A 13th-century cystic echinococcosis from the cemetery of the monastery of Badia Pozzeveri (Lucca, Italy).

OBJECTIVE: To differentially diagnose a calcified formation recovered from a 13th century AD grave from the Tuscan monastery of Badia Pozzeveri, Lucca, Italy. MATERIALS: A calcified formation from the thoraco-abdominal region of a skeleton buried in the monastery cemetery. METHODS: Cone Beam Computed Tomography, Scanning Electron Microscope and Energy Dispersive X-Ray Spectroscopy. RESULTS: A hollow, calcified ovoid formation was identified as typical of a hydatid cyst, permitting the diagnosis of cystic echinococcosis in a 35-45year-old female. CONCLUSIONS: The study reveals the circulation of the parasite Echinococcus granulosus in the region of Lucca in late medieval Tuscany. SIGNIFICANCE: This finding is the fourth case of cystic echinococcosis from an archaeological context in Italy and provides insight into environmental conditions that appear to have affected members of a community, irrespective of social status. LIMITATIONS: Caution and the application of multiple analyses must be exercised in the differential diagnosis to discriminate among calcified formations. SUGGESTIONS FOR FURTHER RESEARCH: Analysis of stable isotopes of the calcified formation, such as 15N and 13C, in order to compare them with isotopic values of the host individual and to further confirm the parasitic origin of the find.

Hydatid cysts in Classical and late Antiquity / Quistes hidatídicos en la Antigüedad clásica y tardía

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A possible Echinococcus granulosus calcified cyst found in a medieval adult female from the churchyard of Santo Domingo de Silos (Prádena del Rincón, Madrid, Spain).

Calcification, or mineralisation, can occur as part of a natural process, or by pathological processes. The purpose of this work is to examine an unidentified semi-spherical and perforate hollow mass, found near the pelvis of an adult female, dated 12th-13th century AD, exhumed of the Church of Santo Domingo de Silos (Prádena del Ricón, Madrid, Spain). The mass was examined by SEM and Energy Dispersive X-Ray Spectroscopy. These procedures revealed a heterogeneous inner surface with both smooth and irregular areas. A larger spherical and several smaller crescent-shaped perforations were noticed. X-ray microanalysis revealed the presence of the elements C, K, P, Ca, Al, Si, Fe, and Mg. The co-localisation of Ca and P suggests that they may be combined in a mineral matrix, likely formed in vivo. Other minerals probably came from the soil, although Fe could be related to the presence of blood. The macroscopic and microscopic appearances, chemical composition, and location of the calcified mass point to a possible hydatid cyst from Echinococcus granulosus, common in agricultural populations. This study used a suite of analytical techniques that are useful in the diagnosis of unknown calcified masses and can, therefore, be recommended for use in future analytical work.

Historical Aspects of Echinococcosis.

Echinococcosis is a zoonosis whose history dates back to antiquity. This article provides an overview on the general history of echinococcosis, including the elucidation of Echinococcus life cycles and the long controversy on the aetiology of the cystic and alveolar forms of echinococcosis (CE and AE), lasting about 100years since the middle of the 19th century. Furthermore, selected historical aspects of some fields of echinococcosis research are discussed and compared with our current knowledge, such as geographic distribution and epidemiology of CE (Echinococcus granulosus) and AE (Echinococcus multilocularis), clinical aspects and pathology, diagnosis in humans and animals, treatment (with focus on chemotherapy), control and basic research. A short paragraph is devoted to the neotropical forms of echinococcosis, caused by Echinococcus vogeli and Echinococcus oligarthrus. In this context the achievements of some ancestral pioneers of echinococcosis research are particularly highlighted and appreciated. Finally, the role of associations, international organizations (World Health Organization and others) and international working groups in echinococcosis research and control is briefly outlined. The retrospective reveals both the admirable achievements of our ancestors and the scientific progress of more recent times. But, it also shows the gaps in our knowledge, skills and resources that we need to control or even eradicate echinococcosis.

Cystic echinococcosis in Bulgaria 1996-2013, with emphasis on childhood infections.

The objective of this study was to determine some features of cystic echinococcosis among children and adolescents, such as epidemiology, diagnosis, organ localization, treatment, and social and environmental factors favoring transmission of the disease. The 18-year study period (1996-2013) includes officially registered primary cases treated surgically, and/or with drug therapy, and/or with the puncture, aspiration, injection, reaspiration technique. Organ localization of the cysts and the most common diagnostic procedures were studied from the patients' medical records. Groups of diseased and healthy children were surveyed to outline some of the environmental and social factors influencing morbidity. From 1996 to 2013, the average annual incidence of cystic echinococcosis in the country was 6.7 per 100,000, but with significant variations in the incidence between different age groups. The hydatid cysts in children aged 0 to 9 years may most frequently be found in the lungs, in contrast to patients from other age groups. Almost 90% of the affected children had sustained contact with dogs. At present, among the countries of the European Union, Bulgaria holds the highest incidence and prevalence of cystic echinococcosis. Childhood echinococcosis remains a serious health problem for the country. Therefore, the study of cystic echinococcosis in children has important epidemiological significance concerning the intensity of transmission.

Cystic echinococcosis in Sudan and South Sudan: research history of a neglected zoonosis.

Cystic echinococcosis is a zoonotic disease affecting mainly various species of livestock and humans. This study aims at highlighting the course of research on cystic echinococcosis in different animals and humans in Sudan (including the recently independent state of South Sudan) since the disease was first reported in 1908. Recent data about the genetic identification of the parasite in the countries in both humans and animals and its importance for future control programs is discussed.

What skeletons tell us. The story of human paleopathology.

Human skeletal paleopathology provides important insight regarding the antiquity of some diseases and their distribution in past human groups. The history of human skeletal paleopathology extends back more than 150 years. Rudolf Virchow published reports on the subject, and research on paleopathology has provided critical data on important topics such as the origin of syphilis. With the development of powerful new research tools, human paleopathology will continue to be a source of data on the development of disease and its effect on human biological and cultural development.

Epidemiology and epizootology of cystic echinococcosis in Romania 1862-2007.

Infections with cestodes from genus Echinococcus are usually acquired by oral ingestion of eggs, direct contact with carriers, and contaminated food (especially vegetables) or water. Echinococcosis, previously characterized as a malady of medical importance only, depends upon veterinary solutions and faces political obstacles; it is considered the most important zoonotic disease in Romania. As a result of the increased number of human and animal cases, Romania was framed in the forefront of the European countries and among the first countries worldwide in 1995. The present paper is the first international systematized review concerning echinococcosis in Romania. It covers a period of 146 years, beginning in 1862, when the first case of human hydatid disease was mentioned in medical annals, until 2007 and aims at overviewing and analyzing data provided by major studies from different fields of human and veterinary medicine. Authors also present unpublished data of a 37-year surveillance performed in a reference infectious disease hospital. During the period 1979-1988, 8557 patients were hospitalized for hydatid disease requiring 210,057 days of health care, and 516 fatalities (6.03%) were registered. The prevalence of the disease in livestock during the period 1983-1994 varied between 24.3% and 92.9% in sheep, 31.2% and 43.6% in cattle, and 20.4% and 73.8% in swine. The economic losses in animals are very high due not only to increased mortality rates but also to weight loss and decreased productivity. Epidemiological data available showed that at least one person from 45.5% of Romanian localities underwent surgery for cystic echinococcosis. The information presented outlines the severity of the situation from human- and livestock-associated cystic echinococcosis in Romania. Control programs based on combinations of animal vaccination, dehelmintization of dogs, and education programs should be implemented to achieve effective prevention of disease transmission.

Emergence of polycystic neotropical echinococcosis.

Echinococcosis is a parasitic zoonosis of increasing concern. In 1903, the first cases of human polycystic echinococcosis, a disease resembling alveolar echinococcosis, emerged in Argentina. One of the parasites responsible, Echinococcus oligarthrus, had been discovered in its adult strobilar stage before 1850. However, >100 years passed from the first description of the adult parasite to the recognition that this species is responsible for some cases of human neotropical polycystic echinococcosis and the elucidation of the parasite's life cycle. A second South American species, E. vogeli, was described in 1972. Obtaining recognition of the 2 species and establishing their connection to human disease were complicated because the life cycle of tapeworms is complex and comprises different developmental stages in diverse host species. To date, at least 106 human cases have been reported from 12 South and Central American countries.

Un desafío a la justicia social peronista: la hidatidosis en la provincia de Buenos Aires, 1946-1952 / A challenge to Peronism's social justice: hydatidosis in the province of Buenos Aires, 1946-1952

Analiza las políticas sanitarias del gobierno de Domingo Alfredo Mercante (1946-1952) - mano derecha de Juan Domingo Perón - en la provincia de Buenos Aires, Argentina, atendiendo a lo que fue una de sus más instigantes líneas de intervención: la erradicación de la hidatidosis. Visibilizando un problema largamente olvidado por la historiografía, especificaremos de qué modo el gobierno mercantiano colocó a la hidatidosis en la agenda estatal a través de una legitimación estadística, socioeconómica y simbólica. Luego, especificaremos las estrategias de esta gestión: sanción de leyes regulatorias contra la endemia, creación de instituciones específicas antihidatídicas estatales, generación de espacios de información y educación interdisciplinaria, interministerial y hasta supranacionales con el fin de alcanzar el mayor conocimiento sobre la enfermedad e intercambiar experiencias que enriquecieran su propia práctica y, finalmente, la definición de acciones enfocadas en el relevo, tratamiento y profilaxis de animales y personas.

This analysis of the sanitary policies enforced in the province of Buenos Aires by Domingo Alfredo Mercante-Juan Domingo Perón's right-hand man - focuses on one of his most fascinating efforts: the eradication of hydatidosis.In exploring an issue largely forgotten by historiography, the article describes how the Mercante administration (1946-52) used statistical, socioeconomic, and symbolic legitimization to place hydatidosis on the State agenda. The administration's strategies are also pinpointed: the passing of regulatory laws against this endemic disease; the creation of specific state anti-hydatidosis institutions; the creation of space for information and for interdisciplinary, interministerial, and even supranational education aimed at achieving greater knowledge of the disease and at the exchange of experiences; and, lastly, the definition of initiatives focused on relief, treatment, and prevention in animals and people.

Un desafío a la justicia social peronista: la hidatidosis en la provincia de Buenos Aires, 1946-1952 / A challenge to Peronism's social justice: hydatidosis in the province of Buenos Aires, 1946-1952

Analiza las políticas sanitarias del gobierno de Domingo Alfredo Mercante (1946-1952) - mano derecha de Juan Domingo Perón - en la provincia de Buenos Aires, Argentina, atendiendo a lo que fue una de sus más instigantes líneas de intervención: la erradicación de la hidatidosis. Visibilizando un problema largamente olvidado por la historiografía, especificaremos de qué modo el gobierno mercantiano colocó a la hidatidosis en la agenda estatal a través de una legitimación estadística, socioeconómica y simbólica. Luego, especificaremos las estrategias de esta gestión: sanción de leyes regulatorias contra la endemia, creación de instituciones específicas antihidatídicas estatales, generación de espacios de información y educación interdisciplinaria, interministerial y hasta supranacionales con el fin de alcanzar el mayor conocimiento sobre la enfermedad e intercambiar experiencias que enriquecieran su propia práctica y, finalmente, la definición de acciones enfocadas en el relevo, tratamiento y profilaxis de animales y personas.(AU)

[Historical aspects of echinococcosis--an ancient but still relevant zoonosis]. / Historische Aspekte der Echinococcose--einer uralten, aber noch immer relevanten Zoonose.

The history of echinococcosis in Europe includes a period of over 2000 years. Already in antiquity metacestodes (hydatids) of Echinococcus granulosus, the causative agents of Cystic Echinococcosis (CE), were observed in animals and humans. Alveolar Echinococcosis (AE), caused by metacestodes of E. multilocularis, was identified as a disease entity only in the middle of the 19th century. It took about 100 years until it was undoubtedly clarified and accepted that CE and AE are not caused by a single Echinococcus species, but by E. granulosus and E. multilocularis, respectively. In the 20th century significant progress has been achieved in echinococcosis research, including diagnosis, epidemiology, therapy, immunology, molecular biology and other fields. However, CE and AE remain actual problems as in many endemic regions resources and structures are lacking for effective surveillance and control of these zoonoses threatening humans.

[112 years of hydatid surgery in Bulgaria (1895-2007)].

Hydatid surgery in Bulgaria dates back of a hundred years. Most of famous Bulgarian surgeons have worked about problem of all locations of the Echonococcus granulosus in the human organism. Their scientific achievements are covered in more of two hundred theses, publications, dissertations. The hydatid disease always was in the schedule of every scientific forums - congresses, conferences, etc. A Bulgarian scientific council has been established with a great experience and very good postoperative results. It's many innovations in diagnostics and surgical treatment, accepted all over the world. Renovations of work in this field are develop. Prophylactic measures for this severe and common disease have been undertaken.

[A challenge to Peronism's social justice: hydatidosis in the province of Buenos Aires, 1946-1952]. / Un desafío a la justicia social peronista: la hidatidosis en la provincia de Buenos Aires, 1946-1952.

This analysis of the sanitary policies enforced in the province of Buenos Aires by Domingo Alfredo Mercante--Juan Domingo Perón's right-hand man--focuses on one of his most fascinating efforts: the eradication of hydatidosis. In exploring an issue largely forgotten by historiography, the article describes how the Mercante administration (1946-52) used statistical, socioeconomic, and symbolic legitimization to place hydatidosis on the State agenda. The administration's strategies are also pinpointed: the passing of regulatory laws against this endemic disease; the creation of specific state anti-hydatidosis institutions; the creation of space for information and for interdisciplinary, interministerial, and even supranational education aimed at achieving greater knowledge of the disease and at the exchange of experiences; and, lastly, the definition of initiatives focused on relief, treatment, and prevention in animals and people.