Epidemiology
The incidence of human infestation with E. multilocularis and disease is increasing in urban areas, as wild foxes (an important reservoir species of the sylvatic cycle) are migrating to urban and suburban areas and gaining closer contact with human populations (Vuitton, 2009). Also, restocking fox enclosures for fox hunting with infected animals spreads the disease. Children, health care workers and domestic animals are at risk of ingesting the cysts after coming into contact with the feces of infected wild foxes. Even with the improvement of health in developed/industrialized countries, the prevalence of alveolar echinococcosis (AE) did not decrease (Vuitton, 2009). On the contrary, incidents of AE have now also been registered in eastern European countries and sporadic incidences in other European countries (Vuitton, 2009).
A study by veterinary parasitologists from Purdue University indicated that the disease is spreading throughout the Midwestern United States, where it was previously rare or nonexistent. Additionally, the disease has extended its range in Europe in the last few decades . Still the infection is fairly rare. Between 1982 and 2000 559 cases were reported in entire Europe .
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