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Echinococcus multilocularis is a small, zoonotic, tapeworm that occurs in central Europe, much of northern, central and eastern Eurasia and parts of North America (Eckert and Deplazes 2004). Adult parasites reside within the small intestine of definitive hosts, which primarily include wild canids (for example, foxes, coyotes, wolves) and domestic dogs. Eggs shed in the faeces of these species are morphologically indistinguishable from Taenia-type eggs. They are also immediately infective for intermediate hosts, which are typically various species of wild rodents (Taylor and others 2007). Subsequent to ingestion of eggs by these species, the immature stage of the parasite hatches, migrates to the liver and develops into alveolar hydatid cysts. This larval stage of the parasite undergoes exogenous budding and behaves like an invasive tumour.
The resultant disease, alveolar echinococcosis (AE), is associated with extensive damage to the liver and occasionally spreads to other organs. The life cycle is completed when an infected intermediate host is ingested by a definitive host; development of the mature tapeworm takes approximately four to five weeks (Deplazes and others 2011). Ingestion of eggs by people may also result in AE, a potentially severe, fatal disease that is currently an emerging issue in parts of central Europe (Gottstein and others 2015).
The above information about the life cycle of E multilocularis is found in most veterinary parasitology textbooks. However, what is missing in almost every book is the fact that, since the late 1980s, cases of AE, primarily involving the liver, have been …