Los Angeles County Department of Public Health, Los Angeles, California, United States of America.
PLoS Negl Trop Dis. 2012;6(2):e1524. doi: 10.1371/journal.pntd.0001524. Epub 2012 Feb 7.
Despite the endemic nature of Echinococcus granulosus and Echinococcus multilocularis infection in regions of the United States (US), there is a lack of data on echinococcosis-related mortality. To measure echinococcosis-associated mortality in the US and assess possible racial/ethnic disparities, we reviewed national-death certificate data for an 18-year period.
METHODOLOGY/PRINCIPAL FINDINGS: Echinococcosis-associated deaths from 1990 through 2007 were identified from multiple-cause-coded death records and were combined with US census data to calculate mortality rates. A total of 41 echinococcosis-associated deaths occurred over the 18-year study period. Mortality rates were highest in males, Native Americans, Asians/Pacific Islanders, Hispanics and persons 75 years of age and older. Almost a quarter of fatal echinococcosis-related cases occurred in residents of California. Foreign-born persons accounted for the majority of echinococcosis-related deaths; however, both of the fatalities in Native Americans and almost half of the deaths in whites were among US-born individuals.
CONCLUSIONS/SIGNIFICANCE: Although uncommon, echinococcosis-related deaths occur in the US. Clinicians should be aware of the diagnosis, particularly in foreign-born patients from Echinococcus endemic areas, and should consider tropical infectious disease consultation early.
尽管在美国（US）的一些地区，细粒棘球蚴和多房棘球蚴感染呈地方性流行，但有关包虫病相关死亡率的数据却很缺乏。为了测量美国的包虫病相关死亡率并评估可能存在的种族/民族差异，我们对 18 年来的全国死亡证明数据进行了审查。
方法/主要发现：从多因编码死亡记录中确定了 1990 年至 2007 年期间与包虫病相关的死亡，并结合美国人口普查数据计算了死亡率。在 18 年的研究期间，共发生了 41 例与包虫病相关的死亡。男性、美国原住民、亚洲/太平洋岛民、西班牙裔和 75 岁及以上的人群死亡率最高。近四分之一的致命包虫病相关病例发生在加利福尼亚州的居民中。外国出生的人占包虫病相关死亡的大多数；然而，在原住民中发生的两例死亡和白人中近一半的死亡都是在美国出生的人。
结论/意义：尽管罕见，但美国仍有包虫病相关死亡。临床医生应注意诊断，特别是在来自包虫病流行地区的外国出生的患者中，并且应尽早考虑热带传染病咨询。
