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Sweden: Echinococcus infections may be locally acquired

The Public Health Agency of Sweden, or Folkhälsomyndigheten have reviewed some recent human Echinococcus multilocularis infection and conclude that some recent infections cannot be ruled out that they were infected in Sweden.


A review of the cases and the fact that in recent years the tapeworm has also been demonstrated among Swedish foxes, means that the Public Health Authority can no longer rule out the fact that people are infected within Sweden.


In total, ten cases of parasitic infection have been reported in Sweden since 2012. The seven previous cases have probably been infected abroad. However, it cannot be ruled out that the last three cases have been infected in Sweden.


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It was expected that sooner or later we would get cases of infection with the fox’s tapeworm where we cannot exclude domestic infection. But the risk of being infected remains very small, both in Sweden and in countries where the parasite is much more common in nature than it is here, says Anders Wallensten, assistant state epidemiologist at the Public Health Authority.


The Public Health Authority estimates that occasional cases may be discovered in the future, but that the infection will continue to be very rare in humans.


According to the Centers for Disease Control and Prevention (CDC), people who accidentally swallow the eggs of the Echinococcus multilocularis tapeworm are at risk for infection. People at high risk include trappers, hunters, veterinarians, or others who have contact with wild foxes, or coyotes, or their stool, or household dogs and cats that have the opportunity to eat wild rodents infected with AE.


Humans can be exposed to these eggs by “hand-to-mouth” transfer or contamination, for example: By directly ingesting food items contaminated with stool from foxes or coyotes. This might include grass, herbs, greens, or berries gathered from fields or by petting or handling household dogs or cats infected with the Echinococcus multilocularis tapeworm. These pets may shed the tapeworm eggs in their stool, and their fur may be contaminated. Some dogs “scent roll” in foreign material (such as wild animal feces) and may become contaminated this way.


If left untreated, the parasite will kill its human host in 10 to 15 years.


If you live in an area where Echinococcus multilocularis is found in rodents and wild canines, take the following precautions to avoid infection:


Don’t touch a fox, coyote, or other wild canine, dead or alive, unless you are wearing gloves. Hunters and trappers should use plastic gloves to avoid exposure.

Don’t keep wild animals, especially wild canines, as pets or encourage them to come close to your home.

Don’t allow your dogs and cats to wander freely or to capture and eat rodents.

If you think that your pet may have eaten rodents, consult your veterinarian about possible preventive treatments.

Wash your hands with soap and warm water after handling dogs or cats, and before handling food.

Teach children the importance of washing hands to prevent infection.

Do not collect or eat wild fruits or vegetables picked directly from the ground. All wild-picked foods should be washed carefully or cooked before eating.