During the period of 2000-2004, 3,096 red foxes from the whole territory of the Slovak Republic were sampled and examined parasitologically for infections with Echinococcus multilocularis, causative agent of serious alveolar echinococcosis in humans. Relations between prevalence of the parasite in individual regions of Slovakia and some environmental factors were weighted. During the study period, great differences of prevalence and infection intensity were found on a regional level and significant between-year fluctuation of both parameters was observed. High-endemic foci with an estimated prevalence of more than 30% were detected in the northern and central part of the country. Climatic conditions, including low mean annual air temperature, high mean annual rainfall and the high humidity of the soil, showed to be important for E. multilocularis distribution. Significant correlation was calculated between prevalence of the tapeworm, mean annual precipitation values, and population density of small mammals.
The pathogenesis of alveolar echonococcosis caused by the metacestode of Echinococcus multilocularis is a process involving the host-parasite interface with both local and distant systemic effects. The survival strategy of the parasite is to continuously subvert the host defenses just as the host responds to contain the infection. There is a complex of signal molecules mediating between parasite-elaborated factors and specific and non specific cellular immune responses behind the gross pathological picture of a space-occupying lesion. This paper attempts to summarize the relationship of experimental findings with the clinicopathological picture by outlining pathways that may be involved in the process of pathogenesis.
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