Alveolar echinococcosis: characteristics of a possible emergence and new perspectives in epidemiosurveillance

The aim of this review is to discuss the situation of alveolar echinococcos is in France in the light of the current knowledge on its transmission patt erns in the world, especially Europe. An important risk of higher contamina tion of the rural environment may be suspected from newly reported cases of infected foxes or votes in several countries where the disease was not fou nd before. Furthermore, the increase of prevalence rate in foxes in Bade-Wu rtemberg (Germany) and Franche-Comte (France), traditionally endemic, also supports this new trend. Urban foxes and the spreading of infected foxes to cities may also be the cause of the extension to urban and suburban areas of a disease which was believed to be limited to rural areas. The setting u p of an epidemio-surveillance system for fox (dog, cat) populations is curr ently in progress. It will be grounded on coprotests (ELISA, PCR) for the d etection of E. multilocularis material in definitive hosts' faeces and on s ampling based on the multiscale analysis of the characteristics of landscap es favourable to transmission. A register of human cases has been establish ed at the European level (WHO Collaborative Centre of the University of Fra nche-Comte and Universities of Ulm and Hohenheim). Unfortunately, the evolu tion of the parasite distribution and of the risks of exposure in France is unrecognised. Progress in surveillance and prevention could be expected if health authorities would attribute higher priority to this disease. (C) 20 01 Editions scientifiques et medicales Elsevier SAS.