Threat of alveolar echinococcosis to public health – a challenge for Europe

•AE represents a serious and steadily increasing threat to larger parts of the European population.•AE, from a clinical viewpoint, is a neglected ‘malignant’ parasitic disease that deserves, from the perspective of the individual patient, the same attention as cancer.•Increased research efforts are necessary to find new prophylactic and therapeutic tools.

Alveolar echinococcosis (AE) is a neglected ‘malignant’ parasitic disease. The European endemic area of Echinococcus multilocularis in foxes is larger than previously anticipated, and there is new evidence that both fox populations and the prevalence of E. multilocularis have increased in many areas, indicating increased pressure for infection with E. multilocularis eggs in intermediate and accidental hosts, including humans. This may result in more human AE cases within the next decades. Current numbers of both immunocompetent and immunocompromised AE patients, and the anticipated future increase, call for scaling-up research to rapidly improve the development and implementation of prevention measures, early diagnosis, and curative treatment of human AE.