Threat of alveolar echinococcosis to public health – a challenge for Europe

Gottstein, Bruno; Stojković, Marija; Vuitton, Dominique A.; Millon, Laurence; Marcinkutė, Audronė; Deplazes, Peter

doi:10.1016/j.pt.2015.06.001

Cited by 121 publications

(111 citation statements)

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“…The increase in the prevalence of infected animals over time is likely to have taken place in most areas since the 1990s in the wake of growing fox populations. Such increases are best documented for Eastern France, parts of Germany, Poland and parts of the Baltic States, but are often anecdotal for other areas and are difficult to verify due to lack of previous baseline data (Romig et al, 2006a;Davidson et al, 2012;Gottstein et al, 2015). There is a clear trend towards the establishment of urban and peri-urban EM transmission in central Europe (Deplazes et al, 2004).…”

Section: Central Area (France To the Baltic States And Poland Denmarmentioning

confidence: 99%

“…This lack of notification requirement at the species level has been highlighted previously (EFSA opinion, 2006). In addition underreporting also occurs due to poor knowledge of clinical symptoms and incorrect clinical management (Romig et al, 1999b;Jorgensen et al, 2008;Stojkovic et al, 2015). (Jorgensen at al., 2008).…”

Section: Tor2b)mentioning

confidence: 99%

“…In addition, several factors were pointed out as reason of the increase of EM/AE in Europe, such as: the landscape change composition and use; urbanization of foxes; changing human attitudes and behaviour toward foxes; globalization; wildlife (re)introduction; effect of climate change on the environment and survival of eggs and DH/IH populations survival (synthesized in Davidson et al, 2012;Atkinson et al, 2013;Gottstein et al, 2015).…”

Section: Tor2b)mentioning

confidence: 99%

“…Improved awareness and better diagnostic tools may have also contributed to increase in records of this parasite in animals and humans. Nevertheless, over the past 20 years, intensive epidemiological research seems to confirm EM/AE expansion in European countries (Gottstein et al, 2015). …”

Section: Tor2b)mentioning

confidence: 99%

“…Whether these new EM records are due to range expansion or reflect an increased surveillance effort will be difficult to prove, since there is a general lack of (negative) baseline data from previous periods in many of these 'newly endemic' countries. However, there are convincing data that EM prevalence and abundance of host species increased dramatically in some countries during the 1990s and since (Romig et al, 2006a;Gottstein et al, 2015). Range increase is likely, but it cannot be excluded that the parasite had remained undetected due to low prevalence or presence in small transmission foci within the 'newly endemic' countries, which may have expanded in the wake of population increases of red foxes (Davidson et al, 2012).…”

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confidence: 99%

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Echinococcus multilocularis infection in animals

Butterworth¹

2015

EFS2

134

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms carnivore species can maintain the lifecycle in the absence of red fox, and this makes it to most relevant target species for surveillance. Movement of infected definitive hosts is an important introduction pathway. The knowledge on the geographical distribution of the environmental factors for the persistence of the lifecycle is scarce. In areas where no suitable autochthonous wild canid hosts and no highly suitable intermediate hosts are present, e.g. Malta, establishment of the EM cycle is considered close to impossible. Such countries do not need to carry out surveillance on domestic dogs to substantiate absence of EM in the relevant animal population. Reconsideration of some aspects of the current legislation regarding surveillance activities might be relevant; for example the identification of epidemiologically relevant units should be independent from political borders. Studies to improve the knowledge on epidemiological risk factors should be encouraged to enable risk-based sampling. Echinococcus notification should always be done at species level in order to discriminate between the more severe alveolar echinococcosis and the cystic echinococcosis. Praziquantel is the substance of choice for the treatment of dogs. However, the treatment window should be reconsidered to reduce the risk of re-infection: a general rule is to treat as close as possible to entry into a non-infected country. There is a lack of standardization of the diagnostic methods between laboratories. The diagnostic sensitivity of the tests should be established in accordance to the World Organisation for Animal Health (OIE) standards for validation. For the time being, the diagnostic sensitivity can be set conservatively to 78%. SCIENTIFIC OPINION © European Food Safety Authority, 2015Keywords: Echinococcus multilocularis, echinococcosis, hosts, risk factors, diagnosis, surveillance, Reproduction is authorised provided the source is acknowledged.The EFSA Journal is a publication of the European Food Safety Authority, an agency of the European Union. E. multilocularis infections in animalswww.efsa.europa.eu/efsajournal 3 EFSA Journal 2015;13(15):4373 SummaryHuman alveolar echinococcosis (AE) is caused by the larval stage of the fox tapeworm Echinococcus multilocularis. It is amongst one of the most dangerous zoonoses. Naturally the parasite transmits between foxes or dogs and small mammals whilst humans are aberrant intermediate hosts.In rodents, the larval mass proliferates rapidly by exogenous budding of germinative tissue and produces an alveolar-like pattern of microvesicles filled with protoscolices. In humans, the larval mass resembles a malignancy in appearance and behavior, because it proliferates indefinitely by exogenous budding and invades the surrounding tissues (Moro et al., 2008). Transmission of A...

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Section: Central Area (France To the Baltic States And Poland Denmarmentioning

confidence: 99%

Section: Tor2b)mentioning

confidence: 99%

Section: Tor2b)mentioning

confidence: 99%

Section: Tor2b)mentioning

confidence: 99%

mentioning

confidence: 99%

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Echinococcus multilocularis infection in animals

Butterworth¹

2015

EFS2

134

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Drug Discovery and Development for the Treatment of Echinococcosis, Caused by the Tapeworms Echinococcus granulosus and Echinococcus multilocularis

Hemphill

Rufener

Ritler

et al. 2019

Neglected Tropical Diseases

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2015

EFSA Journal

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The European Food Safety Authority (EFSA) was required to support the European Commission in preparing the review of Regulation (EU) No 1152/2011. In Europe, red fox (Vulpes vulpes) is the main definitive host of the Echinococcus multilocularis (EM) lifecycle. There is no evidence that any other carnivore species can maintain the lifecycle in the absence of red fox, and this makes it to most relevant target species for surveillance. Movement of infected definitive hosts is an important introduction pathway. The knowledge on the geographical distribution of the environmental factors for the persistence of the lifecycle is scarce. In areas where no suitable autochthonous wild canid hosts and no highly suitable intermediate hosts are present, e.g. Malta, establishment of the EM cycle is considered close to impossible. Such countries do not need to carry out surveillance on domestic dogs to substantiate absence of EM in the relevant animal population. Reconsideration of some aspects of the current legislation regarding surveillance activities might be relevant; for example the identification of epidemiologically relevant units should be independent from political borders. Studies to improve the knowledge on epidemiological risk factors should be encouraged to enable risk-based sampling. Echinococcus notification should always be done at species level in order to discriminate between the more severe alveolar echinococcosis and the cystic echinococcosis. Praziquantel is the substance of choice for the treatment of dogs. However, the treatment window should be reconsidered to reduce the risk of re-infection: a general rule is to treat as close as possible to entry into a non-infected country. There is a lack of standardization of the diagnostic methods between laboratories. The diagnostic sensitivity of the tests should be established in accordance to the World Organisation for Animal Health (OIE) standards for validation. For the time being, the diagnostic sensitivity can be set conservatively to 78%.

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Threat of alveolar echinococcosis to public health – a challenge for Europe

Cited by 121 publications

References 50 publications

Echinococcus multilocularis infection in animals

Echinococcus multilocularis infection in animals

Drug Discovery and Development for the Treatment of Echinococcosis, Caused by the Tapeworms Echinococcus granulosus and Echinococcus multilocularis

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