page_title: Echinococcus multilocularis
section_title: Epidemiology
hierarchical_section_title: Echinococcus multilocularis / Epidemiology
caption_attribution_description: English: Figure 1 of paper. Distribution map by Province of Canadian hospital discharge data of Cystic Echinococcosis (CE), Alveolar Echinococcosis (AE), unspecified Echinococcosis and general liver diseases in Canada for the period 2001–2014. Data for Quebec were not available. Map by K. Berger, 2014.
context_page_description: Echinococcus multilocularis is a small cyclophyllid tapeworm found extensively in the northern hemisphere. E. multilocularis, along with other members of the Echinococcus genus, produce diseases known as echinococcosis. Unlike E. granulosus, E. multilocularis produces many small cysts that spread throughout the internal organs of the infected animal. The resultant disease is called Alveolar echinococcosis, and is caused by ingesting the eggs of E. multilocularis.
  The parasite is commonly maintained in a wildlife life cycle involving two mammalian hosts. Wild canids, dogs, and less commonly cats act as definitive hosts, harbouring the adult stage of the tape worm. Ingestion of a rodent containing alveolar hydatid cysts by a wild canid can result in a heavy infestation of tapeworms.
context_section_description: The incidence of human infestation with E. multilocularis and disease is increasing in urban areas, as wild foxes (an important reservoir species of the sylvatic cycle) are migrating to urban and suburban areas and gaining closer contact with human populations. Also, restocking fox enclosures for fox hunting with infected animals spreads the disease. Children, health care workers and domestic animals are at risk of ingesting the eggs after coming into contact with the feces of infected wild foxes. Even with the improvement of health in developed/industrialized countries, the prevalence of alveolar echinococcosis (AE) did not decrease. On the contrary, incidents of AE have now also been registered in eastern European countries and sporadic incidences in other European countries.
  The disease has extended its range in Europe in the last few decades. Still the infection is fairly rare. Between 1982 and 2000 a total of 559 cases were reported throughout Europe.
  Recent findings indicate that E. multilocularis is likely expanding its range in the central region of the United States and Canada and that invasions of European strains might have occurred; the endemic presence of the parasite in urban areas and a total of 16 human cases in Alberta, Canada have been reported. The first human case in Alberta was diagnosed in 2013. In one case, the infection caused a grapefruit sized tumour in the lung, kidney and diaphragm, which had to surgically removed. Because of the significant difficulty in diagnosising an infection caused by Echinococcus multiocularis, it is suspected that this parasite if often misdiagnosed. Several studies that have been done since the 1950s in North America and indicate a higher prevalance of Echinococcus multiocularis than previously thought. However, due to limited knowledge about the parasite, it is often not monitored in wild or domestic animals; this monitoring will become crucial to the control of the parasite in the future as it continues to spread.
caption: Epidemiology of Echinococcus multilocularis in Canada[12]
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