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Echinococcus multilocularis causes alveolar echinococcosis primarily in rodents, but also in humans where it represents one of the most lethal helmintic infections. We used a susceptible mouse (C57BL/6) model to demonstrate failure in controlling secondary infection with the E. multilocularis metacestode, even when performed at the lowest possible infection dose. This was achieved by intraperitoneal or intrahepatic inoculation of a single parasite vesicle. In secondary infections, the primary physical barrier between the parasite and the host is constituted by the acellular laminated layer (LL), which is predominantly composed of high-molecular-weight glycans and surrounds the entire metacestode. Only those metacestode structures which exhibited an intact LL were successful in establishing infection, whereas metacestodes which were punctured - thus exhibiting an opened LL and thereby an accessible germinal layer - were no longer infective. Conversely, both types of vesicle survived in vivo maintenance, as assessed by RT-PCR based upon II/3 gene expression. In consequence, the encapsulating LL appears to be one of the key factors that mediates survival and successful proliferation of the parasite metacestode in vivo.

An intact laminated layer is important for the establishment of secondary Echinococcus multilocularis infection