Echinostoma miyagawai is a cosmopolitan parasite within the Echinostomatidae and is a cause of human echinostomiasis. Species within the family have been a challenge to disentangle with E. miyagawai being synonyms of several other Echinostoma species. However, complete mitochondrial genomes have been shown to be vital in distinguishing echinostomatid species, but detailed comparisons of not only gene content but also structural features have been limited. Using long range sequencing techniques, the complete mitochondrial genome of E. miyagawai was sequenced and compared to other members of Echinostomatidae. In total 12 protein coding genes, 2 ribosomal RNA genes and 22 transfer RNA genes were identified, as was an extensive noncoding control region (CR), consisting of 2 types of multiple tandem repeat units. Phylogenetic analyses of complete mitochondrial genomes corresponded to previous studies on single mitochondrial genes and nuclear ribosomal nuclear markers confirmed E. miyagawai to be within in the ‘Echinostoma revolutum’ group. The tandem repeat units found in the CR contained promoter sequences containing domains typical of initiation sites for replication and transcription as well as several palindromic regions which were shared between echinostomatid species. The study illustrates not only the utility complete mitogenomes in disentangling the relationship between these parasite species, but also provides some insight into the potential adaptations and other evolutionary processes that may govern the divergence of mitochondrial genomes for the first time in echinostomatids.

Ponto-Caspian gobies became highly abundant in many regions outside their native distribution range (e.g. in the Rhine River system). In the newly invaded habitats, the parasite communities of the invasive gobies are characterized by a lower species richness compared to their native range. Interestingly, acanthocephalans of the genus Pomphorhynchus are highly abundant, although they do not become mature and mostly remain encapsulated in the abdominal cavity as preadults. Thus, gobiids could either represent a dead-end host for Pomphorhynchus sp. declining its population (dilution effect) or act as a paratenic host that could increase the infection pressure if the infected gobies are preyed upon by appropriate definitive hosts (spill back). To determine which of the 2 scenarios the gobiids contribute to, we conducted 2 infection experiments using smaller and larger individuals of the definitive host chub (Squalius cephalus), infected with preadults of Pomphorhynchus sp. collected from the abdominal cavity of Neogobius melanostomus. The results showed that preadults were able to complete their development and mature in the definitive host with mean recovery rates of 17.9% in smaller and 27.0% in larger chubs. Successful infections were observed in 62.0% and 80.0% of the smaller and larger chubs, respectively. Our study demonstrated that gobies can theoretically serve as a paratenic host for acanthocephalans of the genus Pomphorhynchus, and that infection might spill back into the local fish community if infected gobies are preyed upon by suitable definitive hosts of Pomphorhynchus sp. such as large barbel or chub.

Cystic echinococcosis (CE), caused by Echinococcus granulosus s.l. is a neglected zoonosis posing a significant public health challenge. Little is known about human CE in Bhutan. This study was conducted to gain an understanding of the burden, distribution, and potential risk factors of CE in Bhutan. From January 2015 to December 2019 data from Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) and 6 other district-level hospitals were reviewed. Descriptive statistics were used to summarize the data. DALYs and Poisson regression models were used to estimate the burden and explore the relationship between cases and possible risk factors. A total of 159 cases were recorded. Most cases (145) were admitted to the surgical ward and 14 cases were referred to India. The average annual incidence was 4.4 cases per 100 000 population. The burden of disease was estimated to be approximately 39 DALYs per year for treatment-seeking cases, or possibly 80 DALYs per year including non-treatment seeking cases. This translates to approximately to 5.2 DALYs and 10.2 per 100 000 per year respectively. The commonest sites of infection were the liver (78%) and lungs (13%). Most cases were treated with surgery (>82%), and more than 47% were admitted to the hospital for >4 days. Policy interventions targeting community engagement, awareness, education, high risk occupational groups, females, and those living in the endemic districts of the central and western regions may yield larger gains. More studies and the institution of a surveillance system can help better guide policy interventions.

Human alveolar echinococcosis is a hard-to-treat and largely untreated parasitic disease with high associated health care costs. The current antiparasitic treatment for alveolar echinococcosis relies exclusively on albendazole, which does not act parasiticidally and can induce severe adverse effects. Alternative, and most importantly, improved treatment options are urgently required. A drug repurposing strategy identified the approved antimalarial pyronaridine as a promising candidate against Echinococcus multilocularis infections. Following a 30-day oral regimen (80 mg kg−1 day−1), pyronaridine achieved an excellent therapeutic outcome in a clinically relevant hepatic alveolar echinococcosis murine model, showing a significant reduction in both metacestode size (72.0%) and counts (85.2%) compared to unmedicated infected mice, which revealed significantly more potent anti-echinococcal potency than albendazole treatment at an equal dose (metacestode size: 42.3%; counts: 4.1%). The strong parasiticidal activity of pyronaridine was further confirmed by the destructive damage to metacestode tissues observed morphologically. In addition, a screening campaign combined with computational similarity searching against an approved drug library led to the identification of pirenzepine, a gastric acid-inhibiting drug, exhibiting potent parasiticidal activity against protoscoleces and in vitro cultured small cysts, which warranted further in vivo investigation as a promising anti-echinococcal lead compound. Pyronaridine has a known drug profile and a long track record of safety, and its repurposing could translate rapidly to clinical use for human patients with alveolar echinococcosis as an alternative or salvage treatment.

Dioctophyme renale, the giant kidney worm, is a nematode related to Trichuris sp and is distributed worldwide. These parasites locate in the kidney of their definitive hosts (mainly belonging to the order Carnivora) and have an indirect life cycle with an annelid as the main intermediate host. Humans are rarely affected, but in those that are, 1 or both kidneys are destroyed. In South America, D. renale is widespread in riparian regions where changing climatic conditions, environmental degradation, and compromised sanitation are increasing the risk of distribution of this parasite, including humans. Here, we provide the descriptions of the genetic diversity of the parasite in the region by analysing 73 adult D. renale samples collected from domestic and wild carnivores. The most common hosts were (Canis lupus familiaris) and maned wolf (Chrysocyon brachyurus Fam. Canidae) among domestic and wild carnivores, respectively. This work shows the descriptions of the genetic diversity of this parasite complementing molecular methods and classical and probabilistic phylogeography. Our results strongly suggest that this parasite has been present on the continent long enough to develop local genetic variants. Also, the phylogenies show transmission between localities and bidirectional transmission between domestic and wild species. We now have new tools to understand the ecological dynamics of this parasite such as molecular markers to study its genetic diversity as well as for identification and reporting in cryptic cases.

The study aimed to assess the heterogeneity in the distribution of disease awareness, attitudes, and practices related to cystic echinococcosis (CE) in different subgroups and inform health authorities regionally and globally for future evidence-based tailored prevention practices in the region. A cross-sectional study was conducted with 242 participants from Kyrgyz Republic (KR), Issyk-Kul oblast, and utilized survey data to analyse demographics, household information, echinococcosis-related practices, and knowledge. Participants in high-risk environments (HRE) and engaging in high-risk behaviours (HRB) linked to CE contracting were identified. Out of 242 participants, 39% lived in HRE, with 22% engaging in HRB of contracting CE. 13% lived in HRE and engaged in HRB. Only 6% followed all preventive measures, while 56% followed some. 97.5% of participants had heard about CE, but only 6% identified all transmission routes, and 63.4% were unaware of dog contact as a route. Education reduced the odds of being in the highest risk group (HRE&HRB) (OR 0.5, 95% CI 0.23–0.80). The study's findings are alarming, emphasizing factors contributing to regional endemicity. We anticipated a similar pattern in the neighbouring countries, given the shared nomadic customs and historical parallels. Examination of the heterogeneity of disease awareness and practices allows tailored prevention strategies. Urgent prevention programmes focusing on echinococcosis awareness in the KR are crucial to addressing challenges posed by nomadic habits.

Cystic and alveolar echinococcosis are considered the second and third most significant foodborne parasitic diseases worldwide. The microscopic eggs excreted in the feces of the definitive host are the only source of contamination for intermediate and dead-end hosts, including humans. However, estimating the respective contribution of the environment, fomites, animals or food in the transmission of Echinococcus eggs is still challenging. Echinococcus granulosus and E. multilocularis seem to have a similar survival capacity regarding temperature under laboratory conditions. In addition, field experiments have reported that the eggs can survive several weeks to years outdoors, with confirmation of the relative susceptibility of Echinococcus eggs to desiccation. Bad weather (such as rain and wind), invertebrates and birds help scatter Echinococcus eggs in the environment and may thus impact human exposure. Contamination of food and the environment by taeniid eggs has been the subject of renewed interest in the past decade. Various matrices from endemic regions have been found to be contaminated by Echinococcus eggs. These include water, soil, vegetables and berries, with heterogeneous rates highlighting the need to acquire more robust data so as to obtain an accurate assessment of the risk of human infection. In this context, it is essential to use efficient methods of detection and to develop methods for evaluating the viability of eggs in the environment and food.

This study aimed to explore extracellular microRNA derived from Echinococcus multilocularis (EM) in the plasma of patients with alveolar echinococcosis (AE) and assess its potential as a diagnostic biomarker. EM-derived miRNAs were identified in plasma samples from 20 AE patients through miRNA sequencing. Three novel miRNA molecules (emu-miR-novel 1, 2 and 3) were predicted through bioinformatic analysis to elucidate their chromosomal locations, secondary structures and precursor forms. Subsequently, plasma samples from 30 AE patients and 30 controls were utilized to establish an assay via stem-loop reverse transcription PCR, optimizing primers, reaction systems, and conditions to assess cross-reactivity and sensitivity. Clinical validation revealed that emu-miR-novel 1 had the highest diagnostic accuracy, with an area under the curve (AUC) of 0.8994, a P value of less than 0.0001, a sensitivity of 83.3%, and a specificity of 86.7%. Statistically significant differences were observed between the groups for emu-miR-novel 1 (P < 0.05), whereas emu-miR-novel 2 and 3 showed AUC values of 0.7922 and 0.6883, with P values of 0.0001 and 0.012, respectively, indicating no significant difference between groups (P > 0.05). Furthermore, the assay showed no cross-reactivity with samples from 18 common viruses, 4 parasitic infections, and miRNAs from AE sequenced from 8 species, confirming its high specificity. Emu-miR-novel 1 exhibited a sensitivity of 1 femtomolar. Emu-miR-novel 1 holds promise as a key diagnostic tool for AE, offering a novel perspective and approach for disease diagnosis.

Cystic echinococcosis control in South American countries requires a comprehensive integrative ‘One Health’ approach. While insular nations have seen successful in their elimination programmes, South American countries face persistent challenges in hostile environments, with Echinococcus granulosus s.l., posing a significant public health concern. Vaccination of intermediate hosts has demonstrated the efficacy of the EG95 vaccine in reducing transmission rates. For example, since 2009, Rio Negro Province in Argentina has added, with marked success, the EG95 vaccine to the control programme, supplementing dog deworming. The Aysen Region of Chile has also reported encouraging preliminary results in reducing cyst prevalence in vaccinated sheep after 3 years of vaccination. The challenges in aligning control strategies with socio-cultural factors, especially in indigenous communities, underlines the need for context-specific strategies. The Rio Negro programme demonstrated commendable compliance, underlining the importance of community engagement in achieving lasting success. The most promising strategies for effective echinococcosis control involved dog deworming and the routine vaccination of sheep and/or goats, underscoring the importance of sustained implementation until all grazing animals have been replaced. For lasting success, these interventions need to be combined with a robust surveillance system.