Echinococcosis - General Facts

❖ Parasite​:
➢ Cluster: Cestodes
➢ Classification:
​
■ Primarily ​Echinococcus granulosus and​ E. multilocularis
■ Also ​E​ . vogeli and​ E. oligarthrus
➢ Image:
​
■ E. granulosus egg
➢ Associated Diseases:
■ Cystic echinococcosis (caused by E ​ . ​ granulosus)
■ Alveolar echinococcosis (caused by E ​
​ . multilocularis)
❖ Vector/Transmission​:
➢ Primary transmission vector to humans: Ingestion of parasite eggs, or direct
contact with contaminated animal hosts
➢ Primary hosts: dogs and other c​ anidae​, like foxes and wolves
➢ Secondary hosts:
​ ​E. granulosus: sheep, goats, swine, and humans
■ For
■ For​ ​E. multilocularis: mice, squirrels, and other rodents
❖ Life Cycle​:
➢ Life cycle diagram
❖ Epidemiology/Distribution​:
➢ World distribution: worldwide
➢ High-risk demographics: animal husbandry and similar jobs in rural grazing
regions for sheep and cattle
➢ Impact: affects approximately 1 million people worldwide
❖ Diagnosis​:
➢ Primary symptoms:
■ For cystic echinococcosis:
● Often no symptoms for several years or decades until cysts
containing the parasite grow large
● Pain, nausea, and vomiting along with additional symptoms
depending on the location of the cysts
❖ Prevention​:
➢ Avoid consumption of food or water contaminated by dog feces
➢ After handling dogs, wash hands with soap and water before handling food
➢ Periodic deworming of dogs
❖ General Resources for More Information:
➢ http://www.cdc.gov/parasites/echinococcosis/
➢ http://www.who.int/mediacentre/factsheets/fs377/en/
Echinococcosis - Medical Facts
❖ Pathophysiology​:
➢ Metacestodes appear in the liver
❖ Diagnosis​:
➢ Clinical indicators:
■ For cystic echinococcosis: Presence of a cyst-like mass in a person with
history of exposure to sheep and dogs
➢ Primary tests (thresholds):
■ CT scans, ultrasonography, and MRIs to detect cysts
■ Serologic tests
■ Eosinophilia and elevated IgE during ruptures
❖ Treatment​:
➢ Medication:
■ For cystic echinococcosis: Albendazole for 3-6 months
➢ Action:
■ For cystic echinococcosis:
● Surgery to remove cysts
● Injection with a 95% alcohol solution
❖ Control​:
➢ Prevent dogs from feeding on carcasses of infected sheep or other secondary
host animals
➢ Control stray dog populations
➢ Vaccination of sheep
❖ General Resources for More Information:
➢ http://www.cdc.gov/dpdx/echinococcosis/index.html
➢ Diagnosis, treatment, and management of echinococcosis​ ​McManus DP, Gray
DJ, Zhang W, Yang Y, BMJ, June 11, 2012, 344:e3866
➢ Expert consensus for the diagnosis and treatment of cystic and alveolar
echinococcosis in humans​ Brunetti E, Kern P, Vuitton DA, Acta Tropica, April
2010, Vol. 11, pp. 1-16