Abstract
BackgroundAlveolar echinococcosis (AE) caused by Echinococcus multilocularis infections is a dangerous old disease in the Northern Hemisphere. The aim of the paper was to collect and analyze data on human AE in Poland in the last two decades.Methodology/Principal FindingsThe sources of data were both the cases officially registered and detected by an active field and laboratory surveillance. The cases were verified by clinical, epidemiological, and laboratory criteria. Altogether 121 human cases of AE were detected. Among these 83 (68,6%) cases were classified as confirmed, 16 as probable and 22 as possible. During the two decades a continuous increase in detection rate was noticed. The cases were 6–82 years old at the time of diagnosis (mean - 47.7 years). Sex ratio M/F was 0.86/1.0. The AE was fatal in 23 (19%) patients (mean age at death - 54.1 years). Family agglomeration of AE was found in 4 foci, involving 9 patients. Seventy six of the cases were diagnosed in an advanced stage of disease. In all cases the liver was the primary location of AE. In 30 (24.8%) patients a spread to other organs was observed. Ninety four of the patients were treated with albendazole. In 73 (60%) patients a surgical operation was performed, including 15 liver transplantations.Conclusions/SignificanceThe studies confirmed that AE is an emerging disease in Poland, which is the fourth country in Europe with over 120 cases detected. The results also indicate the need of a wider national programme for implementation of screening in the highest AE risk areas (north-eastern Poland) with an effort to increase the public awareness of the possibility of contracting E. multilocularis, and above all, training of the primary care physicians in the recognition of the risk of AE to allow for an early detection of this dangerous disease.
Highlights
During the last three decades there has been a continuous increase in worldwide interest both in human and animal alveolar echinococcosis (AE), mainly due to a substantial increase in the number of recorded AE human cases.Human alveolar echinococcosis is caused by the larval stage of Echinococcus multilocularis, occurring in at least 42 countries of the northern hemisphere
The results indicate the need of a wider national programme for implementation of screening in the highest AE risk areas with an effort to increase the public awareness of the possibility of contracting E. multilocularis, and above all, training of the primary care physicians in the recognition of the risk of AE to allow for an early detection of this dangerous disease
These 121 cases of alveolar echinococcosis include 12 cases diagnosed in the nineties and reported to the EurEchinoReg [1]
Summary
During the last three decades there has been a continuous increase in worldwide interest both in human and animal alveolar echinococcosis (AE), mainly due to a substantial increase in the number of recorded AE human cases. Human alveolar echinococcosis is caused by the larval stage of Echinococcus multilocularis, occurring in at least 42 countries of the northern hemisphere. Alveolar echinococcosis is old disease in Europe [2]. In the last half-century, the most frequent cases of human AE in Europe were described in France, Germany, Switzerland and Austria [1,3], and more recently, in Lithuania, the nearest neighbouring country, where 96 human AE cases were recorded in the years 1997–2008 [4,5]. Alveolar echinococcosis (AE) caused by Echinococcus multilocularis infections is a dangerous old disease in the Northern Hemisphere. The aim of the paper was to collect and analyze data on human AE in Poland in the last two decades
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