[Current problems of echinococcosis (Echinococcus multilocularis)].

Abstract

Alveolar echinococcosis is by far the most dangerous human parasitosis in Central Europe. For the one part this is due to the fact that the parasite is localised in the liver, and for the second part it is due to the infiltrative growth of the larval cestode tissue. The life cycle of echinococcus multilocularis takes place primarily between the fox as final host and mice as intermediate hosts. In this cycle, man is an accidental host and is infected orally via the intake of cestode eggs. The individual channels of infection and their frequency have so far only been subject to speculation. The infection rate of foxes is highest in the range of the Swabian mountain pastures (known as Schwäbische Alb) (up to 55 per cent), but recently values of more than 30% have been registered in the adjacent areas as well. No accurate data are available on the infection rate in humans; seroepidemiological data indicate a prevalence between 0.1 and 0.5 per thousand. IHA, IIFT and ELISA are the most frequently used methods in serodiagnostics of echinococcosis. The specific E. multilocularis antigen should be used instead of the commercially available E. granulosus antigen when examining patients for alveolar echinococcosis. In clinical diagnostics, sonography and especially CT are well tried. If the parasitic infestation is discovered early, radical surgery is the method of choice. Chemotherapy with mebendazole (e.g. Vermox) is still unsatisfactory despite improvements. Possibly an echinococcus therapy of foxes via baits containing praziquantel may be a possibility to minimize the transfer to the human organism.