Cystic echinococcosis in Sardinia: the current role of sheep

Cystic echinococcosis is one of the most widespread parasitosis in the Mediterranean region. Unfortunately this is also true for Sardinia for various reasons, among which is the close relationship between sheep and dogs in the farms. This work first epidemiologically analyses hydatidosis in sheep in Sardinia and then examines the most important causes of the persistence of these metacestodosis in sheep. The work looks at the factors which are responsible for the enormous quantity of illegal slaughtering and the widespread habit of abandoning the sheep carcasses in the grazing areas, as well as possible initiatives which may eliminate these practices. Such initiatives must include reducing the financial costs and bureaucracy involved when sheep are slaughtered in abattoirs, and also increasing the value of sheep meat. In conclusion new checks and controls are hoped for at a political level which will increase the financial support for the farmers and encourage the use of recombinant vaccines which have already been tested in Sardinia. These are extremely useful for effectively curbing cystic echinococcosis.     

Cystic echinococcosis: progress and limits in epidemiology and immunodiagnosis

This study discusses the epidemiology and immunodiagnosis of cystic echinococcosis (caused by Echinococcus granulosus). Despite the development of molecular methods to prepare antigens, nowadays there is no standard, highly sensitive, and specific test available for antibody detection in cystic echinococcosis. Furthermore, because serological tests can give only a limited support to clinical findings there is a clear need for new advances in immunodiagnosis of E. granulosus infection.     

Cystic echinococcosis in Greece. Past and present

Cystic echinococcosis is a zoonotic disease with a wide geographical distribution, Greece included, and is considered to be a serious problem for the public health and the livestock economy. Although the disease was widespread in Greece since ancient times, cystic echinococcosis was identified as a serious problem around 1970, and since then national surveillance programmes are running, based on meat inspection and stray dogs management. Ever since, there are official records of the parasite's prevalence in humans and livestock which show a continuous decline. More precisely, human hydatidosis, according to the official records, declines from an annual incidence of 14.8 per 100,000 inhabitants during 1967-1971 to 0.3 in 2008. Late surveys reveal that in Greece the prevalence of echinococcosis was 23-39.2% for sheep, 7.6-14.7% for goats, 0% in cattle and 0.6% in pigs, while further molecular analyses in Southern Greece showed the existence of the genotypes G1 and G3 in sheep and G7 in goats in that area. All data presented demonstrate that the parasite is still present in Greece. Surveillance is nowadays being performed under EU regulations but it is highly important to improve and adopt corrective and preventive measures to avoid animal and human infection.     

Cystic echinococcosis and the Mediterranean Region: a long-lasting association

Cystic echinococcosis (CE) is an important zoonosis in Italy and in the whole Mediterranean Region, as confirmed by the work by Ettore Biocca, whose contributions to the subject are reported in a summarised annex to the bibliography. The contribution to the understanding and control of CE are presented, with special emphasis on the socio-economic impact, on factors affecting the maintenance of CE in the Mediterranean Region, on the epidemiological situation and control measures, on the present status of epidemiological surveillance, on the control problems in normal and emergency situations, on health education and training. Also, the justifications of combined control programmes are discussed, which may be applied only in situations of peace and well-being.     

Natural history of cystic echinococcosis in humans

This study provides a contribution to understanding of the natural history of the hydatid cyst during its evolution in the human liver examining the high morphostructural variability of larval forms of Echinococcus granulosus. A detailed study of a large sample of intact cysts removed from patients surgically treated by means of total pericystectomy, has enabled to outline the different developmental stages of the parasite over time, up to its death and complete degeneration.     

Cystic echinococcosis in Italy from the 1950s to present

In Italy the epidemiological pattern of cistic echinococcosis (CE) is incomplete and the information for most regions is out of date, contradictory, and almost exclusively limited to the intermediate hosts. The disease is found most frequently in particular social and economic conditions: widespread use of extensive or semi-extensive sheep farming, illegal slaughtering, and high numbers of sheepdogs and other types of dogs. The highest incidence in sheep is found in Sardinia (70.6-92.8%), Sicily (6.5-36.5%), Basilicata (5-28%), Abruzzo (22%) and Tuscany (47%). It North Italy, it is never higher than 0.5% in slaughtered sheep. No data are available on the biomolecular characterization of the strains of E. granulosus in Italy, apart from Sardinia and recently Lazio. G1 (Sheep strain), G7 (Pig strain) G2 (Tasmanian sheep strain) have been identified in Sardinia and G1 and G3 (Buffalo strain) have been recently isolated in Lazio. In Italy, CE has was also found in buffaloes (2.63-9.8%) and horses (<1%). However, further epidemiological surveys and genotyping study are necessary. The small quantity of up to date information on the diffusion of E. granulosus in dogs (Abruzzo 4%, Sardinia 6-10% and Sicily 19.3%) highlights the need for modern, fast, sensitive and low risk diagnostic methods which would provide a true picture of the pattern of the infection in this host.     

Cystic echinococcosis of lung and heart coupled with repeated echinococcosis of brain--a case report

Echinococcosis is rarely encountered as a cystic brain disease. In this article we are presenting a case of a young woman repeatedly operated due to echinococcosis of lung, heart and brain. Recurrent brain ecchinococcosis developed despite preoperative and postoperative albendazol therapy after first and combined therapy with albendazol and praziquantel after the second brain surgery. The mechanism of recurrence remains unclear (primary infestation, dissemination after spontaneous or intraoperative cyst rupture or new infestation).     

Cystic echinococcosis of the pelvic bone with recurrences: a case report

Hydatid cysts commonly affect the liver and the lung. However, they rarely involve bones with vertebral column. We hereby report a case of a female patient with cystic echinococcosis of the hip bone and ilium. She presented with a long history of frequent recurrences highlighting the dismal prognosis at this rare site. Resection of the hydatid cyst from the sacroiliac region was done with allograft and autograft (rib graft) with lumbosacroiliac fixation. Follow-up of the patient at 6 months showed no detectable abnormality on radiology and the patient was doing well.     

Cystic echinococcosis in Spain: current situation and relevance for other endemic areas in Europe

Cystic echinococcosis (CE) remains an important health problem in many regions of the world, both where no control measures have been implemented, and where control programs have been incompletely successful with ensuing re-emergence of the disease. In Spain, official data on CE show an increase in the proportion of intermediate hosts with CE during the last few years, and autochthonous pediatric patients have been reported, a sign of active local transmission of disease. A similar picture emerges from data reported to the European Food Safety Authority by other European countries. Nevertheless, several crucial aspects related to CE that would help better understand and control the disease have not been tackled appropriately, in particular the emergence of infection in specific geographical areas. In this respect, while some data are missing, other data are conflicting because they come from different databases. We review the current situation of CE in Spain compared with areas in which similar problems in the CE field exist, and offer recommendations on how to overcome those limitations. Specifically, we believe that the introduction of national registries for CE with online data entry, following the example set by the European Registry for Alveolar Echinococcosis, would help streamline data collection on CE by eliminating the need for evaluating and integrating data from multiple regions, by avoiding duplication of data from patients who access several different health facilities over time, and by providing much needed clinical and epidemiological data that are currently accessible only to clinicians.     

Critical points in the immunodiagnosis of cystic echinococcosis in humans

This study discusses the immunodiagnosis of cystic echinococcosis (ce, caused by Echinococcus granulosus). The detection by immunoblotting of antibodies specific for the 8 kDa subunit of antigen B and in particular the IgG4 subclass expression, seems the most promising serodiagnostic tool. Despite the development of molecular methods, nowadays there is no standard, highly sensitive, and specific test available for antibody detection in CE. Furthermore, because serological tests can give only a limited support to clinical findings there is a clear need for new advances in immunodiagnosis of E. granulosus infection.     

Molecular diagnosis of cystic echinococcosis in humans from central Poland

The identity of the causative agent of cystic echinococcosis (CE) in humans from central Poland receiving treatment between 2000 and 2010 was determined. A total of 47 samples obtained after hepatectomy were examined and protoscoleces were identified in wet preparations in 27 cases. Using DNA extracted from the samples, two mitochondrial regions (nad1 and cox1 genes) were amplified and the nad1 fragment was sequenced. This PCR analysis confirmed the presence of Echinococcus species in 30 cases and nad1 sequence alignments showed identity with the G7 (pig) strain, Echinococcus canadensis. These data demonstrate that the pig strain of this parasite is the most frequent causative agent of human cystic echinococcosis in central Poland.     

Carcinoembryonic antigen: 3 years' experience in a cancer clinic.

Long-term studies on multiple plasma samples of 988 patients with carcinoma of entodermal origin indicate that, especially for patients with colorectal cancer, repeatedly elevated or rising carcinoembryonic antigen (CEA) values are a sign of poor prognosis when found preoperatively, postoperatively or during chemotherapy. Persistently elevated CEA values in postoperative patients apparently free of disease are a useful marker for early detection of recurrence or metastases. Normal CEA values are of little or no prognostic value.     

Cozart Rapiscan system: our experience with saliva tests

International literature has devoted many contributions to the evaluation of alternative biological matrices (such as saliva) as diagnostic tools in drug testing. The immunoassay Cozart Rapiscan saliva drug system, has been studied in recent years. In the present paper we report our experience with saliva collection and the quali-quantitative determination of drugs of abuse. Fifty-nine saliva samples were collected by the Cozart Rapiscan pad. Qualitative analyses were carried out by Cozart Rapiscan System and the results were confirmed by a solid-phase microextraction-GC-MS technique. Quantitative determinations were performed for methadone and its metabolite by GC-MS technique. The Cozart System provides collection and transfer procedures more easily than other systems, requiring minimal operator intervention.     

Cystic fibrosis typing with DNA probes: experience of a screening laboratory

Summary A sample of 125 individuals from 37 British cystic fibrosis (CF) families with at least one living affected child were typed with probes for restriction fragment length polymorphisms (RFLPs) known to be linked to the CF gene. These probes were MetD, MetH, pJ3.11 and 7C22. Using this combination of probes, 30 out of the 37 families were sufficiently informative to enable prenatal diagnosis of the disease. Linkage analysis has also proved to be useful in excluding CF in two cases where diagnosis of the disease was equivocal in the sibling of an affected child.