Diagnosis of the Echinococcus multilocularis infection in final hosts

In view of the considerable public health significance of Echinococcus multilocularis, the causative agent of the highly lethal human alveolar echinococcosis, there is an urgent need for reliable and simple techniques for the diagnosis of the infection in populations of final hosts (foxes, dogs, cats) and also in individual dogs and cats. The standard technique presently used is parsitological examination of the small intestine at necropsy. This reliable technique requires high expenditure and special safety precautions. An alternative approach is coproantigen detection. Recently, in our laboratory an ELISA was evaluated using rabbit and chicken polyclonal antibodies against E. multilocularis antigens (affinity purified coproantigens and somatic adult worm antigens). The specificity of this test (evaluated in 20 foxes and 661 dogs with helmintic infections other than E. multilocularis) was very high (95%-99.5%). Average sensitivity in 35 foxes infected with E. multilocularis was 80%, but reached 93% in foxes with individual worm burdens over 55. A Polymerase Chain Reaction (PCR) was used for detecting DNA of E. multilocular is in faecal samples of foxes after the parasite eggs had been isolated by a sieving procedure. In a total of 55 foxes specificity was 100% and sensitivity 94%. For field application the coproantigen ELISA has the potential of replacing parasite detection at necropsy, and PCR is a valuable method for confirmation of positive coproantigen results and for diagnosis in individual animals. Detection of circulating anti-Em2 antibodies by ELISA may be useful for primary screening of fox populations but antibody prevalence rates do not correlate with prevalence rates of the intestinal infection with E. multilocularis.