title: Is cystic echinoccocosis re-emerging in western Spain?
abstract: Cystic echinococcosis (CE) remains an important health problem in many areas of the world, including the Mediterranean region. We performed a retrospective study of cases reported from 1998 to 2012 in order to review and update the epidemiology of this disease in a highly endemic area situated in western Spain. A total of 471 patients were diagnosed with hydatid disease. Of these cases, 55·8% were male, with an average age of 62·3 ± 19·5 years. More importantly, 1·5% of patients were children, and 20·5% were aged <45 years. An active therapeutic approach was implemented for 92·6% of the CE patients with primary diagnoses; however, a 'watch and wait' strategy was used in 59·3% of all secondary CE diagnoses. The incidence rate of hydatid disease was significantly higher compared to the incidence described in the Notifiable Disease System in this area. Furthermore, a significant decrease in hydatid incidence during the years included in the study was observed (β = -0·4357, P < 0·001). CE incidence has diminished in recent years, although active transmission remains in paediatric cases. Additionally, CE incidence remains high in our region despite public health plans for its control. The documented incidence of CE disease clearly underestimates the real numbers.
authors: Servicio de Medicina Interna,Complejo Asistencial Universitario de Salamanca (CAUSA),Instituto Biosanitario de Salamanca (IBSAL),Salamanca,Spain.
authors: A
authors: A
authors: Lopez-Bernus
authors: Servicio de Medicina Interna,Complejo Asistencial Universitario de Salamanca (CAUSA),Instituto Biosanitario de Salamanca (IBSAL),Salamanca,Spain.
authors: M
authors: M
authors: Belhassen-García
authors: Servicio de Medicina Interna,Complejo Asistencial Universitario de Salamanca (CAUSA),Instituto Biosanitario de Salamanca (IBSAL),Salamanca,Spain.
authors: A
authors: A
authors: Carpio-Perez
authors: Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS),IBSAL,Salamanca,Spain.
authors: L
authors: L
authors: Perez Del Villar
authors: Servicio de Medicina Interna,Complejo Asistencial Universitario de Salamanca (CAUSA),Instituto Biosanitario de Salamanca (IBSAL),Salamanca,Spain.
authors: A
authors: A
authors: Romero-Alegria
authors: Servicio de Medicina Interna,Complejo Asistencial Universitario de Salamanca (CAUSA),Instituto Biosanitario de Salamanca (IBSAL),Salamanca,Spain.
authors: V
authors: V
authors: Velasco-Tirado
authors: Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS),IBSAL,Salamanca,Spain.
authors: A
authors: A
authors: Muro
authors: Servicio de Medicina Interna,Hospital General de Palencia 'Río Carrión',Palencia,Spain.
authors: J
authors: J
authors: Pardo-Lledias
authors: Servicio de Medicina Interna,Complejo Asistencial Universitario de Salamanca (CAUSA),Instituto Biosanitario de Salamanca (IBSAL),Salamanca,Spain.
authors: M
authors: M
authors: Cordero-Sánchez
authors: Departamento de Medicina Preventiva,Salud Publica y Microbiologia Medica.Universidad de Salamanca,Salamanca,Spain.
authors: M
authors: M
authors: Alonso-Sardón
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001850:Bone Diseases, Infectious / Q000453:epidemiology* / Q000469:parasitology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D021821:Communicable Diseases, Emerging / Q000453:epidemiology*; D004443:Echinococcosis / Q000453:epidemiology; D004444:Echinococcosis, Hepatic / Q000453:epidemiology*; D004445:Echinococcosis, Pulmonary / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
keywords: Echinococcus; emerging infections; hydatid disease; infectious disease epidemiology; zoonoses