Epidemiological and Clinical Characteristics of Alveolar Echinococcosis: An Emerging Infectious Disease in Alberta, Canada.

Houston, Stan; Belga, Sara; Buttenschoen, Klaus; Cooper, Ryan; Girgis, Safwat; Gottstein, Bruno; Low, Gavin; Massolo, Alessandro; MacDonald, Clayton; Müller, Norbert; Preiksaitis, Jutta; Sarlieve, Philippe; Vaughan, Steven; Kowalewska-Grochowska, Kinga (2021). Epidemiological and Clinical Characteristics of Alveolar Echinococcosis: An Emerging Infectious Disease in Alberta, Canada. The American Journal of Tropical Medicine and Hygiene, 104(5), pp. 1863-1869. American Society of Tropical Medicine and Hygiene 10.4269/ajtmh.20-1577

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Human alveolar echinococcosis (AE) is a zoonotic cestode infection which is usually fatal in the absence of treatment. Treatment involves major surgery or indefinite antiparasitic therapy. The incidence is rising in Europe and Asia, with an increased risk observed in immunocompromised individuals. Previously, AE acquisition in North America was extremely rare, except for one remote Alaskan Island. Recent studies have demonstrated a new European-like strain of Echinococcus multilocularis (Em) in wildlife and in human AE in western Canada. We report the experience of all AE patients diagnosed in Alberta. Each was diagnosed by histopathology, serology, and PCR-confirmed by a reference laboratory. Seventeen cases of human AE, aged 19-78 years, nine females, were diagnosed between 2013 and 2020: all definitely or probably acquired in Alberta. Six lived in urban areas, and 14 had kept dogs. In eight, the lesions were found incidentally on abdominal imaging performed for other indications. Six were immunocompromised to varying degrees. Six were first diagnosed at surgery. All have been recommended benzimidazole therapy. One died of surgical complications. Clinicians should be aware of this diagnostic possibility in patients presenting with focal nonmalignant hepatic mass lesions. Greater urbanization of coyotes, the predominant definitive host of Em in Alberta, and growing numbers of immune suppressed individuals in the human population may lead to increasing recognition of AE in North America.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases > Research
04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases > Parasitology
04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases

UniBE Contributor:

Gottstein, Bruno and Müller, Norbert

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

0002-9637

Publisher:

American Society of Tropical Medicine and Hygiene

Language:

English

Submitter:

Bruno Gottstein

Date Deposited:

26 Nov 2021 13:45

Last Modified:

11 Mar 2022 08:20

Publisher DOI:

10.4269/ajtmh.20-1577

PubMed ID:

33755579

BORIS DOI:

10.48350/161593

URI:

https://boris.unibe.ch/id/eprint/161593

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