**5. References**

Bowles, J. & McManus, D.P. (1993). Molecular variation in *Echinococcus. Acta trop.*, 53, 291- 305.

 Echinococcosis is difficult to detect or diagnose in humans without access to imaging tools (eg. ultrasound, CT scan), furthermore the basis for confirmatory laboratory

 Treatment is very difficult and not always very effective, relying largely on costly major surgical or percutaneous hospital-based interventions to remove or sterilise cystic lesions. Furthermore, anthelmintic therapy is not ashighly effective as for other helminthic diseases (eg. gastro-intestinal helminthiases, schistosomiasis or onchocerciasis), and is based on long-term high dose albendazole usually re- quiring a minimum 6 months daily course, for which follow-up is very difficult especially in poor-resource areas. In this regard echinococcosis treatment more closely resembles

 Medical records are usually not very explicit/specific, may involve complex follow-up notes, and may be dispersed across several specialities within/between

 In under-developed regions, human echinococcosis generally occurs in poor, often remote marginalised pastoral societies that may be ethnically/socio-culturally isolated from the general population. Consequently they are not usually very well prioritised by the predominant agricultural-based community district health authorities, and so access

 The burden of echinococcosis disease is therefore difficult to quantify, and official hospital or district records often inaccurate, and in any case represent gross under-

CE is a chronic, asymptomatic infection in domestic animals and is therefore also not

 Dogs are the main carrier and spreader of the parasite, but are asymptomatic. In contrast to livestock numbers, official accurate estimates of dog population sizes (owned and stray) are almost never kept/known by municipal, veterinary or agricultural authorities. Canine echinococcosis is treatable with the anthelmintic praziquantel but requires frequent dosing. Unlike for rabies, there is currently no dog

Control of echinococcosis is difficult and exacerbated by the requirement of cooperation

To my family, and especially to my wife Marta and my sons Marc and Toni for their support

Bowles, J. & McManus, D.P. (1993). Molecular variation in *Echinococcus. Acta trop.*, 53, 291-

recognised by livestock owners as an animal health or economic problem.

between agricultural/veterinary services and medical authorities.

tumour treatments or TB therapy, than that for a parasitic disease.

hospitals/clinics and therefore data is not usually properly collated.

to affordable health care is also poor and/or difficult.

estimates of the real burden in an endemic area.

vaccine against canine echinococcosis.

everywhere and every moment of my life.

**4. Acknowledgment** 

**5. References** 

305.

clinicians (Rojo-Vazquez et al., 2011).

diagnosis is usually expensive serological tests.

integrating data from multiple regions, by avoiding duplication of data from patients who access several different health facilities over time, and by providing much needed clinical and epidemiological data that are currently accessible only to


Echinococcosis/Hydatidosis 321

Profumo, E., Ortona, E., Rigano, R., Gioia, I., Notargiacomo, S., Ioppolo, S. & Siracusano, A.

Rojo-Vazquez, FA., Pardo-Lledias, J., Francos-Von Hunefeld, M., et al. (2011). Cystic

Sarciron, EM., Bresson-Hadni, S., Mercier, M., Lawton, P., Duranton, C., Lenys, D., Petavy,

Sheperd, A. & McManus, D.P. (1987). Specific and cross reactive antigens of *Echinococcus* 

Siracusano, A. & Vuitton, D. (1997). Immunology and immunopathology of *Echinococcus granulosus* and *Echinococcus multilocularis* infections. *Arch. int. Hidatid.*, 32, 132-135. Soriano Arandes, A., Gómez Bertomeu, F., and Maldonado Artero, J. (2010). Microscopic

Thompson, RCA. (1995). Biology and systematics of *Echinococcus*, *In: Echinococcus* and

Torgerson, PR., Keller, K., Magnotta, M., Ragland, N. (2010). The Global Burden of Alveolar

Utrilla, JG., Eyre, FP., Muguerza, R., Alami, H. & Bueno, J. (1991). Hidatidosis en la infancia.

Wen, H. & Craig, PS. (1994). Immunoglobulin G subclass responses in human cystic and

Wolfe, ND., Dunavan, CP., Diamond, J. (2007). Origins of major human infectious diseases.

World Health Organization (WHO) (1996). Guidelines for treatment of cystic and alveolar

World Health Organization (WHO) (2001). International classification of ultrasound images

WHO/DFID-AHP (2006). The Control of Neglected Zoonotic Diseases-A Route to Poverty

echinococcosis. WHO Informal Working Group on Echinococcosis. *Bull. WHO*, 74,

in cystic echinoccosis for application in clinical and field epidemiological settings., *In:* PAIR, an option for the treatment of cystic echinococcosis. WHO, Geneva. World Health Organization (WHO) (2001). WHO/OIE Manual on Echinococcosis in

Humans and Animals: a Public Health Problem of Global Concern. WHO,

Alleviation.World Health Organization, Dept of Food Safety, Zoonoses, and Food-

*granulosus* cyst fluid in hydatid patients. *Parasite Immunol*., 16, 393-398. Rassy, D., Bobes, RJ., Rosas, G., Anaya, VH., Brehm, K., et al. (2010). Characterization of

of an Anti-Cestodiasis Vaccine. *PLoS ONE* 5(6): e11287.

Europe. *PLoS neglected tropical diseases*., 5 (1): e893.

alveolar echinococcosis. *Parasite Immunol*., 19, 61-68.

Echinococcosis. *PLoS Negl Trop Dis* 4(6): e722.

alveolar echinococcosis. *Am. J. trop. Med. Hyg*., 51, 741-748.

*Trop. Med. Hyg.,* 82(6), 980.

*Arch. Hidatid*., 30, 721-730.

*Nature.,* 447, 279-283.

borne Diseases, Geneva.

231-242.

Geneva.

Wallingford, 1-50.

*granulosus* cyst fluid. *Molec. biochem. Parasitol*., 25, 143-154.

(1994). Cellular and humoral responses to antigenic subunits of *Echinococcus* 

S3Pvac Anti-Cysticercosis Vaccine Components: Implications for the Development

echinococcosis in Spain: current situation and relevance for other endemic areas in

AF. & Vuitton, DA. (1997). Antibodies against *Echinococcus multilocularis* alkaline phosphatase as markers for the specific diagnosis and the serological monitoring of

Image of the Protoscolex of *Echinococcus granulosus* on the "Hydatid Sand". *Am. J.* 

hydatid disease (R.C.A. Thompson & A.J. Lymbery, eds). CAB International,


Gottstein, B., D'Alessandro, A. & Rausch, R.L. (1995). Immunodiagnosis of polycystic

Gottstein, B., Jacquier, P., Bresson-Hadni, S. & Eckert, J. (1993). Improved primary

Vaccine Efficacy. *PLoS ONE* 4(4): e5362. doi:10.1371/journal.pone.0005362. Ioppolo, S., Notargiacomo, S., Profumo, E., Franchi, C., Ortona, E., Rigano, R. & Siracusano,

Leggatt, GR. & McManus, DP. (1994). Identification and diagnostic value of a major

Leggatt, GR., Yang, W. & McManus, DP. (1992). Serological evaluation of the 12 kDa subunit

Li, T., Qiu, J., Yang, W., Craig, PS., Chen, X., Xiao, N., Ito, A., Giraudoux, P., Wulamu, M.,

Lightowlers MW & Gauci CG (2001). Vaccines against cysticercosis and hydatidosis. *Vet* 

Ligthowlers, MW. & Gottstein, B. (1995). Echinococcosis/hydatidosis: antigens,

(R.C.A. Thompson & A.J. Lymbery, eds). CAB International, Oxon, 355-410. Liu, YH. (1997). Continuous or intermittent treatment with albendazole? *Arch. int. Hidatid*,

Macpherson, CNL. (2005). Human behaviour and the epidemiology of parasitic zoonoses.

Paul, M. & Stefaniak, J. (1997). Detection of specific *Echinococcus granulosus* antigen 5 in liver

Pawłowski, ZS. (1997). Critical points in the clinical management of cystic echinococcosis: a

Petavy A-F, Hormaeche C, Lahmar S, Ouhelli H, Chabalgoity A, et al. (2008). An Oral

revised review, *In*: Compendium on cystic echinococcosis in Africa and in Middle Eastern Countries with special reference to Morocco (F.L. Andersen, H. Ouhelli & M. Kachani, eds). Brigham Young University, Print Services, Provo, Utah, 119-135. Pérez-Molina, JA., Díaz-Menéndez, M, Gallego, JI, et al. (2011). Evaluation of nitazoxanide

for the treatment of disseminated cystic echinococcosis: report of five cases and

Recombinant Vaccine in Dogs against Echinococcus granulosus, the Causative Agent of Human Hydatid Disease: A Pilot Study. *PLoS Negl Trop Dis* 2(1): e125.

fluid in hydatid patients. *Parasite Immunol.*, 18, 571-578.

Sichuan Province, China. *Emerg Inf Dis*., 11, 1866-1873.

cyst bioptate from human patients. *Acta trop.*, 64, 65-77.

literature review. *Am. J. Trop. Med. Hyg*., 84(2), 351-6.

disease) cyst fluid. *Parasite Immunol.*, 16, 87-96.

*roy. Soc. trop. Med. Hyg*., 86, 189-192.

*Parasitol* 101: 337–352.

*Int J Parasito.l*, 35, 1319-1331.

32, 171-173.

*Med. Hyg.*, 53, 558-563.

hydatid disease/polycystic echinococcosis due to *Echinococcus vogeli. Am. J. trop.* 

immunodiagnosis of alveolar echinococcosis in humans by an enzyme-linked immunosorbent assay using the Em2plus-antigen. *J. clin. Microbiol.*, 31, 373-376. Haag, KL., Gottstein, B., Ayala, FJ. (2009). The EG95 Antigen of Echinococcus spp. Contains

Positively Selected Amino Acids, which May Influence Host Specificity and

A. (1996). Immunological responses to antigen B from *Echinococcus granulosus* cyst

antibody epitope on the 12 kDa antigen from *Echinococcus granulosus* (hydatid

of antigen B in *Echinococcus granulosus* cyst fluid by immunoblot analysis. *Trans.* 

Yu, W., Schantz, PM. (2005). Echinococcosis in Tibetan populations, western

immunological and molecular diagnosis, *In: Echinococcus* and hydatid disease


**19** 

*Mexico* 

**A Programme to Control Taeniosis-**

Aline S. de Aluja1, Julio Morales Soto2 and Edda Sciutto3

*3Lab. de Inmunología, Instituto de Investigaciones Biomédicas,* 

**Cysticercolsis (***Taenia solium***) in Mexico** 

*1Departamento de Patología, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Ciudad Universitaria, D. F., 2Lab. MVZ. Aline S. de Aluja, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Ciudad Universitaria, D. F.* 

*Universidad Nacional Autónoma de México, Ciudad Universitaria, D. F.* 

*Taenia solium* cysticercosis is a zoonosis which affects animals, mainly pigs, and human

In pigs the cysticerci are found both in muscles and in the brain, in human beings predominantly in the form of neurocysticercosis (Escobar,1983; Fleury et al., 2003, 2006, 2010) but muscular, subcutaneous and ocular forms have also been reported. (Larralde &

The disease is found mainly in countries where poverty prevails, hygiene is lacking and

In Mexico the disease is present in marginated rural areas of the southern states, (Guerrero, Oaxaca, Puebla, Veracruz, Tabasco, Yucatan, parts of Morelos and others) where the above mentioned conditions exist and the parasite encounters a favorable environment for its survival. Many of the inhabitants of these areas are extremely poor, their dwellings are made of reed, wood or other cheap materials available in their region. Their number is calculated to be 47,190,000 million (INEGI 2009; CEPAL 2010). Few hamlets or villages have piped water and get their supply from wells that may dry up during the hot season or from ponds where rain water accumulates. Donkeys frequently bring water to isolated dwellings in 20 liter containers of which they carry four. There are villages where water is rationed

Roads are rarely paved, and many become impassable during the rainy season. Children often have to walk long distances to get to school and depending on the weather and road conditions do not go, some barely learn how to read and write. In many of these remote areas the inhabitants speak their indigenous languages, have difficulties understanding

People usually own a few animals and some land, where they grow corn, the harvest being barely enough to feed their family. Their animals, a few cattle, pigs and chicken receive very little care, and in particular the pigs roam about freely searching for food (Copado et al, 2004).

**1. Introduction** 

beings.

Aluja, 2006)

people live in close contact with pigs.

during the very dry months and people get one bucket per day.

Spanish, and an interpreter is needed to communicate with them.

Zhang, W., Li, J., You, H., Zhang, Z., Turson, G., Loukas, A. & McManus, DP. (2003). Short report: *Echinococcus granulosus* from Xinjiang, PR China: CDNAs encoding the EG95 vaccine antigen are expressed in different cycle stages and are conserved in the oncosphere. *Am. J. Trop. Med. Hyg*., 68, 40–43.
