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a Public Health Laboratory Service, Communicable Disease Surveillance Centre (Welsh Unit), Abton House, Roath, Cardiff CF4 3QX, b Department of Biological Sciences, University of Salford, Salford M5 4WT, c Powys Health Promotion, Health Promotion Unit, Mansion House, Bronllys, Brecon, Powys LD3 0LS
Correspondence to: Professor Palmer.
Abstract
Objectives: To evaluate the success of the south Powys hydatid control programme by analysis of trends in cystic disease in humans and sheep and dog infestation.
Design: A review of hospital admissions for human hydatid disease in 1984-90, abattoir prevalence surveys of hydatid cysts in adult sheep, arecoline acetarsol and coproantigen surveys of prevalence of Echinococcus infestation in dogs.
Setting: All hospitals in England and Wales, three abattoirs, and dog populations in mid and south east Wales.
Subjects: Residents of England and Wales admitted to hospital between 1984 and 1990 with a new diagnosis of human hydatid disease (International Classification of Diseases (ICD), ninth revision, code 122) acquired in the United Kingdom.
Results: The average annual incidence of human hydatid disease in Powys, mid-Wales, fell from 3.9 x 10-5 in 1974-83 to 2.3 x 10-5 in 1984-90. Age specific incidence rates in Wales declined over this period only in children, and no cases occurred in children (<15 years) in Powys. Two Welsh children who lived in Gwent and mid-Glamorgan were infected. Prevalence of hydatid cysts in old sheep from south Wales declined during the control period, but in 1993 prevalence of cysts was 13%. Prevalence of E granulosus infestation was zero in the control area in 1993, but it was 2.4% in Powys dogs outside the control area in 1989 and 9.2% in dogs in Gwent in 1991.
Conclusions: Human hydatid disease has been successfully controlled in south Powys but cystic echinococcosis is still endemic in sheep in mid-Wales, and there is a focus of infection in humans, sheep, and dogs in the bordering areas of Gwent and mid-Glamorgan. There is considerable potential for an upsurge in human cases if control measures are relaxed.
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