title: Human alveolar echinococcosis in Poland: 1990-2011.
abstract: BACKGROUND
  Alveolar echinococcosis (AE) caused by Echinococcus multilocularis infections is a dangerous old disease in the Northern Hemisphere. The aim of the paper was to collect and analyze data on human AE in Poland in the last two decades.
  
  
  RESULTS
  The sources of data were both the cases officially registered and detected by an active field and laboratory surveillance. The cases were verified by clinical, epidemiological, and laboratory criteria. Altogether 121 human cases of AE were detected. Among these 83 (68,6%) cases were classified as confirmed, 16 as probable and 22 as possible. During the two decades a continuous increase in detection rate was noticed. The cases were 6-82 years old at the time of diagnosis (mean - 47.7 years). Sex ratio M/F was 0.86/1.0. The AE was fatal in 23 (19%) patients (mean age at death - 54.1 years). Family agglomeration of AE was found in 4 foci, involving 9 patients. Seventy six of the cases were diagnosed in an advanced stage of disease. In all cases the liver was the primary location of AE. In 30 (24.8%) patients a spread to other organs was observed. Ninety four of the patients were treated with albendazole. In 73 (60%) patients a surgical operation was performed, including 15 liver transplantations.
  
  
  CONCLUSIONS
  The studies confirmed that AE is an emerging disease in Poland, which is the fourth country in Europe with over 120 cases detected. The results also indicate the need of a wider national programme for implementation of screening in the highest AE risk areas (north-eastern Poland) with an effort to increase the public awareness of the possibility of contracting E. multilocularis, and above all, training of the primary care physicians in the recognition of the risk of AE to allow for an early detection of this dangerous disease.
authors.affiliation: Department of Tropical and Parasitic Diseases, Chair of Tropical Medicine and Parasitology, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Gdynia, Poland. wnahorski@gumed.edu.pl
authors.forename: Wacław L
authors.initials: WL
authors.lastname: Nahorski
authors.forename: Józef P
authors.initials: JP
authors.lastname: Knap
authors.forename: Zbigniew S
authors.initials: ZS
authors.lastname: Pawłowski
authors.forename: Marek
authors.initials: M
authors.lastname: Krawczyk
authors.forename: Jerzy
authors.initials: J
authors.lastname: Polański
authors.forename: Jerzy
authors.initials: J
authors.lastname: Stefaniak
authors.forename: Waldemar
authors.initials: W
authors.lastname: Patkowski
authors.forename: Beata
authors.initials: B
authors.lastname: Szostakowska
authors.forename: Halina
authors.initials: H
authors.lastname: Pietkiewicz
authors.forename: Anna
authors.initials: A
authors.lastname: Grzeszczuk
authors.forename: Iwona
authors.initials: I
authors.lastname: Felczak-Korzybska
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Gołąb
authors.forename: Natalia
authors.initials: N
authors.lastname: Wnukowska
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Paul
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Kacprzak
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Sokolewicz-Bobrowska
authors.forename: Jolanta
authors.initials: J
authors.lastname: Niścigorska-Olsen
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Czyrznikowska
authors.forename: Lidia
authors.initials: L
authors.lastname: Chomicz
authors.forename: Danuta
authors.initials: D
authors.lastname: Cielecka
authors.forename: Przemysław
authors.initials: P
authors.lastname: Myjak
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002648:Child; D021821:Communicable Diseases, Emerging / Q000453:epidemiology / Q000469:parasitology / Q000473:pathology; D004443:Echinococcosis; D004444:Echinococcosis, Hepatic / Q000453:epidemiology* / Q000469:parasitology / Q000473:pathology; D048210:Echinococcus multilocularis / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D017678:Sex Distribution; D016019:Survival Analysis; D055815:Young Adult