Human Alveolar Echinococcosis in Poland: 1990–2011

Autor: Lidia Chomicz, Józef Piotr Knap, Anna Grzeszczuk, Małgorzata Paul, Z. Pawlowski, Jolanta Niścigorska-Olsen, Waldemar Patkowski, Aleksandra Czyrznikowska, Natalia Wnukowska, Halina Pietkiewicz, Marek Krawczyk, Iwona Felczak-Korzybska, Jerzy A. Polański, Danuta Cielecka, Elżbieta Gołąb, Przemysław Myjak, Beata Szostakowska, Elzbieta Kacprzak, Elżbieta Sokolewicz-Bobrowska, Jerzy Stefaniak, Wacław Nahorski
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Zdroj: PLoS Neglected Tropical Diseases
PLoS Neglected Tropical Diseases, Vol 7, Iss 1, p e1986 (2013)
ISSN: 1935-2735
1935-2727
Popis: Background Alveolar echinococcosis (AE) caused by Echinococcus multilocularis 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. Methodology/Principal Findings 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. Conclusions/Significance 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 E. multilocularis, 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.
Author Summary Human alveolar echinococcosis (AE) is a consequence of accidental ingestion of the eggs of the tapeworm Echinococcus multilocularis. AE constitutes a serious and increasing medical and epidemiological problem in many countries including Poland. The natural environments with a high AE prevalence are the areas where the definitive hosts (foxes, raccoons) and the intermediate hosts (rodents) live. The increasing population of infected foxes that penetrate nearby the village and urban buildings and infected dogs poses a certain risk to human health. This report is a joint clinical and epidemiological analysis of 121 AE cases recorded in the years 1990–2011 in Poland. The highest percentage of E. multilocularis infected foxes in the north-eastern regions of Poland (about 40% of the examined population infected) bears a clear-cut relation to the highest incidence of detected AE human cases in those areas. An epidemiological and clinical survey of the local population conducted for over a dozen years has contributed to the discovery of several new AE cases. Alveolar echinococcosis in humans caused by Echinococcus multilocularis infection belongs to the emerging diseases in Poland where a continuous increase in the detection rate was noticed during the last two decades.
Databáze: OpenAIRE
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