Echinococcus granulosus

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Echinococcus granulosus
Echinococcus granulosus scolex.jpg
Echinococcus granulosus protoscolex
Scientific classification OOjs UI icon edit-ltr.svg
Domain: Eukaryota
Kingdom: Animalia
Phylum: Platyhelminthes
Class: Cestoda
Order: Cyclophyllidea
Family: Taeniidae
Genus: Echinococcus
Species:
E. granulosus
Binomial name
Echinococcus granulosus
Batsch, 1786

Echinococcus granulosus, also called the hydatid worm or dog tapeworm, is a cyclophyllid cestode that dwells in the small intestine of canids as an adult, but which has important intermediate hosts such as livestock and humans, where it causes cystic echinococcosis, also known as hydatid disease. The adult tapeworm ranges in length from 3 mm to 6 mm and has three proglottids ("segments") when intact—an immature proglottid, mature proglottid and a gravid proglottid. [1] The average number of eggs per gravid proglottid is 823. Like all cyclophyllideans, E. granulosus has four suckers on its scolex ("head"), and E. granulosus also has a rostellum with hooks. Several strains of E. granulosus have been identified, and all but two are noted to be infective in humans. [2]

Contents

The lifecycle of E. granulosus involves dogs and wild carnivores as a definitive host for the adult tapeworm. [3] Definitive hosts are where parasites reach maturity and reproduce. Wild or domesticated ungulates, such as sheep, serve as an intermediate host. [3] Transitions between life stages occur in intermediate hosts. The larval stage results in the formation of echinococcal cysts in intermediate hosts. [3] Echinococcal cysts are slow growing, [3] but can cause clinical symptoms in humans and be life-threatening. [4] Cysts may not initially cause symptoms, in some cases for many years. [3] Symptoms developed depend on location of the cyst, but most occur in the liver, lungs, or both. [4]

Echinococcus granulosus was first documented in Alaska but is distributed worldwide. It is especially prevalent in parts of Eurasia, north and east Africa, Australia, and South America. [4] Communities that practice sheep farming experience the highest risk to humans, [4] but wild animals can also serve as an avenue for transmission. For example, dingoes serve as a definitive host before larvae infect sheep in the mainland of Australia. [4] Sled dogs may expose moose or reindeer to E. granulosus in parts of North America and Eurasia. [4]

Transmission

E. granulosus life cycle Echinococcus granulosus - Hydatid disease.png
E. granulosus life cycle

E. granulosus requires two host types, a definitive host and an intermediate host. The definitive host of this parasite are dogs and the intermediate host are most commonly sheep, however, cattle, horses, pigs, goats, and camels are also potential intermediate hosts. [5] Humans can also be an intermediate host for E. granulosus, however this is uncommon and therefore humans are considered an aberrant intermediate host. [5]

The dog serves as the main definitive host for the parasite, with eggs being shed in its scat Defecate brown dog Sri Lanka.jpg
The dog serves as the main definitive host for the parasite, with eggs being shed in its scat

Echinococcus granulosus is ingested and attaches to the mucosa of the intestines in the definitive host and there the parasite will grow into the adult stages. [6] Adult E. granulosus release eggs within the intestine which will be transported out of the body via feces. [6] When contaminated waste is excreted into the environment, intermediate host has the potential to contract the parasite by grazing in contaminated pasture, perpetuating the cycle. [5] [7]

Echinococcus granulosus is transmitted from the intermediate host (sheep) to the definitive host (dogs) by frequent feeding of offal, also referred to as "variety meat" or "organ meat". Consuming offal containing E. granulosus can lead to infection; however, infection is dependent on many factors. [4]

While adult E. granulosus is harmless in dogs, the larval form can be a huge problem in humans. Although rare, the parasite can form a cyst causing cystic echinococcus also known as hydatid disease. [8] The cyst can cause pressure on surrounding tissue which may lead to abnormal organ function, spontaneous fracture of bones, and other neurological effects.

The frequency of offal feedings, the prevalence of the parasites within the offal, and the age of the intermediate host are factors that affect infection pressure within the definitive host. [6] The immunity of both the definitive and intermediate host plays a large role in the transmission of the parasite, as well as the contact rate between the intermediate and the definitive host (such as herding dogs and pasture animals being kept in close proximity where dogs can contaminate grazing areas with fecal matter). [4]

The life expectancy of the parasite, coupled with the frequency of anthelminthic treatments, will also play a role in the rate of infection within a host. The temperature and humidity of the environment can affect the survival of E. granulosus. [4]

Once sheep are infected, the infection typically remains within the sheep for life. However, in other hosts, such as dogs, treatment for annihilating the parasite is possible. However, the intermediate host is assumed to retain a greater life expectancy than the definitive host. [4] [7]

Diagnosis

Diagnosis in the definitive host, the dog, may be done by post mortem examination of the small intestine, or with some difficulty ante mortem by purging with arecoline hydrobromate. Detection of antigens in feces by ELISA is currently the best available technique. [9] The prevalence of Echinococcus granulosus was found to be 4.35% in a 2008 study in Bangalore, India [10] employing this coproantigen detection technique. Polymerase chain reaction (PCR) is also used to identify the parasite from DNA isolated from eggs or feces. [9] However, it is difficult to determine the eggs in feces because it is indistinguishable from other taeniid eggs.

Diagnosis in humans can be done by x-rays, CAT scans, and ultrasounds. [11]

Treatment

If a human becomes infected there are a variety of methods for treatment. [2] [12] The most common treatment in the past years has been surgical removal of the hydatid cysts. [12] The fluid in the cysts contain antigens that can immunologically sensitize the host, so cyst manipulation should be performed with caution, as spilling of cyst contents can cause anaphylactic shock. However, in recent years, less invasive treatments have been developed such as cyst puncture, aspiration of the liquids, the injection of chemicals, and then re-aspiration. [2] Benzimidazole-based chemotherapy is also a new treatment option for humans. [2]

Prevention

Boiling offal containing hydatid cysts for 30 minutes kills the larvae of E. granulosus - a simple method for prevention in remote areas Parasite140085-fig1 Boiling sheep livers containing hydatid cysts (Echinococcus granulosus).tif
Boiling offal containing hydatid cysts for 30 minutes kills the larvae of E. granulosus – a simple method for prevention in remote areas

In order to prevent transmission to dogs from intermediate hosts, dogs can be given anthelminthic vaccinations. [3] [12] In the case of intermediate hosts, especially sheep, these anthelminthic vaccinations do cause an antigenic response—meaning the body produces specific antibody—however it does not prevent infection in the host. [3] [12] Clean slaughter and high surveillance of potential intermediate host during slaughter is key in preventing the spread this cestode to its definitive host. It is vital to keep dogs and potential intermediate host as separated as possible to avoid perpetuating infection. [3] [13] According to mathematical modeling, vaccination of intermediate hosts, coupled with dosing definitive hosts with anthelminths is the most effect method for intervening with infection rates. [3]

Proper disposal of carcasses and offal after home slaughter is difficult in poor and remote communities and therefore dogs readily have access to offal from livestock, thus completing the parasite cycle of Echinococcus granulosus and putting communities at risk of cystic echinococcosis. Boiling livers and lungs which contain hydatid cysts for 30 minutes has been proposed as a simple, efficient and energy- and time-saving way to kill the infectious larvae. [13]

See also

Related Research Articles

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<i>Diphyllobothrium</i> Genus of flatworms

Diphyllobothrium is a genus of tapeworms which can cause diphyllobothriasis in humans through consumption of raw or undercooked fish. The principal species causing diphyllobothriasis is D. latum, known as the broad or fish tapeworm, or broad fish tapeworm. D. latum is a pseudophyllid cestode that infects fish and mammals. D. latum is native to Scandinavia, western Russia, and the Baltics, though it is now also present in North America, especially the Pacific Northwest. In Far East Russia, D. klebanovskii, having Pacific salmon as its second intermediate host, was identified.

Hymenolepiasis is infestation by one of two species of tapeworm: Hymenolepis nana or H. diminuta. Alternative names are dwarf tapeworm infection and rat tapeworm infection. The disease is a type of helminthiasis which is classified as a neglected tropical disease.

Alveolar hydatid disease (AHD) is a form of echinococcosis, or a disease that originates from a parasitic flatworm. AHD is caused by an infection of the flatworm species Echinococcus multilocularis. Although alveolar echinococcosis is rarely diagnosed in humans and is not as widespread as cystic echinococcosis, it is also still a serious disease that has a significantly high fatality rate. It is considered one of the most life-threatening helminthic infections humans can have.

Spirometra is a genus of pseudophyllid cestodes that reproduce in canines and felines, but can also cause pathology in humans if infected. As an adult, this tapeworm lives in the small intestine of its definitive host and produces eggs that pass with the animal's feces. When the eggs reach water, the eggs hatch into coracidia which are eaten by copepods. The copepods are eaten by a second intermediate host to continue the life cycle. Humans can become infected if they accidentally eat frog legs or fish with the plerocercoid stage encysted in the muscle. In humans, an infection of Spirometra is termed sparganosis.

<i>Taenia</i> (tapeworm) Genus of flatworms

Taenia is the type genus of the Taeniidae family of tapeworms. It includes some important parasites of livestock. Members of the genus are responsible for taeniasis and cysticercosis in humans, which are types of helminthiasis belonging to the group of neglected tropical diseases. More than 100 species are recorded. They are morphologically characterized by a ribbon-like body composed of a series of segments called proglottids; hence the name Taenia. The anterior end of the body is the scolex. Some members of the genus Taenia have an armed scolex ; of the two major human parasites, Taenia saginata has an unarmed scolex, while Taenia solium has an armed scolex.

<i>Echinococcus</i> Genus of worms

Echinococcus is a genus within Cestoda, a parasitic class of the platyhelminthes phylum. Human echinococcosis is an infectious disease caused by the following species: E. granulosus, E. multilocularis, E. vogeli or E. oligarthrus.

<i>Echinococcus multilocularis</i> Species of flatworm

Echinococcus multilocularis, the fox tapeworm, is a small cyclophyllid tapeworm found extensively in the northern hemisphere. E. multilocularis, along with other members of the Echinococcus genus, produce diseases known as echinococcosis. Unlike E. granulosus,E. multilocularis produces many small cysts that spread throughout the internal organs of the infected animal. The resultant disease is called Alveolar echinococcosis, and is caused by ingesting the eggs of E. multilocularis.

<i>Dipylidium caninum</i> Species of flatworm

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<i>Hymenolepis nana</i> Species of flatworm

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<span class="mw-page-title-main">Taeniidae</span> Family of flatworms

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<i>Taenia pisiformis</i> Species of flatworm

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<span class="mw-page-title-main">Eucestoda</span> Subclass of flatworms

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<span class="mw-page-title-main">Cestoda</span> Class of flatworms

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<i>Echinococcus vogeli</i> Species of flatworm

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References

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Further reading