An epidemiological and ecological study of human alveolar echinococcosis transmission in south Gansu, China

doi:10.1016/S0001-706X(00)00134-0

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An epidemiological and ecological study of human alveolar echinococcosis transmission in south Gansu, China

Journal Article•DOI•

An epidemiological and ecological study of human alveolar echinococcosis transmission in south Gansu, China

Philip S. Craig¹, Patrick Giraudoux, Dazhong Shi, Brigitte Bartholomot, G. Barnish², Pierre Delattre³, Jean-Pierre Quéré³, S Harraga, Genshu Bao, Yunhai Wang⁴, F. Lu, Akira Ito⁵, Dominique-Angèle Vuitton - Show less +9 more•Institutions (5)

University of Salford¹, Liverpool School of Tropical Medicine², University of Montpellier³, Xinjiang Medical University⁴, Asahikawa Medical College⁵

02 Nov 2000-Acta Tropica (Elsevier)-Vol. 77, Iss: 2, pp 167-177

TL;DR: Long-term transmission of Echinococcus multilocularis and risk of zoonotic infection of south Gansu farmers may be related ultimately to a process of deforestation driven by agriculture and subsequent development of a peri-domestic cycle involving dogs.

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About: This article is published in Acta Tropica.The article was published on 2000-11-02. It has received 187 citations till now. The article focuses on the topics: Echinococcus multilocularis & Echinococcosis.

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Journal Article•DOI•

EFSA and ECDC (European Food Safety Authority and European Centre for Disease Prevention and Control), 2015. The European Union Summary Report on Trends and Sources of Zoonoses, Zoonotic Agents and Food-borne Outbreaks in 2013

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Efsa Journal

01 Jan 2011

TL;DR: The European Food Safety Authority and the European Centre for Disease Prevention and Control have analyzed the information on the occurrence of zoonoses and food-borne outbreaks in 2009 submitted by 27 European Union Member States as mentioned in this paper.

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Abstract: European Union Summary Report on Trends and Sources of Zoonoses, Zoonotic Agents and Food-borne Outbreaks in 2009 DTU Orbit (13/08/2019) European Food Safety Authority, European Centre for Disease Prevention and Control; The European Union Summary Report on Trends and Sources of Zoonoses, Zoonotic Agents and Food-borne Outbreaks in 2009 The European Food Safety Authority and the European Centre for Disease Prevention and Control have analysed the information on the occurrence of zoonoses and food-borne outbreaks in 2009 submitted by 27 European Union Member States. In 2009, 108,614 salmonellosis cases in humans were reported and the statistically significant decreasing trend in the case numbers continued. Eighteen Member States reached the European Union Salmonella reduction target for breeding flocks of fowl, 17 Member States met their reduction target for laying hens and 18 Member States met the reduction target for broilers. In foodstuffs, Salmonella was most often detected in fresh poultry and pig meat. Campylobacteriosis was the most commonly reported zoonosis with 198,252 human cases. Campylobacter was most often detected in fresh broiler meat. The number of listeriosis cases in humans increased by 19.1 % compared to 2008, with 1,645 cases in 2009. Listeria was seldom detected above the legal safety limit from ready-to-eat foods. Member States reported 3,573 verotoxigenic Escherichia coli (VTEC), 7,595 yersiniosis and 401 brucellosis cases in humans, while VTEC bacteria were mostly found from cattle and bovine meat and Yersinia from pigs and pig meat. Brucellosis and tuberculosis decreased in cattle, sheep and goat populations. In humans 1,987 Q fever cases were detected and Q fever was found in domestic ruminants. Trichinellosis and echinococcosis caused 748 and 790 human cases, respectively, and Trichinella and Echinococcus were mainly detected in wildlife. There were 1,259 human cases of toxoplasmosis reported and in animals Toxoplasma was most often found in sheep and goats. Rabies was recorded in one person in the European Union and the disease was also found in animals. Most of the 5,550 reported food-borne outbreaks were caused by Salmonella, viruses and bacterial toxins and the most important food sources were eggs, mixed or buffet meals and pig meat.

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1,809 citations

Journal Article•DOI•

Biological, Epidemiological, and Clinical Aspects of Echinococcosis, a Zoonosis of Increasing Concern

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Johannes Eckert¹, Peter Deplazes¹•Institutions (1)

University of Zurich¹

01 Jan 2004-Clinical Microbiology Reviews

TL;DR: Various aspects of human echinococcosis are discussed in this review, including data on the infectivity of genetic variants of E. granulosus to humans, the increasing invasion of cities in Europe and Japan by red foxes, the main definitive hosts ofE.

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Abstract: Echinococcosis in humans is a zoonotic infection caused by larval stages (metacestodes) of cestode species of the genus Echinococcus. Cystic echinococcosis (CE) is caused by Echinococcus granulosus, alveolar echinococcosis (AE) is caused by E. multilocularis, and polycystic forms are caused by either E. vogeli or E. oligarthrus. In untreated cases, AE has a high mortality rate. Although control is essentially feasible, CE remains a considerable health problem in many regions of the northern and southern hemispheres. AE is restricted to the northern hemisphere regions of North America and Eurasia. Recent studies have shown that E. multilocularis, the causative agent of AE, is more widely distributed than previously thought. There are also some hints of an increasing significance of polycystic forms of the disease, which are restricted to Central and South America. Various aspects of human echinococcosis are discussed in this review, including data on the infectivity of genetic variants of E. granulosus to humans, the increasing invasion of cities in Europe and Japan by red foxes, the main definitive hosts of E. multilocularis, and the first demonstration of urban cycles of the parasite. Examples of emergence or reemergence of CE are presented, and the question of potential spreading of E. multilocularis is critically assessed. Furthermore, information is presented on new and improved tools for diagnosing the infection in final hosts (dogs, foxes, and cats) by coproantigen or DNA detection and the application of molecular techniques to epidemiological studies. In the clinical field, the available methods for diagnosing human CE and AE are described and the treatment options are summarized. The development of new chemotherapeutic options for all forms of human echinococcosis remains an urgent requirement. A new option for the control of E. granulosus in the intermediate host population (mainly sheep and cattle) is vaccination. Attempts are made to reduce the prevalence of E. multilocualaris in fox populations by regular baiting with an anthelmintic (praziquantel). Recent data have shown that this control option may be used in restricted areas, for example in cities, with the aim of reducing the infection risk for humans.

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1,591 citations

Cites background from "An epidemiological and ecological s..."

...Older data from Austria, Germany, France, and Switzerland have indicated that persons working in agriculture were at increased risk of infection (57, 110)....
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...Biological, Epidemiological, and Clinical Aspects of Echinococcosis, a Zoonosis of Increasing Concern Johannes Eckert* and Peter Deplazes Institute of Parasitology, University of Zurich, CH-8057 Zurich, Switzerland INTRODUCTION .......................................................................................................................................................108 E. GRANULOSUS AND CYSTIC ECHINOCOCCOSIS........................................................................................108 The Parasite and Its Life Cycle ............................................................................................................................108 Cystic Echinococcosis in Humans ........................................................................................................................109 Course of infection..............................................................................................................................................109 Diagnosis..............................................................................................................................................................111 Treatment.............................................................................................................................................................112 (i) Surgery........................................................................................................................................................112 (ii) Puncture-aspiration-injection-reaspiration ..........................................................................................112 (iii) Percutaneous thermal ablation.............................................................................................................113 (iv) Chemotherapy ..........................................................................................................................................113 E. granulosus Infection in Animals .......................................................................................................................114 Defintive hosts .....................................................................................................................................................114 Intermediate hosts ..............................................................................................................................................114 Epidemiology ...........................................................................................................................................................114 Life cycle patterns...............................................................................................................................................114 Transmission dynamics......................................................................................................................................115 Infection risk for humans..................................................................................................................................115 Global distribution of E. granulosus and CE in humans ..............................................................................116 Factors associated with persistence, emergence, or reemergence................................................................117 Examples of emergence or reemergence ..........................................................................................................117 Control Options and Prevention ..........................................................................................................................117 E. MULTILOCULARIS AND ALVEOLAR ECHINOCOCCOSIS ........................................................................118 The Parasite and Its Life Cycle ............................................................................................................................118 Alveolar Echinococcosis in Humans ....................................................................................................................118 Course of infection..............................................................................................................................................118 Diagnosis..............................................................................................................................................................119 Treatment.............................................................................................................................................................120 (i) Surgery........................................................................................................................................................120 (ii) Chemotherapy...........................................................................................................................................120 E. multilocularis Infection in Animals ..................................................................................................................121 Defintive hosts .....................................................................................................................................................121 Intermediate and aberrant hosts......................................................................................................................121 Epidemiology ...........................................................................................................................................................121 Parasite-host assemblages .................................................................................................................................121 (i) Arctic region...............................................................................................................................................122 (ii) Sub-Arctic regions....................................................................................................................................122 Influences of landscape characters and rodent populations ........................................................................123 (i) Factors related to larger regions ............................................................................................................123 (ii) Factors related to macro- and microfoci ..............................................................................................123 Eggs in the environment ....................................................................................................................................123 Infection risk for humans..................................................................................................................................124 Global distribution in humans .........................................................................................................................124 Emergence and spread of E. multilocularis?....................................................................................................124 (i) Risk areas and spreading.........................................................................................................................124 (ii) AE in humans as a risk indicator .........................................................................................................125 (iii) Increasing fox populations and parasite prevalences........................................................................125 (iv) Invasion of urban areas by foxes ..........................................................................................................126 (v) Potential modes of spreading..................................................................................................................126 Control Options and Prevention ..........................................................................................................................126 Control in definitive hosts .................................................................................................................................126 * Corresponding author....
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...For example, prevalences up to 21 and 39% have been recorded in two studies of water voles (Arvicola terrestris) in high-endemicity foci in Switzerland (89, 188) and prevalances of 12 to 14% have been recorded in Microtus arvalis in a focus in France (79)....
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...In Zurich, Switzerland, high contamination with fox feces was found in the recreational area, and it was observed that foxes deposit their feces directly on ground systems of A. terrestris (38)....
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...By the end of the 1980s, areas of endemic infection with E. multilocularis were known to exist in only four countries (Austria, France, Germany, and Switzerland), but by the end of 2001 the parasite was known to occur in red foxes in at least nine further central European countries (Belgium, Czech Republic, Denmark, Italy, Liechtenstein, Luxembourg, Poland, Slovak Republic, and The Netherlands) (references 51, 58, and 173 and references therein)....
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Journal Article•DOI•

Rodent-borne diseases and their risks for public health

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Bastiaan G. Meerburg¹, Grant R. Singleton², Aize Kijlstra•Institutions (2)

Wageningen University and Research Centre¹, International Rice Research Institute²

22 Jul 2009-Critical Reviews in Microbiology

TL;DR: A large number of pathogens that are directly or indirectly transmitted by rodents are described and a simplified rodent disease model is discussed.

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Abstract: Rodents are the most abundant and diversified order of living mammals in the world. Already since the Middle Ages we know that they can contribute to human disease, as black rats were associated with distribution of plague. However, also in modern times rodents form a threat for public health. In this review article a large number of pathogens that are directly or indirectly transmitted by rodents are described. Moreover, a simplified rodent disease model is discussed.

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757 citations

Journal Article•DOI•

Prevention and control of cystic echinococcosis

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Philip S. Craig¹, Donald P. McManus², Marshall W. Lightowlers³, José A. Chabalgoity⁴, Hector H. Garcia⁵, Hector H. Garcia⁶, Cesar M. Gavidia⁷, Cesar M. Gavidia⁵, Robert H. Gilman⁵, Robert H. Gilman⁶, Armando E. Gonzalez⁷, Armando E. Gonzalez⁵, Myriam Lorca⁸, César Náquira, Alberto Nieto⁴, Peter M. Schantz⁹ - Show less +12 more•Institutions (9)

University of Salford¹, QIMR Berghofer Medical Research Institute², University of Melbourne³, University of the Republic⁴, Johns Hopkins University⁵, Cayetano Heredia University⁶, National University of San Marcos⁷, University of Chile⁸, Centers for Disease Control and Prevention⁹

01 Jun 2007-Lancet Infectious Diseases

TL;DR: Since the introduction of current (and past) hydatid control campaigns, there have been clear technological improvements made in the diagnosis and treatment of human and animal cystic echinococcosis, the diagnosis of canine echinocentrosis, and the genetic characterisation of strains and vaccination against Echinococcus granulosus in animals.

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Abstract: Human cystic echinococcosis (hydatid disease) continues to be a substantial cause of morbidity and mortality in many parts of the world. Elimination is difficult to obtain and it is estimated that, using current control options, achieving such a goal will take around 20 years of sustained efforts. Since the introduction of current (and past) hydatid control campaigns, there have been clear technological improvements made in the diagnosis and treatment of human and animal cystic echinococcosis, the diagnosis of canine echinococcosis, and the genetic characterisation of strains and vaccination against Echinococcus granulosus in animals. Incorporation of these new measures could increase the efficiency of hydatid control programmes, potentially reducing the time required to achieve effective prevention of disease transmission to as little as 5-10 years.

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533 citations

Journal Article•DOI•

Wilderness in the city: the urbanization of Echinococcus multilocularis

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Peter Deplazes¹, Daniel Hegglin¹, Sandra Gloor, Thomas Romig²•Institutions (2)

University of Zurich¹, University of Ulm²

01 Feb 2004-Trends in Parasitology

TL;DR: Novel tools have facilitated the investigation of the ecology of urban foxes and have demonstrated the urban wildlife cycle of E. multilocularis, the aetiological agent of human alveolar echinococcosis.

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380 citations

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Book•

Echinococcus and hydatid disease

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R.C.A. Thompson, Alan J. Lymbery

01 Jan 1995

TL;DR: A comprehensive understanding of the biology of Echinococcus is essential for the effective treatment and control of Hydatid Disease and this work will provide a model for the integration of basic and applied research in parasitology.

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Abstract: Summary Hydatid disease (echinococcosis), caused by the tapeworm Echinococcus, is a public health and economic problem of global proportions. Treatment of this zoonotic infection usually requires major surgery and the prognosis for some forms of the disease is poor. Control efforts have had little impact globally and new foci of infection and regions of endemicity have recently been recognized. However, in addition to its medical, veterinary and economic significance, Echinococcus is an intriguing biological phenomenon. This book presents a complete synthesis of all aspects of Echinococcus and Hydatid Disease. It builds on the success of a previous volume The Biology of Echinococcus and Hydatid Diseaseby Allen & Unwin, 1986, and details the major advances that have taken place since. In addition, the scope of the book has been broadened to include genetics, evolutionary biology, epidemiology and clinical features. The overriding theme of the book is that a comprehensive understanding of the biology of Echinococcus is essential for the effective treatment and control of Hydatid Disease. The links between laboratory knowledge and field applications are emphasised throughout the book. Consequently, research workers, teachers and students of parasitology, clinicians and field workers, will find this work an indispensable source of information, but it will also provide a model for the integration of basic and applied research in parasitology.

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396 citations

Epidemiology and control of hydatid disease

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Peter M. Schantz, J. Chai, Philip S. Craig, J. Eckert, David Jenkins, Calum N. L. Macpherson, A. Thakur - Show less +3 more

15 Aug 1995

267 citations

"An epidemiological and ecological s..." refers background in this paper

...Lawrence Island) endemic areas (Schantz et al., 1995) reliance on post-mortem studies are not always very useful or efficient, and relative species abundance is then a better measure of the potential role in transmission (Giraudoux et al....
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...There appears to be at least two main regional foci in China, the largest in central western China includes parts of Ningxia, Gansu, Sichuan and Qinghai provinces, the other is a large area in northwest Xinjiang — bordering with Kazakhstan and Mongolia (Schantz et al., 1995)....
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...Locally, however, human infection rates may be as high as 60–80 per 100 000 as in parts of Alaska and Siberia (Schantz et al., 1995)....
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Book Chapter•DOI•

Detection, screening and community epidemiology of taeniid cestode zoonoses: cystic echinococcosis, alveolar echinococcosis and neurocysticercosis.

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Philip S. Craig¹, M.T. Rogan¹, J C Allan¹•Institutions (1)

University of Salford¹

01 Jan 1996-Advances in Parasitology

TL;DR: The chapter addresses the problem of neurocysticercosis and epilepsy in developing countries particularly Latin America and its public health consequences in the USA and elsewhere.

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Abstract: Publisher Summary This chapter focuses on the public health importance of taeniid cestode zoonoses especially cystic echinococcosis, alveolar echinococcosis and T. solium cysticercosis. The chapter addresses the problem of neurocysticercosis and epilepsy in developing countries particularly Latin America and its public health consequences in the USA and elsewhere. E. multilocularis , which is the cause of one of the most pathogenic of all human parasitic infections, appears to be spreading in parts of western Europe, USA, and Japan. The remarkable development in the past 20 years or so of high resolution imaging technologies, such as computerized tomography (CT) scan and ultrasound have enabled precision detection of taeniid larval cystic infection in humans. Coupled with improvements in immunodiagnostic test sensitivity and antigen specificity, diagnosis of cestode zoonoses is now more accurate than ever before. Although further developments in immunodiagnosis are required, laboratory tests have provided improved capability for screening populations in both epidemiological and community studies. Parallel and recent development of genus specific coproantigen tests for human taeniasis and canine echinococcosis have also provided major new tools for epidemiological and surveillance programs.

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213 citations

"An epidemiological and ecological s..." refers background in this paper

...In China the first human AE case was described in the early 1960s (Yao, 1965) though prior to that it was invariably misdiagnosed as hepatic carcinoma, as indeed it still is in greater than 20% of laparotomies in central China (Craig et al., 1996)....
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...Human alveolar echinococcosis (AE) is one of the most lethal of the larval cestode infections and by other helminthic zoonoses (Craig et al., 1996)....
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...Prior to the current study approximately 500 cases of AE were reported in China since 1965 (Craig et al., 1996)....
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Journal Article•DOI•

A large focus of alveolar echinococcosis in central China.

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Philip S. Craig¹, Liu Deshan, Calum N. L. Macpherson², Shi Dazhong², D. Reynolds³, Guy Barnish³, Bruno Gottstein⁴, Wang Zhirong - Show less +4 more•Institutions (4)

University of Salford¹, University of the West Indies², Liverpool School of Tropical Medicine³, University of Zurich⁴

03 Oct 1992-The Lancet

TL;DR: The high prevalence of human AE in this region of central China is most probably due to semi-domestic transmission of E multilocularis between wild rodents and dogs, together with the poverty and poor hygiene in these rural communities.

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162 citations

"An epidemiological and ecological s..." refers background or result in this paper

...A large focus of human AE was recently identified in south Gansu province central-northwest China, following a pilot serological and hepatic ultrasound survey (Craig et al., 1992)....
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...multilocularis in the target region (Zhang county) was from domestic dogs (Craig et al., 1992)....
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...Data on 849 persons screened in 1991 from another three villages (total 31 villages) were also available (Craig et al., 1992)....
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...When the 84 AE cases were combined by village with an additional 51 AE cases previously detected in the same region in 1991 which included three additional villages (Craig et al., 1992), overall prevalence was 4....
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..., 1994), a protoscolex extract EmP (Craig et al., 1992), a purified E....
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Journal Article•DOI•

Spontaneous death of Echinococcus multilocularis: cases diagnosed serologically (by Em2 ELISA) and clinical significance.

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Robert L. Rausch¹, Joseph F. Wilson², Peter M. Schantz³, Brian J. McMahon²•Institutions (3)

University of Washington¹, Alaska Native Medical Center², Centers for Disease Control and Prevention³

01 May 1987-American Journal of Tropical Medicine and Hygiene

TL;DR: The findings show that the Em2 ELISA may be positive in patients having lesions of AHD in which the etiologic agent is no longer viable, in agreement with the clinical impression that the cestode was dead.

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Abstract: Nine cases of asymptomatic alveolar hydatid disease (AHD) of the liver were diagnosed in 1985 among Eskimos from the endemic region of western Alaska. The patients were identified by screening with the enzyme-linked immunosorbent assay, using purified Echinococcus multilocularis antigen (Em2 ELISA). Five patients, and one diagnosed earlier (1979), were found to have lesions in which the larval E. multilocularis had died spontaneously at an early stage of infection. Viability was assessed histologically; by the avidinbiotin immunohistochemical method; and in vivo through intraperitoneal inoculation of membranes of the larval cestode into red-backed voles, Clethrionomys rutilus. The results were in agreement with the clinical impression, based on findings by computerized tomography and ultrasound scanning, and on the macroscopic appearance of the lesions, that the cestode was dead. Spontaneous death of E. multilocularis in humans has not been previously reported. The findings show that the Em2 ELISA may be positive in patients having lesions of AHD in which the etiologic agent is no longer viable.

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141 citations

"An epidemiological and ecological s..." refers background or methods in this paper

...The Em2ELISA in particular has been shown to be highly specific (\98%), and is therefore a reliable indication of abortive AE lesions (Rausch et al., 1987)....
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...Serological testing using a specific purified antigen (Em2) or a more sensitive crude antigen (EgCF) is however important both in confirmation of suspect active lesions, and in the detection of putative abortive lesions (Rausch et al., 1987; Bresson-Hadni et al., 1994; Romig et al., 1999)....
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