Chapter One - Historical Aspects of Echinococcosis

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Abstract

Echinococcosis is a zoonosis whose history dates back to antiquity. This article provides an overview on the general history of echinococcosis, including the elucidation of Echinococcus life cycles and the long controversy on the aetiology of the cystic and alveolar forms of echinococcosis (CE and AE), lasting about 100 years since the middle of the 19th century. Furthermore, selected historical aspects of some fields of echinococcosis research are discussed and compared with our current knowledge, such as geographic distribution and epidemiology of CE (Echinococcus granulosus) and AE (Echinococcus multilocularis), clinical aspects and pathology, diagnosis in humans and animals, treatment (with focus on chemotherapy), control and basic research. A short paragraph is devoted to the neotropical forms of echinococcosis, caused by Echinococcus vogeli and Echinococcus oligarthrus. In this context the achievements of some ancestral pioneers of echinococcosis research are particularly highlighted and appreciated. Finally, the role of associations, international organizations (World Health Organization and others) and international working groups in echinococcosis research and control is briefly outlined. The retrospective reveals both the admirable achievements of our ancestors and the scientific progress of more recent times. But, it also shows the gaps in our knowledge, skills and resources that we need to control or even eradicate echinococcosis.

Introduction

Although echinococcosis has a long history dating back to ancient times, it is still a relevant zoonosis today with considerable socioeconomic impact, affecting humans in many parts of the world (WHO, 2001a, Craig and Pawlowski, 2002; Eckert et al., 2011; Torgerson and Macpherson, 2011; Vuitton et al., 2015). Here, we highlight selected historical aspects of some fields of echinococcosis research, with examples of what contributions our ancestors have made to our current knowledge which has continuously grown, especially since the 19th century and what changes have occurred over the years. The reader is also referred to a chapter on echinococcosis published by Grove in ‘A History of Human Helminthology’ (Grove, 1990).

Echinococcosis is a zoonosis involving carnivores as definitive and a broad spectrum of mammalian species as intermediate hosts. Humans, monkeys and some other mammals can be affected as aberrant hosts. Currently, four forms of echinococcosis are distinguished (WHO, 2001a; D'Alessandro and Rausch, 2008) (Table 1). Cystic and alveolar echinococcosis (CE and AE), the most important forms with the widest geographic ranges, are the focus of this article. CE is also called hydatid disease (Greek: hydatis: water bladder).

Section snippets

Early knowledge of hydatids

The metacestodes of E. granulosus are bladders (cysts) of variable and often large size filled with clear liquid and are called ‘hydatids.’ The first indications of hydatids date back to antiquity and stem from Hippocrates (∼460–377 BC) who wrote in his aphorisms (VII, 55): ‘In those whose water stuffed liver opens into the omentum, the belly is filled with water, and they die.’ (Neisser, 1877; Fuchs, 1895). Galen (129–∼200 BC) regarded the liver as the main site of hydatids and mentioned their

Geographic distribution and epidemiology

By the end of the 19th century and the beginning of the 20th century, a remarkable body of knowledge had accumulated on the worldwide geographic distribution and prevalence of echinococcosis in humans and animals, but the overall picture had considerable gaps.

Taxonomy

Several Echinococcus species, including E. granulosus s.l., E. oligarthrus and E. vogeli, occur in the neotropical region of Central and South America. It is assumed that E. granulosus was introduced with animals from Europe at the beginning of the 16th century (D'Alessandro and Rausch, 2008). For a long time, this species was considered to be the sole cause of echinococcosis in South America, although further Echinococcus species were known to occur in animals originating from this region (

The Role of Associations, International Organizations, and International Working Groups in Echinococcosis Research and Control

International associations and organizations have played and still play a significant role in the field of echinococcosis by facilitating international exchange of knowledge and promoting cooperation in research and control programmes. In 1941 the ‘Asociación International de Hidatilogia’ was founded in South America, later known as ‘International Association of Hydatidology (IAH)’ and since 2015 as ‘World Association of Echinococcosis’ (WAE). Since its foundation this association has organized

Acknowledgements

The authors are grateful to Professor Dominique Vuitton for her valuable information and advice regarding the role of associations, international organizations and international working groups on echinococcosis.

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