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西部低地大猩猩的肺泡型棘球蚴病():阿苯达唑无法阻止疾病进展。

ALVEOLAR ECHINOCOCCOSIS IN WESTERN LOWLAND GORILLAS (): ALBENDAZOLE WAS NOT ABLE TO STOP PROGRESSION OF THE DISEASE.

作者信息

Wenker Christian, Hoby Stefan, Wyss Fabia, Mengiardi Bernard, Vögtli Renate, Posthaus Horst, Deplazes Peter, Gottstein Bruno

机构信息

Zoo Basel, 4054 Basel, Switzerland.

IMAMED Radiologie Nordwestschweiz, 4051 Basel, Switzerland.

出版信息

J Zoo Wildl Med. 2019 Mar 1;50(1):243-253. doi: 10.1638/2018-0064.

Abstract

is the etiologic agent of alveolar echinococcosis (AE), a severe and potentially fatal larval cestode infection primarily affecting the liver. AE is known to occur in dead-end intermediate hosts, including humans and nonhuman primates. Between 1999 and 2016, AE was diagnosed in seven western lowland gorillas (), all from a Swiss zoo. Six gorillas died of the disease. One individual is still alive, receives continuous albendazole medication, and shows no clinical signs. Most infected animals remained asymptomatic for years. Only one young gorilla showed early signs of acute discomfort and abdominal pain. In the final stage of the disease, affected animals died suddenly, or showed a short course of nonspecific but severe clinical signs, including lethargy, recumbency, abdominal enlargement, and anorexia. Postmortem examination confirmed hepatic AE complicated by peritonitis in most cases. infection may remain undetected because of a very long incubation period. Hematological and biochemical parameters rarely showed abnormalities in this phase. Thus, inclusion of abdominal hepatic ultrasound examination and serology is recommended for early AE detection in routine examinations of gorillas in endemic areas or where food is potentially contaminated with eggs. Ultrasound or computed tomography was useful to monitor progression and to estimate the volumetric extension of the hepatic lesions. Current medication with albendazole, which proved to be effective for human patients, was not able to stop progression of hepatic lesions in gorillas. Therefore, its therapeutic value remains questionable in gorillas. However, long-term oral albendazole treatment proved to be safe, and therapeutic plasma levels published for humans were achieved. Preventive measures such as thermo-treatment of food or vaccination of gorillas and other nonhuman primates should be considered in areas where is present.

摘要

是泡型包虫病(AE)的病原体,AE是一种严重且可能致命的幼虫绦虫感染,主要影响肝脏。已知AE发生在终末中间宿主中,包括人类和非人类灵长类动物。1999年至2016年间,在7只西部低地大猩猩()中诊断出AE,它们均来自瑞士一家动物园。6只大猩猩死于该病。1只个体仍然存活,接受持续的阿苯达唑药物治疗,且无临床症状。大多数受感染动物多年来一直无症状。只有1只年轻大猩猩出现了急性不适和腹痛的早期迹象。在疾病的最后阶段,患病动物突然死亡,或表现出短暂的非特异性但严重的临床症状,包括嗜睡、侧卧、腹部肿大和厌食。尸检在大多数情况下证实为肝AE并发腹膜炎。由于潜伏期很长,感染可能未被发现。在此阶段,血液学和生化参数很少显示异常。因此,建议在流行地区或食物可能被虫卵污染的地区对大猩猩进行常规检查时,采用腹部肝脏超声检查和血清学检查以早期检测AE。超声或计算机断层扫描有助于监测病情进展并估计肝脏病变的体积范围。目前用于人类患者且已证明有效的阿苯达唑药物治疗,未能阻止大猩猩肝脏病变的进展。因此,其在大猩猩中的治疗价值仍存在疑问。然而,长期口服阿苯达唑治疗被证明是安全的,并且达到了公布的人类治疗血浆水平。在存在的地区,应考虑采取诸如食物热处理或大猩猩及其他非人类灵长类动物疫苗接种等预防措施。

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