A One-Health evaluation of the burden of cystic echinococcosis and its prevention costs: Case study from a hypo-endemic area in Italy
Rudi Cassini,
Massimo Canali,
Francesca Tamarozzi,
Andrea Angheben,
Gioia Capelli,
Federico Gobbi,
Matteo Legnardi,
Michele Brichese,
Giuseppina Napoletano,
Fabrizio Cestaro,
Adriano Casulli,
Michele Drigo,
Maurizio Aragrande
Affiliations
Rudi Cassini
Dept. Animal Medicine, Production and Health, University of Padova, Viale dell'Università, 16, 35020 Legnaro, PD, Italy; Corresponding author.
Massimo Canali
Dept. of Agricultural and Food Sciences, University of Bologna, Viale Giuseppe Fanin, 50, 40127 Bologna, Italy
Francesca Tamarozzi
Dept. of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro-Cuore Don Calabria Hospital, Via Don A Sempreboni, 5, 37024 Negrar di Valpolicella, VR, Italy
Andrea Angheben
Dept. of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro-Cuore Don Calabria Hospital, Via Don A Sempreboni, 5, 37024 Negrar di Valpolicella, VR, Italy
Dept. of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro-Cuore Don Calabria Hospital, Via Don A Sempreboni, 5, 37024 Negrar di Valpolicella, VR, Italy
Matteo Legnardi
Dept. Animal Medicine, Production and Health, University of Padova, Viale dell'Università, 16, 35020 Legnaro, PD, Italy
Michele Brichese
Veneto Region, Prevention and Public Health, Dorsoduro 3493, 30123 Venezia, Italy
Giuseppina Napoletano
Veneto Region, Prevention and Public Health, Dorsoduro 3493, 30123 Venezia, Italy
Fabrizio Cestaro
Azienda ULSS 9 Scaligera (Local Health Unit), Prevention Department, Via Valverde 42, 37122 Verona, Italy
Adriano Casulli
WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Roma, Italy; European Union Reference Laboratory for Parasites, Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161 Roma, Italy
Michele Drigo
Dept. Animal Medicine, Production and Health, University of Padova, Viale dell'Università, 16, 35020 Legnaro, PD, Italy
Maurizio Aragrande
Dept. of Agricultural and Food Sciences, University of Bologna, Viale Giuseppe Fanin, 50, 40127 Bologna, Italy
An integrated model, based on a One Health approach, was implemented to estimate the epidemiological and economic outcomes of cystic echinococcosis (CE) in Veneto region, an hypo-endemic area of Northern Italy, and the costs for its prevention. Data and information needed to populate the model were retrieved from published literature, official statistics, expert opinions, or actively searched through data mining (i.e., Hospital and slaughterhouse data), when fundamental data were not available. Human-health and animal-health costs, both public and private, were considered. The overall impact of CE in the study area was estimated in an yearly cost of about 0.5 million €, due to an average of 19.5 human hospitalized cases and about 200 infected animals among cattle and sheep, per year. The human:animal costs ratio was about 8:1. Most of the infected animals were autochthonous, while the identification of an autochthonous source of the infection for the human cases was extremely difficult, and unlikely in most cases. No specific action resulted to be in place for human surveillance, while veterinary surveillance accounted for a yearly cost of about 22,000 €. Sheepherders were found to pay privately an overall amount of around 2000 € for the preventive treatment of their dogs every year, but the applied protocol proved to be sub-optimal. The source of most of the human cases was likely external to the study area, and their economic impact accounts for a cost that is far exceeding that of surveillance and preventive actions in place in the veterinary sector. Although autochthonous human cases appeared to be very rare, the strengthening of preventive actions and surveillance systems can reduce the risk of their increment.
