Vol 34 (Suppl 2) 2003 103 ECHINOCOCCOSIS AND CYSTICERCOSIS IN ASIA: EVALUATION OF THE MODERN TECHNOLOGY FOR EPIDEMIOLOGICAL STUDY Akira Ito 1 , Hiroshi Yamasaki 1 , Minoru Nakao 1 , Yasuhito Sako 1 , Kazuhiro Nakaya 2 , Wulamu Mamuti 1, 3 , Ning Xiao 1, 4 , Marcello O Sato 1 and Yuji Ishikawa 1 1 Department of Parasitology, Asahikawa Medical College, Asahikawa, Japan; 2 Animal Laboratory for Medical Research, Asahikawa Medical College, Asahikawa, Japan; 3 Department of Parasitology, Xinjiang Medical University, Urumqi, China; 4 Sichuan Institute of Parasitic Diseases, Chengdu, China Abstract. The recent emergence of zoonotic parasitic diseases of public health importance represents a growing global concern. Among zoonotic helminthic diseases, both echinococcosis and cysticercosis are the most serious diseases threatening human life. Neurocysticercosis (NCC) caused by ingestion of eggs of the pork tapeworm, Taenia solium, is spreading worldwide and not rare even in Muslim or Jewish communities. Alveolar echinococcosis (AE) caused by the proliferation of metacestodes of the fox tapeworm, Echinococcus multilocularis, is the most potentially lethal parasitic infection of the non-tropical northern hemisphere, whereas cystic echinococcosis (CE) caused by the proliferation of metacestodes of the dog tapeworm, E. granulosus, has rather a cosmopolitan distribution. As the life cycles of T. solium, E. multilocularis and E. granulosus are completed through predator-prey interactions, including humans, it is crucial to interrupt the cycle for control of these zoonotic cestodiases. Both NCC and CE are expected to be eradicable, since the principal life cycles of T. solium and E. granulosus are maintained between humans and pigs and between dogs and herbivorous domestic animals, respectively. In contrast, AE is perhaps not eradicable, since the life cycle of E. multilocularis is maintained between wild foxes and rodents. Modern technologies, including imaging, immunology and molecular biology, have been applied for epidemiological surveys. In the present review, we introduce such technologies applied in Japan, China and Indonesia, and point out the problems that need to be solved for control of these three zoonotic cestodiases. serodiagnosis, immunodiagnosis and molecular diagnosis, and 3) applications for epidemiological surveys for these cestode zoonoses based mainly on our own work at Asahikawa Medical College (AMC). PATHOLOGY OF NCC, AE AND CE Pathological characteristics NCC is mainly a neurological disease and differs critically from echinococcosis, either AE or CE, which are hepatic diseases. However, neuro-echinococcosis may be not so rare in some highly endemic AE areas, such as in China. Major symptoms of NCC are seizures, focal neurological deficits, symptoms of increased intracranial pressure, and dementia. In the computed tomography (CT) and magnetic resonance imaging (MRI) scan, the nodule in the brain appears to be a round cyst with contents near water density and a hyperdense scolex. However, only approximately 10% of NCC may show such typical imaging data (Del Brutto et al, 1998). In Papua in Indonesia, the majority of NCC patients have subcutaneous nodules of cysticerci (subcutaneous cysticercosis, SCC) of T. solium simultaneously. It is expected that SCC- suspected patients are asymptomatic for NCC (Wandra et al, 2003). In contrast, both AE and CE are hepatic diseases. AE appears to be like hepatic cancer. In the Correspondence: Akira Ito, Department of Parasitology, Asahikawa Medical College, Midorigaoka-Higashi 2-1-1-1, Asahikawa 078-8510, Japan. Tel: +81-166-68-2420; Fax: +81-166-68-2429 E-mail: akiraito@asahikawa-med.ac.jp INTRODUCTION Although we employ serological tests for cestode zoonoses, including neurocysticercosis (NCC) caused by the pork tapeworm, Taenia solium, alveolar echinococcosis (AE) caused by the fox tapeworm, Echinococcus multilocularis , and cystic echinococcosis (CE) caused by the dog tapeworm, Echinococcus granulosus, during the previous JITMM and/or Food-borne Parasitic Zoonoses meetings (Ito, 1997; Ito et al, 2000, 2001a,b, 2002a) and some other meetings (Ito et al, 2002b,c), we have reported much improved such technologies for the serodiagnosis, immunodiagnosis and molecular diagnosis of these cestode zoonoses. There are several excellent up-to- date reviews on the advances in technology for these cestode zoonoses (Eckert et al, 2000; Siles-Lukas and Gottstein, 2001; Ito, 2002; Ito and Craig, 2003). In the present review, we introduce: 1) the pathology of these three cestode zoonoses; 2) recent advances in