Echinococcosis:

 Part  1    
Cys1c  Disease  and  Hyda1d  Disease    

By  Mramba  Nyindo  and  Jovin  Kitau  at  

Kilimanjaro  Chris1an  Medical  
University  College  
Four  organisms  of  medical  importance  are  commonly    
included  in  the  genus  Echinococcus:  
 Organism        Disease  caused  
1. Echinicoccus  granulosus    cys1c  echinococcosis  
               (hyda1d  disease)  
2. E.  mul1locularis        alveolar  echinococcosis  
3. E.  vogeli                          polycys1c  echinococcosis  
4. E.  oligarthrus          polycys1c  echinococcosis  
• This  presenta1on  will  be  on  Echinococcus  
granulosus  (hyda1d  disease)  and  E.  
mul0locularis  (alveolar  hyda1d  disease)  
Echinococcus  granulosus  causes  cys1c  
echinococcosis  or  hyda1d  disease.  The  disease  is    
common  in  areas  where  sheep  and  caNle  are  
raised      
• Several   Echinococcus   granulosus   genotypes   have   been  
decribed:  
• G1   geno   type   is   maintained   in   life   cycles   involving   dogs   and  
sheep   and   some1mes   infects   humans.   Its   distribu1on   is  
cosmopolitan  
• G2  genotype  is  also  maintained  in  sheep  and  dogs  but  has  a  
shortened  prepatent  period  in  dogs.  It  occurs  in  Tasmania    
• The   G4   genotype   is   common   in   the   UK,   Middle   east   and   is  
adapted   to   equines,   including   horses   and   donkeys.   No   human  
infec1ons  have  been  iden1fied  
• Genotype  5  is  adapted  to  caNle  and  dogs  in  western  Europe  
Other   genotypes   including     genotypes   6   through   10   have   been  
described    
• Echinococcus   granulosus   causes   hyda1d   disease.   The  
defini1ve   host   of   the   parasite   is   the   dog   and   humans   become  
infected  by  being  in  close  contact  with  infected  dogs  
• Echinococcus  granulosus  is  a  small  parasite,  3-­‐6  mm  long  and  
consists   of   4   parts:   scolex,     neck   and   an   immature,   mature  
and  gravid  segments  
•   The   gravid   protogloZd   contains   100-­‐1   500   eggs.   It     detaches  
from  the  mature  progloZd  and  is  voided  with  dog  fees.    
•  Eggs  in  the  environment  can  be  swallowed  by  
intermediate  hosts,  including  humans  
• Following  exposure  to  gastric  and  intes1nal  enzymes  
onchosphere  is  released.  It  penetrates  duodenal  
mucosa,  reaches  the  bloodstream  which  carries  it  to  
various  body  parts  mainly  the  liver  
• In  the  liver  the  onchosphere  grows  and  
differen1ates  into  an  outer  and  inner  layer  
•  Numerous  daughter  cells  (brood  capsules)  
bud  off  from  the  inner  germinal  layer.  Brood  
capsules  are  either  aNached  to  the  inner  layer  
or  float  free  in  the  cys1c  fluid.    
• Individual   scolices   and   daughter   cysts   budding     off  
from  the  cyst  inner  layer  are  known  as  hyda1d  sand  
• Each   scolex   invaginates   in   order   to   protect   its  
hooklets  
• Cysts  grow  at  rate  of  1  cm  per  month    
• The  human  intermediate  host  is  a  dead  end  host        
  When  dogs  consume  viscera  of  intermediate  
hosts,  e.g.  sheep,  containing    the  hyda1d  cyst,  
adult  Echinococcus  granulosus  develop  in  the  
intes1nes.    
• Because   Echinococcus   granulosus   is   a   parasite   of  
dogs,   humans   become   infected   by   swallowing   E.  
granulosus  eggs  released  in  dog  feces  
• Therefore  in1mate  associa1on  of  dogs  with  humans  
is  a  risk  factor  of  infec1on  with  E.  granulosus  
 
• Clinical  manifesta1ons  of  hyda1d  disease  
depend  on  the  loca1on  of  the  cyst  in  the  
body.  Majority  of  cysts  occur  in  the  liver  and    
lungs.  
• This  is  the  end  of  part  1  of  the  presenta1on