Ecology and epidemiology of Echinococcus multilocularis in Europe

Human alveolar echinococcosis (AE), caused by the larval stage of Echinococcus multilocularis has a high mortality rate in untreated patients. The life-cycle of E. multilocularis in Europe predominantly involves foxes as definitive hosts. However, experimental studies demonstrated a comparable biotic potential of E. multilocularis in dogs and raccoon dogs but an insignificant potential in cats. AE occurs in central and eastern Europe at low incidence rates. Recent studies in foxes have shown that E. multilocularis has a wider geographic range (including Italy) than previously thought. In recent years, increases in fox populations have been observed in many European countries, especially in urban areas. As a result, the E. multilocularis cycle is now established in the urban environment. This presents an increased risk of infection for a large human population. Based on these facts and new epidemiological data, possible intervention strategies are presented.     

Ecological and biological factors involved in the transmission of Echinococcus multilocularis in the French Ardennes

In order to identify the respective importance of the ecological and biological factors involved in the transmission of Echinococcus multilocularis, we estimated grassland vole intermediate host (Microtus sp. and Arvicola terrestris) population densities, in relation to the diet of the definitive host (red fox, Vulpes vulpes) and with the prevalence of E. multilocularis in the fox population. The study was conducted in the Ardennes, north-eastern France, which is an area with a high incidence of alveolar echinococcosis. Surface index methods showed that Microtus was the most abundant intermediate host in the area. Furthermore, Microtus was present in one-third of the 144 faeces and 98 stomach content samples examined and represented more than two-thirds of the rodent occurrences. Red fox predation on Microtus was significantly correlated with Microtus relative abundance. In contrast, the relative abundance of A. terrestris was very low. This species, as well as Clethrionomys glareolus and Apodemus sp., was little consumed. E. multilocularis prevalence in foxes was determined from carcasses and reached 53% (95% confidence interval 45-61%). Intensity of infection varied from 2 to 73,380 worms per fox, with 72% of the sampled worm burden harboured by 8% of the sampled foxes. The selected explanatory variables (sex, year, age class, health and nutritional condition, and season) failed to predict prevalence rate and worm burden. The high prevalence rate in foxes indicates the possibility of intense E. multilocularis transmission, apart from periods, or in landscapes, favourable to large population outbreaks of grassland rodents.     

Disappearance rate of praziquantel-containing bait around villages and small towns in southern Bavaria, Germany

In recent years, the red fox (Vulpes vulpes) has increasingly occupied urban areas in central Europe. Meanwhile, prevalence of infection in foxes with the small fox tapeworm (Echinococcus multilocularis) has increased, thereby increasing the human risk of infection with the parasite, which causes alveolar echinococcosis. Baiting strategies to counteract E. multilocularis have been implemented in cities and the open countryside, but there are few data on the situation in villages and small towns (<10,000 inhabitants). We recorded disappearance rates of praziquantel-containing bait within villages and small towns and on settlement edges for 7 days after distribution. Disappearance rates were 89.2% in villages, 88.8% in small towns, and 91.8% in settlement edges. More than 75% of the bait was consistently taken within the first three nights. There were no significant differences in disappearance rates between years or among seasons (Cox proportional hazard model). The survival time of the bait in small towns (P=0.021) and villages (P=0.026) depended on the zone (zone 1, first row of houses bordering on open countryside; zone 2, second to fourth rows, zone 3; beyond the fifth row) in which bait was distributed. In villages, the probability of bait being eaten in zone 1 was 119% higher than it was in zone 3 (P=0.007). In small towns, the probability was 60% higher (P=0.006).     

Echinococcus multilocularis: secondary poisoning of fox population during a vole outbreak reduces environmental contamination in a high endemicity area

This paper describes the role of fox population level on Echinococcus multilocularis infection in foxes in a highly endemic area in eastern France. Fox population level was monitored by spotlight survey at Le Souillot from 1989 to 2000, and from 1992 to 2000 at Chemin, a control site located in a low endemic area. The infection level of the fox population was estimated at Le Souillot from winter 1995 to winter 1999 using a coproantigen ELISA performed on faeces collected in the field. Population biomass of intermediate hosts (Microtus arvalis and Arvicola terrestris) was monitored using index methods from 1995 to 1999. At Le Souillot, a significant decline in the fox population level was recorded after spring 1997 (P<0.001), and the population level remained low until 2000. The decline occurred when 31% of the grassland area was treated with bromadiolone, an anticoagulant used at a large scale for the control of A. terrestris population outbreaks. No decline of population was recorded at Chemin, where bromadiolone was not used for rodent control. Significant differences among ELISA OD distributions in fox faeces were recorded for the five winters under study at Le Souillot (P=0.0004). The median of ELISA OD distribution was 0.209 and 0.207 before the population decline (winter 1995 and 1996, respectively), significantly increased to 0.306 just after the decline (winter 1997), and then significantly decreased to 0.099 and 0.104 afterwards (winter 1998 and 1999, respectively). Therefore, the decrease in infection level occurred during winter 1998, 1 year after the population decline, when the intermediate host biomass in the field was at its highest. These results suggest a complex dependence between the fox population level and E. multilocularis infection in a high endemicity area. Alternative ways to control fox population as a way to reduce E. multilocularis transmission in a given area are discussed.     

Evidence for an increasing presence of Echinococcus multilocularis in foxes in The Netherlands

Echinococcus multilocularis, a tapeworm causing alveolar echinococcosis which is considered a serious zoonosis known to affect humans, appears to be expanding its geographical range in Europe. We studied the emergence of the parasite in the European westernmost edge of its geographical distribution, based on two consecutive parasitological examinations of red foxes (Vulpes vulpes) sampled between 1996 and 2003 in The Netherlands. The average worm count increased from 2.6 worms per fox in the first surveillance to 16.6 worms per fox in the second. Using a mathematical model for a spatially spreading parasite, we found a strong indication that the parasite population is increasing in number and is spreading northward at the speed of 2.7 km per year. The reproduction number (R0), reflecting the parasite's transmission process, is estimated from the surveillance data and it is likely to be more than 1 but not exceeding a value of 4. We analysed a parasite control strategy by estimating the critical fox density for parasite elimination. We conclude that E. multilocularis is an emerging parasite in The Netherlands and thus in the western part of Europe. Control will be very difficult given the current high fox population density.     

Fox faeces and vole distribution on a local range: ecological data in a parasitological perspective for Echinococcus multilocularis

The completion of the life cycle of Echinococcus multilocularis needs a spatial overlap between intermediate host species (voles) and definitive host (fox) faeces. Factors influencing the importance of this overlap were investigated in north eastern France. Kilometric transects were walked to collect fox faeces and to estimate vole relative densities through surface indices. Habitat and climatic conditions were the strongest predictors of the number of faeces collected, while vole densities had no predictive power. Densities of both Microtus sp. and fox faeces were higher in medium-height vegetation edge. The consequences of such results to understand local transmission processes and human exposure are discussed.     

Role of dog behaviour and environmental fecal contamination in transmission of Echinococcus multilocularis in Tibetan communities

On the Eastern Tibetan Plateau region (Sichuan province, China) dogs are regarded as important definitive hosts of Echinococcus multilocularis. We studied dog spatial behaviour in 4 Tibetan villages in order to determine the role of dogs in environmental contamination and their potential interactions with small mammal intermediate hosts. We identified definitive host species and Echinococcus spp. infection status of feces collected in the field by PCR methods and analysed the spatial distribution of canid feces. Nocturnal space utilization of GPS collared dogs in and around villages was also undertaken. E. multilocularis DNA was amplified in 23% of dog feces (n=142) and in 15% of fox feces (n=13) but this difference was not significant. However, dog feces were more frequently observed (78% of collected feces) than fox feces and are therefore assumed to largely contribute to human environment contamination. Feces were mainly distributed around houses of dog owners (0-200 m) where collared dogs spent the majority of their time. Inside villages, the contamination was aggregated in some micro-foci where groups of dogs defecated preferentially. Finally, small mammal densities increased from the dog core areas to grasslands at the periphery of villages occasionally used by dogs; male dogs moving significantly farther than females. This study constitutes a first attempt to quantify in a spatially explicit way the role of dogs in E. multilocularis peri-domestic cycles and to identify behavioural parameters required to model E. multilocularis transmission in this region.     

Recurrent hepatic alveolar echinococcosis: report of the first case in Korea with unproven infection route

Human alveolar echinococcosis (AE), a hepatic disorder that resembles liver cancer, is a highly aggressive and lethal zoonotic infection caused by the larval stage of the fox tapeworm, Echinococcus multilocularis. E. multilocularis is widely distributed in the northern hemisphere; the disease-endemic area stretches from north America through Europe to central and east Asia, including northern parts of Japan, but it has not been reported in Korea. Herein, we represent a first case of AE in Korea. A 41-year-old woman was found to have a large liver mass on routine medical examination. The excised mass showed multinodular, necrotic, and spongiform appearance with small irregular pseudocystic spaces. Microscopically, the mass was composed of chronic granulomatous inflammation with extensive coagulation necrosis and parasite-like structure, which was revealed as parasitic vesicles and laminated layer delineated by periodic acid-Schiff (PAS) stain. Clinical and histologic features were consistent with AE. After 8 years, a new liver mass and multiple metastatic pulmonary nodules were found and the recurred mass showed similar histologic features to the initial mass. She had never visited endemic areas of AE, and thus the exact infection route is unclear.     

Echinococcosis: an emerging or re-emerging zoonosis?

The aim of this review is a critical discussion of factors actually or potentially contributing to persistence or emergence of echinococcosis in humans. Alveolar echinococcosis (AE), a life-threatening infection of humans, is caused by a larval stage of Echinococcus multilocularis. The adult parasite inhabits the intestine of foxes and other carnivores and has a wide distribution in the northern hemisphere (North America and northern and central Eurasia). Recent surveys in central Europe have extended the known geographical occurrence of E. multilocularis in foxes from four countries at the end of the 1980s to at least 11 countries in 1999. Cases of human AE previously regularly reported from only four countries are now recorded from seven countries, but the annual incidences are low. Since adequate information from earlier surveys is not available, it is not possible to conclude if the new findings reflect a recent extension of the parasite's range or just the first identification of hitherto unnoticed endemic areas. Evidence of parasite spreading has been reported from North America and Japan. Factors with the potential of enhancing the infection risk for humans in the future include increasing fox populations and parasite prevalences, progressing invasion of cities by foxes, the establishment of urban cycles of the parasite, and the spill-over of the E. multilocularis infection from wild carnivores to domestic dogs and cats. In view of the potential severity and fatality of AE in humans health authorities should initiate internationally coordinated countermeasures. Although control programmes against human cystic echinococcosis (CE), caused by E. granulosus, have been established in some countries and effective control strategies are available, the parasite has still a wide geographical distribution affecting many countries of all continents. Thus, human CE is persisting in many parts of the world with high incidences, and in some areas it is a re-emerging problem. For example, alarming increases of the number of human cases have been reported from Bulgaria and Kazakhstan, and the People's Republic of China. Progress in control can only be expected if health authorities attribute a higher priority to this disease and if all modern diagnostic and control options (for example vaccination of intermediate host animals) can be used.     

Lethal effects of freezing Echinococcus multilocularis eggs at ultralow temperatures

Methods for killing Echinococcus multilocularis eggs within stool or intestinal samples, without damaging the diagnostic value of the sample, would significantly reduce the risk of animal health providers acquiring alveolar hydatid disease. The first objective of this study was to determine whether E. multilocularis eggs located in fox intestines can survive storage at -70 C for at least 4 days. Results showed that none of 72,000 E. multilocularis eggs remained infectious to defined strains of mice under these conditions, yet, similar eggs recovered from nonfrozen carcasses stored at 4 C for the same time period were viable. The structural identities of adult worms and eggs were not significantly altered by the freezing and thawing processes. These results indicate that ultracold temperatures can be used to kill or inactivate E. multilocularis eggs, making them safe to handle when diagnosing this parasite in definitive hosts. The second objective of this study was to determine whether E. multilocularis eggs could survive freezing to -70 C if commonly used cryopreservation protocols were used. The use of the cryoprotectant solution, 5% dimethyl sulfoxide-35% saline-60% lamb serum, with a -1 C/min freezing rate was unable to prevent the eggs from being killed by freezing to -70 C. Rapid cooling by plunge freezing into liquid nitrogen was also lethal to E. multilocularis eggs. Only a few of the many potential cryopreservation protocols were tested in this study, so it is not yet possible to completely rule out the possibility of preserving these eggs at ultralow temperatures, but it does indicate that temperatures below -70 C are lethal to eggs even under favorable storage conditions.     

Fox Squirrel Survival in Urban and Rural Environments

Abstract A number of studies on mammalian species that have adapted to urban areas suggest survival may be higher for urban populations than rural populations. We examined differences in fatalities between an urban and rural population of fox squirrels (Sciurus niger). We radiocollared (n = 50 rural, n = 78 urban) fox squirrels during approximately 2 years. We found monthly survival of rural fox squirrels (Ŝ = 0.936) was lower than urban fox squirrels (Ŝ = 0.976) over the same 12-month period. Nonetheless, when comparing a 24-month period of survival data on urban squirrels with an 18-month period on the rural squirrels (periods overlapped for 12 months), survival rates were more similar between urban (Ŝ = 0.938) and rural squirrels (Ŝ = 0.945). Our data suggest that sex and season may influence survival of urban squirrels and not rural squirrels. We also found that cause of fatalities differed between the urban and rural squirrels, with >60% of fatalities on the rural site caused by predation. In contrast, <5% of the fatalities on the urban site were caused by predation and >60% of urban fox squirrel fatalities were caused by motor vehicle collisions. This study illustrates the need to advance our ability to understand, predict, and mitigate effects of urbanization on wildlife resources.     

Efficacy of Droncit Spot-on (praziquantel) 4% w/v against immature and mature Echinococcus multilocularis in cats

The causative agent of alveolar hydatidosis in humans, the fox tapeworm Echinococcus multilocularis, is extending its geographical range in Europe and has been found in domestic cats in some areas. A dermally applied cestocidal treatment for domestic cats has been developed and the efficacy of this treatment is reported. Thirty purpose-bred cats were experimentally infected each with 10000 protoscoleces of Echinococcus multilocularis. Ten days later one group of ten cats was treated with Droncit(R) Spot-on (Praziquantel) 4% w/v dermally in one place on the dorsal aspect of the neck at a dose of 8 mg/kg. Eleven days later (21 days p.i.) a second group of ten cats was also treated with Droncit(R) Spot-on the same way. One group of ten cats was left untreated as controls. Twenty three days after infection the cats were examined for the presence of E. multilocularis tapeworms. No E. multilocularis were recovered from any of the cats in either of the treated groups. Echinococcus multilocularis were recovered from eight of the ten cats left untreated as controls. The worm burdens in the untreated cats were 0, 0, 5, 15, 75, 110, 220, 815, 2635, and 3045 worms per cat. The worms ranged in development from the three to four segment stage. Many of the E. multilocularis with four segments contained unshelled eggs in the terminal segment. This study indicates that Droncit(R) Spot-on (Praziquantel) 4% w/v applied dermally at 8 mg/kg is highly effective in removing E. multilocularis from the small intestine of cats infected with immature and mature (prepatent) infections of E. multilocularis. In the cats with the mature infections all tapeworms were absent from the small intestine within 2 days of treatment.     

Habitat Use of Fox Squirrels in an Urban Environment

Abstract: Tree squirrels are one of the most familiar mammals found in urban areas and are considered both desirable around homes and, conversely, a pest. We examined fox squirrel (Sciurus niger) habitat use in inner city and suburban areas using radiotelemetry. We estimated habitat selection ratios at differing scales by season and fox squirrel activity. Telemetry data suggests that during periods of inactivity radiocollared fox squirrels (n = 82) selected 1) areas with greater tree canopy, 2) live oaks (Quercus fusiromis and Q. virginiana), and 3) trees with larger diameters and canopies. When inactive during the winter and spring, fox squirrels also preferred, within their core areas, to use the inside of buildings, and during periods of activity in the autumn and spring, fox squirrels preferred grassy areas. During periods of activity, fox squirrels avoided using pavement but did not exclude it from their core-area movements. Fox squirrels' ability to use buildings and to tolerate pavement in core-area movements make vast areas of the urban environment available to fox squirrels. In evaluating habitat variables that increased fox squirrel activity in urban areas, we found the number of large and medium trees, amount of pavement and grassy areas, canopy cover, number of oaks, and the area covered by buildings were all important factors in predicting fox squirrel activity in an urban environment. Our data suggests urban planners, animal damage control officials, wildlife managers, and landscapers who want to control urban fox squirrel populations through habitat manipulation should consider the reduction of oaks trees, a reduction of the canopy cover, and restricting the access of fox squirrels to buildings. Alternatively, home owners and squirrel enthusiasts hoping to bolster fox squirrel populations in urban areas should consider increasing the number of large mast—bearing trees and canopy cover and providing nest boxes.     

Infection of foxes by Echinococcocus multilocularis in urban and suburban areas of Nancy, France: influence of feeding habits and environment

This study evaluated the impact of biological and environmental factors on the infection of red foxes (Vulpes vulpes) by Echinococcus multilocularis in an endemic area of north-east France. From January 2004 to April 2006, 127 foxes were examined for E. multilocularis and their stomach contents analysed. The effect of year, season, age, sex and urbanisation level on E. multilocularis presence was estimated using a General Linear Model (GLM) with logit link, (i.e. logistic regression). Urbanisation level was the only influencing factor, with a decreasing gradient from rural [54%, CI 95% (40-68)] to peri-urban [31%, CI 95% (15-52)] and urban area [4%, CI 95% (0.7-15)]. The consumption of Arvicola terrestris and Microtus sp., grassland species, the main presumed intermediate hosts of E. multilocularis, was studied by the same approach. The two species were consumed less in the urban area and more in autumn than in spring. Anthropogenic food consumption was linked to urbanisation and to age. The frequency of anthropogenic food consumption decreased in the rural area. A global model explaining the presence of E. multilocularis and including urbanisation level and diet was then elaborated. Independently of urbanisation, there was a suggestion of less E. multilocularis infection with anthropogenic food consumption. Red foxes consuming Microtus sp. and A. terrestris had higher worm burden than those that did not. The results suggest that the decreasing gradient observed from rural to urban area is linked to behaviour and feeding habits.     

Echinococcus multilocularis--a zoonosis of anthropogenic environments?

Transmission of the fox tapeworm Echinococcus multilocularis, the causative agent of human alveolar echinococcosis, is known to depend on various environmental factors which are subject to human influence. Epidemiological data suggest that in most endemic regions anthropogenic landscape changes (e.g. deforestation and agricultural practices) have led to more favourable conditions for the parasite's animal hosts, especially arvicolid rodents, thereby increasing the risk for parasite transmission and human disease. Examples are the conversion of forests or crop fields into meadows and pastures in Europe, China and North America, and overgrazing of natural grassland in central Asia. Other anthropogenic factors include interference with host population densities by wildlife disease control, changing hunting pressure and provision of new habitats, e.g. in urban areas. Domestic dogs may, under certain conditions, get involved in the otherwise largely wildlife-based transmission, and thereby greatly increase the infection pressure to humans. The introduction of neozootic host species may increase transmission, or even initiate the parasite's life-cycle in previously non-endemic regions. Lastly, the parasite itself may be accidentally introduced into non-endemic areas, if suitable host populations are present (e.g. in northern Japan).     

Echinococcus multilocularis in north Italy

Alveolar echinococcosis is a zoonotic infection caused by the metacestode of the tapeworm Echinococcus multilocularis. Fox populations living in the Alpine regions of Italy had been considered free from this parasite until 2002, when two infected foxes were detected in Bolzano province (Trentino Alto Adige region) near Austrian border. A modified nested PCR analysis was used to detect E. multilocularis DNA in faecal samples belonging to red fox populations from five Italian regions. A total of 522 faecal samples were analysed from foxes shot in Valle d'Aosta (N = 65), Liguria (N = 44), Lombardy (N = 105), Veneto (N = 67), and Trentino Alto Adige (N = 241) regions. Among these, 24 samples, all from the Trentino Alto Adige region, were found positive. Moreoever, 1406 faecal samples of red foxes were analyzed by CA-ELISAs commercial test kit. This paper provides an update of the epidemiological knowledge of this parasite in north Italy.     

Epidemiology of alveolar echinococcosis in southern Cantal, Auvergne region, France

Alveolar echinococcosis (AE) is a helminth zoonosis which is encountered only in the northern hemisphere. In central France, the Auvergne region represents the most western and southern extension of this helminthiasis. In 1999, a human case of AE was diagnosed in the southern part of the Cantal department, where AE was supposed absent, and an epidemiological survey was subsequently carried out. The transmission of the zoonosis in the sylvatic and peridomestic definitive hosts was studied, as well as that in the rodent and human intermediate hosts. Eleven red foxes (Vulpes vulpes) were shot, and 50 fox faecal deposits were collected. Twelve farm dogs had their faeces taken by rectal touch, and four were checked after arecoline purgation. Optical detection of Echinococcus multilocularis worms was achieved on fox intestines after scraping, and also on dog stools after arecoline therapy. Coproantigen ELISA assay was performed for the 11 scraping products, for the 50 fox faeces, and for the 12 dog faecal samples. No adult AE agent was observed by microscopy, and the ELISA assay yielded positive results in one of 11 fox intestines, one of 50 fox faeces, and 2 of 12 dog faecal samples. Twenty-five small mammals were trapped, of which 19 were Arvicola terrestris water voles. One rodent liver exhibited a hepatic lesion consistent with AE. An epidemiological questionnaire was completed in 85 human volunteers, who were also serologically tested for AE. Only one (the case's husband) exhibited a Western-blotting pattern indicative of a low-grade AE infection. The results of this preliminary study suggested a slow AE extension to the south of Cantal department from the northern focus.     

Rabies in urban foxes (Vulpes vulpes) in Britain: the use of a spatial stochastic simulation model to examine the pattern of spread and evaluate the efficacy of different control régimes.

The threat of rabies being reintroduced into Britain is probably greater now than at any time over the last 60 years. This threat is reviewed with particular regard to the problems that would be posed should rabies be introduced to the high-density fox populations found in many cities in southern England. Computer models can provide a valuable means of understanding the pattern of rabies spread in fox populations and the likely problems of control, so the construction of previous rabies models was reviewed. None were found to be suitable for analysing the particular problems posed by high-density, spatially heterogeneous, urban fox populations. Therefore, a new spatial stochastic simulation model was produced, based on demographic and other data collected during a long-term study on the urban fox population in Bristol, and fox density data collected from a number of cities in southern England. The simulation model was used to analyse the effects of spatial heterogeneity in the fox population on the pattern of rabies spread. Simulations were then used to evaluate the effects of: (i) varying levels of fox control; (ii) changing the size of the control zone; (iii) the onset of the rabies epizooty at different times of the year: and (iv) delay before the commencement of control on the chances of containing the disease. These simulations were run for four cities (Bournemouth and Poole, Bristol, Leicester and the West Midlands conurbation) with different mean fox population densities. It was found that the variance in the monthly velocity of the rabies front was greater for heterogeneous fox populations. In cities with high fox densities, low or moderate levels of control were unsuccessful in containing the disease, but these urban areas had the highest rates of success with the highest levels of control. A three-month delay in the commencement of a rabies control campaign on average reduced the chance of successfully controlling the disease by 10-20%, although this was higher in lower-density fox populations. Rabies outbreaks in the dispersal period were on average 10% less likely to be contained. Increasing the size of the control zone increased the chances of successfully containing the disease, although this effect was density dependent, so the effect was less in low-density fox populations. These results are discussed in relation to the current rabies contingency plans for British urban areas.     

Protective immune mechanisms against the metacestode of Echinococcus multilocularis

Infection with the larval stage of the fox tapeworm Echinococcus multilocularis results in a life-threatening hepatic disease concerning humans and intermediate rodent hosts. Immunoepidemiological surveys provided information that a large proportion of infected individuals may demonstrate either constitutional resistance to early post-oncospheral development of the parasite or late resistance to disease by exhibiting an intrahepatic died-out parasite lesion. Similar events have been found in secondary infections of laboratory rodents. Dissection of humoral and cell-mediated immune responses in susceptible versus resistant individuals provides insight into immunological pathways associated with the different outcome of infection. Survival strategy of the metacestode obviously focuses on the crucial role played by the parasite laminated layer. This layer protects the metacestode from host effector mechanisms which can potentially kill the proliferating germinative compartments in case of resistant hosts. Bruno Gottstein and Richard Felleisen here discuss the need to search for more parameters discriminating between the different immune pathways in order to find out (immunogenetic?) predispositions responsible for the respective phenomena.     

Fears,attitudes and opinions of suburban residents with regards to their urban foxes

Throughout Central Europe, foxes have taken over urban areas as their habitat. In Southern Germany, these foxes are also carriers of the small fox tapeworm, which causes a serious zoonotic infection in humans. Therefore, a survey was carried out in a suburb of the city of Munich. A postal questionnaire was used to analyse the attitudes, opinions and fears of these participants towards their urban foxes and the background to these attitudes. Questionnaires were sent to all households with gardens and collected in again via the community council. Seven hundred and seventy-nine or 31% of questionnaires were returned. Only a few people are afraid of the fox itself; however, 55% are afraid of the fox tapeworm. Worming the animals is the preferred counter-measure, with 81% in favour. The majority of inhabitants are pleased to see a fox in the community and feel the animals have a right to live. People are afraid of the tapeworm either because they have children in the household or because of increased knowledge of the subject or because it has increasingly become an issue. On the basis of the results of this study, it is to be expected that radical solutions such as killing the foxes are unlikely to be accepted among the population. Worming of the foxes does, however, meet with general approval.