Monitoring incidence of human echinococcosis in Spain: 2000-2021

Since 1982, when human cystic echinococcosis (CE) became a notifiable disease in Spain, following European guidelines, its incidence has decreased by more than 90% to reach values below the European average. During the study period, mean incidence values ranged from 1.34/10⁵ inhabitants (2000) to 0.14/10⁵ inhabitants (2021) Therefore, Spain can be considered currently as an endemic (instead of hyperendemic) area for human CE. While the national trend during the study period (2000-2021) has generally shown a decline, several Spanish regions with more intensive livestock and slaughtering activities particularly those related to sheep meat production have experienced an increase in both the number of cases and incidence during the last one to two years, according to the available data. Despite official numbers of human CE may also be underestimated in Europe and Spain, as well, our data highlight the importance of educational, preventive and control programs. Nevertheless, despite being a notifiable disease, there is still a great disparity in the availability of official data for the different Spanish regions, which makes it difficult to monitor CE incidence values in real time.