A molecular survey of Echinococcus granulosus sensu lato in central-eastern Europe

Central-eastern Europe is an endemic region for cystic echinococcosis where multiple species of intermediate hosts are commonly infected with Echinococcus granulosus sensu lato tapeworms of major medical and veterinary importance. Investigations of the genetic variation of 25 Echinococcus isolates from five countries (Slovakia, Romania, Ukraine, Hungary, Poland) were undertaken using three mitochondrial DNA markers. The 18 isolates from pigs derived from Slovakia and Ukraine and the four human isolates from Slovakia, Poland and Ukraine were identified as E. canadensis G7, whereas the three human isolates from Romania and Hungary were classified as E. granulosus sensu stricto G1. This study reports the first confirmed human case of E. granulosus s.s. in Hungary. The haplotype G7A with two polymorphic sites relative to the most common regional variant of E. canadensis G7 was recorded in both pigs from Ukarine and in a single pig isolate from Slovakia. The results of this study support the circumstantial evidence that E. canadensis G7 with low infectivity for humans is highly prevalent in the northern parts of the region (Poland, Slovakia, forest-steppe zone of Ukraine),while infections with E. granulosus s.s. which are highly infectious for humans are more commonly encountered in Romania and Hungary

A molecular survey of Echinococcus granulosus sensu lato in central-eastern Europe

Central-eastern Europe is an endemic region for cystic echinococcosis where multiple species of intermediate hosts are commonly infected with Echinococcus granulosus sensu lato tapeworms of major medical and veterinary importance. Investigations of the genetic variation of 25 Echinococcus isolates from five countries (Slovakia, Romania, Ukraine, Hungary, Poland) were undertaken using three mitochondrial DNA markers. The 18 isolates from pigs derived from Slovakia and Ukraine and the four human isolates from Slovakia, Poland and Ukraine were identified as E. canadensis G 7, whereas the three human isolates from Romania and Hungary were classified as E. granulosus sensu stricto G1. This study reports the first confirmed human case of E. granulosus s.s. in Hungary. The haplotype G7A with two polymorphic sites relative to the most common regional variant of E. canadensis G7 was recorded in both pigs from Ukraine and in a single pig isolate from Slovakia. The results of this study support the circumstantial evidence that E. canadensis G7 with low infectivity for humans is highly prevalent in the northern parts of the region (Poland, Slovakia, forest-steppe zone of Ukraine), while infections with E. granulosus s.s. which are highly infectious for humans are more commonly encountered in Romania and Hungary

Human Alveolar Echinococcosis in Poland: 1990–2011

<div><h3>Background</h3><p>Alveolar echinococcosis (AE) caused by <em>Echinococcus multilocularis</em> 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.</p> <h3>Methodology/Principal Findings</h3><p>The 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.</p> <h3>Conclusions/Significance</h3><p>The 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 <em>E. multilocularis</em>, 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.</p> </div

Incidence of alveolar echinococcosis in Varmia-Masuria province, Poland, during 1990 through 2011.

a<p>Total number of cases (1990–2011),</p>b<p>Per 100 000 population (yearly - mean).</p

Geographical distribution of human AE cases in Poland.

<p><b>A – Number of AE cases in each province.</b> Localizations of three patients could not be determined. A – Pomorskie Province; B – Varmia-Masuria Province; C- Podlaskie Province. <b>B – Distribution of 65 AE cases in the Varmia - Masuria Province.</b> Global area amounts to 24 173 km², and population 1 426 155 (2008). a – Elbląski district; b – Lidzbarski district; c – Kętrzyński district; d – Węgorzewski district; e – Iławski district.</p

Age of 117 patients in the year of AE diagnosis and death of 21 persons.

<p>Age of 117 patients in the year of AE diagnosis and death of 21 persons.</p