Human alveolar echinococcosis–global, regional, and national annual incidence and prevalence rates

BACKGROUND: Alveolar echinococcosis (AE) of humans is a disease caused by the larval (metacestode) stage of the 'fox tapeworm' Echinococcus multilocularis. AE primarily affects the liver and, like cancer, can spread to surrounding or distant organs. Its slow progression and resemblance to malignant tumours emphasise the critical importance of early detection and intervention, as there is no highly effective vaccine against AE. Although recognised as a neglected disease, there has been no recent, comprehensive review of the distribution, incidence and prevalence of AE in humans around the world. OBJECTIVES: To estimate the global, regional, and national annual incidence rates and prevalences of human AE in endemic countries. SOURCES: Incidence and prevalence data were obtained from published articles from 1980 to 2024, accessible via public databases. CONTENT: This article provides a brief background on E. multilocularis, its biology and impact; reviews the geographic distribution and incidence of AE; and gives a perspective on the prevention and control of this neglected disease in humans. IMPLICATIONS: The AE burden in humans is substantial and emphasises the need for enhanced public awareness, surveillance, prevention, and control, particularly in under-resourced communities to mitigate the health, economic, and psychological impact of AE.