Cistična ehinokokoza: svjetska zoonoza i javnozdravstveni problem

Prof. Dr. Sami Simsek*
Zavod za parazitologiju, Fakultet veterinarske medicine, Sveučilište u Firatu, Elazig-Turska
*e-mail: ssimsek@firat.edu.tr

Cistična ehinokokoza (CE) važan je zoonotski problem u mnogim endemskim područjima svijeta. Smatra se zanemarenom zoonotskom bolešću uzrokovanom larvalnim oblikom Echinococcus spp. Echinococcus granulosus je uzročnik CE. Bolest se smatra značajnom globalnom javnozdravstvenom brigom. CE ljudi i stoke je važan javnozdravstveni i gospodarski problem s globalnom zemljopisnom raspodjelom i javlja se na svim kontinentima. Raširenost E. granulosus javlja se prvenstveno u sinantropskom ciklusu između domaćih pasa (konačni nositelji) i stoke (intermedijarni nositelji). Raspon intermedijarnih vrsta u ovom ciklusu ovisi o vrsti Echinococcus spp, razlikama u prisutnosti različitih intermedijarnih nositelja i nekim drugim čimbenicima. Najviše prevalencije CE u ljudi utvrđene su u populacijama uključenim u uzgoj ovaca, naglašavajući pritom golemi zdravstveni značaj ‘pas-ovca’ ciklusa E. granulosus sensu stricto. U nekim zemljama, silvatični ciklusi E. granulosus s.s. mogu imati ulogu izvora infekcije i za domaće životinje i za ljude.
Unatoč uspostavi kontrolnih programa u nekim zemljama, CE još uvijek ima široku geografsku raspodjelu. Nedavni dokazi ukazuju na to da je CE javnozdravstveni problem koji sve više zabrinjava u brojnim zemljama gdje su kontrolni programi smanjeni zbog gospodarskih problema i nedostatka sredstava, ili tek trebaju biti u potpunosti potaknuti. Vrlo je vjerojatno da će se, osim ako državna zdravstvena tijela ne odrede prioritet bolesti i potaknu odgovarajuće metode kontrole, CE održati ili ponovno pojaviti u mnogim endemskim područjima širom svijeta, uzrokujući teške bolesti i znatan ekonomski gubitak.

Cystic Echinococcosis: A Worldwide Zoonosis and Public Health Problem

Prof. Dr. Sami Simsek*
Department of Parasitology, Faculty of Veterinary Medicine, University of Firat, Elazig-TURKEY
*e-mail: ssimsek@firat.edu.tr

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Cystic Echinococcosis (CE) is an important zoonotic problem in many endemic areas of worldwide. It is considered a neglected zoonotic disease caused by the larval form of Echinococcus spp. Echinococcus granulosus is the causative agent of CE. The disease is considered a significant global public health concern. CE of humans and livestock is an important public health and economic problem and has a worldwide geographic distribution and occurs in all continents. Spread of E. granulosus occurs primarily in a synanthropic cycle between domestic dogs (final hosts) and livestocks (intermediate hosts). The range of intermediate host species in this cycle depends on the species of Echinococcus spp, differences in the presence of various intermediate hosts and some other factors. Highest prevalences of CE in humans are detected in populations involved in sheep breeding, thus emphasising the overwhelming public health significance of the dog-sheep cycle of E. granulosus sensu stricto. In some countries, sylvatic cycles of E. granulosus s.s. may play a role as an infection source for both domestic animals and humans.

Despite the establishment of control programmes in some countries, CE still has a wide geographic distribution. Recent evidence implies to CE being a public health problem of increasing concern in a number of countries where control programmes have been reduced due to economic problems and lack of resources, or have yet to be fully instigated. It is likely that, unless government health authorities prioritise the disease and encourage appropriate control methods, CE will persist or re-emerge in many endemic areas worldwide, causing severe disease and considerable economic loss.