title: Echinococcus multilocularis in North America: the great unknown.
abstract: Over the last decade, studies have begun to shed light on the distribution and genetic characterization of Echinococcus multilocularis, the causative agent of alveolar echinococcosis (AE), in North America. Recent findings indicate that the parasite is likely expanding its range in the central region of the United States and Canada and that invasions of European strains might have occurred. In our review, we present the available data on E. multilocularis infections in wild and domestic animals and humans in North America and emphasize the lack of knowledge on the distribution of the parasite in wild and domestic hosts. Furthermore, we stress the need to better understand the complexity of host communities and their roles in shaping the transmission and distribution of the parasite. We hypothesize that a lack of knowledge about AE by North American physicians might result in the misdiagnosis of cases and an underestimation of disease incidence. The endemic presence of the parasite in urban areas and a recent human case in Alberta, Canada, suggest that the scientific community may need to reconsider the local public health risks, re-assess past cases that might have been overlooked and increase surveillance efforts to identify new cases of human AE.
authors.affiliation: Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Massolo
authors.affiliation: Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada - Department of Biological Sciences, Faculty of Sciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Stefano
authors.initials: S
authors.lastname: Liccioli
authors.affiliation: Department of Veterinary Integrative Biosciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Budke
authors.affiliation: Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Claudia
authors.initials: C
authors.lastname: Klein
mesh_terms: D000818:Animals; D000829:Animals, Domestic / Q000469:parasitology*; D000835:Animals, Wild / Q000469:parasitology*; D002335:Carnivora / Q000469:parasitology; D002371:Cat Diseases / Q000453:epidemiology / Q000469:parasitology / Q000635:transmission; D002415:Cats; D004283:Dog Diseases / Q000453:epidemiology / Q000469:parasitology / Q000635:transmission; D004285:Dogs; D004443:Echinococcosis; D004444:Echinococcosis, Hepatic / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission / Q000662:veterinary*; D048210:Echinococcus multilocularis / Q000187:drug effects / Q000302:isolation & purification* / Q000502:physiology; D020387:Food Chain; D058507:Host Specificity; D006801:Humans; D015994:Incidence; D038622:Internationality; D009656:North America / Q000453:epidemiology; D010270:Parasite Egg Count / Q000379:methods; D011159:Population Surveillance; D011634:Public Health; D012306:Risk; D012376:Rodent Diseases / Q000453:epidemiology / Q000469:parasitology; D012377:Rodentia / Q000469:parasitology; D012423:Rural Health; D012621:Seasons; D014504:Urban Health; D015047:Zoonoses