Division of Infectious Diseases, University of Vermont Larner College of Medicine, Burlington, Vermont, USA.
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
Clin Infect Dis. 2021 Apr 8;72(7):1117-1123. doi: 10.1093/cid/ciaa245.
Echinococcus multilocularis is one of the most severe and lethal parasitic diseases of humans, most often reported in Europe and Asia. Only 1 previous case has been documented in the contiguous United States from Minnesota in 1977. European haplotypes have been identified in carnivores and domestic dogs as well as recently in patients in western and central Canada.
We used immunohistochemical testing with the monoclonal antibody Em2G11 and a species-specific enzyme-linked immunosorbent assay affinity-purified antigen Em2, as well as COX1 gene sequencing.
Using pathology, immunohistochemical staining, specific immunodiagnostic testing, and COX1 gene sequencing, we were able to definitively identify E. multilocularis as the causative agent of our patient's liver and lung lesions, which clustered most closely with the European haplotype.
We have identified the first case of a European haplotype E. multilocularis in the United States and the first case of this parasitic infection east of the Mississippi River. Given the identification of this haplotype in Canada, this appears to be an emerging infectious disease in North America.
泡状棘球蚴病是人类最严重和致命的寄生虫病之一，主要发生在欧洲和亚洲。1977 年，美国明尼苏达州曾有 1 例病例报告。在欧洲，在肉食动物和家养犬中以及最近在加拿大西部和中部的患者中都发现了欧洲单倍型。
我们使用单克隆抗体 Em2G11 进行免疫组织化学检测，并使用种特异性酶联免疫吸附测定亲和纯化抗原 Em2，以及 COX1 基因测序。
通过病理学、免疫组织化学染色、特异性免疫诊断检测和 COX1 基因测序，我们能够明确鉴定出泡状棘球蚴病是导致我们患者肝和肺病变的原因，其与欧洲单倍型最为密切相关。
我们在美国发现了首例欧洲单倍型泡状棘球蚴病病例，也是密西西比河以东首例此类寄生虫感染病例。鉴于在加拿大发现了这种单倍型，这似乎是北美正在出现的一种传染病。
