An epidemiologic survey of human alveolar echinococcosis in southwestern Germany

The inhabitants of a rural community in southwestern Germany were examined for alveolar echinococcosis (AE). The study was prompted by the recent incr ease of the prevalence of the parasite in foxes and the increase of fox pop ulations: in the study area, 75% of the foxes carried Echinococcus multiloc ularis. The human population was screened using hepatic ultrasound and sero logy. All participants were interviewed for demographic and potential risk factors. Of 2,560 participants, one was identified with active AE, while 3 others had suspicious liver lesions. Another 9 participants were seropositi ve for specific antibodies without detectable lesions. Demographic and beha vioral factors were not correlated with active or suspected cases nor with seropositivity. If the prevalence of 40/100,000 (95% confidence interval = 15-295/100,000) for active cases would be representative for the rural popu lation in high endemicity areas, the, current number of AE cases in southwe stern Germany is considerably higher than previously suspected.