Echinococcus multilocularis in North America: the great unknown

Area of Science:

• Veterinary Parasitology
• Zoonotic Diseases
• Epidemiology

Background:

• Echinococcus multilocularis is the parasite responsible for alveolar echinococcosis (AE).
• Recent studies suggest a potential range expansion of E. multilocularis in North America, possibly due to European strain introductions.
• There is limited data on the parasite's distribution in wild and domestic animals across North America.

Purpose of the Study:

• To review current data on Echinococcus multilocularis distribution and genetic characterization in North America.
• To highlight knowledge gaps concerning parasite distribution in various hosts.
• To emphasize the need for understanding host communities in parasite transmission dynamics.

Main Methods:

• Review of existing literature and data on E. multilocularis in North America.
• Analysis of reported infections in wild animals, domestic animals, and humans.
• Synthesis of information regarding parasite genetics and potential strain origins.

Main Results:

• Evidence suggests E. multilocularis is expanding its range in central US and Canada.
• Potential invasions by European strains of the parasite have been identified.
• Significant gaps exist in understanding the parasite's distribution across different host populations.

Conclusions:

• Physician awareness of AE in North America needs improvement to prevent misdiagnosis and underestimation of incidence.
• The endemic presence in urban areas and recent human cases necessitate re-evaluation of public health risks.
• Enhanced surveillance is required to detect new cases of human AE and understand transmission dynamics.