Landscape and climatic characteristics associated with human alveolar echinococcosis in France, 1982 to 2007

M Piarroux; J Gaudart; S Bresson-Hadni; K Bardonnet; B Faucher; F Grenouillet; J Knapp; J Dumortier; J Watelet; A Gerard; J Beytout; A Abergel; M Wallon; D A Vuitton; R Piarroux; collective the FrancEchino network

doi:10.2807/1560-7917.ES2015.20.18.21118

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Landscape and climatic characteristics associated with human alveolar echinococcosis in France, 1982 to 2007
M Piarroux¹ , J Gaudart¹ , S Bresson-Hadni^2,3 , K Bardonnet^3,4 , B Faucher⁵ , F Grenouillet⁶ , J Knapp^3,6 , J Dumortier⁷ , J Watelet⁸ , A Gerard⁹ , J Beytout¹⁰ , A Abergel¹¹ , M Wallon¹² , D A Vuitton^2,3 , R Piarroux⁵ , collective the FrancEchino network¹³
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Affiliations: ¹ Aix-Marseille University, INSERM-IRD-AMU UMR 912, Marseille, France ² Franche-Comté University, CNRS UMR 6249, Besançon, France ³ WHO Collaborating Centre for Prevention and Treatment of Human Echinococcosis, University Hospital Jean Minjoz, Department of digestive surgery, Besançon, France ⁴ University Hospital Jean Minjoz, Department of biochemistry, Besançon, France ⁵ Aix-Marseille University, UMR MD 3, Marseille, France ⁶ Centre National de Référence Echinococcose alvéolaire, Department of parasitology, CHRU Jean Minjoz Besançon, France ⁷ University Hospital Edouard Herriot, Department of hepatogastroenterology, Hospices civils de Lyon, Lyon, France ⁸ University Hospital Brabois, Department of hepatogastroenterology, Nancy, France ⁹ University Hospital Brabois, Department of intensive care, Nancy, France ¹⁰ University Hospital G Montpied, Department of tropical medicine and infectious diseases, Clermont-Ferrand, France ¹¹ University Hospital Estaing, Department of hepatogastroenterology, Clermont-Ferrand, France ¹² University Hospital de la Croix Rousse, Institute of parasitology and medical mycology, Hospices civils de Lyon, Lyon, France ¹³ Members of the network are listed at the end of the article.

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M Piarroux
Renaud.Piarroux ap-hm.fr
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Citation style for this article: Piarroux M, Gaudart J, Bresson-Hadni S, Bardonnet K, Faucher B, Grenouillet F, Knapp J, Dumortier J, Watelet J, Gerard A, Beytout J, Abergel A, Wallon M, Vuitton D A, Piarroux R, the FrancEchino network collective. Landscape and climatic characteristics associated with human alveolar echinococcosis in France, 1982 to 2007. Euro Surveill. 2015;20(18):pii=21118. https://doi.org/10.2807/1560-7917.ES2015.20.18.21118 Received: 15 Mar 2014

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Abstract

Human alveolar echinococcosis (AE) is a severe hepatic disease caused by Echinococcus multilocularis. In France, the definitive and intermediate hosts of E. multilocularis (foxes and rodents, respectively) have a broader geographical distribution than that of human AE. In this two-part study, we describe the link between AE incidence in France between 1982 and 2007 and climatic and landscape characteristics. National-level analysis demonstrated a dramatic increase in AE risk in areas with very cold winters and high annual rainfall levels. Notably, 52% (207/401) of cases resided in French communes (smallest French administrative level) with a mountain climate. The mountain climate communes displayed a 133-fold (95% CI: 95-191) increase in AE risk compared with communes in which the majority of the population resides. A case-control study performed in the most affected areas confirmed the link between AE risk and climatic factors. This arm of the study also revealed that populations residing in forest or pasture areas were at high risk of developing AE. We therefore hypothesised that snow-covered ground may facilitate predators to track their prey, thus increasing E. multilocularis biomass in foxes. Such climatic and landscape conditions could lead to an increased risk of developing AE among humans residing in nearby areas. .