Clinical epidemiology of human AE in Europe.
This review gives a critical update of the situation regarding alveolar echinococcosis (AE) in Europe in humans, based on existing publications and on findings of national and European surveillance systems. All sources point to an increase in human cases of AE in the "historic endemic areas" of Europe, namely Germany, Switzerland, Austria and France and to the emergence of human cases in countries where the disease had never been recognised until the end of the 20th century, especially in central-eastern and Baltic countries. Both increase and emergence could be only due to methodological biases; this point is discussed in the review. One explanation may be given by changes in the animal reservoir of the parasite, Echinococcus multilocularis (increase in the global population of foxes in Europe and its urbanisation, as well as a possible increased involvement of pet animals as definitive infectious hosts). The review also focuses onto 2 more original approaches: (1) how changes in therapeutic attitudes toward malignant and chronic inflammatory diseases may affect the epidemiology of AE in the future in Europe, since a recent survey of such cases in France showed the emergence of AE in patients with immune suppression since the beginning of the 21st century; (2) how setting a network of referral centres in Europe based on common studies on the care management of patients might contribute to a better knowledge of AE epidemiology in the future.
WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis, and French National Centre for Alveolar Echinococcosis, UMR 6249 'Chrono-Environment' and EA 3181 'Epithelial Carcinogenesis: Prevention and Prediction Factors', University of Franche-Comté and University Hospital, 25030 Besançon, France(1). Electronic address: dvuitton@univ-fcomte.fr.
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Vuitton
WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis, and French National Centre for Alveolar Echinococcosis, UMR 6249 'Chrono-Environment' and EA 3181 'Epithelial Carcinogenesis: Prevention and Prediction Factors', University of Franche-Comté and University Hospital, 25030 Besançon, France(1).
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Demonmerot
WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis, and French National Centre for Alveolar Echinococcosis, UMR 6249 'Chrono-Environment' and EA 3181 'Epithelial Carcinogenesis: Prevention and Prediction Factors', University of Franche-Comté and University Hospital, 25030 Besançon, France(1).
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Knapp
WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis, and French National Centre for Alveolar Echinococcosis, UMR 6249 'Chrono-Environment' and EA 3181 'Epithelial Carcinogenesis: Prevention and Prediction Factors', University of Franche-Comté and University Hospital, 25030 Besançon, France(1).
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Richou
WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis, and French National Centre for Alveolar Echinococcosis, UMR 6249 'Chrono-Environment' and EA 3181 'Epithelial Carcinogenesis: Prevention and Prediction Factors', University of Franche-Comté and University Hospital, 25030 Besançon, France(1).
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Grenouillet
WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis, and French National Centre for Alveolar Echinococcosis, UMR 6249 'Chrono-Environment' and EA 3181 'Epithelial Carcinogenesis: Prevention and Prediction Factors', University of Franche-Comté and University Hospital, 25030 Besançon, France(1).
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Chauchet
WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis, and French National Centre for Alveolar Echinococcosis, UMR 6249 'Chrono-Environment' and EA 3181 'Epithelial Carcinogenesis: Prevention and Prediction Factors', University of Franche-Comté and University Hospital, 25030 Besançon, France(1).
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Vuitton
WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis, and French National Centre for Alveolar Echinococcosis, UMR 6249 'Chrono-Environment' and EA 3181 'Epithelial Carcinogenesis: Prevention and Prediction Factors', University of Franche-Comté and University Hospital, 25030 Besançon, France(1).
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Bresson-Hadni
WHO-Collaborating Centre for Prevention and Treatment of Human Echinococcosis, and French National Centre for Alveolar Echinococcosis, UMR 6249 'Chrono-Environment' and EA 3181 'Epithelial Carcinogenesis: Prevention and Prediction Factors', University of Franche-Comté and University Hospital, 25030 Besançon, France(1).
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Millon
D000818:Animals; D004197:Disease Reservoirs; D004443:Echinococcosis; D004444:Echinococcosis, Hepatic / Q000453:epidemiology* / Q000469:parasitology / Q000473:pathology*; D048210:Echinococcus multilocularis / Q000276:immunology / Q000502:physiology*; D005060:Europe / Q000453:epidemiology; D005589:Foxes / Q000469:parasitology; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology
Alveolar echinococcosis; Cancer; Chronic inflammatory diseases; Echinococcus multilocularis; Epidemiology; Europe; Immune suppression