Title : One health approaches to echinococcosis control: The role of vaccines

Background: Echinococcosis (hydatid disease) is a neglected zoonosis caused by Echinococcus granulosus and Echinococcus multilocularis, affecting over one million people globally and causing annual economic losses of approximately $3 billion. The disease cycle involves definitive hosts (canids) and intermediate hosts (sheep, yaks, humans). Traditional control relies on dog deworming, improved slaughter hygiene, and health education, but sustained transmission persists. The One Health approach – integrating human, animal, and environmental health – offers a strategic framework for effective control, within which vaccination plays an increasingly critical role.

Methods: This review synthesizes data from field trials, large-scale immunization programs, and recent experimental studies (2020–2025). We evaluated the efficacy of the recombinant EG95 vaccine in intermediate hosts (sheep and yaks) across endemic regions of China (Tibet, Qinghai, Sichuan, Inner Mongolia, Xinjiang). For definitive hosts (dogs), we assessed recent vaccine candidates including MAPII protein, a cocktail vaccine, and an oral Bacillus subtilis?based vaccine. Emerging platforms – DMON?based nanovaccines, multi?epitope vaccines (MEV, FL46), and an oral papaya?system vaccine – were also reviewed for their potential to complement One Health strategies.

Results: In intermediate hosts, EG95 vaccination achieved 96–100% protection against cystic echinococcosis. In Nagqu, Tibet (2020–2023), an integrated One Health strategy combining dog deworming with EG95 sheep vaccination reduced infection rates to 6.88% in dogs, 39.82% in sheep, and 15.50% in cattle. Vaccinated households in Qinghai owned on average 52 more livestock (≈36% increase), yielding ~26,500 RMB additional profit per household. For definitive hosts, a canine cocktail vaccine achieved 80.58% worm reduction, and an oral Bacillus vaccine 62.26% reduction. Nanovaccines (DMON+CpG+EG95) induced stronger and longer?lasting Th1?biased immunity than commercial Quil?A adjuvanted vaccine. A nanovesicle vaccine achieved complete parasite clearance against E. multilocularis. Multi?epitope vaccine FL46 gave 59.16% cyst inhibition with reduced liver fibrosis. The oral papaya?based KETc7 vaccine (92% conserved across tapeworms) offers 10?year stability and improved bioavailability (12%→68% via microencapsulation), ideal for resource?limited settings.

Conclusions: The EG95 vaccine has proven highly effective in livestock and, when deployed within a One Health framework alongside dog deworming and community engagement (as successfully demonstrated in Argentina, Chile, and China’s Tibetan regions), significantly reduces transmission and economic losses. While canine vaccines remain challenging, recent breakthroughs (cocktail, MAPII, oral Bacillus) show promise. Next?generation platforms (nanovaccines, multi?epitope, oral) provide new tools for human and animal vaccination. Sustained political commitment, multi?sectoral collaboration, and integration of vaccination into comprehensive One Health programs are essential to achieve elimination of echinococcosis as a public health problem.

Keywords: One Health; echinococcosis; vaccine; definitive host vaccine; nanovaccine; integrated control

Jun Li received her Ph.D. in Population Health from Queensland University in 2004 and a bachelor’s degree in Phamacology from Xinjiang Medical University in 1984. She worked as a Pharmacy reseacher at Xinjiang People’s Hospital from 1983 to 1999 and Senior research officer at PanBio Company in Australia from 2004 to 2008 and Queensland Institute of Medical Research, Australia from 2009 to 2013. She has studies at the First Affiliated Hospital of Xinjiang Medical University since 2013. Her research interests include drug development for treating echinococcosis.  She actively and heavily involved in screening and digging the genome and transcriptome of Echinococcus and Brucellosis. Based on the finding of novel molecular targets, she found several small molecules showing strong killing echinococcal cysts. Professor Li has published 130 refereed papers/articles in her research career.Most of her publications focus on natural components and small molecules against infectious diseases including flu and parasite diseases.