بیماریهای زئونوز سگ: تمرکز بر روی بیماریهای هاری، لیشمانیوز و اکینوکوکوز
محورهای موضوعی : فصلنامه زیست شناسی جانوری
1 - گروه زیست شناسی، دانشکده علوم، دانشگاه بیرجند، بیرجند، ایران
کلید واژه: هاری, سازمان بهداشت جهانی, سگ, لیشمانیوز, اکینوکوکوز,
چکیده مقاله :
سه بیماریهاری، کیست هیداتید و لیشمانیوز که سه نوع بیماری هستند که از طریق سگ به انسان منتقل میشود و بر اساس گزارش سازمان جهانی بهداشت، جزو بیماریهای بومی ایران محسوب میشوند در این مقاله مورد بررسی و مطالعه قرارگرفته است. هدف از انجام این مطالعه آشنایی به گسترش این بیماریها و تحقیقات انجام شده در ایران و در نهایت پیشنهاد راهکارها و تمهیداتی برای کنترل بیماری است. برای پیشگیری از بیماریهاری بنظر میرسد استفاده از لباسهای محافظ، شستن زخمها با آب صابون و واکسیناسیون هاری به عنوان درمان اولیه ضروری است. طی سه دهه گذشته، علیرغم تلاشهای فراوان برای کنترل بیماری لیشمانیوز جلدی در ایران، میزان ابتلا در برخی مناطق همچنان بالا باشد. این واقعیت نشان میدهد که زیرساختهای اساسی و طرح حمایتی و اجرایی قبلی مربوط به تشخیص، داروها و واکسنها در داخل و خارج از کشور ناکافی است. درکل برای کنترل ناقل، استفاده از استراتژیهای اخلاقی برای کاهش جمعیت سگهای ولگرد را توصیه شده است، مانند اخته کردن سگهای ولگرد، شناسایی سگهای شناسنامه دار مشکوک با تست آگلوتیناسیون مستقیم دورهای و درمان یا نظارت سریع بر روی آنهایی که سرم مثبت یافتهاند. علاوه بر این، با توجه به اهمیت تشخیص مورد انسانی، درمان کارآمد و آموزش بهداشت عمومی هدفمند، به ویژه در مناطق بومی و کانون بیماری پیشنهاد میشود.
Three diseases, rabies, hydatid cyst and leishmaniasis, which are three types of diseases that are transmitted to humans through dogs, and according to the report of the World Health Organization, are considered among the indigenous diseases of Iran. They have been investigated and studied in this research. The purpose of this study is to provide more information about outbreak of these diseases in Iran, related studies and finally to propose solutions and approaches to control the disease. To prevent rabies, it seems that using protective clothing, washing wounds with soap and vaccination as primary treatment is necessary. During the last three decades, despite many efforts to control cutaneous leishmaniasis in Iran, the infection rate is still high in some areas. This fact shows that the basic structure and previous support and implementation plan related to diagnosis, medicines and vaccines inside and outside the country are insufficient. In general to control vectors, the use of ethical strategies to reduce the population of stray dogs is recommended, such as castration of stray dogs, identification of dogs with suspicious pedigrees by periodic direct agglutination testing, and prompt treatment or monitoring of those that are seropositive. In addition, due to the importance of human case diagnosis, efficient treatment and targeted public health education are suggested, especially in disease centers.
1. Abedi M., Doosti-Irani A., Jahanbakhsh F., Sahebkar A. 2019. Epidemiology of animal bite in Iran during a 20-year period (1993-2013): a meta-analysis. Tropical Medicine and Health. 47:55.
2. Abedi-Astaneh F., Hajjaran H., Yaghoobi-Ershadi M.R., Hanafi-Bojd A.A., Mohebali M., Shirzadi M.R. 2016. Risk mapping and situational analysis of cutaneous leishmaniasis in an endemic area of Central Iran: a GIS-based survey, PloS One 11 (8), e0161317.
3. Alatif H. Burden and trends of Leishmaniasis over the last one decade across the globe: trend analysis of WHO regions. 2021. Integrative Journal of Medical Sciences. 8.
4. Alvar J., Vélez I.D., Bern C., Herrero M., Desjeux P., Cano J. 2012. Leishmaniasis worldwide and global estimates of its incidence. PLoS One, 7:e35671.
5. Apt, W., Pérez, C., Galdamez, E., Campano, S., Vega, F., Vargas D., Ro-dríguez, J., Retamal, C., Cortés, P., Zulantay, I., Rycke, PH. 2000. Equinococosis/hidatidosis en la VII Región de Chile: diagnóstico e in-tervención educativa. Revista Panamericana de Salud Pública 7(1), 8-16.
6. Asbury A.K. Cornblath D.R. 1990. Assessment of current diagnostic criteria for Guillain–Barre syndrome. Annals of Neurology, 27 (1), S21–S24.
7. Badirzadeh A., Mohebali M., Ghasemian M., Amini H., Zarei Z., Akhoundi B. 2013. Cutaneous and post kala-azar dermal leishmaniasis caused by Leishmania infantum in endemic areas of visceral leishmaniasis, northwestern Iran 2002–2011: a case series, Pathogens and Global Health. 107(4) 194-197.
8. Badirzadeh A., Mohebali M., Asadgol Z., Soong L., Zeinali M., Mokhayeri Y. 2017. The burden of leishmaniasis in Iran, acquired from the global burden of disease during 1990-2010. Asian Pacific Journal of Tropical Disease. 7(9):513-518.
9. Bentounsi B, Meradi S, Ayachi A, Cabaret J. 2009. Cestodes of untreated large stray dog populations in Algeria: a reservoir for herbivore and human parasitic diseases. Open veterinary journal, 3:64-67.
10. Bhatt D.R., Hattwick M.A.W., Gerdsen R., Emmons R.W., Johnson H.N. 1974. Human rabies: diagnosis, complications, and management. American journal of diseases of children, 127(6),862–869.
11. Bijari B, Sharifzade GR, Abbasi A, Salehi S. 2011. Epidemiological survey of animal bites in east of Iran. Iranian journal of clinical infectious diseases 6(2):90-2.
12. Budke, CM, Campos-Ponce, M, Qian, W, Torgerson, PR. 2005a. A canine purgation study and risk analysis for echinococcosis in a high endemic region of the Tibetan plateau. Veterinary parasitology 127:43–49.
13. Budke, CM, Jiamin, Q, Craig, PS, Torgerson, PR. 2005b. Modeling the transmission of Echinococcus granulosus and Echinococcus multilocularis in dogs for a high endemic region of the Tibetan plateau. International Journal for Parasitology ; 35:163–170.
14. Carrión-Ascarza, Y.P., Bustinza-Cardenas, R.H., Valderrama-Pomé, A.A. 2021. Comiso de vísceras por fascioliasis y equinococosis quística en bovinos, ovinos y caprinos faenados en Apurímac, Perú. Revista MVZ Córdoba, 26(2):1-10.
15. Centers for Disease Control and Prevention (CDC). 2020. Parasites–Echinococcosis. https://www.cdc.gov/paras ites/echin ococc osis
16. Chaâbane-Banaoues, R., Oudni-M’rad, M., Cabaret, J., M’rad, S., Mezhoud, H., & Babba, H. 2015. Infection of dogs with Echinococcus granulosus: causes and consequences in an hyperendemic area. Parasites and vectors, 8, 1-9.
17. Chahed M.K., Bellali H., Touinsi H., Cherif R., Ben Safta Z., Essoussi M. 2010. Distribution of surgical hydatidosis in Tunisia, results of 2001–2005 study and trends between 1977 and 2005. Arch Inst Pasteur Tunis. 87(1–2):43-52.
18. Ciaramella P., Oliva G.D., De Luna R. 1997. A retrospective clinical study of canine leishmaniasis in 150 dogs naturally infected by Leishmania infantum. Veterinary Record Case Reports, 141(21):539-543.
19. Craig P.S., Giraudoux P., Shi D., Bartholomot B. 2000. An epidemiological and ecological study of human alveolar echinococcosis transmission in south Gansu, China. Acta tropica, 77:167-177.
20. Croft S.L., Sundar S., Fairlamb A.H. (2006). Drug resistance in leishmaniasis, Clinical Microbiology Reviews. 19(1):111-126.
21. Dakkak A. 2010. Echinococcosis/hydatidosis: A severe threat in Mediterranean countries. Veterinary parasitology. 174:2–11.
22. Dalimi A., Motamedi G., Hosseini M., Mohammadian B., Malaki H., Ghamari Z. 2002. Echinococcosis/ hydatidosis in western Iran. Veterinary Parasitology, 105(2):161-171.
23. Davoudi-Kiakalayeh A., Gharib Z., Mohammadi R., Kanafi Vahed L., Davoudi-Kiakalayeh S. 2024. Trends in Animal Bites and Rabies-related Deaths in Northern Iran: Implications for Public Health Interventions. Archives of Iranian Medicine. 27(5):272-276
24. Deplazes P., Alther P., Tanner I., Thompson R.C.A. 1999. Echinococcus multilocularis coproantigen detection by enzyme linked immunosorbent assay in fox, dog, and cat populations. Journal of Parasitology Research, 85:115-121.
25. Doi R., Matsuda H., Uchida A., Kanda E. 2003. Possibility of invasion of Echinococcus into Honshu with pet dogs from Hokkaido and overseas. The Japanese Journal of Public Health, 50:639–649.
26. Dupont J.R., Earle K.M. 1965. Human rabies encephalitis. A study of forty-nine fatal cases with a review of the literature. Neurology, 15:1023-1034.
27. Eckert J., Conraths F.J., Tackmann K. 2000. Echinococcosis: an emerging or re-emerging zoonosis? International Journal for Parasitology 30:1283–1294.
28. Editorial, 1975. Diagnosis and management of human rabies. British medical journal, 3:721–722.
29. Eisenman E.J.L., Uhart M.M., Kusch A., Vila A. R., Vanstreels R.E.T., Mazet J.A. K., Briceño C. 2023. Increased prevalence of canine echinococcosis a decade after the discontinuation of a governmental deworming program in Tierra del Fuego, Southern Chile. Zoonoses and Public Health, 70:213-222.
30. Eslami A., Hosseini S.H. 1998. Echinococcus granulosus infection of farm dogs in Iran. Journal of parasitology research 84(3):205-7.
31. Fallah M., Taherkhani H., Sadjjadi M. 1995. Echinococcosis in stray dogs in Hamedan, west of Iran. Iranian journal of medical sciences 29:170-172.
32. Farahtaj F., Fayaz A., Howaizi N., Biglari P., Gholami A. 2014. Human rabies in Iran. Tropical Doctor. 44(4):226-229.
33. Fasihi Harandi M., Budke C.M., Rostami S. 2012. The Monetary Burden of Cystic Echinococcosis in Iran. PLOS Neglected Tropical Diseases 6(11):e1915.
34. Gessese A.T. 2020. Review on epidemiology and public health significance of hydatidosis. Veterinary medicine international. 3:8859116.
35. Gholamrezaei M., Mohebali M., Hanafi-Bojd A.A., Sedaghat M.M., Shirzadi M.R. 2016. Ecological Niche Modeling of main reservoir hosts of zoonotic cutaneous leishmaniasis in Iran, Acta tropica. 160:44-52.
36. Gottstein B., Saucy F., Deplazes P., Reichen J. 2001. Is high prevalence of Echinococcus multilocularis in wild and domestic animals associated with disease incidence in humans? Emerging Infectious Diseases, 7:408-412.
37. Gracia Romero J., Labarta Aizpun J.I., Monreal Gálvez M.J., Elías Pollina J. 1992. [Dog bites in children. Epidemiologic and clinical study of 144 cases]. Anales Espanoles de Pediatria, 37(4):287-290. [Spanish].
38. Hanafi-Bojd A.A., Yaghoobi-Ershadi M.R., Haghdoost A.A., Akhavan A.A., Rassi Y., Karimi A. 2015. Modeling the distribu-tion of cutaneous leishmaniasis vectors (Psychodidae: Phlebotominae) in Iran: a potential transmission in disease prone areas. Journal of Medical Entomology, 52(4):557-565.
39. Harada C., León D., Gamarra N., Falcón N. 2019. Indicadores de-mográficos y estimación de la población de canes en el distrito de Bel¬lavista, Callao - Perú. Salud y Tecnología Veterinaria, 7(1):27-32.
40. Hattwick M.A.W. 1974. Human rabies. Public Health Reviews, 3:229-274.
41. Hemachudha T., Wacharapluesadee S., Mitrabhakdi E., Morimoto K. Lewis R.A. 2005. Pathophysiology of human paralytic rabies. Journal of Neuroviroloy, 11(1):93-100.
42. Heydarpour F., Sari A.A., Mohebali M., Shirzadi M., Bokaie S. 2013. Incidence and disability-adjusted life years (Dalys) attributable to leishmaniasis in Iran, Ethiopian Journal of Health Sciences, 26(4):381-388.
43. Holakouie-Naieni K, Mostafavi E, Boloo-rani AD, Mohebali M, Pakzad R. 2017. Spatial modeling of cutaneous leishman-iasis in Iran from 1983 to 2013. Acta Tropica, 166:67-73.
44. Jackson A.C., Ye H., Phelan C.C., Ridaura-Sanz C., Zheng Q., Li Z., Wan X., Lopez-Corella E. 1999. Extraneural organ involvement in human rabies. Laboratory Investigation, 79(8):945-951.
45. Jackson A.C. 2011. Update on rabies. Research and Reports in Tropical Medicine, 2:31-43.
46. Jackson A.C. 2013. Current and future approaches to the therapy of human rabies. Antiviral Research, 99(1):61-67.
47. Jackson A.C. 2018. Rabies: a medical perspective. Revue Scientifique et Technique, 37(2):569-580
48. Jenkins EJ, Schurer JM, Gesy KM. 2011. Old problems on a new playing field: Helminth zoonoses transmitted among dogs, wildlife, and people in a changing northern climate. Veterinary Parasitology, 182:54-69.
49. Johnson N., Un H., Fooks A.R., Freuling C., Müller T., Aylan O. 2010. Rabies epidemiology and control in Turkey: past and present. Epidemiology and Infection, 138(3):305-312.
50. Karimkhani C., Wanga V., Coffeng L.E., Naghavi P., Dellavalle R.P., Naghavi M. 2016. Global burden of cutaneous leishmaniasis: a cross-sectional analysis from the Global Burden of Disease Study 2013, The Lancet Infectious Disease. 16(5):584-591.
51. Khazaei S.G.M., Mohebali M. 2015. Seroepidemiological survey of human visceral leishmaniasis and canine visceral leishmaniasis in Dehloran district, Ilam province in 2014, Navid No, 18(60):8-15.
52. Kitala P.M., McDermott J.J., Kyule M.N., Gathuma J.M. 2000. Community-based active surveillance for rabies in Machakos District, Kenya. Journal of preventive veterinary medicine 44(1-2):73-85.
53. Maier T., Schwarting A., Drosten C. 2010. Management and outcomes after multiple corneal and solid organ transplantations from a donor infected with rabies virus. Clinical Infectious Diseases, 50(8):1112–1119.
54. Mitrabhakdi E., Shuangshoti S., Wannakrairot P., Lewis R.A., Susuki K., Laothamatas J., Hemachudha T. 2005. Difference in neuropathogenetic mechanisms in human furious and paralytic rabies. Journal of the Neurological Sciences, 238(1-2):3-10.
55. Mohebali M., Edrissian G., Akhoundi B., Shirzadi M., Hassanpour G., Behkar A., Rassi Y., Hajjaran H., Keshavarz H., Gouya M. M., Arshi S., Zeinali M., Zarei Z., Sharifi I., Kakooei Z. 2023. Visceral Leishmaniasis in Iran: An Update on Epidemiological Features from 2013 to 2022. Iranian Journal of Parasitology, 18(3):279-293
56. Moro P., Schantz P.M. 2006. Cystic echinococcosis in the Americas. Parasitology International, 55:S181-S186.
57. Mostafavi E., Ghasemian A., Abdinasir A., Nematollahi Mahani S.A., Rawaf S., Salehi Vaziri M. 2021. Emerging and re-emerging infectious diseases in the WHO eastern Mediterranean region, 2001–2018. International Journal of Health Policy and Management, 11:1286-300.
58. Nonaka N., Iida M., Yagi K., Ito T. 1996. Time course of coproantigen excretion in Echinococcus multilocularis infections in foxes and an alternative definitive host, golden hamsters. International Journal for Parasitology, 26:1271–1278.
59. Nonaka N., Kamiya M., Kobayashi F., Ganzorig S., Ando S., Yagi K., Iwaki T., Inoue T, Oku Y. 2009. Echinococcus multilocularis infection in pet dogs in Japan. Vector-Borne and Zoonotic Diseases, 9(2):201-206.
60. Norouzinezhad F., Ghaffari F., Norouzinejad A., Kaveh F., Gouya M.M., 2016. Cutaneous leishmaniasis in Iran: results from an epidemiological study in urban and rural provinces, Asian Pacific journal of tropical biomedicine, 6(7):614-619.
61. Oku Y., Kamiya M. 2003. Biology of Echinococcus. In Otsuru, M, Kamegai, S, Hayashi, S, eds. Progress of Medical Parasitology in Japan. Tokyo: Meguro Parasitological Museum:293–318.
62. Oryan A., Akbari M. 2016. Worldwide risk factors in leishmaniasis, Asian Pacific Journal of Tropical Medicine, 9(10):925-932.
63. Pasa S., Kargin F., Bildik A., Seyrek K., Ozbel Y., Ozensoy S. 2003. Serum and hair levels of zinc and other elements in dogs with visceral leishmaniasis. Biological trace element research, 94(2):141-147.
64. Piroozi B., Moradi G., Alinia C., Mohamadi P., Gouya M.M., Nabavi M. 2019. Incidence, burden, and trend of cutaneous leishmaniasis over four decades in Iran, Iran. Journal of Public Health Medicine, 48(Supple 1):28-35.
65. Postigo J.A.R. 2010. Leishmaniasis in the world health organization eastern mediterranean region, International Journal of Antimicrobial Agents, 36:S62-S65.
66. Ramírez D.Y., Jefferson M.E., Hernández I.H., León C., Falcón, P.N. 2018. Conocimientos, percepciones y prácticas relacionados a equinococosis quística en familias con antecedentes de la enfermedad. Revista de Investigaciones Veterinarias del Perú, 29(1):240-252.
67. Rausch R.L., Fay FH. 2002. Epidemiology of alveolar echinococcosis, with reference to St. Lawrence Island, Bering Sea. In Craig, P, Pawlowski, Z, eds. Cestode Zoonosis: Echinococcosis and Cysticercosis. Amsterdam: IOS Press, pp:309-325.
68. Razmi G.R., Sardari K., Kamrani A.R. 2006. Prevalence of Echinococcus granulosus and other intestinal helminths of stray dogs in Mashhad area, Iran. Archives of Razi Institute, 61(3):143-148.
69. Rokni M.B. 2009. Echinococcosis/hydatidosis in Iran. Iranian journal of parasitology, 4(2):1-16.
70. Romig T. 2002. Spread of Echinococcus multilocularis in Europe? In Craig, P, Pawlowski, Z, eds. Cestode Zoonosis: Echinococcosis and Cysticercosis. Amsterdam: IOS Press:65-80.
71. Sabzevari S., Hosseini Teshnizi S., Shokri A., Bahrami F., Kouhestani F. 2021. Cutaneous leishmaniasis in Iran: A systematic review and meta-analysis. Microbial Pathogenesis, 152:104721
72. Savioli L., Daumerie D., Crompton D.W.T. 2013. Sustaining the drive to overcome the global impact of neglected tropical diseases: Second WHO report on neglected tropical diseases. World Health Organization.
73. Sharifi I, Daneshvar H, Ziaali N, Fasihi harand M, Nikian Y, Ebrahimi A. 1996. Evaluation of a Control Program on Hydatid Cyst in City of Kerman. Journal of Kerman University of Medical Sciences, 3(4):168-174
74. Sheikh K.A., Ramos-Alvarez M., Jackson A.C., Li C.Y., Asbury A.K., Griffin J.W. 2005. Overlap of pathology in paralytic rabies and axonal Guillain–Barre syndrome. Annals of Neurology, 57(5):768-772.
75. Shokri A., Sharifi I., Khamesipour A., Nakhaee N., Harandi M.F., Nosratabadi J. 2012, The effect of verapamil on in vitro susceptibility of promastigote and amastigote stages of Leishmania tropica to meglumine antimoniate, Journal of Parasitology Research, 110(3):1113-1117.
76. Shokri A., Fakhar M., Teshnizi S.H. 2017a. Canine visceral leishmaniasis in Iran: a systematic review and meta-analysis, Acta Tropica, 165:76-89.
77. Shokri A., Saeedi M., Fakhar M., Morteza-Semnani K., Keighobadi M., Teshnizi S.H. 2017b. Antileishmanial activity of Lavandula angustifolia and Rosmarinus officinalis essential oils and nano-emulsions on Leishmania major, Iran. Journal of Parasitology Research, 12(4):622.
78. Shokri A., Sabzevari S., Hashemi S.A. 2020. Impacts of flood on health of Iranian population: infectious diseases with an emphasis on parasitic infections, Parasite Epidemiology and Control, 9:e00144.
79. Smith J.S., Fishbein D.B., Rupprecht C.E., Clark K. 1991. Unexplained rabies in three immigrants in the United States: a virologic investigation. The New England Journal of Medicine, 324(4):205-211.
80. Srinivasan, A., Burton, E.C., Kuehnert, M.J., Rupprecht, C., Sutker, W.L., Ksiazek, T.G., Paddock, C.D., Guarner, J., Shieh, W.J., Goldsmith, C. and Hanlon, C.A. 2005. Transmission of rabies virus from an organ donor to four transplant recipients. The New England Journal of Medicine, 352:1103-1111.
81. Teimouri A., Mohebali M., Kazemirad E., Hajjaran H. 2018. Molecular identification of agents of human cutaneous leishmaniasis and canine visceral leishmaniasis in different areas of Iran using internal transcribed spacer 1 PCR-RFLP, Journal of Arthropod-borne Diseases, 12(2):162.
82. Tillotson J.R., Axelrod D., Lyman D.O. 1977. Rabies in a laboratory worker. New York. The Morbidity and Mortality Weekly Report., 26:183-184.
83. Torgerson P.R., Budke C.M. 2003. Echinococcosis, an international public health challenge. Research Journal of Veterinary Sciences, 74:191-202.
84. Torres-Guerrero E., Quintanilla-Cedillo M.R., Ruiz-Esmenjaud J., Arenas R. 2017. Leishmaniasis, a review. F1000Research, 6:750.
85. Tsukada H., Morishima M., Nonaka N., Oku Y. 2000. Preliminary study of the role of red foxes in Echinococcus multilocularis transmission in the urban area of Sapporo, Japan. Parasitology, 120:423-428.
86. Valderrama A.A., Mamani G., Uzuriaga F.J. 2023. Determination of copro-prevalence of Echinococcus granulosus and associated factors in domestic dogs: a household cross-sectional study in Huancarama, Peru. Austral Journal of Veterinary Science, 55:167-175
87. Vora N.M., Basavaraju S.V., Feldman, K.A., Paddock C.D., Orciari L., Gitterman S., Griese S., Wallace R.M., Said M., Blau D.M., Selvaggi G. 2013. Raccoon rabies virus variant transmission through solid organ transplantation. The Journal of the American Medical Association, 310(4):398-407.
88. Warrell D.A., Davidson N.M., Pope H.M., Bailie W.E., Lawrie J.H., Ormerod L.D., Kertesz A., Lewis P. 1976. Pathophysiologic studies in human rabies. American Journal of Medicine Studies, 60(2):180-190.
89. Winkler W.G., Fashinell T.R., Leffingwell L., Howard P., Conomy J.P. 1973. Airborne rabies transmission in a laboratory worker. The Journal of the American Medical Association, 226:1219-1221.
90. World Health Organization (WHO). 1995. Report of the Second WHO Meeting on Emerging Infectious Diseases, Geneva, Switzerland, and 12-13 January 1995.
91. World Health Organization (WHO). 2010. Control of the leishmaniases.World Health Organ Tech Rep Ser, 949:1-186.
92. World Health Organization (WHO). 2011. Interagency Meeting on Planning the Prevention and Control of Neglected Zoonotic Disease (NDZs). Geneva.
93. World Health Organization (WHO). 2012. Regional strategic plan for integrated neglected tropical diseases control in South-East Asia region, 2012–2016. WHO Regional Office for South-East Asia.
94. World Health Organization (WHO). 2013. Sustaining the drive to overcome the global impact of neglected tropical diseases: Second WHO report on neglected tropical diseases. World Health Organization.
95. World Health Organization (WHO). 2019. Leishmaniasis. Fact Sheet, WHO, 2019. https://www. who.int/news-room/fact-sheets/detail/leishmaniasis,.
96. World Health Organization (WHO). 2020. Echinococcosis Fact Sheet.https://www.who.int/news-room/fact-sheets/ detai l/echin ococcosis.
97. World Health Organization (WHO). 2021. Echinococcosis.. Available from: https://www.who.int/news-room/fact-sheets/detail/echinococcosis.
98. World Health Organization (WHO). 2022. Tackling dog-related zoonoses in the Islamic Republic of Iran: momentum grows to prevent and control cystic echinococcosis. https://www.who.int/news-room/feature-stories/detail/tackling-dog-related-zoonoses-in-the-islamic-republic-of-iran21june 2022.
99. Zeiler F.A., Jackson A.C. 2016. Critical appraisal of the Milwaukee protocol for rabies: this failed approach should be abandoned. The Canadian journal of neurological sciences 43(1):44-51.
100. Zuñiga-A, I., Jaramillo-A, C.J, Martínez-M, J.J., Cárdenas-L, J. 1999. In¬vestigación experimental de la equinococosis canina a partir de quiste hidatídico de origen porcino en México. Revista de Saúde Pública, 33(3):302-308.