Effective control of echinococcosis is often complicated by a wide intermediate host range, and exacerbated further where there is the possibility of interaction with susceptible species of wildlife. This is particularly so for E. multilocularis because of the importance of wild animal cycles in perpetuating the parasite in all endemic regions. In most cases, control through elimination of sylvatic hosts would be impractical, but where human exposure to the risk of infection is likely to be related to cycles involving domestic hosts, protection might be achieved by regular cestocidal treatment of dogs (Schantz et al, 1995).
Prevention of human infection with MAE in regions where E. multilocularis is perpetuated in wild animal cycles is dependent on personal preventive measures, particularly avoiding foxes and other potentially infected definitive hosts. It is also important to try to prevent infection from sylvatic cycles becoming established in domestic pets, and thus domestic dogs and cats must be well controlled in such endemic areas. A more recent approach to controlling the transmission of E. multilocularis in wild animal cycles is to deliver cestocidal drugs, such as praziquantel, in baits (Schantz et al., 1995). Recent trials in southern Germany using bait pellets each containing 50 mg praziquantel have shown a reduction in prevalence in foxes from 32% to 4% after six baiting campaigns over a period of 14 months (Schelling et al., 1997). However, the long-term efficacy of this control strategy has still to be determined.
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