Echinococcus granulosus and E. multilocularis in the Arctic

Eskild Petersen, MD, DTM&H, DSc

Department of Infectious Diseases

Aarhus University HospitalSkejby, Denmark

ProMED Moderator, Parasitic Diseases

Kulusuq

E.granulosus

CDC

Væskefyldt process

Echinococcus granulosus

WHO/OIE 2001

Echinococcus granulosus is shown to occur in eastern Finland in

a sylvatic cycle involving wolves (Canis lupus) as the definitive

host and reindeer (Rangifer tarandus tarandus) and probably also

elk (Alces alces) and the wild forest reindeer (Rangifer tarandus

fennicus) as intermediate hosts.

Even though the prevalence of E. granulosus in reindeer has

increased in recent years, it is still very low (<0.013%).

Hirvelä-Koski V et al. Vet Parasitol 2003;111:175-92

Finland

Norway and Sweden

E. granulosus occur in northern Norway, Sweden and Finland in a dog –

Reindeer cycle.

In Norway, the infection in reindeer has decreased after introduction of

annual praziquantel treatment of dogs (Kummeneje 1982).

E. granulosus has been found in reindeer in northern Sweden in 1996

Arvid Uggla cited in:

Parasites of the Colder Climates, Akuffo H, Linder E, Ljungström I, Wahlgren M. Taylor and Francis 2003

The last human autochthonous case in Sweden was in 1984

Parasites of the Colder Climates, Akuffo H et al. Taylor and Francis 2003

Iceland and Greenland

E. granulosis and E. multilocularis have not been reported from

Iceland or Greenland.

It is believed that the absence from Greenland is due to unsuitability of the

local rodents as intermediate hosts.

Parasites of the Colder Climates, Akuffo H et al. Taylor and Francis 2003

Russia

WHO/OIE Manual on Echinococcosis in Humans and Animals: a Public Health Problem of Global Concern

J. Eckert, M.A. Gemmell, F.-X. Meslin and Z.S. Pawłowski

World Organisation for Animal Health (Office International des Epizooties) and World Health Organization, 2001

E. Granulosis is reported in 25% to 70% of domesticated reindeer in north-eastern Siberia.

Parasites of the Colder Climates, Akuffo H et al. Taylor and Francis 2003

Alaska

Life-cycle and pathology of E.multilocularis

Photo: Peter Deplazes, University of Zürich

Life cycle by Christian Kapel

No human case has been identified so far

Petersen E. et al. Ugeskr Læg

2001,163:275-77

Denmark

Echinococcus multilocularis

WHO/OIE 2001

E. multilocularis is found in the northern hemisphere with a high prevalence inNorthwestern Canada, Alaska, Russia, Japan and China.

Parasites of the Colder Climates, Akuffo H et al. Taylor and Francis 2003

Alaska and orther arctic regions

Echinococcosis - China

Fig. 1. Map of China showing provinicial borders and main distribution of E. granulosus (lines) and E. multilocularis (stippled, overlaps with E. granulosus) (Craig et al. 1991.

Serological screening. In a 1994 study 7 884 Japanese were investigated for E. multilocularis specific antibodies and 289 were positive and were retested. In the retest, 152 were positive and 140 underwent clinical examination and ultrasound/computerized tomography of the liver and 12 cases were found.

Ultrasound and a variety of antigens in Bavaria, Germany. Two cases were found by ultrasound screening of which one was seronegative (but positive by PCR on biopsy material) and 5 tested positive against at least 2 antigens.

ProMED

Norway

Norway

Echinococcus and climate change

Echinococcus granulosus and E. multilocularis are already present in the arctic

and indeed in many other areas of the world.

Distribution seem to be dependent of proper host and exchange between

hosts and not climate.

Distribution of final hosts (i.e. dogs and foxes) may be climate dependent,

but both are adapted to all global climatic zones.

More research are needed on the presence or absence of E.granulosis and

E.multilocularis in the Arctic.

Predictions:

E.multilocularis will be found in new areas like Greenland

Thank you

20 February 2001 Eskild Petersen 9

Echinococcus multilocularis hit the media in 2000

Echinococcus – Life Cycle (cont.)

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Echinococcus multilocularis - Europe