Human Echinococcosis Incidence in Canada: A Retrospective Descriptive Study Using Administrative Hospital and Ambulatory Visit Data, 2000-2020

Overview

Journal Can Commun Dis Rep

Specialties Infectious Diseases
Public Health

Date 2024 Sep 13

PMID 39267615

Authors

Ayisha Khalid

Pia K Muchaal

Danielle A Julien

Affiliations

Soon will be listed here.

Abstract

Background: Echinococcosis is a zoonotic disease caused by the ingestion of tapeworm eggs shed by canids. The potential recent establishment of a more virulent European-type strain may be impacting human echinococcosis in Canada, yet information is limited.

Objective: Administrative hospital and ambulatory visit data were used to provide a baseline of human echinococcosis cases in Canada between 2000-2020.

Methods: Canadian Institute of Health Information's Discharge Abstract Database, Hospital Morbidity Database and National Ambulatory Care Reporting System were combined to identify cases. Risk ratios (RR) by demographic factors and cumulative incidences (CIN) over place and time were calculated.

Results: A total of 806 echinococcosis cases were identified in Canada between 2000-2020, for a mean annual CIN of 1.3 cases per million population. Over the two decades, the mean annual CIN of cases increased nationally (1.3-1.4 cases per million), in the Northwest Territories (6.3-9.1 cases per million), in Alberta (1.5-2.4 cases per million) and in the Atlantic provinces (0.2-0.6 cases per million). Those from the Territories had the highest risk of echinococcosis (RR 17.1; 95% confidence interval: 8.7-33.7).

Conclusion: Though explanations are multifactorial, the new European-type strain may have a role in the small absolute increase in echinococcosis CIN in Canada observed over the study period. The CIN is likely underestimated and the validity of administrative data for analyzing zoonoses warrants investigation. Though this study contributes important awareness and a baseline, improved data are needed to clarify the effects of the new strain and inform public health response.

References

Butler A, Smith M, Jones W, Adair C, Vigod S, Lesage A . Multi-province epidemiological research using linked administrative data: a case study from Canada. Int J Popul Data Sci. 2020; 3(3):443. PMC: 7299461. DOI: 10.23889/ijpds.v3i3.443. View

Houston S, Belga S, Buttenschoen K, Cooper R, Girgis S, Gottstein B . Epidemiological and Clinical Characteristics of Alveolar Echinococcosis: An Emerging Infectious Disease in Alberta, Canada. Am J Trop Med Hyg. 2021; 104(5):1863-1869. PMC: 8103444. DOI: 10.4269/ajtmh.20-1577. View

Massolo A, Liccioli S, Budke C, Klein C . Echinococcus multilocularis in North America: the great unknown. Parasite. 2014; 21:73. PMC: 4273702. DOI: 10.1051/parasite/2014069. View

Catalano S, Lejeune M, Liccioli S, Verocai G, Gesy K, Jenkins E . Echinococcus multilocularis in urban coyotes, Alberta, Canada. Emerg Infect Dis. 2012; 18(10):1625-8. PMC: 3471618. DOI: 10.3201/eid.1810.120119. View

Samuel W, Ramalingam S, Carbyn L . Helminths in coyotes (Canis latrans Say), wolves (Canis lupus L.), and red foxes (Vulpes vulpes L.) of southwestern Manitoba. Can J Zool. 1978; 56(12):2614-7. DOI: 10.1139/z78-351. View

Martini M, Dumendiak S, Gagliardo A, Ragazzini F, La Rosa L, Giunchi D . and Other Taeniid Metacestodes of Muskrats in Luxembourg: Prevalence, Risk Factors, Parasite Reproduction, and Genetic Diversity. Pathogens. 2022; 11(12). PMC: 9781964. DOI: 10.3390/pathogens11121414. View

Santa M, Umhang G, Klein C, Grant D, Ruckstuhl K, Musiani M . It's a small world for parasites: evidence supporting the North American invasion of European . Proc Biol Sci. 2023; 290(1994):20230128. PMC: 9993045. DOI: 10.1098/rspb.2023.0128. View

Gesy K, Hill J, Schwantje H, Liccioli S, Jenkins E . Establishment of a European-type strain of Echinococcus multilocularis in Canadian wildlife. Parasitology. 2013; 140(9):1133-7. DOI: 10.1017/S0031182013000607. View

Schurer J, Rafferty E, Farag M, Zeng W, Jenkins E . Echinococcosis: An Economic Evaluation of a Veterinary Public Health Intervention in Rural Canada. PLoS Negl Trop Dis. 2015; 9(7):e0003883. PMC: 4489623. DOI: 10.1371/journal.pntd.0003883. View

10.

Schmidberger J, Uhlenbruck J, Schlingeloff P, Maksimov P, Conraths F, Mayer B . Dog Ownership and Risk for Alveolar Echinococcosis, Germany. Emerg Infect Dis. 2022; 28(8):1597-1605. PMC: 9328925. DOI: 10.3201/eid2808.212514. View

11.

Kotwa J, Isaksson M, Jardine C, Campbell G, Berke O, Pearl D . Echinococcus multilocularis Infection, Southern Ontario, Canada. Emerg Infect Dis. 2019; 25(2):265-272. PMC: 6346450. DOI: 10.3201/eid2502.180299. View

12.

Hotez P . Neglected infections of poverty among the indigenous peoples of the arctic. PLoS Negl Trop Dis. 2010; 4(1):e606. PMC: 2811175. DOI: 10.1371/journal.pntd.0000606. View

13.

Luong L, Chambers J, Moizis A, Stock T, St Clair C . Helminth parasites and zoonotic risk associated with urban coyotes () in Alberta, Canada. J Helminthol. 2018; 94:e25. DOI: 10.1017/S0022149X1800113X. View

14.

Jenkins E, Castrodale L, de Rosemond S, Dixon B, Elmore S, Gesy K . Tradition and transition: parasitic zoonoses of people and animals in Alaska, northern Canada, and Greenland. Adv Parasitol. 2013; 82:33-204. DOI: 10.1016/B978-0-12-407706-5.00002-2. View

15.

Peregrine A, Jenkins E, Barnes B, Johnson S, Polley L, Barker I . Alveolar hydatid disease (Echinococcus multilocularis) in the liver of a Canadian dog in British Columbia, a newly endemic region. Can Vet J. 2013; 53(8):870-4. PMC: 3398525. View

16.

Gilbert N, Dare O, Libman M, Muchaal P, Ogden N . Hospitalization for trichinellosis and echinococcosis in Canada, 2001-2005: the tip of the iceberg?. Can J Public Health. 2010; 101(4):337-40. PMC: 6974090. View

17.

Priest J, McRuer D, Stewart D, Boudreau M, Power J, Conboy G . New geographic records for in coyotes and moose from Nova Scotia, Canada. Int J Parasitol Parasites Wildl. 2021; 16:285-288. PMC: 8646049. DOI: 10.1016/j.ijppaw.2021.11.004. View