1. ABDI RAHMAN GULAID ECHINOCOCCUS (GRANULOSUS AND MULTILOCULARIS )

2. INTRODUCTION Echinococcosis :  Echinococcosis commomly known as Hydatid Disease or Hydatidosis, is caused by a parasitic cestodes (tapeworms) of the genus Echinococcus.

3.  Four species of Echinococcus cause infection in humans are:  E. granulosus causes cystic echinococcosis  E. multilocularis causes alveolar echinococcosis  E. vogeli causes polycystic echinococcosis  E. oligarthrus is an extremely rare cause of human echinococcosis.

4. THE GEOGRAPHIC DISTRIBUTION  Echinococcus granulosus is widely distributed across Canada and more frequent in rural, grazing areas.  Echinococcus multilocularis occurs in the northern hemisphere, including central Europe and the northern parts of Europe, Asia, and North America.  E. vogeli and E. oligarthrus occur in Central and South America.

5. SizeDefinitiveIntermediate E. granulosus Usually 3 to 6 mm long and consist of a scolex with suckers and hooks, as well as at least three proglottid segments. Adult worm : (adult worm): wolves, coyotes, domestic dogs Larval worm: Sheep, Goat, Camel, cattle, Goat, and Horse. E. Multiloculari s 1.2-3.7 mm long with two to six proglottic segments. Adult worm: Arctic and red foxes, coyotes, sometimes domestic dogs and cats. Larval worm: rodents (voles, mice, muskrats). Humans E.GRANULOSUS HOST & E.MULTILOCULARIS HOST

6. TRANSMISSION AND LIFE CYCLE OF ECHINOCOCCUS The Hydatid Tapeworm Life Cycle Diagram 1. Adult worm present in intestine of definitive host 2. Eggs passed in feces, ingested by humans or intermediate host 3. Onchosphere penetrates intestinal wall, carried via blood vessels to lodge in organs 4. hydatid cysts develop in liver, lungs, brain, heart 5. After ingestion, the protoscolices attach to the intestine. 6. Ingested protoscolices attach to small intestine and develops into adult worm and the cycle starts all over again.

7. LIFECYCLE:

8. ECHINOCOCCUS EGG IN FECES

9. SYMPTOMS E. granulosus Can remain silent for years It is the enlarging cysts that cause symptoms in organs Hepatic involvement (75%) (abdominal pain, mass in the hepatic area, biliary duct obstruction) Pulmonary involvement (chest pain, Cough, hemoptysis) Brain, bone, and heart (10-20%) Rupture of cyst (fever, hives, pus, anaphylactic shock, and the cyst spreads throughout body cavity) E. multilocularis Affects the liver as a slow growing destructive tumor Abdominal pain, biliary obstruction, and sometimes metastatic lesions in lungs and brain are common symptoms

10. A SECTION OF HUMAN LUNG SHOWS MULTIPLE PROTOSCOLECES LIBERATED FROM A RUPTURED HYDATID CYST

11. E. MULTILOCULARIS SIGNS AND SYMPTOMS OF ALVEOLAR HYDATID DISEASE  No early symptoms  Cysts in multiple body organs  Symptoms of liver infestation: upper abdominal pain, weakness, weight loss, chest pain, cough, coughing blood, jaundice  Symptoms of brain infestation:  Blindness  Epilepsy  Symptoms of ruptured cysts:  Allergic rash  Fever

12. DIAGNOSIS Imaging (CT, MRI, and ultrasound) Serologic testing (enzyme immunoassay, immunofluorescent assay) Examination of cyst fluid Protoscoleces in a hydatid cyst removed from lung tissue

13. TREATMENT  Surgical removal via laparoscopy, can be curative for the treatment of echinococcosis  Medication is sometimes effective to keep the cyst from growing back  Praziquantel for definitive host (dog)  Albendazole, mebendazole intermediate host (sheep, other host)

14. REMOVAL BY SURGERY

15. CONTROL METHOD interrupt lifecycle by an possible means. Destroy stray dogs General education program Sheep herders should not live closely with their dogs

16.  - Center of Disease Control. http://www.dpd.cdc.gov/dpdx/html/Echinococcosis.htm  - journals.cambridge.org/production/action/cjoGetFulltext?fulltex td... by JD SMYTH - 1964 - Cited by 64 - Related articlesCited by 64Related articles  - www.sciencedirect.com/science/article/pii/0166685185900167 by DP McManus - 1985 - Cited by 42 - Related articleswww.sciencedirect.com/science/article/pii/0166685185900167Cited by 42Related articles  - www.springerlink.com/index/MD4LQW968V6TUBPE.pdf by CP Nunes - 2004 - Cited by 12 - Related articles www.springerlink.com/index/MD4LQW968V6TUBPE.pdfCited by 12Related articles  http://www.fao.org/docrep/t1300t/t1300T0m.htm by A. Permin and J.W. Hansen http://www.fao.org/docrep/t1300t/t1300T0m.htm SOURCES