[Controlling cystic echinococcosis: outlook in the 21st centuryControle da equinococose/hidatidose cística: perspectivas no século XXI].

Abstract

Cystic echinococcosis (CE) is a serious public health problem in South America, one that the Pan American Health Organization (PAHO) has included in its Plan of Action for the Control of Neglected Infectious Diseases. A logical framework for CE control was defined: this includes establishing the objective to be achieved (eradication or elimination as a public health problem) and determining levels of endemicity which serve as a guide for establishing frequencies of intervention (high endemicity, endemic, and low endemicity, according to rates in the different hosts). There are two validated tools for CE control: systematic deworming of dogs using praziquantel (PZQ) and systematic vaccination of sheep with recombinant EG95 protein, or a combination of both tools. Complementary strategies include the development of sanitary infrastructure on ranches, health education, and active searches for asymptomatic cases followed by timely treatment.Decreased prevalence in dogs and sheep is associated with a loss of acquired immunity, making the animals susceptible to infection.Although ready-to-use tools are available, CE control continues to present difficulties. It is vital that the Veterinary Public Health Unit of PAHO's Pan American Center for Foot-and-Mouth Disease and Veterinary Public Health (PANAFTOSA/VPH-PAHO/WHO) provide support to national programs and local efforts under the CE Initiative for control and surveillance in South America, promoting novel strategies for disease control and early diagnosis of human cases, with a One Health approach.