Fig. 1.

The real (a) and perceived (b) life cycle of Echinococcus granulosus in High Atlas, Morocco. Adapted from Marcotty et al. (2013). a Life cycle of Echinococcus granulosus in the High Atlas, Morocco. b Transmission routes as perceived by the Moroccan communities in the High Atlas (focus group discussions). a Adult E. granulosus live in the intestine of dogs and disseminate their eggs in the environment with the dogs’ faeces. Rains contribute to the egg dissemination, and the cold and humid climate allows their survival in the environment. Through direct or indirect contacts with dogs, ruminants (through grazing) and humans (through contamination of hands, food, and water) are infected by dogs’ faeces. Dogs become infected when feeding on organs infected with hydatid cysts (larval stage). b Dogs first, and infected sheep meat, a close second, are seen as the two main sources of human hydatidosis. Sheep, and to a lesser extent, humans, get infected in humid or cold climatic conditions or in unhygienic environments. Dogs, as well as cats, are thought to contribute to hydatidosis and other diseases in humans through saliva, hairs, and bites. Infection of dogs through feeding on infected organs is not perceived as a risk. (The plain arrows represent the direct cause of disease and the dotted arrows represent the influence in the causal chain of transmission.)