disease resembling liver cancer and is caused by the larval stage (metacestode) of
E. multilocularis. Untreated, alveolar echinococcosis may result in severe hepatic
dysfunction and metastases in other organs with high mortality. Human infection
results from ingestion ofEchinococcuseggs shed by a definitive host. The lifecycle
ofE. multilocularisis predominantly sylvatic, and includes mainly foxes but
sometimes dogs and cats as definitive hosts. Small mammals, mainly rodents, are
intermediate hosts (Deplazes and Eckert 2001 ).E. multilocularisis endemic in the
northern hemisphere including central and Eastern Europe (Fig. 1 ). The prevalence
rate ofE. multilocularisin foxes in the core endemic region of central Europe is in
the range of 35–65% (Torgerson et al. 2008 ). Inevitably, this high incidence
together with the increased fox population in urban areas results in increased
environmental contamination withE. multiloculariseggs, leading in turn to an
exacerbated zoonotic risk (Dyachenko et al. 2008 ). Cystic echinococcosis is a
condition of livestock and humans caused by the ingestion of infective eggs of
E. granulosus. Dogs are the primary definitive hosts, and ungulates (e.g. ruminants,
pigs, horses) are intermediate hosts. Humans are aberrant intermediate hosts.
Infections result in the development of cysts in the liver, lungs or other organ
systems, which usually require surgical removal. Prevalence of different genotypes
ofE. granulosusis high in southern and Eastern Europe (Fig. 1 ), North Africa, the
Middle East and Asia (Budke et al. 2006 ).
Regular anthelmintic treatment of dogs and cats that may have access to viscera
of intermediate hosts is an important component of human disease prevention. To
this end, the use in household pets of effective cestodicidal compounds, such as
praziquantel or epsiprantel is generally recommended (Esccap 2006). These drugs
are also effective against the flea-transmitted tapewormDipylidium caninumand
are generally available in combination with nematodicidal compounds, as either
oral tablets or spot-on preparations and can be administered as part of a broad-
spectrum de-worming programme. Anthelmintic (praziquantel) baiting campaigns
Fig. 1Geographic distribution ofEchinococcus granulosus(left) andEchinococcus multilo-
cularis(right) in Europe (reproduced with permission fromwww.esccap.org)
120 H. Benchaoui