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At least 19 recordsLinked to original sources
PubMed2003

European echinococcosis registry: human alveolar echinococcosis, Europe, 1982-2000.

Surveillance for alveolar echinococcosis in central Europe was initiated in 1998. On a voluntary basis, 559 patients were reported to the registry. Most cases originated from rural communities in regions from eastern France to western Austria; single cases were reported far away from the disease-"endemic" zone throughout central Europe. Of 210 patients, 61.4% were involved in vocational or part-time farming, gardening, forestry, or hunting. Patients were diagnosed at a mean age of 52.5 years; 78% had symptoms. Alveolar echinococcosis primarily manifested as a liver disease. Of the 559 patients, 190 (34%) were already affected by spread of the parasitic larval tissue. Of 408 (73%) patients alive in 2000, 4.9% were cured. The increasing prevalence of Echinococcus multilocularis in foxes in rural and urban areas of central Europe and the occurrence of cases outside the alveolar echinococcosis-endemic regions suggest that this disease deserves increased attention.

Adolescent↗
PubMed2001

[Introduction of ongoing research projects on echinococcosis at Asahikawa Medical College and some comments on the surveillance, prevention and control of alveolar echinococcosis in Japan].

All researchers working at Department of Parasitology, Asahikawa Medical College (AMC) have been involved in either basic or applied research on echinococcosis (alveolar echinococcosis; AE, cystic echinococcosis; CE) and neurocysticercosis (NCC). As these parasitic diseases are 1) most serious helminthic infections threatening human life, 2) caused by the larval stage of very closely related taeniid cestodes and 3) recognized as global emerging parasitic diseases, we have to establish research reference center for differentiation of these diseases, since the recommendations for the treatment of these three diseases differ critically. We at AMC have already established highly reliable differential serodiagnosis for these all using native antigens and recombinant antigens for AE and NCC. Based on such scientific contribution, we have been involved in many international collaboration projects on AE, CE and NCC in Asia, Europe, Africa and America. Basic research from mitochondrial DNA analysis of Echinococcus multilocularis (causative agent of AE) and Taenia solium (NCC) has revealed and/or implied the origin of the polymorphism of these parasites in the world and diversity of pathogenicity. Epidemiological surveillance of AE in China has strongly suggested that the risk factor is dog carer but not dog feces, dog owned, wild herbs or fox hunting. As the ongoing serology in Hokkaido carried out by the Hokkaido Institute of Public Health is for the primary screening of AE, it is impossible to identify AE patients. It is, therefore, recommended that serology for identification of AE without surgical confirmation is the key to be introduced for differentiation of AE patients, either asymptomatic or symptomatic, in order to recognize the incidence of AE in Hokkaido. Without the true incidence of AE, it is impossible to establish any reliable systems for the surveillance, prevention and control of AE in Hokkaido, Japan.

Echinococcosis↗
PubMed1991

[Preliminary investigation of liver alveolar echinococcosis and liver cystic, echinococcosis in Xiji County, Ningxia].

This article reports on the result of an investigation on the prevalence of liver alveolar echinococcosis (LAE) and liver cystic echinococcosis (LCE) in the peasants and the residents of Xiji County, Ningxia Hui Autonomous Region. Among 2,389 selected persons examined with B-ultrasound, 197 cases were diagnosed to have LAE or LCE; the prevalence being 8.2%. Of the 197 cases, 141 (5.9%) had LAE; 56 (2.3%) had LCE. Among 1,413 peasants, 9.7% had LAE; 3.8% had LCE. Among 976 residents, 0.4% had LAE, 0.2% had LCE. Obviously, the peasants were more prone to be infected with the disease, suggesting LAE had much to do with the job of hunting the fox and capturing the Citellus dauricus, while the infectious source of LCE was mainly the domestic dog.

Adolescent↗
PubMed1996

Guidelines for treatment of cystic and alveolar echinococcosis in humans. WHO Informal Working Group on Echinococcosis.

Summarized in this article are recent experiences in the treatment of human cystic echinococcosis (CE) and alveolar echinococcosis (AE) of the liver caused by the metacestode stages of Echinococcus granulosus and E. multilocularis, respectively. For CE, surgery remains the first choice for treatment with the potential to remove totally the parasite and completely cure the patient. However, chemotherapy with benzimidazole compounds (albendazole or mebendazole) and the recently developed PAIR procedure (puncture-aspiration-injection-re-aspiration) with concomitant chemotherapy offer further options for treatment of CE cases. Chemotherapy is not yet satisfactory: cure can be expected in about 30% of patients and improvement in 30-50%, after 12 months' follow-up. AE is generally a severe disease, with over 90% mortality in untreated patients. Radical surgery is recommended in all operable cases but has to be followed by chemotherapy for at least 2 years. Inoperable cases and patients who have undergone nonradical resection or liver transplantation require continuous chemotherapy for many years. Long-term chemotherapy may significantly prolong survival, even for inoperable patients with severe AE. Liver transplantation may be indicated as a life-saving measure for patients with severe liver dysfunction, but is associated with a relatively high risk of proliferation of intraoperatively undetected parasite remnants. Details of indications, contraindications, treatment schedules and other aspects are discussed.

Anthelmintics↗
PubMed2003

Evaluation of use of recombinant Em18 and affinity-purified Em18 for serological differentiation of alveolar echinococcosis from cystic echinococcosis and other parasitic infections.

To further evaluate recombinant Em18 antigen (rEm18) for immunodiagnosis of human alveolar echinococcosis, 208 serum samples were examined by enzyme-linked immunosorbent assay (ELISA). To comparatively assess the results of rEm18-ELISA, ELISA and immunoblot analysis with two affinity-purified native antigens were also performed with 45 selected serum samples. The results indicate that rEm18 is highly useful for serodiagnosis.

Animals↗
PubMed1994

Effect of chemotherapy on the larval mass and the long-term course of alveolar echinococcosis. Swiss Echinococcosis Study Group.

The efficacy of long-term chemotherapy in nonresectable alveolar echinococcosis is debated, particularly because of the difficulty in defining therapeutic success. In this study the effect of chemotherapy on the parasitic mass was evaluated in a series of 37 patients. The patients had larval lesions documented by serial computed tomography studies at least 1.5 yr after chemotherapy (mean = 6.4 yr, range = 1.5 to 10.7 yr). The therapeutic regimen consisted of mebendazole (n = 34) or albendazole (n = 3) as previously described. The maximal areas of the parasitic lesions were assessed morphometrically by means of digital image analysis, utilizing the point-integration method, before and after chemotherapy. Marked regression of larval tissue occurred in 18 patients (group A; 48.6%), stationary lesions were noted in 13 patients (group C; 35.1%) and progression was found in 6 patients (group B; 16.2%). The three groups did not differ significantly with regard to age, plasma drug levels, duration of chemotherapy or initial size and composition of lesions (e.g., cystic cavities, degree of calcification). Despite morphologically successful chemotherapy in moist patients (e.g., 84%; groups A and C), late cholestatic complications after 1.5 to 11 yr of chemotherapy occurred in 10 patients (group A, n = 7; group C, n = 3; 4 of them died) and esophageal variceal bleeding occurred in 3 patients (relieved by sclerotherapy). These late complications were probably mainly due to posttherapy fibrosis of hilar structures. In conclusion, our data support the efficacy of chemotherapy. However, chemotherapy is not curative, and severe late complications were observed in patients with hilar (fibrotic) involvement.

Adult↗
PubMed1978

Immunomorphology and pathogenesis of echinococcosis. III: Microscopic immunofluorescence studies in experimental alveolar echinococcosis.

By application of immunohistological methods in experimental alveolar echinococcosis, detailed information was obtained on the antigenic properties of each component of the echinococcus cyst. It was established that of the various layers, the capsula germinativa of the parasite cyst possesses the strongest antigenicity regardless of localization and maturity of the cysts. The dissemination of echinococcal antigens within the internal organs of the experimental animals was found to follow the general trends of other infections. Substances obtained from the capsula germinativa appear most suitable as reagents for immunodiagnostic purposes due to their strong antigenicity.

Animals↗