Spread of Echinococcosis caused by Echinococcus species (E. multilocularis and E. granulosus) in the Republic of Bulgaria and prevention and control measures.

For the period from 2002 to 2019 in Bulgaria, there is a trend of gradual decline in the incidence of echinococcosis (2002 - 832, 2019 - 193), as well as the average annual incidence of 8.2% ₀₀₀ in 2002 to 2.74% 2019 in 2019. However, in recent years Bulgaria continues to occupy a leading position in the incidence of echinococcosis among the European countries, remaining one of the countries with the highest endemicity for E. granulosus sl. in the EU.

Studying the reasons for this high incidence of echinococcosis in Bulgaria, it shows the existence of serious gaps in the health culture and the behavior of the population, in the context of a prolonged socio-economic crisis, which lead to deteriorating health and a quality of life. The worrying fact is that the young people most often suffer - children and adolescents between 10-19 years (morbidity 7.3%. For the period 2009 – 2019, cases of echinococcosis were found in all regions of the country, with most primary cases and recurrences were registered in Plovdiv - 963, Burgas - 655 and Sliven regions - 631. The average incidence for the period 2000 - 2017 is unevenly distributed on the territory of the country. It varies from 1.6% in Sofia to 15.8% ₀₀₀ in Sliven region.

A study of the role of environmental and natural factors in the spread of the disease in Bulgaria shows that echinococcosis is acquired at a "home", rural environment and it is considered to be more of a "soil / environment transmitted" infection, similar to "classical" helminthiasis, with a probable hand-to-mouth transmission mechanism, while through the food / water transmission may be of secondary importance.

The golden jackal (Canis aureus) population appears to be on an increasing trend of migration from the EU's Eastern Member States to neighboring western countries, which should be taken into account when considering the potential future spread of E. multilocularis. In Bulgaria, as a country with a high prevalence of cystic echinococcosis, there are all conditions for the spread of alveococcosis in humans and E. multlocularis in foxes, dogs and other carnivorous mammals. Some of the most important breeders, such as field rodents, are also widespread.

The high incidence of echinococcosis in the country compared to other Balkan and European countries, the delay in early diagnosis and its high proportion in childhood and adolescence age, based on scientific evidence, as well as the high proportion of infected pets are grounds for urgent renewal of the  The National program for control of Echinococcosis in Bulgaria in order to achieve a lasting trend towards its reduction to sporadic among humans and animals.