棘球蚴(包虫)病160年控制失败和成功经验教训及我国的控制对策

Failures and successes learned from 160 years of echinococcosis control and countermeasures in China

1853年明确棘球绦虫循环史后,冰岛于1863年率先启动针对切断病原循环链的控制措施,十多个国家/地区随之也先后实施了控制计划,在至今的160余年期间,即有失败的教训,也有成功的经验。本文回顾和总结了几个具有代表性的国家(地区)包括冰岛、新西兰、乌拉圭、英国威尔士、肯尼亚图尔卡纳和意大利撒丁岛实施细粒棘球蚴病(由细粒棘球绦虫Echinococcus granulosus引起)的防控措施实例,分析其失败的原因和成功的经验,重点总结宣教、犬驱虫、病畜屠宰管制等措施对棘球蚴病控制的作用。因多房棘球蚴病(由多房棘球绦虫Echinococcus multilocularis引起)尚没有很成功的控制经验,但根据多房棘球绦虫在犬体内寄生30 d排卵及幼虫寄生在啮齿类动物体内的生物学特性,对多房棘球蚴病高发地区的犬采取每月驱虫1次可以作为控制该病的基本措施。

The transmission cycle of echinococcosis was established in 1853.More than 160 years have elapsed since Iceland initiated control measures to break the transmission cycle of echinococcosis in 1863.Control plans have been implemented in more than a dozen countries/territories,and lessons have been learned from failures as well as successes.In this review,we focus on the failure experiences,which have also promoted successes in the control of cystic echinococcosis(caused by the parasite Echinococcus granulosus) in regions including Iceland,New Zealand,Uruguay,Wales(England),Turkana(Kenya),and Sardinia(Italy).The causes of the failures were analyzed,and the effects of health education,dog deworming,and control measures for infected animal slaughter on echinococcosis control are comprehensively summarized.However,no successful experience has been reported in the control of alveolar echinococcosis(caused by the parasite Echinococcus multilocularis).On the basis of the biological characteristics of E.multilocularis parasitization in dogs for a duration of 30 days and larvae parasitization in rodents,the fundamental measure for controlling alveolar echinococcosis is administration of monthly deworming treatments to dogs in high prevalence areas.