“…It is commonly found in high latitude regions of the northern hemisphere (such as Canada, Central Europe, Russian Federation, Mongolia, Hokkaido of Japan and Northern China), alpine regions (such as the Qinghai-Tibet Plateau of China) and permafrost regions (such as Alaska of USA) [ 28 ]. However, there is an obvious difference between E. ortleppi and E. multilocularis, according to the statistical results of Shi et al [ 17 ], E. ortleppi infection cases in humans or other intermediate hosts have been reported in Asia, Africa, America and Europe, but, the countries with more than 10 cases reported are mainly in the low-latitude tropical area, such as Brazil (536 cases) in South America [ 29 – 33 ], Ethiopia (13 cases) [ 29 , 34 ], Kenya (91 cases) [ 29 , 35 , 36 , Sudan (17 cases) [ 29 , 37 ], Zambia (53 cases) [ 29 ] and Namibia (38 cases) [ 29 ] in Africa, and India (12 cases) [ 2 , 38 , 39 ] in South Asia. So, it was inferred that there may be a stable tropical strain of Echinococcus in the long-term environmental adaptive evolution.…”