In their analysis, the international research team, with the participation of Herbert Auer (Center for Pathophysiology, Infectiology and Immunology, MedUni Vienna), Felix Lötsch (Clinical Department of Laboratory Medicine, MedUni Vienna) and Heimo Lagler (Department of Medicine I, Head of Austria's only interdisciplinary outpatient clinic for echinococcosis, MedUni Vienna), evaluated data from 40 European countries. Scientific publications, local disease registers, officially reported case numbers and unpublished reports ("grey literature") for the period 1997 to 2023 formed the basis for this analysis. The result: a total of 4,207 cases of alveolar echinococcosis were recorded in 28 of the countries studied. Based on the incidence rates and trends identified in this study, the Alpine region and the Baltic States were identified as hotspots. Austria, France, Germany and Switzerland alone accounted for 2,864 (68.08 per cent) of the cases.
The study shows that alveolar echinococcosis is underreported, even though it is a notifiable disease in most European countries. Furthermore, the figures show that there has been a clear increase in diagnoses in recent years – in Austria, for example, from a few isolated cases to around 20 new infections per year. High fox populations or increasing contact between wild animals, domestic animals and humans are possible causes of the risk of infection.
Consistent implementation of reporting requirements
Alveolar echinococcosis is a zoonotic disease, in which the pathogen is transmitted from animals to humans. The pathogen is usually the fox tapeworm, which releases its eggs into the environment via fox faeces. Transmission to humans usually occurs through contact with soil or contaminated food. The infection often remains asymptomatic for years and only manifests itself later, particularly through pathologic changes in the liver. Treatment involves surgical removal of the affected liver tissue and/or administration of antiparasitic medication. In Europe, alveolar echinococcosis is considered one of the most dangerous parasitic infectious diseases.
The current review study highlights the importance of systematic recording of this infection – not only for a realistic assessment of case numbers, but also for targeted prevention and education measures. The research team therefore calls for the existing reporting requirements to be consistently implemented and for surveillance systems to be established in countries where little data are currently available in order to monitor fox tapeworm specifically. In addition, it is necessary to raise awareness in the medical community and to standardise diagnostic standards across Europe.
Publication: The Lancet Infectious Diseases
Unveiling the incidences and trends of alveolar echinococcosis in Europe: a systematic review from the KNOW-PATH project.
Adriano Casulli PhD, Bernadette Abela, Daniele Petrone, Barbara Šobaf, Balázs Dezsényi, Jacek Karamon, Prof Laurence Millon, Prof Urmas Saarma, Daniela Antolová, Prof François Chappuis, Severin Gloor, Marcel Stoeckle, Prof Beat Müllhaupt, Relja Beck, Heimo Lagler, Felix Lötsch, Prof Herbert Auer, Prof Marie-Pierre Hayette, Prof Libuše Kolářová, Sniedze Laivacuma, Azzurra Santoro.
https://doi.org/10.1016/S1473-3099(25)00283-X