ECHINOCOCCOSIS IN AMERICAN INDIANS LIVING IN ARIZONA AND NEW MEXICO

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Abstract
Schantz, P. M. (Parasitic Diseases Division, Bureau of Epidemiology, CDC, Atlanta, GA 30333). Echinococcosis in American indians living in Arizona and New Mexico: A review of recent studies. Am J Epidemiol 106:370–379, 1977. An unusual space and time cluster of human cases of cystic hydatid disease (Echinococcus granulosus infection) in Arizona and New Mexico prompted an epidemiologic investigation which began in August 1974. Retrospective surveys of hospital records covering the years 1969–1976 and serologic screening of patients' family members have established the diagnosis of 21 human cases acquired locally in the two-state region. Nineteen of these infections occurred in American indians of the Navajo (13), Zuni (four), and Santo Domingo (two) tribes, and two in non-Indians. Investigation of the home environments of recent cases, diagnostic testing of dogs, and abattoir records revealed that echinococcosis is endemic at low prevalence in the sheep-dog cycle in rural areas of the Navajo reservation. The source of exposure for human cases in urban Navajo centers, and in the Zuni and Santo Domingo pueblos, appeared to be infected dogs which acquired their infections by eating home-butchered sheep offal of sheep purchased from off-reservation sources. Existing evidence suggests that the two-state region of Arizona and New Mexico is the most recently disclosed extension of the cestode's range in the western United States. Surveys of the Navajo and Zuni populations revealed a variety of animal husbandry and cultural practices highly conducive to the continued and possibly increased transmission of cestodes in the dog-sheep cycle.