Alveolar echinococciasis: a malicious orphan disease

A widespread disease: Significant progress in screening for alveolar echino cocciasis has reduced the number of new cases observed in Europe Health edu cation and serodetection campaigns have allowed earlier diagnosis and more effective treatment The disease cannot however be totally eradicated due to the widespread wild reservoirs, sometimes even in the center of large citi es. Therapeutics: Early diagnosed and treatment can inhibit the inevitable prog ression observed after clinical manifestations appear. Drugs can block dise ase progression and surgical excision can be most effective, inversely, the hopes raised by liver transplantation in patients with advanced stage dise ase have not been fulfilled due to the more or less late-onset metastasis f avored by immunosuppressive treatments. Perspectives: There has been considerable progress in our knowledge of this parasite disease, particularly in improved diagnostic techniques. They hav e also demonstrated that humans are poor hosts for the parasite which is of ten spontaneously ejected. We are beginning to better understand the mechan isms of this spontaneous cure. Practical consequences would be a definition of receptive patient profiles or "vaccine" or immunotherapeutic procedures .