Transmission Of Echinococcus Multilocularis Research Articles

Assessment of a 10-year dog deworming programme on the transmission of Echinococcus multilocularis in Tibetan communities in Sichuan Province, China

Human alveolar echinococcosis (AE) is considered a neglected zoonotic disease by the World Health Organization (WHO). The causative pathogen, Echinococcus multilocularis, lives as an adult tapeworm in the intestinal tract of canines. AE was identified as an emerging public health issue in Tibetan communities of Shiqu County 20 years ago. On St. Lawrence Island, Alaska (USA), in the 1980s peri-domestic transmission of E. multilocularis was controlled by regular deworming of owned dogs over a 10-year period. In Tibetan communities, on the Tibetan Plateau, control of E. multilocularis transmission is challenging due to the continental setting, complex epidemiology, disease ecology, geography, and socio-cultural factors. However, a control programme based on deworming owned dogs using praziquental (PZQ) has been carried out since 2006. Assessment was conducted in townships where baseline data were available 10 years prior. Purging of dogs by oral administration of arecoline was used to measure E. multilocularis prevalence, trapping small mammals around communities was employed to assess the change in infection of pikas and voles, and analysis of human AE abdominal ultrasound-based data was used to understand the change in prevalence in the past decade. In all three evaluated townships, the E. multilocularis prevalence in owned dogs was significantly (P < 0.01) reduced from 7.23% (25/346) during 2000–2003 to 0.55% (1/181) in 2016. Human AE ultrasound-based prevalence (adjusted for age and sex) in five evaluated townships decreased significantly (P < 0.01) from 6.25% (200/3,198) during 2000–2002 to 3.67% (706/19,247) during 2015–2017. The 2016 prevalence of E. multilocularis metacestodes in small mammal intermediate hosts was not significantly different from the prevalence in 2008. The control programme was effective in reducing E. multilocularis infection in owned dogs and human AE prevalence, but did not significantly impact infection in wildlife intermediate hosts.

Global dynamics for mathematical model of Echinococcus multilocularis in rodents and red foxes

A deterministic model for transmission of Echinococcus multilocularis (EM), a parasitic disease responsible for human alveolar echinococcosis, is formulated and analyzed rigorously. The model consists of two hosts, with three compartments each, and concentration of the parasites from environment as sources of infection. The model takes into account a predator‐prey relationship between the major hosts and obtained a threshold value for their existence. Systematic derivation of basic reproduction number, , is provided. Thorough qualitative analysis of the model reveals that it has a local and global asymptotic stable disease‐free equilibrium when ; thus, (EM) will die out in the populations. However, when exceeds unity, the model exhibits a unique endemic equilibrium, which is globally asymptotic stable; hence, disease will persist. The elasticity indices and partial rank correlation coefficients of the basic reproduction number and cumulative new cases of the two hosts with respect to parameter values are computed. Sensitivity analyses identified key parameters that are the most sensitive and can be used for control strategies in reducing below unity. Numerical simulations are used to verify theoretical results and quantify prevalence of the disease in host populations.

Peroral Echinococcus multilocularis egg inoculation in Myodes glareolus, Mesocricetus auratus and Mus musculus (CD-1 IGS and C57BL/6j).

Echinococcus multilocularis transmission predominantly occurs in Europe between the red fox (Vulpes vulpes) and various species of rodent intermediate hosts. We infected 3 species of rodent, Myodes glareolus (n = 47), Mesocricetus auratus (n = 11) and outbred Mus musculus (CD-1 IGS) (n = 9) with an E. multilocularis egg suspension that contained 100 eggs with viable oncospheres and performed post mortem examination 6, 8 (M. glareolus) and 10 weeks post inoculation (wpi). C57BL/6j mice (n = 4) were used as positive controls as they have been shown to exhibit macroscopic liver lesions 4 wpi. To the best of our knowledge, this is the first study to experimentally assess susceptibility in the ostensibly competent host M. glareolus. Lesions were only detected in 2 of 47 M. glareolus (4.3%) at 8 and 10 wpi and although both contained protoscolices (1675 at 8 wpi and 88 at 12 wpi) the low percentage of infected animals brings into question their role as transmitters of the parasite. Significant differences were observed between inbred and outbred mice with E. multilocularis infection in the former demonstrating increased establishment (p ≤ 0.0001) and growth (p ≤ 0.0001). No lesions were found in all 11 M. auratus.

Trophic ecology, behaviour and host population dynamics in Echinococcus multilocularis transmission

The life cycle of the cestode Echinococcus multilocularis primarily involves canids and small mammals (rodents, lagomorphs) as definitive and intermediate hosts, respectively. Several surveys have identified marked temporal and geographical variations at different scales in the parasite’s prevalence in both types of hosts, suggesting variations in the biological and ecological factors that control transmission processes. The parasite transmission from intermediate to definitive hosts is determined by the predator–prey relationship, which theoretically depends on prey population dynamics and the complex dietary response of predators to varying densities of prey species and other food items. Parasite eggs are transmitted to intermediate hosts via carnivore faeces, whose distribution in the environment is driven by the defecating behaviour of final hosts. We reviewed field-based studies that address issues related to the trophic ecology and behaviour of definitive hosts, interactions between definitive and intermediate hosts, and E. multilocularis transmission both in wild and domestic animals in rural and urban environments. Two density-dependent mechanisms control the transmission dynamics in definitive hosts: one is based on the variations in the availability of intermediate hosts, and the other is based on the variations in the density of the definitive host and its faeces. Non-linearity and the direct and delayed responses of definitive host contamination in relation to intermediate host population variations were recorded. The dietary response of the red fox was shown to be complex when abundant alternative resources were available (anthropogenic food, multiple intermediate host prey species). Micro-local hotspots of parasite transmission to intermediate hosts in a landscape, as well as areas of higher risk for human contamination in village and urban settings, may be explained by the definitive hosts’ activity patterns and defecation behaviour.

A Newly Discovered Epidemic Area of Echinococcus multilocularis in West Gansu Province in China.

Alveolar echinococcosis (AE) is a lethal parasitic disease. In Gansu Province of China, all AE cases reported in literature were from Zhang and Min Counties, the southern part of the province. Here, we report the discovery of nine AE cases and one cystic echinococcosis (CE) case from Nanfeng Town of Minle County, in the middle of Hexi Corridor in west Gansu Province. The diagnosis of these cases were confirmed by serology, histopathology, computed tomography, B-ultrasound, immunohistochemistry method, DNA polymerase chain reaction and sequencing analysis. Because eight of nine AE cases came from First Zhanglianzhuang (FZLZ) village, we conducted preliminary epidemiological analyses of 730 persons on domestic water, community and ecology such as 356 dogs’ faeces of FZLZ, in comparison with those of other five villages surrounding FZLZ. Our studies indicate that Nanfeng Town of Minle County is a newly discovered focus of AE in China as a CE and AE co-epidemic area. Further research of Echinococcus multilocularis transmission pattern in the area should be carried for prevention of this parasitic disease.

Feeding ecology informs parasite epidemiology: prey selection modulates encounter rate with Echinococcus multilocularis in urban coyotes.

We investigated the role of urban coyote feeding ecology in the transmission of Echinococcus multilocularis, the causative agent of Alveolar Echinococcosis in humans. As coyotes can play a main role in the maintenance of this zoonotic parasite within North American urban settings, such study can ultimately aid disease risk management. Between June 2012 and June 2013, we collected 251 coyote feces and conducted trapping of small mammals (n = 971) in five parks in the city of Calgary, Alberta, Canada. We investigated E. multilocularis epidemiology by assessing seasonal variations of coyote diet and the selective consumption of different rodent intermediate host species. Furthermore, accounting for small mammal digestibility and coyote defecation rates we estimated the number of small mammal preys ingested by coyote and consequently, coyote encounter rates with the parasite. Dominant food items included small mammals, fruit and vegetation, although hare and deer were seasonally relevant. The lowest frequency of occurrence per scat of small mammals was recorded in winter (39.4 %), when consumption of deer was highest (36.4 %). However, highest encounter rates (number of infected hosts predated/season) with E. multilocularis (95% CI: 1.0 - 22.4), combined with the lack of predation on non-competent small mammal species, suggest that winter is the critical season for transmission and control of this parasite. Within the small mammal assemblage, voles (Microtus pennsylvanicus and Myodes gapperi) were the selected preys of urban coyotes and likely played a key role for the maintenance of the urban sylvatic life-cycle of E. multilocularis in Calgary.

Predictors of Echinococcus multilocularis Prevalence in Definitive and Intermediate Hosts: A Meta-Analysis Approach

Echinococcus multilocularis (EM) is a pathogenic and potentially fatal cestode causing human alveolar echinococcosis (AE). A meta-analysis was conducted using a generalized estimation equation approach (GEE) to assess the effect of taxonomic, environmental, and diagnostic variables on EM prevalence in different hosts. Red foxes ( Vulpes vulpes ) had significantly higher prevalence of EM than domestic dogs ( Canis lupus familiaris), with the diagnostic method playing an important factor in assessing prevalence. For intermediate hosts genera was significantly associated with EM prevalence, although there was some indication of publication bias in this dataset. This study also highlights the possible importance of temperature and precipitation to EM transmission. This implies the possibility of a changing climate affecting the future distribution of the parasite.

Fox defecation behaviour in relation to spatial distribution of voles in an urbanised area: An increasing risk of transmission of Echinococcus multilocularis?

Urbanisation of alveolar echinococcosis is a new phenomenon that has been highlighted during the last few decades. It has thus become necessary to understand the dynamics of transmission of Echinococcus multilocularis in urbanised areas. Spatial heterogeneity of infection by E. multilocularis has been explained as the result of a multifactorial dependence of the transmission in which the factors depend on the scale of the investigation. The aim of this study was to assess, in an urbanised area, the effect of such environmental factors as season, habitat type and the level of urbanisation, on the availability of two major intermediate hosts (Microtus spp. and Arvicola terrestris), the distribution of red fox faeces and the distribution of E. multilocularis as determined by detection of coproantigens in faeces. Results of the study revealed higher densities of Microtus spp. in rural than in peri-urban areas. Moreover this species was highly aggregated in urban wasteland. Arvicola terrestris densities did not appear to be linked to the level of urbanisation or to the type of habitat studied. Distribution of faeces was positively linked to distance walked and to Microtus spp. and A. terrestris distributions whatever the level of urbanisation. Such a distribution pattern could enhance the transmission cycle in urban areas. The Copro-ELISA test results on faeces collected in the field revealed that ODs were significantly negatively correlated with the abundance of A. terrestris. The larger population densities of Microtus spp. found in urban wastelands and the well known predominance of Microtus spp. in the red fox diet in the region suggest that Microtus spp. may play a key role in urban transmission of the parasite in the study area.

Ecological and biological factors involved in the transmission ofEchinococcus multilocularisin the French Ardennes

In order to identify the respective importance of the ecological and biological factors involved in the transmission of Echinococcus multilocularis, we estimated grassland vole intermediate host (Microtus sp. and Arvicola terrestris) population densities, in relation to the diet of the definitive host (red fox, Vulpes vulpes) and with the prevalence of E. multilocularis in the fox population. The study was conducted in the Ardennes, north-eastern France, which is an area with a high incidence of alveolar echinococcosis. Surface index methods showed that Microtus was the most abundant intermediate host in the area. Furthermore, Microtus was present in one-third of the 144 faeces and 98 stomach content samples examined and represented more than two-thirds of the rodent occurrences. Red fox predation on Microtus was significantly correlated with Microtus relative abundance. In contrast, the relative abundance of A. terrestris was very low. This species, as well as Clethrionomys glareolus and Apodemus sp., was little consumed. E. multilocularis prevalence in foxes was determined from carcasses and reached 53% (95% confidence interval 45-61%). Intensity of infection varied from 2 to 73,380 worms per fox, with 72% of the sampled worm burden harboured by 8% of the sampled foxes. The selected explanatory variables (sex, year, age class, health and nutritional condition, and season) failed to predict prevalence rate and worm burden. The high prevalence rate in foxes indicates the possibility of intense E. multilocularis transmission, apart from periods, or in landscapes, favourable to large population outbreaks of grassland rodents.

A stochastic model of Echinococcus multilocularis transmission in Hokkaido, Japan, focusing on the infection process

Echinococcus multilocularis causes human alveolar echinococcus. In Japan, high prevalence of E. multilocularis among the fox population has been reported throughout Hokkaido. Accordingly, control measures, such as fox hunting and the distribution of bait containing Praziquantel, have been conducted. This study developed a transmission model for individuals in the fox population and included a stochastic infection process to assess the prevalence of E. multilocularis. To make our model realistic, we used the worm burden for each individual in the fox population. We assumed that the worm burden depends on the number of protoscoleces in a predated vole and the number of infection experiences. We carried out stochastic simulations with 1,000 trials for the situations of Koshimizu and Sapporo, Hokkaido, Japan. The distribution of the worm burden among foxes obtained using the model agreed with dissection data. The simulation indicates that a careful choice of season is necessary for an effective distribution of Praziquantel-containing bait. A stochastic model for E. multilocularis, which can assess the range of the prevalence in the fox population, would be helpful in analyzing their complex life-cycle and also in designing control strategies.

Impact of overgrazing on the transmission of Echinococcus multilocularis in Tibetan pastoral communities of Sichuan Province, China

Overgrazing was assumed to increase the population density of small mammals that are the intermediate hosts of Echinococcus multilocularis, the pathogen of alveolar echinococcosis in the Qinghai Tibet Plateau. This research tested the hypothesis that overgrazing might promote Echinococcus multilocularis transmission through increasing populations of small mammal, intermediate hosts in Tibetan pastoral communities. Grazing practices, small mammal indices and dog Echinococcus multilocularis infection data were collected to analyze the relation between overgrazing and Echinococcus multilocularis transmission using nonparametric tests and multiple stepwise logistic regression. In the investigated area, raising livestock was a key industry. The communal pastures existed and the available forage was deficient for grazing. Open (common) pastures were overgrazed and had higher burrow density of small mammals compared with neighboring fenced (private) pastures; this high overgrazing pressure on the open pastures measured by neighboring fenced area led to higher burrow density of small mammals in open pastures. The median burrow density of small mammals in open pastures was independently associated with nearby canine Echinococcus multilocularis infection (P = 0.003, OR = 1.048). Overgrazing may promote the transmission of Echinococcus multilocularis through increasing the population density of small mammals.

Echinococcus Multilocularis: Why are multidisciplinary and multiscale approaches essential in infectious disease ecology?

Understanding the transmission ecology of parasites involves the challenge of studying the complexity of life-cycles at multiple levels of biological organisation and at various space-time scales. We think that a single field of science alone cannot fully address this issue and that a way to understand such complexity is to connect various fields of science, to consider the whole transmission system, and to identify which are the variables reasonably accessible to measurement and the relevant scales at which they may provide information about transmission processes and indicate a higher risk of transmission⁄emergence. Based on ongoing studies carried out in Europe and in China, the aim of the present paper is to discuss this approach and to show how results obtained from mass-screening of human populations may be combined to those obtained from small mammal and landscape ecology studies and modelling to promote an understanding of Echinococcus multilocularis transmission and to determine how differences in the time-space scales at which human infection and small mammal population dynamic processes occur may complicate the analysis.

Spatial modelling and ecology of Echinococcus multilocularis transmission in China

Recent research in central China has suggested that the most likely transmission mechanism for Echinococcus multilocularis to humans is via domestic dogs which are allowed to roam freely and hunt (infected) small mammals within areas close to villages or in areas of tented pasture. This assertion has led to the hypothesis that there is a landscape control on transmission risk since the proximity of suitable habitat for susceptible small mammals appears to be the key. We have tested this hypothesis in a number of endemic areas in China, notably south Gansu Province and the Tibetan region of western Sichuan Province. The fundamental landscape control is its effect at a regional scale on small mammal species assemblages (susceptible species are not ubiquitous) and, at a local scale, the spatial distributions of small mammal populations. To date the research has examined relationships between landscape composition and patterns of human infection, landscape and small mammal distributions and recently the relationships between landscape and dog infection rates. The key tool to characterize landscape is satellite remote sensing and these data are used as inputs to drive spatial models of transmission risk. This paper reviews the progress that has been made so far in spatial modeling of the ecology of E. multilocularis with particular reference to China, outlines current research issues, and describes a framework for building a spatial–temporal model of transmission ecology.

Epidemiology of human alveolar echinococcosis in China

Globally human alveolar echinococcosis (AE) is a rare zoonotic helminthic disease confined to the Northern Hemisphere as sporadic infections in rural populations, principally in some areas of North America, west-central Europe, the Near East, Siberia, Central Asia, Japan and China. In China the first human cases were reported from western regions in the 1960s, but most hospital records remain fragmented and inadequate. From the mid-1990s mass screening surveys using portable ultrasound scanners recorded higher prevalences (up to 6% by county) than in any other areas of the world with some village rates as high as 15%. Risk factors identified for AE cases included ethnicity, sex, age and occupation. The role of the dog in transmission of Echinococcus multilocularis to humans now appears to be significant and may be one of the most important risk factor, in combination with landscape/land-use features conducive to maintaining wildlife host populations.

A model for the transmission of Echinococcus multilocularis in Hokkaido, Japan

A mathematical model for Echinococcus multilocularis transmission would be useful for estimating its prevalence and determining control strategies. We propose a mathematical model which quantitatively describes the transmission of E. multilocularis in Hokkaido, Japan. The model takes into account the influence of the dynamics of both the definitive and the intermediate host populations, which show large scale seasonal variation as they are wild animals. The simulations based on the model clarify the mechanism of seasonal transmission of E. multilocularis quantitatively, notwithstanding a lack of seasonal prevalence data. At present, human alveolar echinococcosis is prevalent throughout the mainland of Hokkaido. The risk of being infected in the human population has been investigated by analyzing the seasonal fluctuation in parasite egg dispersion in the environment. This is necessary for the planning of more suitable preventive measures against E. multilocularis.

Multi-scale spatial analysis of human alveolar echinococcosis risk in China

Risk factors for the transmission of Echinococcus multilocularis to humans operate at a range of spatial scales. Over a large area, such as China, regional scale risk is correlated with variation in climatic conditions because of its effect on the spatial distribution of landscapes that can support E. multilocularis transmission in wildlife hosts and the probability of egg survival. At a local scale of a few kilometres, or tens of kilometres, transmission risk is related to the spatial proximity of human populations and landscapes with active transmission. At the patch scale, when considering individual villages or households, human behavioural factors are important and for individuals genetic and immunological factors play a role. Satellite remote sensing can provide landscape information at a range of spatial scales and provide a spatial framework within which to examine transmission patterns. This paper reviews the application of remotely sensed data and spatial data analysis to develop a better understanding of disease transmission and shows how such data have been used to examine human alveolar echinococcosis infection patterns, at a range of spatial scales, in an endemic area in central China.

An epidemiological and ecological study of human alveolar echinococcosis transmission in south Gansu, China

Human alveolar echinococcosis (AE) is usually a rare, highly pathogenic zoonotic disease, transmitted across the northern hemisphere between fox and rodent hosts. In China the first cases were described in 1965; however very few epidemiological studies have been undertaken since. Following identification in 1991 of a serious focus of human AE in south Gansu province, detailed village-based community and ecological studies were carried out between 1994 and 1997. Hepatic ultrasound mass screening with serological testing (five tests) identified 84/2482 new AE cases (3%). An overall prevalence of 4.1% (135/3331) was recorded for the area when previous cases were also included. Based on a seropositive result only, without an ultrasound scan indication, no additional AE cases were identified. Of the evolutive AE cases, 96% were seropositive in at least one test, while up 15–20% of individuals who exhibited hepatic calcified lesions and 12–15% exhibiting hepatic nodular lesions were seropositive for specific Em2 or Em18 antibodies. Village ( n=31) human AE prevalence rates varied from 0 to 15.8%. Questionnaire analysis indicated that total number of dogs owned over a period was a risk factor ( P<0.006), but not a history of red fox hunting ( P>0.6). Rodent ecology studies revealed an association between density indices of voles ( Microtus limnophilus) and village AE prevalence rates, on the one hand, and village landscape characterised by a ratio of scrub/grassland to total area above 50% ( P<0.005). Long-term transmission of Echinococcus multilocularis and risk of zoonotic infection of south Gansu farmers may be related ultimately to a process of deforestation driven by agriculture. This in turn probably results in creation of optimal peri-domestic habitats for rodents that serve as intermediate host species (such as M. limnophilus) and subsequent development of a peri-domestic cycle involving dogs.

Preliminary study of the role of red foxes in Echinococcus multilocularis transmission in the urban area of Sapporo, Japan

In order to assess the infection risk of alveolar echinococcosis among urban residents of Sapporo, the capital of Hokkaido, Japan, a survey was conducted on fox distribution in the urban area and on the prevalence of Echinococcus multilocularis among the foxes. The fox distribution, evaluated from fox footprints left on the snow in parks and woodlands, and from locations of fox carcasses recorded by the Sapporo municipality, was concentrated along the border of the urban area and in the southwestern part of the city, facing the mountain. Fox faeces were collected around active fox dens, and analysed by a coproantigen detection assay and parasite egg examination for the Echinococcus infection. Thirty-three out of 155 faeces were coproantigen positive. Coproantigen-positive faeces were collected from 11 den sites (57.9% of total den sites), and all except 1 were located in the urban fringe. A high intensity of taeniid eggs (> 100 eggs per 0.5 g) containing faeces were also collected in the 3 sites of them. Although Echinococcus infection in rodents was not observed from the necropsy of 23 rodents captured around active fox dens, arvicolid rodents, a suitable intermediate host for E. multilocularis, were captured in the urban fringe. Therefore, the urban fringe offers suitable conditions in which the life-cycle of E. multilocularis could be maintained. Prompt measures to control echinococcus infection should be taken, even in urban areas.

Experimental evaluation of mink and Apodemus speciosus in the Echinococcus multilocularis life-cycle in Hokkaido, Japan.

The epizootiological status of mink (Mustela vison) as definitive hosts and Apodemus speciosus as intermediate hosts in the transmission of Echinococcus multilocularis in Hokkaido, Japan, were evaluated by orally inoculating mink with protoscoleces, and A. speciosus with eggs of the cestode, respectively. No tapeworms were recovered from the alimentary tract of the mink, and no hydatid cysts were recovered from the viscera of the egg-inoculated A. speciosus. We conclude that mink and A. speciosus cannot serve as definitive hosts and intermediate hosts of E. multilocularis, respectively, in Hokkaido.