Prevention and Control
The three steps to be used for prevention and control of echinostomiasis are diagnosis, treatment, and prevention. The life cycle of echinostomes can be interrupted if diagnosis is made and pharmacologic therapy is implemented wherever possible in endemic areas.
Due to the similar nature of echinostomes to other helminths, public health programs can be implemented for the control of several diseases at one time. Programs should include widespread diagnostics and pharmacologic treatment plans, while also focusing on prevention, which seems to be the best way of controlling echinostomiasis. Because transmission of the parasite to humans occurs mainly through the ingestion of uncooked mollusks (snails), fish, and amphibians (tadpoles), health education and changed eating habits could go far in prevention of the disease. Also, industrialization, improved sanitation, and water treatment could prove to be effective for prevention of helminthiases.
The problem that is most specific to echinostomiasis control is that it can infect multiple species of birds and mammals, as well as many different intermediate hosts. These organisms can act as reservoirs for the disease, thus making control of it very difficult. This difficulty has been shown to be true by previous public health programs implemented by the World Health Organization (WHO). Such programs for broad-spectrum anthelmintics, in addition to industrialization and improved sanitation, have led to significant drops in the prevalence of several intestinal helminthic disease, but not echinostomiasis.
Other problems include the economic difficulty of purchasing fuel for cooking, thereby making changes in eating habits less achievable. Also, traditional methods of food preparation in endemic areas often include fermentation, smoking or pickling, practices that do not effectively kill echinostome metacercariae, allowing infection to continue.
Nonetheless, with substantial health education, widespread availability of diagnostic and treatment services, and an awareness of the differences between helminthic diseases like echinostomiasis and the very different arthropod-transmitted pathologies should be effective in reducing the prevalence of echinostomiasis and the morbidity it can cause.
(Fried, Graczyk, Tamang 161-62; Haseeb and Eveland 94-95)
Echinostome Image - www.olympusmicro.com