title: Human echinococcosis mortality in the United States, 1990-2007.
abstract: BACKGROUND
  Despite the endemic nature of Echinococcus granulosus and Echinococcus multilocularis infection in regions of the United States (US), there is a lack of data on echinococcosis-related mortality. To measure echinococcosis-associated mortality in the US and assess possible racial/ethnic disparities, we reviewed national-death certificate data for an 18-year period.
  
  
  RESULTS
  Echinococcosis-associated deaths from 1990 through 2007 were identified from multiple-cause-coded death records and were combined with US census data to calculate mortality rates. A total of 41 echinococcosis-associated deaths occurred over the 18-year study period. Mortality rates were highest in males, Native Americans, Asians/Pacific Islanders, Hispanics and persons 75 years of age and older. Almost a quarter of fatal echinococcosis-related cases occurred in residents of California. Foreign-born persons accounted for the majority of echinococcosis-related deaths; however, both of the fatalities in Native Americans and almost half of the deaths in whites were among US-born individuals.
  
  
  CONCLUSIONS
  Although uncommon, echinococcosis-related deaths occur in the US. Clinicians should be aware of the diagnosis, particularly in foreign-born patients from Echinococcus endemic areas, and should consider tropical infectious disease consultation early.
authors.affiliation: Los Angeles County Department of Public Health, Los Angeles, California, United States of America. benbristowmd@gmail.com
authors.forename: Benjamin N
authors.initials: BN
authors.lastname: Bristow
authors.forename: Sun
authors.initials: S
authors.lastname: Lee
authors.forename: Shira
authors.initials: S
authors.lastname: Shafir
authors.forename: Frank
authors.initials: F
authors.lastname: Sorvillo
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004443:Echinococcosis / Q000401:mortality*; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D055815:Young Adult