Echinococcus Infections in Man and Animals in Kenya

1. Hydatid cysts are found in more than 30 per cent of all cattle, sheep and goats in Kenya, but the disease is prevalent in man only in the semi-desert area of Turkana. Up to the time of the present investigation the life-cycle of the parasite in East Africa had not been studied, but it was suggested that wild carnivores, such as hyenas and jackals, might be the main hosts of the adult worms. 2. One hundred and forty-three carnivores, representing 23 species, have been examined. Echinococcus adults were found in 27 out of 43 domestic dogs (Canis familiaris), in three out of four hunting dogs (Lycaon pictus), in one out of nine jackals (Thos mesomelas), and in three out of 19 hyaenas (Crocuta crocuta). 3. A detailed morphological study was made of the Kenya material. After comparison with specimens from other parts of the world, it was concluded that the only species occurring in Kenya was E. granulosus, but it is possible that the minor morphological and biological differences are evidence of distinct strains. Further laboratory studies are necessary to compare the parasite from man and animals in different parts of Kenya with material from elsewhere. 4. A search was made for larval hydatids in 92 ungulates representing 18 species, and in a miscellaneous collection of nearly 2,000 rodents and primates representing a further 31 species. Only one animal was positive, a wildebeest (Gorgon taurinus). 5. The infections in the wild carnivores were all very light; only domestic dogs were heavily infected. It is concluded that the main cycle of transmission in Kenya is between dogs and domestic livestock. 6. Turkana tribesmen are the most heavily infected people in Kenya, either because the strain of parasite is more pathogenic to man in that area, or, more probably, because of the intimate contact between children and the large number of infected dogs. A particularly dangerous custom in the area is the use of dogs to clean the face and anal regions of babies when they vomit or have diarrhea. No satisfactory explanation can be given for the rarity of the disease in man in many of the other areas of Kenya where hydatids are very common in domestic animals. 7. The control of the disease will depend upon an active health-education campaign, together with the destruction of all unregistered dogs and improvement in meat hygiene.

On the Ecology and Distribution of Echinococcus spp. (Cestoda: Taeniidae), and Characteristics of Their Development in the Intermediate Host. II. Comparative Studies on the Development of Larval E. multilocularis Leuckart, 1863, in the Intermediate Host

This paper reports the results of a comparative study of the development of the larval Echinococcus multilocularis Leuckart, 1863), and associated tissue reaction in naturally and experimentally infected mammals representing 31 species. The histogenesis of the larval cestode was traced in detail in arvicoline rodents of several species, and interspecific differences were defined. In arvicoline rodents, the developing larva exhibited host-specific characteristics within about a month after infection was established. The tissue reaction in Microtus oeconomus was characterized by the production of a large quantity of detritus around the larva, and by the formation of a thick epithelioid zone. In one subspecies, M. oeconomus innuitus, development of the larva was retarded, and the detrital mass was often calcified; in another, M. oeconomus operarius, the detritus rarely became calcified and the larva proliferated more rapidly. In M. pennsylvanicus, the tissue reaction was minimal, and little detritus was present. The characteristics of the tissue reaction in M. montebelli placed it in an intermediate position between the aforementioned species. In Clethrionomys rutilus, a thin epithelioid zone and an outer zone of loose collagenous fibers composed the adventitial layer; exogenous budding was retarded in this vole. A minimal tissue reaction occurred in Lagurus curtatus. In Lemmus spp., larger cysts were characteristic, but areas of small-cystic proliferation were always present. Similar differences in species or subspecies of Citellus and Dicrostonyx were described. Lesions of alveolar bydatid disease in man also were studied. The invasive growth of the larval cestode in the human liver involves a process comparable to small-cystic proliferation in the natural intermediate hosts. Although the later stages of development of the larval cestode are inhibited in man, exogenous proliferation of vesicles continues for the life of the host. The lesion in man was compared with a morphologically similar formation produced by anomalous development of the larval E. granulosus in the bovine liver. The latter is distinguished by the absence of areas of small-cystic proliferation. Non-echinococcal lesions found in the tissues studied, some of which resembled foci caused by the larval E. multilocularis, were briefly discussed.

Taxonomic Characters in the Genus Echinococcus (Cestoda: Taenlidae)

Not more than four species of cestodes of the genus Echinococcus Rudolphi, 1801, are recognized as valid. The larval stage of at least three of them is able to develop in man, causing respective types of hydatid disease. Accurate characterization of these cestodes, including both larval and adult stages, is essential for identification, upon which depends development of methods for preventing infection of man and domestic animals. Because morphological characteristics of the larval cestodes may be modified according to the species of host in which they develop, identification should be based upon taxonomic characters of specimens from the respective natural hosts, which can be identified by means of ecological investigations in endemic areas in combination with controlled infection of experimental animals. The morphological and biological characteristics of the known species are discussed, and the two species most important to public health and economically--E. granulosus (Batsch, 1786) and E. multilocularis Leuckart, 1863--are distinguished. French résumé: Trois espèces de cestodes du genre Echinococcus Rudolphi, 1801 ont été identifiées: E. granulosus (Batsch, 1786); E. multilocularis Leuckart, 1863; et E. oligarthrus (Diesing, 1863). On n'a pas encore déterminé avec certitude s'il fallait leur adjoindre E. patagonicus Szidat, 1960. Ce dernier mis à part, tous ces ténias sont connus pour provoquer chez l'homme des formes spécifiques d'échinococcose hydatique; l'infestation par les larves de E. granulosus est également fréquente chez les ongulés domestiques et la répartition de ce cestode est presque cosmopolite. E. multilocularis est très largement répandu dans l'hémisphère nord, tandis que E. oligarthrus ne se trouve que dans le centre et le sud de I'Amérique. Pour définir des critères morphologiques qui permettent de distinguer avec précision les différentes espèces d'Echinococcus, il convient de prendre les spécimens sur leurs hôtes naturels, sinon l'évolution du stade strobilaire se trouve habituellement retardée et le stade larvaire présente une gamme étendue de variations morphologiques. Pour identifier les hôtes naturels, il faut étudier l'écologie dans les zones d'éndemicité, ainsi que les manifestations de l'infection contrôlée chez des animaux d'expérience. Le stade strobilaire des ténias peut présenter plusieurs caractères spécifiques importants qui concernent notamment la taille, le nombre et la répartition des testicules, la position du pore génital dans les segments gravides, la forme de l'utérus gravide et, dans certains cas, la taille et la forme des crochets du rostre. La structure de la larve normalement développée est caractéristique de chacune des trois espèces relativement bien connues. Les caractéristiques biologiques jouent également un rôle important dans la différenciation de ces cestodes. Au stade larvaire, le laps de temps nécessaire au développement des scolex infectants est directement fonction de la durée de vie de l'hôte intermédiaire. La larve de E. multilocularis présente des scolex infectants dès le deuxième ou le troisième mois, alors qu'ils n'apparaissent qu'au bout d'un ou deux ans chez la larve de E. granulosus. Un tableau donne la liste comparative des caractéristiques taxonomiques qui permettent de faire la distinction entre ces deux espèces.

Redundancy and recombination in the Echinococcus AgB multigene family: is there any similarity with protozoan contingency genes?

Numerous genetic variants of the Echinococcus antigen B (AgB) are encountered within a single metacestode. This could be a reflection of gene redundancy or the result of a somatic hypermutation process. We evaluate the complexity of the AgB multigene family by characterizing the upstream promoter regions of the 4 already known genes (EgAgB1-EgAgB4) and evaluating their redundancy in the genome of 3 Echinococcus species (E. granulosus, E. ortleppi and E. multilocularis) using PCR-based approaches. We have ascertained that the number of AgB gene copies is quite variable, both within and between species. The most repetitive gene seems to be AgB3, of which there are more than 110 copies in E. ortleppi. For E. granulosus, we have cloned and characterized 10 distinct upstream promoter regions of AgB3 from a single metacestode. Our sequences suggest that AgB1 and AgB3 are involved in gene conversion. These results are discussed in light of the role of gene redundancy and recombination in parasite evasion mechanisms of host immunity, which at present are known for protozoan organisms, but virtually unknown for multicellular parasites.

Purification and characterization of a specific antigen from Echinococcus multilocularis.

A polypeptide (Em2a) purified by affinity chromatography from the Echinococcus multilocularis metacestode showed a high degree of purity as assayed by SDS-PAGE and analytical isoelectrical focusing. A minor contamination with host albumin was revealed. Estimation of relative mol. mass gave a value of 54,000. The isoelectric point was found to be 4.8. Antigenic activity of the polypeptide was demonstrated by immunoprecipitation and western blotting. In these assays the protein was recognized only by homologous sera from patients infected with larval E. multilocularis. This antigen (Em2a) did not react in the ELISA with sera from patients infected with heterologous helminths; these sera were highly cross-reacting with antigen from E. granulosus hydatid fluid. Seventy-three (94%) from 78 investigated patients (alveolar echinococcosis) showed a seropositive reaction with the polypeptide Em2a.

First report of a human case of polycystic echinococcosis due to Echinococcus vogeli from neotropical area of Peru, South America

We report a human case of polycystic hidatidosis due to Echinococcus vogeli from Contamana (Department of Loreto) village located in the central jungle of Peru. The patient is a 44 year-old lady, teacher, who carried a painless liver mass since a year ago. She was submitted to abdominal surgery and the liver mass was removed and showed multiple cysts containing colorless liquid as is showed in the polycystic hidatidosis. The morphology and measure of the hooks obtained from the liquid contained in the cysts are from Echinococcus vogeli. It is the first report of this parasitism in Perú.

Cistos de Echinococcus vogeli em fígado de paca (Cuniculus paca) originária do Estado do Acre, Brasil

Quatro dos pacientes com doença hidática policística por nós observados referiam ter reconhecido doença no figado de pacas caçadas a fim de serem utilizadas como alimento; as vísceras desses animais eram, habitualmente, dadas aos cães domésticos. Todos os nossos 7 pacientes referiam contactos com cães que previamente haviam ingerido vísceras de pacas. O exame de fígado considerado doente por um dos pacientes e retirado de uma paca abatida na mesma região (Estado do Acre, Brasil) de onde provieram os casos humanos mostrou a presença de cistos hidáticos. As características dos acúleos do protoscolex indicaram tratar-se da forma larval do Echinococcus vogeli. Essas observações confirmam a participação da paca no ciclo biológico do E. vogeli e a via pela qual o homem pode tomar-se o hospedeiro intermediário alternativo desse equinococo.

Inquérito sorológico da infecção pelo Echinococcus sp no município de Sena Madureira, AC

Foi realizado no município de Sena Madureira, Acre, um inquérito soroepidemiológico para avaliar o contato de indivíduos com o Echinococcus sp. Escolheu-se duas populações distintas, uma residente na área urbana e a outra na área rural do município, distribuída em comunidades ribeirinhas da região. Foram avaliados no total 1.064 indivíduos, dos quais 851 pertencentes à área urbana e 213 à área rural. O estudo foi dividido em duas partes: inquérito sorológico, no qual foram coletadas e enviadas amostras de sangue ao Laboratório de Sorologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, onde foram realizados os testes imunológicos pela técnica de contraimunoeletroforese; inquérito epidemiológico para avaliação individual, além de as condições de moradia e hábitos dos indivíduos. A prevalência sorológica na área rural foi 6%, enquanto na urbana fomos 3,5%. A prevalência geral foi 4%. Quando analisada a possibilidade da existência de outros hospedeiros intermediários no ciclo do Echinococcus vogeli, foram encontrados resultados que sugerem ser o porco doméstico o mais provável.

Liver transplantation for neotropical polycystic echinococcosis caused by Echinococcus vogeli: a case report

Neotropical polycystic echinococcosis (NPE) is a parasitic disease caused by cestodes of Echinococcus vogeli. This parasite grows most commonly in the liver, where it produces multiples cysts that cause hepatic and vessel necrosis, infects the biliary ducts, and disseminates into the peritoneal cavity, spreading to other abdominal and thoracic organs. In cases of disseminated disease in the liver and involvement of biliary ducts or portal system, liver transplantation may be a favorable option. We present a report of the first case of liver transplantation for the treatment of advanced liver NPE caused by E. vogeli.

Feeding ecology of Pterodoras granulosus (Siluriformes, Doradidae) in the Lajeado Reservoir, Tocantins, Brazil

The diet and feeding habits of armado catfish, Pterodoras granulosus (Valenciennes, 1821), were studied in the Lajeado Reservoir, Tocantins, Brazil, and the mouth of its tributaries. Stomach contents of 327 specimens were analyzed by the percentage composition and volumetric methods. The feeding of armado on a wide variety of foods, including both animal and plant items, leads to its classification as a euriphagic species with herbivorous tendency. However, it should be noted that armado showed a strong ontogenetic diet shift, with the gradual replacement of detritus and sediment by plant items, especially terrestrial ones. The environmental use pattern of P. granulosus corroborates the ontogenetic shift observed in its diet. Small fish predominated mainly in the benthic region and detritus and sediment represented an important resource, whereas large fish fed mainly on terrestrial plants, as they explore open water sites and the surface of the water column.

Neoparaseuratum travasssosi, n. g., n. sp. (Nematoda: Quimperiidae), a new parasite from thorny catfish Pterododas granulosus in Brazil

A new nematode genus and species. Neoparaseuratum travassosi n. g., n. sp., is described from the intestine of the freshwater thorny catfish, Pterodoras granulosus (Valenciennes), from the Paraná River, Brazil. This seuratoid nematode species represents a new genus of the family Quimperiidae, being characterized mainly by the presence of numerous narrow longitudinal bands of inflated cuticle extending along the cephalic region of the body, small deirids, postoesophageal position of the excretory pore, relatively short (0.159-0.303 mm), equal spicules and a gubernaculum, the absence of caudal alae and preanal sucker in the male, and by some other features.

Inferior vena cava syndrome due to Echinococcus multilocularis.

Alveolar echinococcosis is an invasive, tumor-like zoonosis, accidentally transmitted to humans. We present a case of recurrent inferior vena cava (IVC) syndrome due to alveolar echinococcosis and strongly suspected on transthoracic echocardiographic examination.

An Autochthonous Case of Echinococcus vogeli Rausch & Bernstein, 1972 Polycystic Echinococcosis in the State of Rondônia, Brazil

The present case report refers to a patient from the State of Rondônia, North region of Brazil, attended with clinical suspicion of hepatic echinococcosis. Examination by imaging (ultrasonography and computerized tomography) revealed a conglomerate of cystic lesions, with mobile contents within the cyst. The serology (immunoblot) for Echinococcus sp. was positive (21 and 31 kDa bands). This case is the first reported in Rondônia, suggesting the need to investigate the polycystic echinococcosis in individuals with hepatic cysts from areas of tropical forest and hunting habits where wild life was present as wild dogs, cats and rodents, particularly Agouti paca (paca) and Dasyprocta aguti (agouti).