Cystic Echinococcosis in Spain: Current Situation and Relevance for Other Endemic Areas in Europe

Cystic echinococcosis (CE) remains an important health problem in many regions of the world, both where no control measures have been implemented, and where control programs have been incompletely successful with ensuing re-emergence of the disease. In Spain, official data on CE show an increase in the proportion of intermediate hosts with CE during the last few years, and autochthonous pediatric patients have been reported, a sign of active local transmission of disease. A similar picture emerges from data reported to the European Food Safety Authority by other European countries. Nevertheless, several crucial aspects related to CE that would help better understand and control the disease have not been tackled appropriately, in particular the emergence of infection in specific geographical areas. In this respect, while some data are missing, other data are conflicting because they come from different databases. We review the current situation of CE in Spain compared with areas in which similar problems in the CE field exist, and offer recommendations on how to overcome those limitations. Specifically, we believe that the introduction of national registries for CE with online data entry, following the example set by the European Registry for Alveolar Echinococcosis, would help streamline data collection on CE by eliminating the need for evaluating and integrating data from multiple regions, by avoiding duplication of data from patients who access several different health facilities over time, and by providing much needed clinical and epidemiological data that are currently accessible only to clinicians

Crimean-Congo haemorrhagic fever (CCHF) virus-specific antibody detection in blood donors, Castile-León, Spain, summer 2017 and 2018

BackgroundCrimean-Congo haemorrhagic fever virus (CCHFV) is considered an emerging or even a probable re-emerging pathogen in southern Europe. Presence of this virus had been reported previously in Spain in 2010.AimWe aimed to evaluate the potential circulation of CCHFV in western Spain with a serosurvey in asymptomatic adults (blood donors).MethodsDuring 2017 and 2018, we conducted a CCHFV serosurvey in randomly selected asymptomatic blood donors from western Spain. Three assays using specific IgG antibodies against CCHFV were performed: the VectoCrimea ELISA test, an in-house ELISA and indirect immunofluorescence (EuroImmun) test with glycoprotein and nucleoprotein.ResultsA total of 516 blood donors participated in this cross-sectional study. The majority of the study participants were male (68.4%), and the mean age was 46.3 years. Most of the participants came from rural areas (86.8%) and 68.6% had contact with animals and 20.9% had animal husbandry practices. One in five participants (109/516, 21.1%) were engaged in at-risk professional activities such as agriculture and shepherding, slaughtering, hunting, veterinary and healthcare work (mainly nursing staff and laboratory technicians). A total of 15.3% of the participants were bitten by ticks in the days or months before the date of sampling. We detected anti-CCHFV IgG antibodies with two diagnostic assays in three of the 516 individuals and with one diagnostic assay in six of the 516 individuals.ConclusionSeroprevalence of CCHFV was between 0.58% and 1.16% in Castile-León, Spain. This is the first study in western Spain that showed circulation of CCHFV in healthy people.This study was supported by the Institute of Health Carlos III, ISCIII, Spain (www.isciii.es), grants: RICET RD16/0027/0018 (AM) and RD16/0003/0003 (MPSS), DTS16/00207 (AM), PI16/01784 (PFS), European Union co-financing by FEDER (Fondo Europeo de Desarrollo Regional) ‘Una manera de hacer Europa’.S

Age distribution of cystic echinococcosis human cases reported in Spain in 2006.

<p>Source: National Statistics Institute. Five autochthonous CE cases are found in the age range 5–14 years, indicating active transmission of the parasite. The rest of the cases are distributed as follows: 11 cases among 15- to 24-year-old patients, 19 among those aged 25–34, 36 among those aged 35–44, 46 among those aged 45–54, 40 among those aged 55–64, 54 among those aged 65–74, 27 among those aged 75–84, and five among patients aged 85 years old or more.</p

Prevalence (%) of cystic echinococcosis in livestock and wild animals in Spain from 2000 to 2008.

<p>Source: Ministerio de Medio Ambiente y Medio Rural y Marino, Spain. NA, not available.</p

Epidemiology of <i>Echinococcus granulosus</i> in Spain.

<p>The main domestic cycle is maintained between dogs and sheep, with man as accidental intermediate host (a; white arrows). Wild cycles could occur between wolves, wild boars, and cervids, among others (b). The sylvatic cycle could be occasionally peridomestic (black arrow), since the G1 genotype, the most frequent in sheep and human patients, has been found in isolates from wild animals.</p

Reported cases per 100,000 inhabitants of cystic echinococcosis in Spain from 2000 to 2008.

<p>Source: Ministerio de Sanidad, Spain, from the databases “Enfermedades de Declaración Obligatoria” (EDOs), “Sistema Microbiológico de Información” (SIM), and “Conjunto Mínimo Básico de Datos” (CMBS); European Food Security Authority (EFSA); and Consejeria de Sanidad y Bienestar Social de la Junta de Castilla y León (Castilla-León). NA, not available.</p

National Rare Disease Registries: overview from Spain

From 7th European Conference on Rare Diseases and Orphan Products (ECRD 2014).N