The geographical distribution and prevalence of Echinococcus multilocularis in animals in the European Union and adjacent countries: a systematic review and meta-analysis.
BACKGROUND
This study aimed to provide a systematic review on the geographical distribution of Echinococcus multilocularis in definitive and intermediate hosts in the European Union (EU) and adjacent countries (AC). The relative importance of the different host species in the life-cycle of this parasite was highlighted and gaps in our knowledge regarding these hosts were identified.


METHODS
Six databases were searched for primary research studies published from 1900 to 2015. From a total of 2,805 identified scientific papers, 244 publications were used for meta-analyses.


RESULTS
Studies in 21 countries reported the presence of E. multilocularis in red foxes, with the following pooled prevalence (PP): low (≤ 1 %; Denmark, Slovenia and Sweden); medium (> 1 % to < 10 %; Austria, Belgium, Croatia, Hungary, Italy, the Netherlands, Romania and the Ukraine); and high (> 10 %; Czech Republic, Estonia, France, Germany, Latvia, Lithuania, Poland, Slovakia, Liechtenstein and Switzerland). Studies from Finland, Ireland, the United Kingdom and Norway reported the absence of E. multilocularis in red foxes. However, E. multilocularis was detected in Arctic foxes from the Arctic Archipelago of Svalbard in Norway.


CONCLUSIONS
Raccoon dogs (PP 2.2 %), golden jackals (PP 4.7 %) and wolves (PP 1.4 %) showed a higher E. multilocularis PP than dogs (PP 0.3 %) and cats (PP 0.5 %). High E. multilocularis PP in raccoon dogs and golden jackals correlated with high PP in foxes. For intermediate hosts (IHs), muskrats (PP 4.2 %) and arvicolids (PP 6.0 %) showed similar E. multilocularis PP as sylvatic definitive hosts (DHs), excluding foxes. Nutrias (PP 1.0 %) and murids (PP 1.1 %) could play a role in the life-cycle of E. multilocularis in areas with medium to high PP in red foxes. In areas with low PP in foxes, no other DH was found infected with E. multilocularis. When fox E. multilocularis PP was >3 %, raccoon dogs and golden jackals could play a similar role as foxes. In areas with high E. multilocularis fox PP, the wolf emerged as a potentially important DH. Dogs and cats could be irrelevant in the life-cycle of the parasite in Europe, although dogs could be important for parasite introduction into non-endemic areas. Muskrats and arvicolids are important IHs. Swine, insectivores, murids and nutrias seem to play a minor or no role in the life-cycle of the parasite within the EU and ACs.
Finnish Food Safety Authority Evira (FINPAR), Elektroniikkatie 3, FI-90590, Oulu, Finland.
Antti
A
Oksanen
Department of Parasitic Zoonoses, IRNASA, CSIC, Cordel de Merinas, 40-52, 37008, Salamanca, Spain.
Mar
M
Siles-Lucas
Department of Parasitology, National Veterinary Research Institute, 57 Partyzantów Avenue, 24-100, Puławy, Poland.
Jacek
J
Karamon
Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanitá, Viale Regina Elena, 299, 00161, Rome, Italy.|European Reference Laboratory for Parasites (EURLP), Rome, Italy.
Alessia
A
Possenti
Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Epidemiology, Südufer 10, 17493, Greifswald-Insel Riems, Germany.
Franz J
FJ
Conraths
Universität Hohenheim, FG Parasitologie 220 B, 70599, Stuttgart, Germany.
Thomas
T
Romig
Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Institute of Epidemiology, Südufer 10, 17493, Greifswald-Insel Riems, Germany.
Patrick
P
Wysocki
Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza University of Roma, Piazzale Aldo Moro 5, 00185, Rome, Italy.
Alice
A
Mannocci
Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza University of Roma, Piazzale Aldo Moro 5, 00185, Rome, Italy.
Daniele
D
Mipatrini
Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza University of Roma, Piazzale Aldo Moro 5, 00185, Rome, Italy.
Giuseppe
G
La Torre
Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanitá, Viale Regina Elena, 299, 00161, Rome, Italy.|European Reference Laboratory for Parasites (EURLP), Rome, Italy.|World Health Organization Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar echinococcosis (in humans and animals), Rome, Italy.
Belgees
B
Boufana
Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanitá, Viale Regina Elena, 299, 00161, Rome, Italy. adriano.casulli@iss.it.|European Reference Laboratory for Parasites (EURLP), Rome, Italy. adriano.casulli@iss.it.|World Health Organization Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar echinococcosis (in humans and animals), Rome, Italy. adriano.casulli@iss.it.
Adriano
A
Casulli
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