%) patients (mean age at death - 54.1 years). Family agglomeration of AE was found in 4 foci, involving 9 patients. Seventy six of the cases were diagnosed in an advanced stage of disease. In all cases the liver was the primary location of AE. In 30 (24.8%) patients a spread to other organs was observed. Ninety four of the patients were treated with albendazole. In 73 (60%) patients a surgical operation was performed, including 15 liver transplantations.Conclusions/SignificanceThe studies confirmed that AE is an emerging disease in Poland, which is the fourth country in Europe with over 120 cases detected. The results also indicate the need of a wider national programme for implementation of screening in the highest AE risk areas (north-eastern Poland) with an effort to increase the public awareness of the possibility of contracting E. multilocularis, and above all, training of the primary care physicians in the recognition of the risk of AE to allow for an early detection of this dangerous disease.

First detection of Echinococcus multilocularis in dogs in a highly endemic area of Poland

“…Especially because the problem of human AE in Poland is present. From 1990-2011, more than 120 human cases of AE were detected (Nahorski et al 2013) and new cases have been registered since then (Gołąb and Czarkowski 2014).…”

One world health: Socioeconomic burden and parasitic disease control priorities

“…In some communities in China the disease has a very high local burden (Budke et al, 2004). In Europe and central Asia the disease appears to be emerging in some localities (Schweiger et al, 2007, Nahorski et al 2013Ussymbaeva et al, 2013 ). The global burden of disease has been estimated at about 666,000 DALYs per year and thus the impact is high -mainly due to the high mortality rate as the number of new cases per year is approximately 18,000.…”

Genetic diversity of Echinococcus multilocularis in red foxes in Poland: the first report of a haplotype of probable Asian origin

“…In a recent study in Poland, E. multilocularis was found in relatively high percentages in red foxes -in some provinces the prevalence reached up to approximately 50% (Karamon et al 2014(Karamon et al , 2015. Moreover, more than one hundred cases of human alveolar echinococcosis (AE) were described (Nahorski et al 2013) -a relatively small number in comparison to the high prevalence of the parasite in red foxes. However, it must be stressed that most human AE records in Poland were detected sporadically and not in a planned monitoring study.…”