Epidemiology and Epizootology of Cystic Echinococcosis in Romania 1862-2007

Infections with cestodes from genus Echinococcus are usually acquired by oral ingestion of eggs, direct contact with carriers, and contaminated food (especially vegetables) or water. Echinococcosis, previously characterized as a malady of medical importance only, depends upon veterinary solutions and faces political obstacles; it is considered the most important zoonotic disease in Romania. As a result of the increased number of human and animal cases, Romania was framed in the forefront of the European countries and among the first countries worldwide in 1995. The present paper is the first international systematized review concerning echinococcosis in Romania. It covers a period of 146 years, beginning in 1862, when the first case of human hydatid disease was mentioned in medical annals, until 2007 and aims at overviewing and analyzing data provided by major studies from different fields of human and veterinary medicine. Authors also present unpublished data of a 37-year surveillance performed in a reference infectious disease hospital. During the period 1979-1988, 8557 patients were hospitalized for hydatid disease requiring 210,057 days of health care, and 516 fatalities (6.03%) were registered. The prevalence of the disease in livestock during the period 1983-1994 varied between 24.3% and 92.9% in sheep, 31.2% and 43.6% in cattle, and 20.4% and 73.8% in swine. The economic losses in animals are very high due not only to increased mortality rates but also to weight loss and decreased productivity. Epidemiological data available showed that at least one person from 45.5% of Romanian localities underwent surgery for cystic echinococcosis. The information presented outlines the severity of the situation from human-and livestock-associated cystic echinococcosis in Romania. Control programs based on combinations of animal vaccination, dehelmintization of dogs, and education programs should be implemented to achieve effective prevention of disease transmission.