Molecular Evidence for Local Acquisition of Human Alveolar Echinococcosis in Saskatchewan, Canada

Abstract

Alveolar echinococcosis (AE) is a life-threatening parasitic disease caused by the zoonotic cestode Echinococcus multilocularis. Our goals were to confirm infection, identify species and analyze biogeographical origin of metacestode tissues from a suspected human AE case in Saskatchewan, Canada. We conducted PCR targeting the nad1 mitochondrial gene for E. multilocularis and the rrns ribosomal RNA gene for E. granulosus and conducted haplotype analysis at the nad2 locus. Our analysis confirmed AE and indicated that sequences matched infected Saskatchewan coyotes and European E3/E4 haplotypes. The patient had no travel history outside North America. This suggests autochthonous transmission of a European-type strain.

A review on invasions by parasites with complex life cycles: the European strain ofEchinococcus multilocularisin North America as a model

“…1), and multiple aberrant cases of AE in dogs in previously non-endemic areas of British Columbia (Jenkins et al ., 2012) and Ontario (Skelding et al ., 2014; Oscos-Snowball et al ., 2015). Moreover, there has been an unprecedented outbreak of human AE cases, with 17 locally acquired cases described since 2013 in the province of Alberta (Massolo et al ., 2019; Houston et al ., 2021) and the first confirmed human case in Saskatchewan (Schurer et al ., 2020), after only two locally acquired cases ever reported (in 1923 and 1977) for continental North America (Massolo et al ., 2014; Klein and Massolo, 2015). Furthermore, molecular characterization (when possible) confirmed the European strain as the causative agent, yet none of these patients had travelled outside Canada, suggesting autochthonous transmission of this strain (Massolo et al ., 2019).…”

Solving the Puzzle of Global Health Inequity: Completing the Picture Piece by Piece by Piece

“…Health system reform also needs to be considered outside the context of the current pandemic to address global health inequities. Existing frameworks such as the One Health approach can assist in promoting a greater integration and coordination of services that is clearly necessary and useful for global pandemics (Henley, 2020 ) but can also assist in the timely and accurate diagnosis of rare but potentially dangerous and even fatal diseases such as human alveolar Echinococcosis (Schurer et al, 2020b ). A greater coordination of services would also assist in the effective and timely treatment of comorbidities such as depressive symptomatology with lower limb lymphoedema (Semrau et al, 2020 ).…”

“…It is possible, however, to use system-wide interventions to change important elements such as organizational culture and leadership (Linnander et al, 2020 ). For changes to be effective, responsive, and sustained, decisions regarding system reform should be informed by the genuine and meaningful contributions of all stakeholders including patients (Rabideau, 2020 ) and Community Health Workers (Schurer et al, 2020a , 2020b ).…”

“…Process: Engaging What is the ideal organization of health services and systems for eradicating global health inequities? •Systems must provide specialist but essential services during global pandemics •Ongoing monitoring and evaluation could guide the redesign of services and systems •Recruitment and retention of appropriately trained and skilled staff is critical Ademuyiwa et al ( 2020 ), Lazarus et al ( 2020a , ( 2020b ), Binagwaho and Mathewos ( 2020a ), Phillips et al ( 2020 ), Binagwaho et al ( 2020a , 2020b ), Binagwaho and Mathewos ( 2020b ), Carey and Binagwaho ( 2020a ), Binagwaho ( 2020 ), Henley ( 2020 ), Schurer et al ( 2020 ), Semrau et al ( 2020 ), Hines et al ( 2020b ), Linnander et al ( 2020 ), Rabideau ( 2020 ), Schurer et al ( 2020a , 2020b ) III. Inner setting: Readiness for implementation—available resources IV.…”

Canine Alveolar Echinococcosis: An Emerging and Costly Introduced Problem in North America

“…Prevalence of E. multilocularis in coyotes ranged from 25%-65% in Alberta [22,24] to 72% in Saskatchewan [25]. Terefore, there is a pressing need to raise awareness of this parasite in North America due to rising numbers of locally acquired human cases [26,27], high prevalence in local wildlife, spread of the parasite to new areas, the cryptic and chronic nature of the disease, poor clinical outcomes if not detected early in both dogs and people, and the preventable nature of infection of dogs with the adult tapeworms.…”