Epidemiology of echinococcosis in Kazakhstan: an update.

Kazakhstan is highly endemic for echinococcosis. Both Echinococcus granulosus and E. multilocularis are widely distributed in the country. Official records of human cystic echinococcosis over the past 5-10 years suggest a stable incidence of approximately 800-1000 cases per year, which is 5 cases per 100,000 per year. This followed a rapid increase in the incidence following the dissolution of the Soviet Union. Between 2007 and 2013, 5949 cases were reported in the national surveillance data. The prevalence in sheep, based on slaughterhouse studies, suggests that between 30 and 50% of sheep are infected with hydatid cysts, while cattle have a prevalence of approximately 7%. Rural dogs have a high prevalence of infection of between 5 and 10%, with shepherd dogs having prevalences of over 20%. G1 and G6/7 strains of E. granulosus have been isolated from dogs in Kazakhstan. Wolves are also infected, with one prevalence estimate of approximately 20%. The incidence of human alveolar echinococcosis is less clear, although estimates from Kazakhstani expatriates living in Germany and the hospital records of a single referral centre in Almaty suggest 34 or 130 cases per year (or an annual incidence of 0.20 or 0.76 cases per 100,000), respectively, could be occurring in Kazakhstan. Studies suggest that in some rural dog populations the prevalence may be about 5%. The parasite is widely distributed in foxes and small mammals through much of Kazakhstan.