Echinococcus multilocularis in Northern Hungary

To the Editor: Echinococcus mul-tilocularis infection is one of the most dangerous zoonoses in the Northern Hemisphere and causes more human death than rabies in Europe. Recent data indicate that E. multilocularis infection is spreading geographically and is being transmitted at an increasing rate in Europe (Figure). Since 1995, the parasite has been found in Poland, the Czech Republic, the Slovak Republic, Belarus, Hungary, and Romania; infections in humans have been increasing in frequency in central eastern Europe since the late 1990s (1–4). Since the 1990s, similar infection trends in foxes and humans have been observed in central western European countries, including eastern Austria, northern Germany, Denmark, the Netherlands, Luxembourg, and Belgium (1,2,5). Despite the increasing prevalence of E. multilocularis infection in foxes, the number of human cases did not vary in the historically known area (eastern France, Switzerland, southern Germany, and western Austria) during the 1990s (1), probably because of increased public awareness and control measures. In our previous study (2), the parasite was detected only in foxes in the Hungarian-Slovak border area in northeastern Hungary. In the current study, we found the parasite distributed along the watershed area of the River Danube in northern Hungary. In the second half of 2003, carcasses of red foxes were sent to the Central Veterinary Institute in Budapest for examination in connection with the rabies immunization and control program in seven counties Borsod-Abaúj-Zemplén) that bordered or were near the border of Austria and the Slovak Republic. These foxes were included in the current study. Methods of transporting and storing the carcasses, examining the intestinal tracts, and identifying parasites have been described previously (2). mature worms of Echinococcus. On the basis of the most important mor-phometric guidelines and the results of the species-specific polymerase chain reaction (PCR) assay, the parasites were identified as E. multilocu-laris. The examined foxes were found from 5 to 70 km from the known endemic areas of the Slovak Republic, Austria, and Hungary, and from 5 to 50 km from the northern border of the country. On the basis of this information and the previous study (2), the overall prevalence rate of infection was 16% (24/156) in the five northern counties of Hungary (Gyor-Sopron 30%, Nógrád 26%, Komárom-Esztergom 7%, Pest 6%, and Borsod-Abaúj-Zemplén 5%). This prevalence rate is similar to those observed in Poland, Belgium, and the Slovak Republic in recent years. In these countries, a total of 30 …