Rudolf Virchow and the recognition of alveolar Echinococcosis, 1850s

Alveolar echinococcosis, which is caused by the larval stage of the fox tapeworm Echinococcus multilocularis, is one of the most dangerous parasitic diseases. It is endemic in many parts of the Northern Hemisphere and an emerging health problem in the People’s Republic of China. In Europe and North America, human cases are rare, but concomitant with an increase in the population of the final host, the red fox, an increase of human infections is expected. Rudolf Virchow, the father of the concept of cellular pathology, determined in the 1850s that an Echinococcus sp. was the causative agent of this enigmatic emerging disease. In his famous publication in 1855, he described the clinical course of the disease, its macroscopic aspects, and histopathologic findings in detail. He also identified the disease formerly known as alveolar colloid of the liver to be an infection with the larval stage of an Echinococcus sp.

Rudolf Virchow (1821–1902), the originator of the concept of cellular pathology, also concerned himself extensively with the pathology of infectious diseases. In 1848, when he was working as a military physician at the Charité Hospital in Berlin, he distributed oppositional political pamphlets and was thereupon suspended from work. On the condition that he would no longer get involved with political activities, he was offered a position as a professor of pathology at the University of Würzburg, Lower Franconia, Germany. He stayed only 7 years in Würzburg, but it was during these years, from 1849 to 1856, that he made some of his major discoveries. Virchow initially worked in the Theatrum Anatomicum, a baroque but rather small pavilion in the center of the city. He shared the site with Albert Kölliker (1817–1905), a contemporary anatomist who once called the place “a gaunt dive”.

In Würzburg, Virchow soon became the secretary of the local scientific society, Physicalisch-Medicinische Gesellschaft, (Physico-Medical Society). In 1855, the society’s scientific journal Verhandlungen der Physicalisch-Medicinischen Gesellschaft (Proceedings of the Physico-Medical Society) published his observations and conclusions about a disease that we know today as alveolar echinococcosis. The title of the article was “Die multiloculäre, ulcerirende Echinokokkengeschwulst der Leber” (The multilocular, ulcerating Echinococcus-tumor of the liver. He was the first to conclude and publish that the enigmatic emerging disease called alveolar colloid was caused by the larval stage of a previously unknown member of the genus Echinococcus and was thus not a form of cancer, as was generally believed. He presented his findings and assumptions during meetings of the scientific society on March 10, 1855, and May 12, 1855.

Emerging Infectious Diseases
May 29, 2007

Original web page at Emerging Infectious Diseases