“…Present within Europe, North America, Central Asia, China, Japan, and the former USSR, it is a highly pathogenic zoonosis (Ammann & Eckert, 1996), with over 94% mortality in untreated patients ten years after diagnosis (Wang et al, 2010). The spatial distribution of Em is highly variable, with significant regional and local differences in parasite prevalence resulting in patchy distributions of endemicity (Eckert et al, 2001;Giraudoux et al, 2006;Giraudoux, Raoul, Afonso, Ziadinov, Yan, et al, 2013) within which transmission hotspots of much larger prevalence may occur (Danson, Craig, Man, Shi, & Giraudoux, 2004;Said-Ali et al, 2013). Examples include Gansu and Sichuan Provinces, China, where prevalence rates of N 10% have been observed locally (Craig et al, 1992;Li et al, 2010).…”