title: Present status, actions taken and future considerations due to the findings of E. multilocularis in two Scandinavian countries.
abstract: When Echinococcus (E.) multilocularis was first detected in mainland Scandinavia in Denmark in 2000, surveillance was initiated/intensified in Sweden, mainland Norway and Finland. After 10 years of surveillance these countries all fulfilled the requirements of freedom from E. multilocularis as defined by the EU, i.e. a prevalence in final hosts <1% with 95% confidence level. However, in 2011 E. multilocularis was detected in Sweden for the first time and surveillance was increased in all four countries. Finland and mainland Norway are currently considered free from E. multilocularis, whereas the prevalence in foxes in Sweden and Denmark is approximately 0.1% and 1.0%, respectively. E. multilocularis has been found in foxes from three different areas in Denmark: Copenhagen (2000), Højer (2012-14) and Grindsted (2014). Unlike Sweden, Norway and Finland, human alveolar echinococcosis (AE) is not notifiable in Denmark, and the number of human cases is therefore unknown. In Sweden, E. multilocularis has been found in foxes in four counties, Västra Götaland, Södermanland, Dalarna (2011) and Småland (2014). E. multilocularis has also been found in an intermediate host in Södermanland (2014). Two cases of AE have been reported in humans (2012), both infected abroad. No cases of E. multilocularis or AE have been reported in Finland and Norway. Recommendations and future considerations are discussed further.
authors.affiliation: Zoonosiscenter, National Veterinary Institute, Uppsala, Sweden. Electronic address: helen.wahlstrom@sva.se.
authors.forename: Helene
authors.initials: H
authors.lastname: Wahlström
authors.affiliation: Section for Bacteriology, Pathology and Parasitology, National Veterinary Institute, Copenhagen, Denmark.
authors.forename: Heidi L
authors.initials: HL
authors.lastname: Enemark
authors.affiliation: Section for Parasitology, Norwegian Veterinary Institute, Oslo, Norway.
authors.forename: Rebecca K
authors.initials: RK
authors.lastname: Davidson
authors.affiliation: Production Animal and Wildlife Health Research Unit, Finnish Food Safety Authority Evira (FINPAR), Oulu, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Oksanen
mesh_terms: D000818:Animals; D004443:Echinococcosis / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control*; D048210:Echinococcus multilocularis / Q000502:physiology*; D006801:Humans; D011159:Population Surveillance; D018570:Risk Assessment; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology
keywords: Costs; Denmark; Echinococcus multilocularis; Finland; Norway; Risk management; Surveillance; Sweden