title: Human alveolar echinococcosis after fox population increase, Switzerland.
abstract: We analyzed databases spanning 50 years, which included retrospective alveolar echinococcosis (AE) case finding studies and databases of the 3 major centers for treatment of AE in Switzerland. A total of 494 cases were recorded. Annual incidence of AE per 100,000 population increased from 0.12-0.15 during 1956-1992 and a mean of 0.10 during 1993-2000 to a mean of 0.26 during 2001-2005. Because the clinical stage of the disease did not change between observation periods, this increase cannot be explained by improved diagnosis. Swiss hunting statistics suggested that the fox population increased 4-fold from 1980 through 1995 and has persisted at these higher levels. Because the period between infection and development of clinical disease is long, the increase in the fox population and high Echinococcus multilocularis prevalence rates in foxes in rural and urban areas may have resulted in an emerging epidemic of AE 10-15 years later.
authors.affiliation: Institute of Parasitology, University of Zurich, Zurich, Switzerland.
authors.forename: Alexander
authors.initials: A
authors.lastname: Schweiger
authors.forename: Rudolf W
authors.initials: RW
authors.lastname: Ammann
authors.forename: Daniel
authors.initials: D
authors.lastname: Candinas
authors.forename: Pierre-Alain
authors.initials: PA
authors.lastname: Clavien
authors.forename: Johannes
authors.initials: J
authors.lastname: Eckert
authors.forename: Bruno
authors.initials: B
authors.lastname: Gottstein
authors.forename: Nerman
authors.initials: N
authors.lastname: Halkic
authors.forename: Beat
authors.initials: B
authors.lastname: Muellhaupt
authors.forename: Bettina Mareike
authors.initials: BM
authors.lastname: Prinz
authors.forename: Juerg
authors.initials: J
authors.lastname: Reichen
authors.forename: Philip E
authors.initials: PE
authors.lastname: Tarr
authors.forename: Paul R
authors.initials: PR
authors.lastname: Torgerson
authors.forename: Peter
authors.initials: P
authors.lastname: Deplazes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002648:Child; D004444:Echinococcosis, Hepatic / Q000453:epidemiology* / Q000635:transmission; D048210:Echinococcus multilocularis / Q000472:pathogenicity; D005589:Foxes / Q000469:parasitology*; D006790:Host-Parasite Interactions; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012424:Rural Population; D013557:Switzerland / Q000453:epidemiology; D014505:Urban Population; D015047:Zoonoses