Echinococcosis Etiology & Epidemiology
Echinococcosis / Hydatid Disease kyste hydatique / Hydatidosis Zoonotic infection caused by the larval stages of cestodes belonging to the genus Echinococcus
How many Echinococcus species are there? classic medical literatures: 4 species - E. granulosus > cystic echinococcosis - E. multilocularis > Alveolar echinococcosis - E. vogeli > polycystic echinococcosis - E. oligarthra > Unicystic echinococcosis Recent findings reveal at least 10 species
Echinococcus granulosus sensu lato
www.who.int/echinococcosis/en
In dogs and other carnivores
Global importance of cystic echinococcosis Non-monetary burden: - More than one million DALY Monetary burden: - $ 3.0 billion
Epidemiology of cystic echinococcosis What is Epidemiology ? - in people - in dogs and other carnivores - in sheep, etc.
www.who.int/echinococcosis/en
CE status in Iran Annual surgical cases : 0.6-2.6 / 10 5 population Ultrasound (US) prevalence in humans: 0.2-1.8 % Prevalence in dogs: 6.8-55.7 % Prevalence in livestock: 0.4-74.4 %
January 1990 to December 2015 Most cases of human hydatidosis were in southern Iran, with a prevalence of 5.8% (3.2–9.2%).
Craig P .S., et al. , The Lancet Inf. Dis., 7, 2007
What is needed for CE to have a persistent domestic transmission? Population of dogs with sufficient range of movement
Population of dogs with sufficient range of movement Harandi MF., 2011
What is needed for CE to have a persistent domestic transmission? Cultural / Religious festivals
Cultural / Religious festivals
What is needed for CE to have a persistent domestic transmission? Close human-dog relationship
Close human-dog relationship
Close human-dog relationship
What is needed for CE to have a persistent domestic transmission? Food habits High fresh vegetable consumption
Raw vegetable consumption
per capita vegetable consumption in Egypt, Iran and Turkey
What is needed for CE to have a persistent domestic transmission? Traditional farming System
Traditional farming system
Traditional animal husbandry and nomadic / seminomadic life
What is needed for CE to have a persistent domestic transmission? Sylvatic cycle with sufficient infection pressure
Sylvatic cycle with sufficient infection pressure Feral dogs Wild sheep Wolf Goitered Gazelle Jackal Free-ranging Baboons Hyena Feral pigs Red fox ?
What is needed for CE to have a persistent domestic transmission? Highly fertile cysts i.e. susceptible intermediate hosts Diverse intermediate host species in the region
At least 13 different intermediate host species Sheep Camelus dromedarius Goat Camelus bactrianus Cattle Sus scrofa Buffalo Ovis orientalis Horse Gazalla subgutturosa Donkey Papio hamadryas
Routes of TRANSMISSION Dog contact contaminated vegetables Soil contaminated by dog feces Vocational / occupational Recreational activities
Major determinants of CE TRANSMISSION
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