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Echinococcosis (hydatidosis, or hydatid disease): Echinococcus infection


Overview:
Human echinococcosis (hydatidosis, or hydatid disease) is a parasite infection due to infection by cestode genus Echinococcus.
 Echinococcus granulosus causes cystic echinococcosis (CE),  Echinococcus multilocularis causes alveolar echinococcosis (AE), Echinococcus vogelicauses polycystic echinococcosis, and Echinococcus oligarthrus is an extremely rare cause of human echinococcosis.

Habitat:
The most common species of genus Echinococcus are Echinococcus granulosus and Echinococcus multilocularis .
Larval stage of Echinococcus granulosus  lives inside dogs and other carnivores, then transmitted to human and other herbivorous species.
Larval stage of Echinococcus multilocularis  lives mainly inside foxes but dogs and wolves also, then transmitted to small rodents and rarely humans

Causes:
Adult Echinococcus granulosus  release eggs within the intestine which will be transported out of the body via feaces.
When contaminated waste is excreted into the environment, the intermediate host has the potential to contract the parasite by grazing in contaminated pasture .
It is transmitted from the intermediate host (sheep) to the definitive host (dogs) by frequent feeding of offal. Consuming offal containing Echinococcus granulosus can lead to infection.

Symptoms:
Ingested eggs from animal hatch in the gut and release oncospheres which penetrate the intestinal wall, migrate via the circulation, and lodge in the liver or lungs or, less frequently, in the brain, bone, or other organs.
In tissue , Echinococcus granulosus  oncospheres develop into cysts, which grow slowly (usually over many years) into large fluid-fluid lesions hydatid cysts
If a cyst in the liver leaks or ruptures, infection can spread in the peritoneum.
Symptoms depend upon the site of infection:
- Liver cysts: cause abdominal pain or palpable mass. jaundice may occur if the bile duct is obstructed. Rupture into the bile duct, peritoneal cavity , or lung may cause fever, urticaria or a serious anaphylactic reaction.
- Pulmonay cysts: can cause cough, chest pain, and hemoptysis.
- Brain and spinal cord: cause epilepsy and blindness.

Diagnosis:
By Detection of antigens in feces by ELISA is currently the best available technique.
Other technique are:
- Imaging.
- Examination of cyst fluid.

Prevention:
In order to prevent transmission of infection from dogs to human , dogs can be given anthelmintic vaccination.
Clean slaughter and high surveillance of potential any reservoir animals during slaughter is the key in preventing the spread of this cestode.
Proper disposal of offal after slaughter to prevent dogs access to offal from livestock.
Boiling livers and lungs which contain hydatid cysts for 30 minutes has been proposed as a simple, efficient and saving way to kill the infectious larvae.

Treatment:
- Surgical removal of hydatid cysts 90% effective but can be risky depending on location, size and advancement of cyst.
- It may need chemotherapy to prevent recurrence.
- Chemotherapy: Albendazole is preferred treatment because it penetrated into hydatid cysts. Dosage 10mg/kg body weight or 400mg 2x daily for 4 weeks. Mebendazole. Dosage: 40 mg/kg body weight 3x daily for 3-6 monthes.
- Dogs are effectively treated with praziquantel.
- PAIR treatment )puncture, aspiration, injection, respiration(.
- Inject protoscolicial substances into cyst.
Echinococcosis (hydatidosis, or hydatid disease): Echinococcus infection Reviewed by Tpdsm on September 30, 2017 Rating: 5

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