Human Cystic Echinococcosis: A Neglected Zoonotic Public Health Problem in Pakistan.

Abstract

This review represents an updated scenario on the epidemiology, transmission cycle, diagnosis and treatment surveillance and one health approach of a cestode parasite Echinococcus granulosus (E. granulosus) infection causing cystic echinococcosis (CE) in humans. It is life-threatening neglected zoonotic disease that occurs in both developed and developing countries including Pakistan and is recognized as a major public health problem. It spread through infected feces of canids and is associated with high morbidity and mortality. In Pakistan, rural lifestyle supports spread of the disease and it often presents with complications posing a high treatment cost. The life cycle of E. granulosus involves a definitive host (dogs and other canids) for the adult E. granulosus that resides in the intestine and an intermediate host (sheep and other herbivores) for the tissue-invading metacestode (larval) stage. Humans are only incidentally infected; since the completion of the life cycle of E. granulosus depends on carnivores feeding on herbivores bearing hydatid cysts with viable protoscoleces, humans represent usually the dead end for the parasite. Community awareness, mandatory reporting and responsible pet ownership are recommended for elimination of the disease.

Key words: Human Cystic Echinococcosis, diagnosis and treatment.