Applying a multi-scale HACCP approach to understanding and preventing zoonotic parasite transmission in urban ecosystems: Echinococcus multilocularis and Alveolar Echinococcosis in North America.

Echinococcus multilocularis is an emerging zoonotic parasitic of the family Taenidae, and it is the causative agent of alveolar echinococcosis (AE) in humans, a disease with a case mortality rate of up to 90 per cent when untreated. The natural cycle of the disease involves wild canids as the definitive hosts and rodents that serve as the intermediate hosts. Infection of humans occurs through accidental ingestion of parasite eggs through contaminated food or close interactions with infected domestic dogs. In this chapter we describe the complex transmission dynamics of E. multilocularis at the interface of wildlife, domestic animals, humans and the environment, focusing on the emerging situation in a North American urban setting. We describe key ecological and socioeconomic factors that affect parasite distribution and the subsequent risk for humans at different geographical (local, regional and global) and temporal (seasonal and pluri-annual) scales. We also present various parasite control and risk management options based on a hazard analysis and critical control point (HACCP) approach.