The pathology, phylogeny, and epidemiology of Echinococcus ortleppi (G5 genotype): a new case report of echinococcosis in China

Abstract

Background Cystic echinococcosis (CE), caused by the larval stage of the complex Echinococcus granulosus sensu lato (s.l.), is a zoonotic parasitic disease with a high social burden in China. E. ortleppi is a species (formerly genotype 5 of E. granulosus s.l.) with unique epidemic areas (tropical areas), transmission patterns (mainly cattle origin), and pathological characteristics (large and small hook lengths) compared to other species that cause CE. A 19-year-old female patient in an area with no history of echinococcosis in Guizhou Province, China, was diagnosed with E. ortleppi infection in 2019. This study is to understand the source of this human E.ortleppi infection. Methods We performed computer tomography (CT) scans, surgical operation, morphological sectioning, molecular diagnosis, phylogenetic analyses, and epidemiological investigation in Anshun City, Guizhou Province, China in 2019. Results The patient presented with intermittent distension and pain in the upper abdomen without other abnormal symptoms. Routine blood examination results were normal. However, abdominal CT revealed a fertile cyst with a diameter of approximately 8 cm, uniform density, and a clear boundary, but without an evident cyst wall in the right lobe of the liver. The cyst was fertile, and phylogenetic analyses revealed that the isolates represented a new E. ortleppi genus haplotype. A result of 10‒14 years incubation period with indigenous infection was considered available for the case through the epidemiological survey. Conclusions CE due to E. ortleppi infection can be confused with other diseases causing liver cysts, resulting in misdiagnosis. A transmission chain of E. ortleppi may exist or existed in the past in the previously considered non-endemic areas of echinococcosis in southwestern China. Graphic abstract

Molecular Epidemiology and the Control and Prevention of Cystic Echinococcosis in China: What is Known from Current Research

“…As anticipated, G1 is also the dominant genotype in China, and the majority of reported cases are concentrated in the Qinghai-Tibet Plateau, where the epidemic is most severe. The geographic distribution of different genotypes from human CE reported in China is delineated in Fig 2 and Table 1 [9,31,32]. Human CE cases caused by G1, G3, and G6 have been reported in echinococcosis endemic provinces (Xinjiang, Qinghai, Sichuan, Gansu, Ningxia, Tibet, and Inner Mongolia), whereas human CE cases caused by G1, G5, G7, and G10 have been reported in echinococcosis non-endemic provinces (Heilongjiang, Liaoning, Guangxi, and Guizhou).…”

“…In addition, an increasing number of E. granulosus s.l. genotypes and haploids from different regions or hosts have been reported over the years, even in non-endemic areas [9]. An emphasis on genotypes is not part of the current national control and prevention program, and surveys regarding the various genotypes from humans and animal hosts have not received sufficient attention.…”

Weighted gene co-expression network analysis reveals immune evasion related genes in Echinococcus granulosus sensu stricto

“…E. granulosus s.l. is a cluster that groups different species of Echinococcus such as E. equinus , E. ortleppi , E. canadensis , E. felidis and E. granulosus sensu stricto (s.s.) [ 5 ]. The latter, which corresponds to the sheep-dog cycle, is the main E. granulosus s.l.…”

Cytology and Genetic Analysis of Liver Echinococcosis in a Woman Came from Bolivia

“…Meanwhile, E. ortleppi infection was first reported in a herd of cattle in Holland; thus, it was named a cattle strain [6] [7]. Hosts of E. ortleppi have been reported from cattle, camels, pigs, goats, sheep and wild animals, and humans in many regions, Europe, Africa, the Middle East, Asia and Latin America [12] [13]. However, E. ortleppi infection has not been reported in Japan.…”