Download Echinococcosis (Hydatid disease) ICD

Echinococcosis (Hydatid disease)
ICD-10 B67
Identification
A space occupying disease, in humans caused by the larval stage of the
dog tapeworm, Echinococcus granulosus. The signs, symptoms and
extent of disease are determined by the size and location of the unilocular
cysts (hydatid cyst) that are characteristic of this disease. Symptoms
develop as result of pressure, leakage and rupture of cysts. The most
common site for the cysts is the liver; less commonly brain, lungs, kidney
and uncommonly the heart, thyroid and bone. Cyst may remain viable or
.dies and calcifies. They may be detected on routine x-ray
Case classification
Suspected: clinically suspected case with history of contact to animals or
animal viscera Probable: diagnosis by plain x-ray, ultrasound or CT,
casoni test
)Confirmed: Laboratory (PCR , IFAT , ELISA
Infectious agent 3.4.2
Echinococcus granulosus
Reservoir
Dogs and foxes. Major intermediate hosts include goats, sheep, and
.cattle
Mode of transmission 3.4.5
Infection occurs by hand-to mouth transfer of tapeworm eggs from dog
.faces
The larvae penetrate the intestinal mucosa, enter the portal system and
carried to various organs where they produce the cysts. The important
.life cycle is the dog-sheep-dog
Incubation period 3.4.6
.Variable, from months to years
Period of communicability 3.4.7
Not communicable through person-to-person transmission. Dogs pass
eggs approximately seven weeks after infection. In the absence of
.reinfection, this ends in about one year
Susceptibility and resistance 3.4.8
.Adults (ages 15-49) are more often infected than children
Methods of control 3.4.9
a Preventive measures3.4.9
•
Educate the public on the danger of close association with dogs and
.on the need to wash hands after contact with dogs
.Treat infected dogs and destroy unwanted dogs
•
Control slaughter of animals, particularly sheep. The area should
•
be enclosed to prevent the access by dogs and have adequate drainage, an
.incinerator and/ or disposal pit
b Control measures3.4.9
.Monthly report of cases to health authority
•
.No need for isolation, or concurrent disinfection
•
•
Surgery is treatment of choice. Mebendazole is used when surgery
.is contraindicated
.Household contacts should be examined for evidence of infection
.Dogs on contact with patient should be investigated
•
•
Management of the disease 3.4.10
Two benzimidazolic drugs, mebendazole and albendazole, are the
only anthelmintics effective against cystic echinococcosis. Albendazole
.and mebendazole are well tolerated but show different efficacy
Albendazole is significantly more effective than mebendazole in
the treatment of liver cysts. Benzimidazole treatment alone requires
prolonged administration over many weeks, with an unpredictable
.outcome in terms of response rates in individuals
o
Treatment with albendazole in E granulosus infection can result in
o
an apparent cure in as many as 30% of patients, with a further 40-50% of
patients showing objective evidence of response when observed short
term. Patients who do not show obvious initial evidence of response may
.be found to be cured when observed over several years
Albendazole efficacy increases with courses of up to 3 months in
the more common cyst sites. Overall, albendazole has been demonstrated
to be a useful advance in the management of cystic echinococcosis when
.used as sole treatment or as an adjunct to surgery or other treatments