Human Echinococcosis Research Articles

Validation of PCR-based protocols for the detection of Echinococcus multilocularis DNA in the final host using the Intestinal Scraping Technique as a reference

Oral uptake of infectious Echinococcus multilocularis eggs shed by canids with their faeces may lead to development of alveolar echinococcosis in humans, which is clinically similar to a malignant infiltrative tumor and may be fatal if left untreated. E. multilocularis is therefore regarded as one of the most important and neglected metazoan parasites in the Northern hemisphere. The diagnosis of this tapeworm in the final host plays a key role in the epidemiology of E. multilocularis.The diagnostic performance of a magnetic-capture (MC) DNA extraction protocol in combination with a minor groove-binder real time PCR (MC-MGBqPCR) for the detection of E. multilocularis eggs was determined relative to a highly sensitive variant of the Intestinal Scraping Technique (IST) using faecal samples of foxes. In addition, we compared results obtained by MC-MGBqPCR with those of a previously validated protocol (QIAamp Fast DNA Stool Mini Kit (QT) combined with a TaqMan qPCR). Furthermore, a workflow using the NucleoMagVet DNA extraction kit (NM) in combination with MGBqPCR and TaqMan-qPCR was also included in the comparisons.To estimate the analytical sensitivity, phosphate-buffered saline and fox faecal samples were spiked with different numbers of eggs and tested in defined combinations of DNA extraction and PCR protocols. To assess the diagnostic sensitivity of the different workflows, samples were used that had been collected from the ampulla recti or the rectum of 120 foxes hunted in Brandenburg, Germany. The samples represented five IST categories formed according to the E. multilocularis worm burden of the foxes. For DNA extraction by MC or using two other commercial extraction kits, the supernatants obtained from 3 g of bead-beaten faecal samples were used. The extracted DNAs were then processed in the respective PCR protocols.The MC-MGBqPCR showed the highest diagnostic sensitivity (93%; 95% Confidence Interval (CI): 86–97%) relative to IST. The QT extraction protocol in combination with TaqMan-qPCR had the second highest sensitivity (89%; 95% CI: 80–94%), followed by NM with MGBqPCR (86%; 95% CI: 77–93%) in comparison to IST. The lowest diagnostic sensitivity was found for the NM combined with the TaqMan-qPCR protocol (72%; 95% CI: 62–82%).In conclusion, the MC-MGBqPCR seems to represent a suitable alternative to IST. However, applied to 3 g faecal samples, the less costly QT-TaqMan-qPCR workflow yielded a similar diagnostic sensitivity relative to IST. However, differences between these two workflows were not statistically significant.

Risk Factors for Human Cystic Echinococcosis in Latvia.

Despite the importance of Echinococcus spp. in the Baltic States, little is known about the locally relevant risk factors for contracting the human disease they can cause. The aim of this study was to compare the frequency of selected potential risk factors in individuals diagnosed with cystic echinococcosis (CE) in 1999-2015 and matched controls. The diagnoses of the cases were based on combination of serology and diagnostic imaging, and they were not confirmed to species level of the causative parasite. A total of 46 cases and 46 control individuals were included in the study and answered questions covering a selection of potential risk factors for CE. Living in rural dwelling, owning dogs kept or roaming outdoors, owning dogs fed with viscera of livestock, having close contact with dogs or cats, owning livestock, home slaughtering, and having hunters in the family were significantly more common among the cases than the controls. The identified risk factors can inform planning preventive measures, but species/strain-level diagnoses of human echinococcosis would help in targeting the preventive measures more specifically.

Expansion of a highly sensitive and specific ELISA test for diagnosis of hydatidosis using recombinant EgB8/2 protein.

Objective(s):Hydatidosis is a zoonotic infection and endemic in Iran. Due to the serological cross-reactivity (of sera) with other parasitic infection, diagnosis of hydatid cyst is considered to be problematic. In this regard, application of recombinant antigens improves serological diagnosis for human hydatidosis. Here, we present an ELISA test based on B8/2 recombinant antigen of Echinococcus granulosus with particular regard to its capability to diagnose human hydatidosis.Materials and Methods:The synthesized E. granulosus B8/2 (EgB8/2) gene was sub-cloned into pET28b (+) plasmid. Nde1 and Hind3 restriction enzymes were used to confirm the recombinant plasmid extraction. Cloning was verified by colony PCR, digestion enzymes, and sequence determination methods. To express rtEgB8/2, strains of Escherichia coli BL21 (DE3) pLysS and Rosetta (DE3) were induced with isopropyl β-D-1-thiogalactopyranoside (IPTG). A Ni-NTA column was used for purification, and the expressed protein was analyzed by SDS-PAGE as well as western blotting. ELISA test was used to identify the antigenicity of produced protein.Results:The presence of EgB8/2 gene fragment in the recombinant plasmid was confirmed. SDS-PAGE showed that the BL21 (DE3) pLysS strain had the highest level of expression and a protein band of 11 kDa was observed in induced bacteria. Western blotting approved the purity of rtEgB8/2 protein, and ELISA test measured sensitivity and specificity as 95% and 97.5%, respectively.Conclusion: E. granulosus metacestode contains a high amount of antigen B protein. These results confirm the reproducibility of high-quality rtEgB8/2 recombinant antigen as a reliable candidate in serological test.

Evaluation of direct costs associated with alveolar and cystic echinococcosis in Austria.

BackgroundCystic echinococcosis (CE) is a globally occurring zoonosis, whereas alveolar echinococcosis (AE) is endemic only in certain parts of the Northern Hemisphere. The socioeconomic impact of human echinococcosis has been shown to be considerable in highly endemic regions. However, detailed data on direct healthcare-related costs associated with CE and AE are scarce for high income countries. The aim of this study was to evaluate direct costs of human disease caused by CE and AE in Austria.MethodsClinical data from a registry maintained at a national reference center for echinococcosis at the Medical University of Vienna were obtained for the years 2012–2014. These data were used in conjunction with epidemiological data from Austria’s national disease reporting system and diagnostic reference laboratory for echinococcosis to assess nationwide costs attributable to CE and AE.ResultsIn Austria, total modelled direct costs were 486,598€ (95%CI 341,825€ – 631,372€) per year for CE, and 683,824€ (95%CI 469,161€ - 898,486€) for AE. Median costs per patient with AE from diagnosis until the end of a 10-year follow-up period were 30,832€ (25th– 75th percentile: 23,197€ - 31,220€) and 62,777€ (25th– 75th percentile: 60,806€ - 67,867€) for inoperable and operable patients, respectively. Median costs per patients with CE from diagnosis until end of follow-up after 10 years were 16,253€ (25th– 75th percentile: 8,555€ - 24,832€) and 1,786€ (25th– 75th percentile: 736€ - 2,146€) for patients with active and inactive cyst stages, respectively. The first year after inclusion was the most cost-intense year in the observed period, with hospitalizations and albendazole therapy the main contributors to direct costs.ConclusionsThis study provides detailed information on direct healthcare-related costs associated with CE and AE in Austria, which may reflect trends for other high-income countries. Surgery and albendazole therapy, due to surprisingly high drug prices, were identified as important cost-drivers. These data will be important for cost-effectiveness analyses of possible prevention programs.

The first case of autochthonous Echinococcus multilocularis in human in the Republic of Kalmykia

Purpose: Two recognized species of Echinococcus, have special medical importance - E. granulosus and E. multilocularis - causing cystic echinococcosis (CE) and alveolar echinococcosis (AE) in humans. Due to the developed pasture livestock farming, the prevalence of the rural population in the territory of the Republic of Kalmykia, cases of CE are recorded annually. However, no cases of AE have been observed in this area. Purpose to describe the first case of AE in the territory of the south of Russua. Methods & Materials: Case of AE was described in 46-year-old patient, who contracted disease in non-endemic area. Results: In September 2016, a 46-year-old patient, a resident of the rural area of Kalmykia, applied to the surgical clinic of Rostov Medical University. The patient complained of the appearance of large tumor in the right side of the abdomen. With tomography, a lumpy tumor of the right lobe of the liver was found, 18 × 20 cm in size, with sharp uneven contours, and an inhomogeneous density. Condition of health in patient was relatively satisfactory. Markers of pathological changes in the blood tests were absent. The level of AlAt exceeded the normal values by 3 times. Patient was examined with an enzyme-linked immunosorbent assay (ELISA) and antibodies G against E. Granulosus were discovered (coefficient of positivity 1.5). A Western Blot IgG reaction detected antigen fractions 26–28 kDa specific for E. multilocularis. The tumor was removed in the surgical clinic of Rostov Medical University. The patient underwent liver resection. Alveolar echinococcosis was verified by histological examination of the tumor. The patient was under medical supervision in clinic of infectious and parasitic diseases of Rostov-on-Don Research Institute of Microbiology and Parasitology. The patient received chemotherapy with albendazole 800 mg per day per day in 2 doses with an interval of 12 hours continuous course during 9 months. The patient was examined in March 2018, signs of recurrence of alveococcosis were not revealed. Conclusion: The appearance of alveolar echinococcosis in areas where it was not previously recorded in human is also noted by some European scientists. Thus, it is necessary to improve the serological methods for diagnosis AE.

Hepatic Hydatid Cyst in a Young Rural Female: A Case Report

Introduction: Hydatid disease in humans occurs as result of infection by the larval stages (hydatid cysts) of taeniid cestodes of the genus Echinococcus. The growth of the hydatid cysts in the internal organs (mainly liver and lungs) of humans may affect the health and lead to appearance of the disease manifestations. Introduction: Hydatid disease in humans occurs as result of infection by the larval stages (hydatid cysts) of taeniid cestodes of the genus Echinococcus. The growth of the hydatid cysts in the internal organs (mainly liver and lungs) of humans may affect the health and lead to appearance of the disease manifestations. Results: Imaging investigations demonstrated a cystic lesion within right lobe of the liver extending to adjacent part of the left lobe. A hydatid cyst was diagnosed. The patient underwent radical excision of the cyst with total removal. She also received pre and postoperative oral albendazole. Conclusion: Hydatid disease cases of the liver may remain silent and become symptomatic and are usually diagnosed in adult patients because of the slowly growing nature of the cyst. The diagnosis needs careful history taking, examination and imaging investigations.

Human hydatidosis with different therapeutic modalities

Introduction In early phase of hydatidosis, the Th1 mediates protective immunity against the parasite and helps to eliminate the larval stage, whereas later, the Th2 subset promotes humoral immune response and reflects susceptibility to disease. Aim of the study To investigate the local immunohistochemical pattern of T cell populations in Egyptian patients exposed to variable therapeutic modalities and to identify the dominating type of T cells in patients infected with hydatidosis using two immunocellular markers (STAT-4 and GATA-3), representing Th1 and Th2, respectively, and to evaluate systemic immune response using commercially available indirect hemagglutination (IHA) test. Patients, materials, and methods Forty-five cases with human hydatidosis were enrolled and divided according to treatment they received into four groups. Fresh samples of hydatid cyst wall were fixed in 10% formalin for immunohistochemical examination. Antibody titer was measured using commercial available IHA test. Results Significantly higher expression levels of GATA-3 in comparison with STAT-4 were recorded in all studied groups. Unexpectedly, IHA test recorded positive findings in only 22 of the 45 cases, exhibiting difficulty in the diagnosis and prognosis of such parasitic infection. Conclusion These local and systemic immunological profiles may reflect the efficiency of the parasite to sequestrate its antigen away from the host immune system applying variable therapeutic modalities with pronounced overshadowed Th2 response. Consequently, these data may help to develop new immunotherapeutic strategies to successfully eliminate this serious helminthic infection.

Molecular characterization of Echinococcus granulosus in paraffin-embedded human tissues from Southwest Iran

Objective: To investigate Echinococcus (E.) granulosus genotypes as the causative agents of hydatidosis in humans in the southwest of Iran (Khuzestan province). Methods: In this study, isolates of 80 archived human paraffin embedded hydatid cysts were collected from pathology laboratories in Ahvaz city, Khuzestan province. DNA was extracted and examined by nested-PCR of ribosomal DNA (rDNA) internal transcribed spacer 1 (ITS1), and PCR-RFLP. In addition, the sequences of fragments of genes coding for Cox space1 and NADH dehydrogenase 1 (ND1) were also examined. Results: Of the 80 paraffin samples, 44 (55.0%) were from the liver, 27 (33.8%) from the lung, and the rest from other organs. The amplified hydatid genomic DNA showed that the cysts were E. granulosus strains. The results of PCR-RFLP and sequencing analysis revealed the presence of G1 genotype (sheep strain) in all human isolates. Furthermore, no camel strain (G6) was detected among all samples in the regions studied. Conclusions: The molecular findings indicate that the predominant genotype involved in E. granulosus transmission in southwest of Iran is the common sheep strain (G1), which occurs in human populations. These results may have important implications for hydatid disease control in the studied areas.

Primary hydatid cyst of the thigh: about four cases

The hydatid echinococcosis is preferentially localized in the liver. Muscle localization is very rare, representing less than 1% of the locations of human hydatid echinococcosis. The clinical symptomatology is insidious and not very suggestive, causing a frequent diagnostic delay. the diagnosis is confirmed by imaging: ultrasonography and / or magnetic resonance imaging. The curative treatment remains however surgical. We report a retrospective study over a period of 3 years including 4 cases of primary hydatid cysts of the thigh at the service of Traumatology- Orthopedics B4 of Hassan II CHU all treated surgically.

Genetic diversity of Echinococcus vogeli in the western Brazilian Amazon.

Human polycystic echinococcosis is a parasitic infection caused by the larval stage of Echinococcus vogeli, which occurs in rural areas of Central and South America. Until now, little information on the genetic variability of E. vogeli is available. Here, 32 samples from human-excised E. vogeli cysts had a 396-bp sequence of the mitochondrial cytochrome oxidase I (COI) gene sequenced and compared to another 17 COI sequences representing nine Echinococcus species. A Bayesian COI tree revealed that all E. vogeli sequences formed a monophyletic and well-supported clade with an E. vogeli reference sequence. The occurrence of geographically restricted E. vogeli COI haplotypes suggests retention of ancestral polymorphisms with little migration in Acre, Brazil.

Echinococcosis transmission on the Tibetan Plateau.

Since the mid-1990s detailed studies and field investigations on the Tibetan Plateau have revealed human echinococcosis to be an under-reported major public health problem, particularly in the dominant pastoral communities in the eastern and central regions. Human prevalence surveys showed that cystic echinococcosis (CE, caused by Echinococcus granulosus) and alveolar echinococcosis (AE, caused by Echinococcus multilocularis) are co-endemic with higher burdens of each disease than other endemic world regions. Epidemiological investigations identified some major risk factors for human CE and AE including dog ownership, husbandry practices and landscape features. Dogs appear to be the major zoonotic reservoir for both E. granulosus and E. multilocularis, but the latter is also transmitted in complex wildlife cycles. Small mammal assemblages especially of vole and pika species thrive on the Plateau and contribute to patterns of E. multilocularis transmission which are influenced by landscape characteristics and anthropogenic factors. Tibetan foxes are a principal definitive host for both E. multilocularis and E. shiquicus. In 2006 a national echinococcosis control programme was initiated in Tibetan communities in northwest Sichuan Province and rolled out to all of western China by 2010, and included improved surveillance (and treatment access) of human disease and regular deworming of dogs with annual copro-testing. Control of echinococcosis in Tibetan pastoral communities poses a difficult challenge for delivery and sustainability.

Application of Latex Agglutination and Sandwich ELISA in Detection of Human Hydatidosis

Application of Latex Agglutination and Sandwich ELISA in Detection of Human Hydatidosis

Determination of risk factors and patient profile in human hydatidosis

Determination of risk factors and patient profile in human hydatidosis

Dumb-Bell Shaped Hydatid Cyst in the Parotid Gland – A Rare Presentation

Human echinococcosis is a zoonotic infection caused by the tapeworm of the genus Echinococcus and transmitted by dog and other canine animals. It is a serious problem in tropical areas and is seen in many parts of Bangladesh. In children lungs are the most common site of infection, whereas in adults liver is infected most frequently. Primary hydatid cyst of the parotid gland is extremely rare, even in the endemic areas and very few cases are reported in parotid gland The disease is prevalent in most part of the world, though it is most extensive in the sheep and cattle raising areas. FNAC is contraindicated in suspected hydatid cyst cases due to risk of hypersensitivity reaction and additional precaution of intact cyst excision is mandatory in such cases to prevent recurrence and anaphylaxis reaction. A 30 year old female patient presented with gradually increasing painless large smooth cystic swelling of the right parotid region with trismus. CT scan showed a huge dumb bell shaped cystic lesion in the superficial and deep lobe of the parotid gland that is compatible with hydatid cyst. The parotid tumor was surgically removed by midline mandibulotomy approach. Pathological study of the cystic lesion confirmed hydatid disease of the parotid gland.TAJ 2017; 30(1): 73-77

Anaphylactic Shock in Patient with Hepatic Hydatic Cyst: An Experience at a Rural Hospital

Hydatid disease is mainly caused by infection with the larval stage of the dog tapeworm Echinococcus granulosus. Infestation by hydatid disease in humans most commonly occurs in the liver (55- 70%) followed by the lung (18- 35%); the two organs can be affected simultaneously in about 5-13% of cases. Hydatid disease is endemic in many parts of the world, including India, Africa, South America, New Zealand, Australia, Turkey and Southern Europe. Hydatid disease is more prevalent in rural areas where there is a closer contact between people and dogs and various domestic animals which act as intermediate vectors. Hydatid disease remains frequent in JUMLA. In Karnali Academy of Health sciences 26 surgeries for hydatid cyst was done between 2016-2018.
 Hydatid cyst of liver in a child is a challenge to anesthesiologist in a remote city such as Jumla. Anaphylactic and anaphylactoid reactions during anesthesia are a major cause of concern for anesthesiologists. During the perioperative period, any symptomatology relating to sudden onset hemodynamic collapse or increased airway pressures during certain surgical procedures should raise suspicion of anaphylaxis. We report a case of intraoperative sudden anaphylaxis and its management.

Hydatid masquerade: A case of hydatid disease of the hip joint

Hydatid disease of the bone represents about 1–2.5% of all human hydatid disease. Hydatid disease of bone is uncommon. We present a rare case of echinococcal infection of pelvis which presented as painful limp in the left lower limb with selling in the inguinal region.

Demographic aspects of human hydatidosis in Iranian general population based on serology: A systematic review and meta-analysis.

Aim:Human cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus cestodes, is a globally distributed chronic disease that is an important socioeconomic and public health problem in humans and livestock in developing countries, including Iran. The aim of this study was to determine the overall seroprevalence of hydatid infection in the general population of Iran.Materials and Methods:This systematic review began by searching electronic databases in English (PubMed, Science Direct, Scopus, and Google Scholar) and Persian (Magiran, Scientific Information Database, Iran Medex, and Iran Doc).Results:Our search resulted in a total of 40 reports published from 1995 to 2015. Of 49,460 individuals surveyed, 3090 cases of hydatidosis were reported. Community-based studies showed that the seroprevalence of CE in the Iranian general population was 6.0% (95% confidence interval: 5.0-7.0%). The age group with the highest CE seroprevalence was 20-40 years, and the lowest one was in the under 20 year’s group. The seroprevalence of hydatidosis in males was significantly higher than that in females. In addition, the intended rate was significantly higher in rural regions than in urban areas.Conclusion:Management program for developing more efficient diagnostic tests should be established. Further, cost-effective preventive approaches, including relevant research, should be considered. Finally, hydatid cyst control programs that are important for interrupting the transmission of human CE should be improved.

Molecular characterization of human echinococcosis in Sichuan, Western China

Cystic echinococcosis (CE) and alveolar echinococcosis (AE) are highly co-endemic in Sichuan, a part of Qinghai-Tibet Plateau where is a typical Tibetan nomadic community living area. In order to better understand the Echinococcus spp. of human being infected origins in this area, 140 lesions were collected from echinococcosis patients who were received operations during the period of 2014–2016 in different geographic districts in this region. Partial DNA sequences of the mitochondrial cox1 gene were analyzed. The genetic characterization of the isolates from 3 different places including Ganzi, Aba and Liangshan were assessed. Of all the 140 samples, the great majority was identified as Echinococcus granulosus sensu stricto (n = 108). Echinococcus multilocularis was confirmed to be another important pathogen of the human infections (n = 31). Additionally, one Echinococcus canadensis (G6/7) isolate from Ganzi was confirmed. Comparing the clinical diagnosis with the sequencing results, 6.4% (9/140) of the cases were misdiagnosed between AE and CE, and another 8.6% (12/140) were unclassified to sub-type in echinococcosis. Higher rates of misdiagnosis and unclassified diagnosis were found in AE cases (12.9%, 4/31 and 16.1%, 5/31 respectively) compared to CE (4.6%, 5/109 and 6.4%, 7/109 respectively). In E.granulosus s.s., a total of 34 haplotypes were detected, and 4 haplotypes were inferred from E.multilocularis. The haplotype networks of the 2 species exhibited a similar star-shaped feature with a dominant haplotype in the center. Geographically specific haplotypes were observed in Ganzi and Aba respectively. This study provides insight into the current species causing human echinococcosis in the Tibetan districts of Sichuan. E.granulosus s.s. and E.multilocularis are confirmed to be the main causative agents, and the existence of E.canadensis (G6/7) is also observed in the region. Molecular diagnosis was proven to be essential for the confirmation of human echinococcosis in the area.

Cystic echinococcosis in adult hospitalized patients: A 10-year retrospective study in Western Romania

Background: Human cystic echinococcosis (CE) is a parasitic zoonotic disease caused by tapeworms of the genus Echinococcus.Due to high rates of echinococcosis in humans and animals, Romania is listed among the first contries worldwilde, being recognized as a highly endemic area.The aim of the present study was to evaluate the epidemiological aspects of this disease in patients hospitalized in surgical clinics in Timisoara, Western Romania. Methods & Materials: This retrospective study included 228 adult patients admitted in 6 surgical clinics in Timisoara, between January 1st2007 and September 30th2017.Clinical, laboratory and epidemiological data were collected from the clinical records of these patients. Results: The 228 patients aged 19 to 82 years (mean = 46.2), 124(54.4%)were females, 136 (59.6%) from rural area.High prevalence of CE was observed in patients aged 50-59 years (21.7%) and 30-39 years (20.7%). Hospitalization period ranged between 3 and 46 days (mean 13.4 days).The meanlength of hospital stay was significantly higher in patients aged 60-69 years(16 days) compared to those aged 30-39 years (11 days), 40-49 years (7.5 days) and 50-59 years (11 days)(p < 0.05).Seventy-two patients (31.6%) had two or more hospitalizations.The most frequent localizations of the cysts were: liver (75.9%) and lung (10.5%). Multiple cysts have been reported in 53 (23.2%) patients.Fifty-one patients (22.4%) presented complications: anaphylactic shock, cardio-respiratory arrest, bacterial superinfection, cystic rupture, biliary fistula.The mean lengh of hospital stay was significantly higher in patients with complications (15.7 days) compared to those without complications (12.7 days)(p = 0.017). A significantly higher mean length of hospitalization was recorded in patients who underwent cystectomy (15.4 days) compared to those in whom percutaneous procedure (9 days) was performed(p < 0.001). Conclusion: Our findings indicate a higher prevalence of CE in females and rural area. Liver and lungs were the most affected organs.The length of hospital stay may be reduced in patients undergoing percutaneous procedure and in those without complications. Public Health Autorities should improve monitoring CE in order to evaluate and design of targeted prevention and control actions.

Epidemiological features of Echinococcus granulosus in Southern Russia

Background: Human Echinococcosis is a widely distributed parasitic infection with formation of permanent endemic foci. Dry and hot climate in the South of Russia, a large number of livestock and dogs maintain current foci of disease. These areas are the habitat of all wild animals - definitive hosts of Echinococcosis (wolf, jackal, fox, raccoon dog and Vulpes corsac). High prevalence of echinococcosis in humans constantly is recorded in Karachay-Cherkessia and Kabardino-Balkaria, Astrakhan and Stavropol Territories. Human morbidity in these areas exceeds the average level in Russian Federation 2 times or even more. However, in the neighboring areas (Ingushetia, Chechnya, Rostov region), with the same conditions for the implementation of the full life cycle of parasite, the incidence of Echinococcosis is missing or significantly below average in Russian Federation. Aim of the study is to determine the reasons of variability in the incidence of Echinococcosis population on the territories with similar climatic and household conditions in southern Russia Methods & Materials: During the period from 2008 to 2016 we performed a retrospective analysis of 92 medical records of patients who were surgically treated for echinococcosis in the Republican hospital in Karachay-Cherkessia and 76 patients, operated on Echinococcosis in Regional hospitals #2 in the Rostov region. Also we analyzed 96 epidemiological survey of Echinococcosis cases in the Karachay-Cherkessia and 52 - in the Rostov region. 6210 blood serum of healthy inhabitants of Rostov and Astrakhan regions, Krasnodar Territory, Adygea and Karachay-Cherkessia has been studied by enzyme immunoassay (ELISA). Results: Analysis of the medical records demonstrated that the number of patients received surgical treatment in hospitals of Rostov region in the period 2008-2016 exceeds the number officially registered. In Karachay-Cherkessia the number of officially reported cases more than number of patients surgery treated for Echinococcosis in the Republican hospital, because patients operated in other territories of southern Russia are also taken into account. The results of sero-epidemiological surveys showed that the percentage of seropositive persons among conditionally healthy population of the Rostov Region two times higher than in Karachay-Cherkessia (1.01% and 2.85% respectively). Conclusion: The real prevalence of Echinococcosis in some territories of southern Russia higher than official statistics.