Echinococcus multilocularis Infection

Echinococcus multilocularis infection (EMI) is an infection caused by a microscopic parasite called Echinocococcus. The infection is a result of being infected with the larval stage of the tapeworm, found in foxes, coyotes, dogs, and cats. Although human cases are rare, infection in humans causes parasitic tumours to form in the liver and possibly other organs.

How is EMI spread?

The tapeworm eggs are shed into the environment mostly by foxes and coyotes with intestinal infections caused by the adult tapeworms. Dogs and cats can then become infected by hunting and eating infected wild rodents (such as mice, rats, voles, chipmunks, etc.). People can become infected by eating food or drinking water that has been contaminated with dog feces that contains the tapeworm.
What are the symptoms of EMI?

EMI can cause a very severe diseases in humans called alveolar echinococcosis. Symptoms of alveolar echinococcosis may only appear 5 to 15 years after being exposed to the tapeworm. There are often no symptoms until the tumours grow large enough to cause pain, nausea and vomiting. The tumours start in the liver but may spread to other organs in the body, such as the lungs and brain. The tumours caused by EMI are often confused with liver disease or cancer.
What is the treatment for EMI?

Medications are available to treat EMI. Early diagnosis and treatment is key to reduce the risk of complications and death.
How can I protect myself against EMI?
  • Always wash hands well with soap and water for at least 15 seconds after handling pets or their feces and before preparing food
  • Avoid exposure to areas where there may be feces from foxes, coyotes or other wild canids
  • Wear plastic gloves if hunting, trapping or handling foxes, coyotes or other wild canids or their carcasses
  • Avoid eating wild fruits and vegetables from the ground; all wild-picked foods should be carefully washed with clean running water from a safe source or cooked before being eaten
  • Pet owners should prevent dogs and cats from eating rodents
  • All dogs and cats having access to wild rodents in areas known to have EMI should consider monthly deworming to reduce the risk of exposure in household environments
  • Decontaminate areas inhabited by dogs and cats with known EMI infections to prevent the risk of exposure on surfaces such as pet beds, floors, carpets and car interiors
What is Ottawa Public Health’s role?

All human cases of EMI must be reported to public health for follow up and investigation. Ottawa Public Health interviews the individual, provides education, and also identifies and notifies close contacts if there is potential they were exposed to the same source and recommends follow up by their healthcare providers where appropriate.

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