ReviewEchinococcosis/hydatidosis: A severe threat in Mediterranean countries
Introduction
Human populations of the Mediterranean region (MR) have always depended on animals as sources of food, transport, labour and companionship. Livestock continue to make an important contribution to most economies because they produce food, provide security, enhance crop production, generate cash income for rural and urban populations, and produce value-added goods which can have multiplier effects and create a need for services. However, numerous species of animals are also sources of viral, bacterial and parasitic diseases transmitted by direct contact or by contaminated food and water. Indeed, the Mediterranean basin is one of the regions where zoonoses are most numerous and widespread (over 200 different zoonoses have been reported from this area). Sheep and goats are traditionally raised for meat and milk production and are the main livestock resource in many countries of the MR. Milk is transformed into typical cheeses and other products which continue to be more greatly appreciated than dairy products derived from cow's milk (Boyazoglu and Hatziminaoglou, 2002).
Cystic echinococcosis (CE) is one of the most important zoonotic diseases in the world and is currently among the five most frequently diagnosed zoonoses in the Mediterranean (along with brucellosis, rabies, leishmaniasis and food-borne zoonotic infections) (Sadjjadi, 2006). CE has been present for centuries in the MCs. Hippocrates mentioned it in Greece in the 4th century B.C. The Italian Rudolphi formally described the genus Echinococcus in 1801, and, a century later in France, Devé described the structure of the cyst and the risk of secondary echinococcosis (Houin, 1998). It was only in the middle of the 19th century that alveolar echinococcosis was identified as a disease entity. It took about 100 years until it was undoubtedly clarified and accepted that CE and AE are not caused by a single Echinococcus species, but by E. granulosus and E. multilocularis, respectively.
A number of studies have shown that hydatidosis is an increasing public health and socio-economic concern. It is currently considered an emerging or re-emerging disease and the geographic distribution and extent are greater than previously believed (Thompson and McManus, 2002, Torgerson et al., 2003, Moro and Schantz, 2009).
CE is theoretically an eradicable disease, but numerous factors are involved in the maintenance of the cycle in the MC, including behavioural and cultural factors that are often difficult to regulate or modify.
In this review, the present epidemiological situation of Echinococcus sp. infection in dogs and other definitive and intermediate hosts is reviewed, together with its public health and socio-economic impact and the main factors associated with persistence of this disease in the MR.
Section snippets
Epidemiology
On a global basis, E. granulosus is the most common and widespread species, with endemic foci present on every inhabited continent. In the MR, the prevalence of CE is high in both human and animals, especially in North Africa (Battelli et al., 2002). Ten strains of E. granulosus have been described, but only 6 have been identified in the MR. The common sheep strain (G1), the Tasmanian sheep strain (G2), the buffalo strain (G3) and E. equinus (the old G4 strain) have been found in Spain, Italy,
Socio-economic impact
Assessing the socio-economic impact of hydatidosis is difficult. It is necessary to consider not only human and animal health, but agriculture, trade, and market factors as well. Evaluation of the costs of echinococcosis to national economies has been reviewed by Budke et al. (2006). However, the true impact may still be substantially under-represented.
Human CE has a number of important economic effects: lost income during illness, treatment, and the convalescent period must be taken into
Key factors for the development and persistence of CE in the Mediterranean region
The epidemiological situation of animal and human echinococcosis presented above has shown that medium to high infection rates are recorded in most countries of the MR. Infection with E. granulosus is closely associated with a number of risk factors that influence the frequency and distribution of CE these countries.
Conflict interest statement
The authors declare that they have no conflict of interest with the contents of this paper in any respect.
References (106)
- et al.
Hydatidosis in Sardinia: review and recommendations
Trans. R. Soc. Trop. Med. Hyg.
(1985) - et al.
Cost-effectiveness analysis of echinococcosis/hydatidosis eradication project in Sardinia
Soc. Sci. Med.
(1984) - et al.
Epidemiological study of the cystic echinococcosis in morocco
Vet. Parasitol.
(2006) - et al.
Modelling the transmission of Echinococcus granulosus in dogs in the northwest and in the southwest of Morocco
Vet. Parasitol.
(2007) - et al.
Cystic echinococcosis in Algeria: cattle act as reservoirs of a sheep strain and may contribute to human contamination
Vet. Parasitol.
(2003) - et al.
Dog echinococcosis in northern Spain: comparison of coproantigen and serum antibody assays with coprological exam
Vet. Parasitol.
(2006) - et al.
Canine echinococcosis in northwest Libya: assessment of coproantigen ELISA, and a survey of infection with analysis of risk factors
Vet. Parasitol.
(2005) - et al.
Epidemiological survey of cestode-larva disease in Greek sheep flocks
Vet. Parasitol.
(2008) - et al.
Screening of dogs for Echinococcus granulosus coproantigen in a low endemic situation in Cyprus
Vet. Parasitol.
(2002) - et al.
Progress in control of cystic echinococcosis in La Rioja, Spain: decline in infection prevalences in human and animal hosts and economic costs and benefits
Acta Trop.
(2002)
Public health education/importance and experience from the field. Educational impact of community-based ultrasound screening surveys
Acta Trop.
Ultrasonographic screening for cystic echinococcosis in sheep in Tunisia
Vet. Parasitol.
Transmission dynamics of the Echinococcus granulosus sheep dog strain (G1 genotype) in camels in Tunisia
Vet. Parasitol.
Echinococcosis in Tunisia: a cost analysis
Trans. R. Soc. Trop. Med. Hyg.
Molecular evidence of ovine (G1) and camel (G6) strains of Echinococcus granulosus in Tunisia and putative role of cattle in human contamination
Vet. Parasitol.
Hydatidosis in the province of Salamanca (Spain): should we let down our guard?
Enferm. Infecc. Microbiol. Clin.
Present situation of echinococcosis in the Middle East and Arabic North Africa
Parasitology International
Occurrence and molecular characterization of Echinococcus granulosus in Turkish mouflon (Ovis gmelinii anatolica)
Acta Trop.
Hydatidosis-echinococcosis in Greece
Acta Trop.
Towards a taxonomic revision of the genus Echinococcus
Trends Parasitol.
Human cystic echinococcosis in Kyrgystan: an epidemiological study
Acta Trop.
The emerging epidemic of echinococcosis in Kazakzhstan
Trans. R. Soc. Trop. Med. Hyg.
Molecular genetic characterization of different isolates of Echinococcus granulosus in east and southeast regions of Turkey
Acta Trop.
Cystic echinococcosis in the Levant countries (Jordan, Palestinian Authority, Israel, Syria, and Lebanon)
Human cystic echinococcosis in the West Bank of Palestine: surgical incidence and seroepidemiological study
Parasitol. Res.
Prevalence of cyst hydatic in slaughtered cattle between April and May 2005 in Sivas
Turkiye Parazitol Derg.
Cystic echinococcosis (hydatidosis) in sheep, goats, cattle and camels in Shahat Abattoir, Al-Jabal, Libya
Cystic and alveolar echinococcosis in Turkey
Ann. Trop. Med. Parasitol.
Past to present: echinococcosis in Turkey
Acta Trop.
Investigation of alveolar echinococcosis in human under high risk infection in Turkey
Int. Arch. Hydatid.
Molecular characterization of Egyptian human and animal Echinococcus granulosus isolates by RAPD-PCR technique
J. Egypt. Soc. Parasitol.
Echinococcus granulosus strain typing in North Africa: comparison of eight nuclear and mitochondrial DNA fragments
Parasitology
Socio-economic impact of cystic echinococcosis and of its control: some data and considerations
Parassitologia
Cystic echinococcosis and the Mediterranean Region: a long-lasting association
Parassitologia
Knowledge, behaviour and implications on hydatidosis in Tunisia
Rev. Tun. Infectiol.
Prevalence of echinococcosis in street dogs in Tripoli District, Libya
J. Egypt. Soc. Parasitol.
Estimation of the prevalence of bovine hydatid cyst in south Pyrenees
Parasite
Livestock genetic resources and production systems: a Mediterranean overview
Arch. Latinoam. Prod. Anim.
Global socio-economic impact of cystic echinococcosis
Emerg. Infect. Dis.
Echinococcosis/hydatidosis: a method for the assessment of hospital costs
Inf. Circ.-WHO Mediterr. Zoon. Control Cent.
Cystic echinococcosis in water buffaloes (Bubalus bubalis)
Ital. J. Anim. Sci.
Le chien et la contamination de l’environnement par les oncospheres d’Echinococcus granulosus: Cas de 4 régions du Maroc
Epidémiologie de l’échinococcose/hydatidose au Maroc
Praziquantel in prevention of complicated echinococcosis relapses
Mater. Soc. Med.
Current status of hydatidosis/echinococcosis: guidelines for surveillance, siology, diagnosis and recommendations for prevention and control in Egypt
Laparoscopic resection of a primary hydatid cyst of the adrenal gland: a case report
J. Med. Case Reports
Echinococcosis in animals: clinical aspects, diagnosis and treatment
Evaluation of control programmes for echinococcosis/hydatidosis in Cyprus
Rev. Sci. Tech.
Cited by (171)
Knowledge, awareness and practice regarding cystic echinococcosis in Algeria: A cross-sectional survey among the general population
2024, Veterinary Parasitology: Regional Studies and ReportsMolecular and immunological diagnosis of cystic echinococcosis from different hosts in the Gaza Strip, Palestine
2023, Parasite Epidemiology and ControlAnti-parasitic effects of resveratrol on protoscolices and hydatid cyst layers
2022, Experimental ParasitologyPrevalence, risk factors and zoonotic potential of intestinal parasites in dogs from four locations in Morocco
2022, Veterinary Parasitology: Regional Studies and Reports