Risk Factors and the Character of Clinical Course of the Echinococcus multilocularis Infection in Patients in Poland

Abstract

Alveolar echinococcosis (AE) is a chronic zoonotic disease caused by the larval form of Echinococcus multilocularis. In humans, it may become a serious chronic infection of the liver which resembles a slow malignant process leading to death when untreated. The aim of the study was an assessment of the risk factors of the E. multilocularis infections and the description of AE clinical course in the group of 36 patients with confirmed AE, hospitalized at the Department and Clinic of Tropical and Parasitic Diseases, Poznan University of Medical Sciences between 2013 and 2022. Among the study participants, most patients cultivated land, bred livestock, worked in the forest, or were employed in animal shelters. The E. multilocularis infection was diagnosed based on imaging and immunoassay techniques within 6 months in the majority of patients hospitalized in the Department. All patients hospitalized in the Department initiated anti-parasitic therapy at the moment of the diagnosis. Pharmacological treatment combined with surgery was applied in most of the study participants, who were presented with more advanced stages of infection. We conclude the following: 1. For humans in the risk group, regular abdominal imaging examinations and the detection of specific antibodies against E. multilocularis are recommended. 2. Regular screening tests in the hyperendemic areas of AE would increase the early detection of the disease and to improve the clinical prognosis in this extremely life-threatening parasitic disease.

Keywords: alveolar echinococcosis; clinical course; diagnosis; epidemiology; human alveolar echinococcosis; parasitic disease.

Figure 1

Study participants age at the time of diagnosis, with alveolar echinococcosis from Poland between 2013 and 2022.

Figure 2

Geographic origin of alveolar echinococcosis patients from Poland between 2013 and 2022. The number of patients infected with E. multilocularis currently living in this area/the number of study participants born in this area. A—West Pomerania, B—Warmian-Masurian region, C—Podlaskie region, D—Masovia, E—Lubuskie region, F—Greater Poland, G—Łódź region, H—Silesia, I—Lesser Poland, J—Subcarpathian region.

Figure 3

The period of time when the final diagnosis of alveolar echinococcosis has been documented in patients from Poland between 2013 and 2022.

Figure 4

The size of lesion in the liver at the time of diagnosis of alveolar echinococcosis in patients from Poland between 2013 and 2022.