Echinococcosis | |
---|---|
Other names | Hydatid disease, hydatidosis, echinococcal disease, hydatid cyst |
Echinococcus granulosa life cycle (click to enlarge) | |
Specialty | Infectious disease |
Symptoms | Variable[1] |
Causes | Tapeworm of the Echinococcus type[1] |
Diagnostic method | Medical imaging, blood tests[1] |
Prevention | Vaccination of sheep, treating infected dogs[1] |
Treatment | Conservative, medications, surgery[1][2] |
Medication | Albendazole[1] |
Frequency | 1.4 million (cystic form, 2015)[3] |
Deaths | 1,200 (cystic form, 2015)[4] |
Echinococcosis is a parasitic disease caused by tapeworms of the Echinococcus type.[1] The two main types of the disease are cystic echinococcosis and alveolar echinococcosis.[1] Less common forms include polycystic echinococcosis and unicystic echinococcosis.[1]
The disease often starts without symptoms and this may last for years.[1] The symptoms and signs that occur depend on the cyst's location and size.[1] Alveolar disease usually begins in the liver, but can spread to other parts of the body, such as the lungs or brain.[1] When the liver is affected, the patient may experience abdominal pain, weight loss, along with yellow-toned skin discoloration from developed jaundice.[1] Lung disease may cause pain in the chest, shortness of breath, and coughing.[1]
The infection is spread when food or water that contains the eggs of the parasite is ingested or by close contact with an infected animal.[1] The eggs are released in the stool of meat-eating animals that are infected by the parasite.[5] Commonly infected animals include dogs, foxes, and wolves.[5] For these animals to become infected they must eat the organs of an animal that contains the cysts such as sheep or rodents.[5] The type of disease that occurs in human patients depends on the type of Echinococcus causing the infection.[1] Diagnosis is usually by ultrasound though computer tomography (CT) or magnetic resonance imaging (MRI) may also be used.[1] Blood tests looking for antibodies against the parasite may be helpful as may biopsy.[1]
Prevention of cystic disease is by treating dogs that may carry the disease and vaccination of sheep.[1] Treatment is often difficult.[1] The cystic disease may be drained through the skin, followed by medication.[1] Sometimes this type of disease is just watched.[2] The alveolar form often requires surgical intervention, followed by medications.[1] The medication used is albendazole, which may be needed for years.[1][2] The alveolar disease may result in death.[1]
The disease occurs in most areas of the world and currently affects about one million people.[1] In some areas of South America, Africa, and Asia, up to 10% of the certain populations are affected.[1] In 2015, the cystic form caused about 1,200 deaths; down from 2000 in 1990.[4][6] The economic cost of the disease is estimated to be around US$3 billion a year.[1] It is classified as a neglected tropical disease (NTD) and belongs to the group of diseases known as helminthiases (worm infections).[7] It can affect other animals such as pigs, cows and horses.[1]
Terminology used in this field is crucial, since echinococcosis requires the involvement of specialists from nearly all disciplines. In 2020, an international effort of scientists, from 16 countries, led to a detailed consensus on terms to be used or rejected for the genetics, epidemiology, biology, immunology, and clinical aspects of echinococcosis.[8]