Name: |
Hydatid disease |
Causative agent: |
Parasite - Echinococcus granulosus |
Animals affected: |
Definitive host: Dog and other canids
Intermediate hosts: sheep, goats, camels, cattle, kangaroos and others |
Zoonotic: |
Yes, causes cystic echinococcosis (CE) Included in the WHO list of Neglected Tropical Diseases |
Distribution: |
Transmission is most intense in communities where pastoral activities predominate and veterinary services are limited, and where offal from slaughtered animals is accessible to dogs. Highly endemic areas are mostly found in the eastern part of the Mediterranean region, northern Africa, middle East, southern and Eastern Europe, at the southern tip of South America, in Central Asia, Siberia and western China. It is considered an emerging disease in various regions, e.g. the Middle East, central Asia and northern and eastern Africa. |
Description: |
The parasite is host-specific with respect to its definitive hosts (dogs and other canids) which harbour the sexually reproducing tapeworm parasite. Infective tapeworm eggs are released with the faeces, contaminating the environment. Many herbivorous and omnivorous species may be infected as intermediate hosts, after they accidentally eat the eggs and the parasite invades the hosts' tissues and develops into larval stages, most commonly in the liver and lungs. When the offal containing the cysts is eaten by dogs or other canids, they develop the mature parasite completing the cycle.
Humans are accidental intermediate hosts through the ingestion of items contaminated with parasite eggs, including contaminated food, water or thorough direct contact with canine hosts. |
Impact: |
Humans:
· Cystic echinococcosis (CE) in humans manifests as fluid-filled parasitic cysts occurring predominantly in the liver and lungs, although the cysts may occur in any body organ. Commonly, growth of a cyst interferes with the functions of the organ involved, and causes pain. Rupture of the cysts may cause anaphylaxis and death. CE is expensive and complicated to treat, often requiring extensive surgery (2.2% post-operative death rate and 6.5% cases relapsing), and/or prolonged drug therapy which is very difficult in remote areas.
· According to the WHO, more than 1 million people are affected with echinococcosis at any one time (WHO, 2014). Disability-adjusted life years (DALYs) resulting from human CE, are estimated at 1,009,662 DALYs.
· In endemic regions, human incidence rates for CE can reach greater than 50 per 100,000 population, and prevalence as high as 5-10% may occur in parts of East Africa, Argentina, Central Asia, China and Peru.
Sheep and other animals:
· Offal condemnation; potentially causes a reduction in productivity (incompletely defined).
Economic Impact: (examples)
· The annual costs associated with CE are estimated to be US$ 3 billion, which includes costs for treating cases and losses to the livestock industry.
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Prevention and control: |
CE is a preventable disease. Periodic deworming of dogs, preventing dogs from feeding on carcasses of infected animals, control of stray dog populations, improved hygiene in the slaughtering of livestock (including proper destruction of infected offal), and public education campaigns have been found to lower and, in high income countries, prevent transmission of the disease.
However, in spite of efforts to control transmission of E. granulosus in many parts of the world, the disease remains prevalent in humans throughout many regions. There remains an urgent need for new CE control activities and the implementation of improved methods for control for example including vaccination of intermediate hosts, particularly sheep. |
INAND involvement: |
Facilitate the deployment of the sustainable and effective control measures to reduce transmission of E. granulosus and reduce the incidence of cystic echinococcosis in humans. |