Using appropriate words/expressions in the field of Echinococcosis: WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis, & French National Reference for Echinococcoses ; Besançon University Hospital & University Bourgogne Franche-Comté. Using appropriate words/expressions in the field of Echinococcosis: background, aim and method to reach this goal Dominique A. Vuitton, for the WAE ECHINOCOCCOSIS NOMENCLATURE GROUP

Background: history, geography and languages From Hippocrates to the 20th century, languages from Greek and Latin origin have served to name the parasites/diseases associated with Echinococcus spp. For historical reasons, German and Russian language, in the 19th century, and Chinese language, in the 20th century, have also ‘built’ words and expression Words and expressions used by English-speaking scientists and/or translated in English by scientists from other languages, have led to the emergence of ‘false-synonyms’ (different in the various endemic countries, because of the local language of the professionals) A lot of such ‘false-synonyms’ are currently found in the scientific literature, and are source of misunderstanding .

Background: the recent emergence of new species within the Echinococcus genus Progressive development of genetics and molecular biology techniques, and of their application to the epidemiology of Echinococcus spp. → coexistence of already defined species with ‘types’, ‘strains’, based on genetic characteristics → better definition of the limits of the species, on biological and genetic grounds → agreement on the definition and names of the ‘new’ species → the use of the newly defined species has not still definitely entered the practice of professionals → the delineation of the clinical presentation/course of disease associated with the various species is not so clear yet…

Hydatid disease Germinal layer Hydatid cyst Scolices Scoleces Cystic chinococcosis Laminated membrane Alveococcus Cyst Echinococcus veterinorum Echinococcus hominis Hydatid disease Alveolar echinococcosis Taenia echinococcus Daughter cyst Echinococcus multilocularis Germinal layer Echinococcus sibiricensis Echinococcus granulosus Hydatid cyst Pseudocystic Echinococcus cysticus Taenia echinococcus alveolaris Cystoid Taenia echinococcus multilocularis Echinococcus hydatidosis Chemotherapy Anti-infectious therapy Echinococcus multilocularis alveolaris Pericystectomy Cystectomy Anti-infective therapy Hydatid Hydatic Hydatid cyst

Why do we need to agree on common words/expressions in scientific communication/publication on echinococcosis? The use of a variety of words/expressions to designate the parasites, the diseases, the therapeutic interventions adds to the feeling of the ‘echinococcosis world’ as non-scientific/non-rigorous The multidisciplinary nature of the studies on Echinococcus spp. and their consequences in humans and animals has added to the simple ‘linguistic issue’ to create ‘false-synonyms’ and confusion The necessary cooperation of various disciplines within science and within medicine to solve the multiple problems of Echinococcus spp. infection (‘One-Health’ concept) makes the use of a common vocabulary crucial in the 21st century The World Association of Echinococcosis which includes all types of professionals involved in the study of echinococcosis seems to be legitimate for such an endeavor.

AIMS To provide a basis for discussion and decision on the accepted words/expressions in English to designate the parasites of the Echinococcus genus, and related diseases To reach a consensus after further scientifically- and/or historically- and/or linguistically-based discussion with the recognized specialists of each field To publish this consensus in an internationally indexed journal.

Proposed Method and Schedule At the 27th World Congress of Echinococcosis (Oct 4-7, 2017): Presentation of a list of ‘sensitive issues’ regarding words and expression commonly used in the scientific/medical literature on echinococcosis, with the ‘pros’ and ‘cons’ for their usage (based on etymology, history, biology, decision of international societies…), in three domains, Species nomenclature Parasite biology/immunology Clinical aspects. Constitution of working groups on each of the domains, on a voluntary basis.

Proposed Method and Schedule From Oct 7, 2017 to Dec 31, 2017: Email exchanges between the participants in the 3 working groups on the various words/expression to enrich the scientific/terminological basis for further decisions; Designation of a ‘writing committee’. End of Jan 2018: Decisions on the definitively accepted words/expressions

Proposed Method and Schedule Feb 1st, 2018 to Jun 30th, 2018: Preparation of the manuscript for the publication of the ‘WAE nomenclature on Echinococcus spp/Echinococcosis’ (provisional title, to be discussed) Jul 2018: Submission of the manuscript, with an expected publication within the year 2018 The editor-in-chief of PARASiTE accepted to waive the publication fees for this ‘position paper’ Impact Factor: 2.545

Reasons for acceptance Denomination of diseases Word/expression Definition Reasons for acceptance Reasons for rejection Denomination of diseases Echinococcosis (Plural: Echinococcoses) All diseases related to infection with parasites of the Echinococcus genus Recommended by the World Federation of Parasitologists (WFP) (i.e. name of the genus –osis) The English name of the World Association of Echinococcosis was modified in 2015 to follow this rule   Hydatidosis Disease related to infection with E. granulosus s.l. Historical name for the infection due to E. granulosus s.l. -not only Echinococcus spp develop ‘hydatids’; -does not fit with the unified recommendations of the WFP -when used wrongly for E. mutilocularis infection, increases the confusion of clinicians between the diseases due to E. granulosus s.l. and E. multilocularis respectively Hydatid disease Same definition as Hydatidosis Alternative historical name for the infection due to E. granulosus s.l. Id. Alveolar echinococcosis (Abbreviation: AE) Disease related to infection with E. multilocularis Widely used since the recognition of the disease in the 19th century Recommended by the WHO-Informal Working Group on Echinococcosis since the first ‘Guidelines’ (1996); -differentiates the disease due to E. granulosus s.l. and to E. multilocularis respectively easily -follows the recommendation of the WFP for the names of parasitic diseases Alveococcosis Historical name for the infection due to E. multilocularis in Russia/Russian language and Russia-related countries Not in use in other countries / languages than Russia / Russian Not conform to the recommendations of the WFP (name of species, not name of genus)

WAE Nomenclature Working Group And now? The frame for a complete list is available The various ‘pros’ and ‘cons’ should be completed The working group should be set up: Everybody is welcome (with a will to work!) Please write your name down on the appropriate board, at this congress, or get in touch with Dominique A. Vuitton or Antonio da Silva by email: dominique@drouhard.fr mensilvapt@yahoo.com WAE Nomenclature Working Group