Dr. Murai Éva szerk.: Parasitologia Hungarica 11. (Budapest, 1978)

Para-il. Hun». 11. 1978 Recent Advances in the Diagnosis of Hydatidosis (1970-1976) Dr. Irving G. KAGAM Center for Disease Control, Public Health Service, U. S. Department of Health. Education, and Welfare. Atlanta. Georgia. USA "Recent advances in the diagnosis of hydatidosis (1970-1976)"- Kagan, I. G. - Parasit. Hung. U,. 31-50. 1978. ABSTRACT. In this extensive review experiences reported from 1970 to 1976 on the diagnosis of infection with Echinococcus granulosus and E. multilocularis in humans by immunodiagnostic procedures (complement fixation test, indirect hemagglutination test, latex test, bentonité flocculation test, immunofluorescence test, enzyme-linked immunosorbent assay, agar gel methods, radioimmunoassay, intradermal test, etc. ) are evaluated. There are 144 references. The cosmopolitan distribution of Echinococcus granulosus, the circumpolar distribution of E. multilocularis, the discovery of at least two other species of Echinococcus (E. oligarthrus and E. vogeli) in Central and South America, and the recognition of at least nine biological strains of E. granulosus have resulted in a continued and vigorous effort in many parts of the world to develop and evaluate more efficient antigens and more sensitive and specific immunologic procedures (KAGAN, 1973a) for the diagnosis of human diseases caused by these organisms. The literature on immunodiagnosis has been reviewed a number of times (KAGAN, 1968, 1970, 1973a, 1973b, 1976; APT, 1975). Although the last review appeared in 1976, it covered the scientific literature on immunodiagnosis from 1968 to 1972. This review covers the literature from 1970 to 1976. Complement-fixation test (CFT) The CFT is still used in various parts of the world. The test, however, has a number of serious deficiencies. The sensitivity of the test appears to be highly correlated with the quality of the antigen used. The test also yields very high levels of nonspecific reactions with sera from patients with various types of cancer. For increased sensitivity and specificity, more than one antigen should be employed and more than one dilution of antigen. The recent literature on the CFT is presented in Table 1. Indirect hemagglutination test (IHAT) The IHAT continues to be used both for diagnosis and for epidemiologic studies. The technique has been stabilized by use of various fixing agents, and stable sensitized cells can be lyophilized or stored frozen for long periods. The sensitivity of all serologic techniques varies from country to country and is probably influenced by the location of the cyst, the duration of infection, and the type of Echinococcus endemic in the area (KAGAN, 1973, 1973b). VARELA-DIAZ et al. (1975a) have carefully evaluated a number of variables that influence the test. Its specificity must be controlled very carefuUy because of the high level of nonspecific reactivity reported. This has led some workers to recommend the latex test (LAT) Submitted to the IX. International Congress of Hydatidosis, Athens, 30th May - 2nd June, 1977.