Echinococcosis

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What is it about ?

Echinococcosis is a disease caused by a parasitic flat worm, echinococcus. There are several variations of this parasitic worm. The two most important are Echinococcus granulosus

(dog echinococcus) and Echinococcus multilocularis (fox echinococcus), which are therefore present in dogs and foxes respectively. Dogs and foxes get sick from eating contaminated meat or offal. The human being is an occasional guest. It can be infected by eating food that has been found in the feces of animals infected with the parasitic worm, gardening, being licked by an infected dog, or stroking it.

Parasitic worms deposit their eggs in the intestine. The eggs turn into larvae, which pass through the intestinal wall and nestle in the liver and lungs. There they encapsulate and form a cyst, which can grow to a few centimeters.

What is its frequency?

Echinococcosis is very rare. In 2018, 14 new cases were reported in Belgium, a figure comparable to those in previous years1.

How to recognize it?

Dog echinococcal disease is often discovered by chance (eg on ultrasound). Cysts don’t cause symptoms while they’re still small. But as they grow, they put pressure on nearby tissue, usually in the lungs or liver. Exceptionally, a cyst may burst and cause a shock reaction or cough up blood.

Fox echinococcal disease does not cause symptoms for the first 5 to 15 years, then causes an upset stomach, shortness of breath, or jaundice. The infection almost always starts in the liver. Gradually, the parasite completely destroys the liver and also affects neighboring organs. The infection may spread through the bloodstream to more distant organs.

How is the diagnosis made?

The diagnosis is made after finding typical cysts during an X-ray examination (ultrasound, x-ray of the lungs, CT-scan, MRI). Sometimes antibodies are found in the blood. The contents of the cyst can be removed by surgery or aspiration (pricking the cyst to empty it). But this is rarely done because of the risk of the parasite spreading.

What can you do ?

Never feed your dog raw meat or raw offal, and certainly not abroad, in a country where you are unfamiliar with slaughter procedures. This also applies to game meat. As a preventive measure, it may be helpful to give your dog an echinococcus dewormer. For this, follow the advice of the veterinarian. Always wash your hands well if you have been in contact with dogs or canines, after gardening or working the soil outside. Wash wild berries, self-picked mushrooms and autumn fruits thoroughly and cook them if possible before eating them.

What can the doctor do?

Treatment depends on the size, location and structure of the cyst. We can not intervene (immediately) and carefully follow the evolution. Possible treatments are surgery, medication against the parasite [SL1] and aspiration of the cyst. Untreated, fox echinococcal disease is potentially fatal.

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