Control of hydatid disease in WalesBMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7032.674 (Published 16 March 1996) Cite this as: BMJ 1996;312:674
- S R Palmer, regional epidemiologista,
- A H Biffin, principal scientista,
- P S Craig, professorb,
- T M Walters, hydatid disease campaign coordinatorc
- 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.
- Accepted 5 December 1995
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.
Humans are infected by ingesting eggs of the dog tapeworm, which the dog acquires by eating sheep offal containing hydatid cysts
Regular dosing of dogs with praziquantel has eliminated infestation of dogs in the control area and reduced prevalence in sheep
No cases in children occurred in Powys, but there were cases outside of the control area in Gwent and mid-Glamorgan
Prevalence of hydatid cysts in old sheep in Powys and Gwent is still high and control measures must be continued and the control area extended
We thank Dr Tony Swan, PHLS, for statistical advice.
Funding Powys Health Authority and Welsh Office.
Conflict of interest None.
- Accepted 5 December 1995