Heartworm infection

Temperature-bounded development of Dirofilaria immitis larvae restricts the geographical distribution and seasonality of its transmission: case study and decision support system for canine heartworm management in Australia

Dirofilaria immitis is the causative agent of canine heartworm disease. We used the established heartworm development unit (HDU) principle to map the extrinsic incubation period (EIP) of D. immitis in Australia using historical weather data from 2013-2022. We found weather conditions suitable for EIP completion showed substantial seasonality and geographical variability. Whilst a considerable percentage of the Australian territory showed suitable weather conditions to always support EIP completion (17%), only 2.7% of the 2021 Australian human population lived in this region. Therefore, 97% of the population lived in an area that changed its EIP suitability within the study period. EIP completion is required prior to D. immitis transmission, meaning that infection risk of D. immitis is seasonal and location-dependent, being disrupted each year for most of the human population's dogs. We developed an online, open access tool allowing us to visualise EIP completion across Australia historically and in near real-time. We aim to support veterinarians to make risk-based recommendations for dirofilariosis prevention by using the tool, available at https://heartworm-mapping.adelaide.edu.au/shiny/.

Molecular characterization of canine filarioids in a previously non-endemic area of Rio de Janeiro State, Brazil

Dirofilaria immitis is the causative agent of canine heartworm disease, a severe health problem in dogs, especially in coastal areas of tropical and subtropical regions of the world. We employed molecular methods to investigate the occurrence of canine infection by filarioids in five municipalities of Baixada Fluminense (Magé, Duque de Caxias, Guapimirim, Nova Iguaçu, and São João de Meriti), a non-endemic area of Rio de Janeiro State, Southeast Brazil. A total of 110 canine blood samples collected from 2017 to 2018 and positive for microfilariae at the modified Knott's test were screened by cPCR targeting DNA fragments of the 12S rDNA gene for filarial nematodes. Seventy-seven samples (70%) tested positive at the molecular analysis. Of these, 72 were identified as D. immitis and 5 (4.5%) as Acanthocheilonema reconditum. Dirofilaria repens was not detected in the studied municipalities of Baixada Fluminense. This is the first record of D. immitis and A. reconditum in the Baixada Fluminense region, Rio de Janeiro State, Brazil. The prevalence of D. immitis cases in the five municipalities suggests the establishment and maintenance of its enzootic cycle in the studied region, which indicate vulnerability to the occurrence of epidemic cycles and, possibly, human cases.

Mosquito abundance in a Dirofilaria immitis hotspot in the eastern state of Rio de Janeiro, Brazil

Coastal lowlands in the state of Rio de Janeiro, Brazil, support high numbers of heartworm-infected dogs. Microfilariae of heartworm need to be ingested by a potencial mosquito vector in order to develop into infective larvae and infect a new host. Ochlerotatus taeniorhynchus and Ochlerotatus scapularis are the primary vector species in the coastal lowlands of metropolitan Rio de Janeiro; thus, the aim of this study was to investigate whether these two species were abundant enough at the heartworm hotspot in the eastern area of the state to be important to the local parasite's life cycle. The study was conducted at the Massambaba sandbank (22°55'45″S;42°18'51″W), where canine heartworm prevalence was 53.1%. Mosquitoes were captured monthly using two traps with CO₂, as well as eventual human landing. A total of 6118 mosquitoes of 16 species were collected. Ochlerotatus taeniorhynchus (37.5%), Culex quinquefasciatus (19.3%), Oc. scapularis (18.2%), and Coquillettidia sp. (10.5%) were the most abundant species. The monthly variation in frequency was marked for Oc. scapularis and Cx. quinquefasciatus and steadier for Oc. taeniorhynchus and Coquillettidia sp. The abundance of the two Ochlerotatus species reaffirms that they are the primary natural vectors for D. immitis in the coastal Rio de Janeiro state lowlands.

Changes in canine serum N-glycosylation as a result of infection with the heartworm parasite Dirofilaria immitis

Filariases are diseases caused by infection with filarial nematodes and transmitted by insect vectors. The filarial roundworm Dirofilaria immitis causes heartworm disease in dogs and other carnivores. D. immitis is closely related to Onchocerca volvulus, Wuchereria bancrofti and Brugia malayi, which cause onchocerciasis (river blindness) and lymphatic filariasis (elephantiasis) in humans and are neglected tropical diseases. Serum N-glycosylation is very sensitive to both pathological infections and changes in mammalian biology due to normal aging or lifestyle choices. Here, we report significant changes in the serum N-glycosylation profiles of dogs infected with D. immitis. Our data derive from analysis of serum from dogs with established patent infections and from a longitudinal infection study. Overall, galactosylation and core fucosylation increase, while sialylation decreases in infected dog sera. We also identify individual glycan structures that change significantly in their relative abundance during infection. Notably, the abundance of the most dominant N-glycan in canine serum (biantennary, disialylated A2G2S2) decreases by over 10 percentage points during the first 6 months of infection in each dog analyzed. This is the first longitudinal study linking changes in mammalian serum N-glycome to progression of a parasitic infection.

Comparison of six commercial antigen kits for detection of Dirofilaria immitis infections in canines with necropsy-confirmed heartworm status

Patient-side test kits for detecting antigenemia in dogs associated with sexually mature female heartworms (Dirofilaria immitis) have been available for three decades, and these tests are continually updated and improved. To define the sensitivity (Se) and specificity (Sp) of contemporary antigen detection tests against cardiopulmonary D. immitis burden, we evaluated five patient-side kits-Anigen Rapid One Step^® (Bio note), SNAP^® 4Dx Plus Test Kit (IDEXX), WITNESS^® Heartworm Canine Heartworm Antigen Test Kit (Zoetis), VetScan^® Canine Heartworm Rapid Test (Abaxis), and Solo Step^® CH Canine Heartworm Antigen Test (Heska), and one microplate ELISA (DiroCHEK^®; Zoetis), using archived canine sera divided into five subclasses of female worms (0, 1-5, 6-20, 21-40, and >40). The patient-side tests were performed once, side-by-side according to each manufacturer's protocol by personnel blinded to the D. immitis status of each dog. The overall Se and Sp of the patient-side kits was ≥97.5 and =94.0%, respectively. For samples from dogs with 1-5, 6-20, and 21-40 D. immitis, the Se was between 96 and 100%, with a slight increase in Se in dogs with ≥41 worms. The agreement between tests for all subclasses of D. immitis burden was between 99 and 100%. The Se and Sp for the ELISA compared with the necropsy results of dogs was 99 and 96%, respectively. Agreement between each patient-side test and the ELISA was between 97 and 100%. All commercially available tests can give practitioners excellent patient-side information, allowing them to make informed decisions on the need for additional diagnostic work-up before instituting new or continuing D. immitis prophylaxis.

Biology and Diseases of Ferrets

Ferrets (Mustela putorius furo) belong to the ancient family Mustelidae, which is believed to date back to the Eocene period, some 40 million years ago. The taxonomic groups in the family Mustelidae, as recognized by Nowak (1999), include 67 species in 25 genera from North, Central, and South America; Eurasia; and Africa. No other carnivore shows such diversity of adaptation, being found in a wide variety of ecosystems ranging from arctic tundra to tropical rainforests. Mustelids have retained many primitive characteristics, which include relatively small size, short stocky legs, five toes per foot, elongated braincase, and short rostrum (Anderson, 1989). The Mustelinae is the central subfamily of the Mustelidae. The best-known members of the Mustelinae are the weasels, mink, ferrets (genus Mustela), and the martens (genus Martes) (Anderson, 1989). The genus Mustela is divided into five subgenera: Mustela (weasels), Lutreola (European mink), Vison (American mink), Putorius (ferrets), and Grammogale (South American weasels). The smallest member of the Mustelidae family is the least weasel (Mustela nivalis), which weighs as little as 25 g, and the largest member is the sea otter (Enhydra lutris), which can weigh as much as 45 kg (Nowak, 1999).

Computed tomographic changes associated with the prepatent and early patent phase of dirofilariasis in an experimentally infected dog

Evolution of pulmonary arterial and parenchymal changes as assessed with computed tomography (CT) is described in a dog experimentally infected with Dirofilaria immitis. The dog was imaged 125, 168, 216, and 402 days after infection. Initial changes during the prepatent phase of infection included enlargement of the peripheral caudal lobar pulmonary arteries and intermittent periarterial interstitial infiltrates. The changes were progressive, involving additional arteries over time, but remained mild. With the presence of adult filariae a filling defect was observed in the caudal lobar pulmonary artery using CT angiography. Recognizing thoracic CT findings associated with the prepatent phase of canine heartworm infection may be important in endemic areas.

Heartworm disease in animals and humans

Heartworm disease due to Dirofilaria immitis continues to cause severe disease and even death in dogs and other animals in many parts of the world, even though safe, highly effective and convenient preventatives have been available for the past two decades. Moreover, the parasite and vector mosquitoes continue to spread into areas where they have not been reported previously. Heartworm societies have been established in the USA and Japan and the First European Dirofilaria Days (FEDD) Conference was held in Zagreb, Croatia, in February of 2007. These organizations promote awareness, encourage research and provide updated guidelines for the diagnosis, treatment and prevention of heartworm disease. The chapter begins with a review of the biology and life cycle of the parasite. It continues with the prevalence and distribution of the disease in domestic and wild animals, with emphasis on more recent data on the spreading of the disease and the use of molecular biology techniques in vector studies. The section on pathogenesis and immunology also includes a discussion of the current knowledge of the potential role of the Wolbachia endosymbiont in inflammatory and immune responses to D. immitis infection, diagnostic use of specific immune responses to the bacteria, immunomodulatory activity and antibiotic treatment of infected animals. Canine, feline and ferret heartworm disease are updated with regard to the clinical presentation, diagnosis, prevention, therapy and management of the disease, with special emphasis on the recently described Heartworm Associated Respiratory Disease (HARD) Syndrome in cats. The section devoted to heartworm infection in humans also includes notes on other epizootic filariae, particularly D. repens in humans in Europe. The chapter concludes with a discussion on emerging strategies in heartworm treatment and control, highlighting the potential role of tetracycline antibiotics in adulticidal therapy.

Prevalence of the Dirofilaria immitis infection in dogs from Merida, Yucatan, Mexico

The aim of the present study was to estimate the prevalence of Dirofilaria immitis infection, and to examine the relationship between host factors (gender, age and breed) and D. immitis infection in dogs. The study was designed as a cross-sectional study. A total of 676 dogs were examined for D. immitis infection. Adult worms (necropsy) and blood samples were collected from all animals for diagnosis of D. immitis. Blood samples were examined using a modified Knott's and thick drop techniques. Fifty-six of 676 dogs were diagnosed infected with D. immitis. The odds of infection were 2.85 times higher in female dogs, compared to male dogs (OR = 2.85, 95% CI = 1.5-5.5, P = 0.01). In addition, the odds of infection were 2.11 times higher in > or =3 years old dogs, compared with younger dogs (OR = 2.11, 95% CI = 1.1-4.2, P = 0.03). This information is important for a better understanding of the epidemiology of D. immitis in dogs in Yucatan, Mexico.

Identification and analysis of genes expressed in the adult filarial parasitic nematode Dirofilaria immitis

The heartworm Dirofilaria immitis is a filarial parasitic nematode infecting dogs and other mammals worldwide causing fatal complications. Here, we present the first large-scale survey of the adult heartworm transcriptome by generation and analysis of 4005 expressed sequence tags, identifying about 1800 genes and expanding the available sequence information for the parasite significantly. Brugia malayi genomic data offered the most valuable information to interpret heartworm genes, with about 70% of D. immitis genes showing significant similarities to the assembly. Comparative genomic analyses revealed both genes common to metazoans or nematodes and genes specific to filarial parasites that may relate to parasitism. Characterization of abundant transcripts suggested important roles for genes involved in energy generation and antioxidant defense in adults. In particular, we proposed that adult heartworm likely adopted an anaerobic electron transfer-based energy generation system distinct from the aerobic pathway utilized by its mammalian host, making it a promising target in developing next generation macrofilaricides and other treatments. Our survey provided novel insights into the D. immitis transcriptome and laid a foundation for further comparative studies on biology, parasitism and evolution within the phylum Nematoda.

An ivermectin-sensitive glutamate-gated chloride channel subunit from Dirofilaria immitis

Dirofilaria immitis is a filarial nematode that infects dogs and causes cardiopulmonary disease. The most effective way of controlling the infection is by chemoprophylaxis, using members of the avermectin/milbemycin (A/M) class of anthelmintics, which includes ivermectin; these drugs act at invertebrate glutamate-gated chloride channels (GluCl). We have cloned two cDNAs encoding D. immitis GluCl subunits and demonstrated that at least one may be an important molecular target for the A/Ms in vivo. The subunits are orthologues of the alternatively spliced GluClalpha3A and alpha3B subunits (encoded by the avr-14 gene) previously identified in Caenorhabditis elegans and in Haemonchus contortus. Although the alternative splicing of avr-14 is conserved across the species, the processing of the mature GluClalpha3A mRNA differs in D. immitis compared to C. elegans and H. contortus. Two-electrode voltage clamp recordings were made from Xenopus oocytes injected with subunit-specific cRNAs. The DiGluClalpha3B subunit formed channels that were gated by L-glutamate (1-100 mM) and ivermectin (1 microM). Oocytes injected with DiGluClalpha3A cRNA failed to respond to L-glutamate. The qualitative responses obtained were consistent with the pharmacology observed for the GluClalpha3 subunits from C. elegans and H. contortus.

Prevalence of canine dirofilariosis in the City of Buenos Aires and its outskirts (Argentina)

During the past 10 years, the prevalence of canine dirofilariosis in the City of Buenos Aires and its outskirts, particularly in the northern and southern areas, has increased significantly. In the present work, studies were carried out in dogs living in the city and in its northern, western and southern outskirts from 1997 to 2001. For this purpose, 782 blood samples were collected and analyzed to determine circulating antigen, processed with the Witness Merial antigen test. The samples resulted in negative tests for subjects who lived in the city; however, 17.7 and 23.5% of the tests were positive from the northern and southern outskirts, respectively. When analyzed by sex, positive results were distributed as follows: 62.5% males and 37.5% females (P<0.05). No significant statistical difference was found on comparing purebred and cross-breds (P<0.05). It is interesting to point out the geographical distribution of the disease, which confirms that ecological factors such as water currents, abundant vegetation and the existence of mosquitoes all year round, are important for the biological cycle of Dirofilaria immitis.

Dirofilaria repens infection in a dog: diagnosis and treatment with melarsomine and doramectin

Therapy of canine dirofilariois due to Dirofilaria repens is indicated for dogs suffering from clinical signs of this disease, such as dermal swelling, sub-cutaneous nodules and pruritus. It is also important in order to decrease the risk of infection to other dogs and humans in the vicinity of the infected animal when suitable mosquito vectors are present. Combined therapy with the arsenic adulticide melarsomine and the avermectin microfilaricidal doramectin was effective in clearing infection with D. repens in a dog. The number of microfilariae dropped from 17 microl(-1) blood pre-treatment to 7 microl(-1) following the first adulticide injection and reached 0 a day after the microfilaricidal administration. The dog remained negative for D. repens microfilaremia during a follow-up period of 90 days. Euthanasia and necropsy performed 3 months after the initiation of therapy due to a progressive neoplastic disease revealed no evidence of filariae.

[Prevalence of canine filariasis by Dirofilaria immitis and Dipetalonema reconditum in Maceió, Alagoas State, Brazil]

A survey on the prevalence of Dirofilaria immitis and Dipetalonema reconditum was conducted in 1,519 dogs from Maceió and two coastal areas in the State of Alagoas, Northeast Brazil, from 1995 to 1999, by testing for microfilariae in blood. All blood samples were from exclusively domiciled dogs with a known history, showing that the infections were autochthonous, confirming transmission of canine filariasis in these areas. In Greater Metropolitan Maceió, 15 (1.3%) microfilaremic dogs were detected with D. immitis and 15 (1,3%) with D. reconditum. In the southern coastal area there was an estimated prevalence of 12.7% for D. immitis. D. immitis and D. reconditum microfilaria were 298.1 micrometer and 249.2 micrometer long and 7.3 micrometer and 4.4 micrometer wide, respectively. A Witness immunotest that detects D. immitis antigen was used to confirm parasitological results and reveal occult dirofilariasis cases. Of the total 6,579 females examined, 8 (0.1%) Culex quinquefasciatus were observed to be naturally infected with D. immitis larvae. These results proved dirofilariasis transmission in Maceió and demonstrated D. reconditum in the same geographic area.

Susceptibility of mosquitoes in central Taiwan to natural infections of Dirofilaria immitis

From October 1997 to September 1998, 3085 Culex quinquefasciatus (Say) (Diptera: Culicidae), 584 Cx. tritaeniorhynchus (Giles) (Diptera: Culicidae), 392 Cx. annulus (Theobald) (Diptera: Culicidae), 374 Aedes albopictus (Skuse) (Diptera: Culicidae) and 102 Armigeres subalbatus (Coquillet) (Diptera: Culicidae) were collected and examined for Dirofilaria immitis (Leidy) (Spirurida: Filariidae) infection. However, only Cx. quinquefasciatus and Ae. albopictus were infected, with a prevalence of 4.28% and 3.74%, respectively. The intensity of D. immitis found in Ae. albopictus (3.43 larvae/mosquito) was higher than that found in Cx. quinquefasciatus (2.89 larvae/mosquito). After being fed with canine blood containing 7500 microfilariae (mf) per mL, Cx. quinquefasciatus ingested approximately two times as many mf as Ae. albopictus (mean of 31.73 in comparison to 16.47). However, almost three times as many third-stage infective larvae developed in Ae. albopictus as in Cx. quinquefasciatus (mean of 3.25 as compared with 1.10), with a vector efficiency index (VEI) of 19.73 and 3.47, respectively. The results showed that Cx. quinquefasciatus and Ae. albopictus served as natural vectors of D. immitis in central Taiwan. Although Ae. albopictus was more efficient for heartworm transmission, Cx. quinquefasciatus may play a more prominent role on the transmission of dirofilariasis in central Taiwan.

Survey of Dirofilaria immitis (Leidy, 1856) in random source cats in metropolitan Rio de Janeiro, Brazil, with descriptions of lesions

To evaluate the prevalence of heartworm disease in metropolitan Rio de Janeiro, RJ, Brazil, cats submitted for euthanasia were evaluated by laboratory tests and by necropsy for signs of heartworm infection. Of the 135 cats examined, one (0.8%)--a stray male from an urbanizing district--had one male worm (14.5 cm) in the left lung and showed severe muscular hypertrophy of small pulmonary arteries and arterioles with no right ventricle enlargement or passive congestion. Microfilariae were not detected in the blood of any cats. The prevalence of canine heartworm in the area from which this cat originated is estimated to be approximately 12%. The prevalence of canine heartworm in the urban area of Rio de Janeiro has been determined to be approximately 5%. It has been shown that the prevalence of feline heartworm disease parallels that in dogs, but at a lower rate. Results of this survey strongly suggest that heartworm prevention measures should be taken under consideration, especially among cats living in a high canine heartworm prevalence area.

The prevalence of Dirofilaria immitis in dogs in Sydney

Four hundred and four dogs from 9 pounds in Sydney were examined for circulating microfilariae and antigens of Dirofilaria immitis. One hundred of these were also examined post mortem for adult heartworms. The prevalence of infection in the 404 dogs as shown by serology was 11.4%, and 5.9% had circulating microfilariae of D immitis. Adult heartworms were present in 15 of 100 dogs. Dipetalonema reconditum microfilariae were present in 3.7% of dogs. Dirofilariosis is still a common and important parasite of dogs in the Sydney region and chemoprophylaxis is recommended.

Seven cases of heartworm disease (dirofilariosis) in dogs in The Netherlands

We present here the clinical history, diagnosis, and treatment of seven dogs with dirofilariosis. All dogs were imported into the Netherlands after residing in an area in which dirofilariosis is endemic. In three of these dogs the infection was occult, for the serological test was positive but there was no microfilaraemia. Weight loss, coughing, dyspnoea, and decreased exercise tolerance were the most prominent clinical signs. Two of the dogs had the characteristic electrocardiographic and radiographic signs of enlargement of the right heart. Treatment with thiacetarsamide and ivermectin resulted in complete remission in six dogs. One dog died, presumably as a result of acute renal failure. In the past year (1992-1993) seven cases of canine dirofilariosis were diagnosed, nearly equal to the number in the preceding 10 years (n = 9). This most probably reflects the greater sensitivity of the serological diagnosis of dirofilariosis in comparison with identification of microfilariae in the circulation, but a real increase in the number of dogs with dirofilariosis as a result of growing international traffic of tourists accompanied by pets cannot be excluded.

Prevalence of microfilaraemia in episodic weakness and clinically normal dogs belonging to hunting breeds

Blood samples from 50 dogs with episodic weakness and 50 clinically normal dogs, all belonging to hunting breeds, were examined for microfilariae using the modified Knott's method. The prevalence of microfilaraemia in dogs belonging to the episodic weakness group was 10% for Dirofilaria immitis, 30% for Dirofilaria repens and 8% for Acanthocheilonema reconditum. In the clinically normal group, the figures were 14% for Dirofilaria repens and 4% for Acanthocheilonema reconditum. The overall percentage of dogs with microfilaremia in the episodic weakness group was 44 and that of the clinically normal group 16, with a statistically significant difference (P < 0.01). The prevalence of microfilaremia due to the nonpathogenic filarial species (Dirofilaria repens, Acanthocheilonema reconditum) was 34% and 16% for the episodic weakness group and the clinically normal dogs, respectively, with no significant difference.

Diagnostic parasitology

Diagnosis of parasitic infections in small animals is challenging, interesting, and fun, and involves the recognition of parasite stages based on size, morphology, color, and movement. Size and morphology are the major diagnostic parameters, and a calibrated microscope is the essential tool in the diagnostic laboratory. The fecal flotation technique is used routinely for the diagnosis of most parasites that reside within the gastrointestinal tract. The specific gravity and type of solution used often will influence the results obtained. A sugar flotation solution with a specific gravity of 1.27 is one that will float a majority of parasite stages with minimal distortion. Other techniques for diagnosis of specific gastrointestinal parasites include the direct smear and the merthiolate-iodine-formalin preservative method for diagnosis of Giardia sp, the Baermann technique for diagnosis of lungworm and other live larvae, the direct sedimentation technique for diagnosis of trematode eggs, the ether-formalin-sedimentation technique for diagnosis of trematode eggs and concentrating protozoan cysts from feces with high fat content, and the McMaster technique, a dilution modification of the fecal flotation technique. Techniques for evaluation of parasites in blood include the Knott's test, hematocrit method, and direct blood smear for diagnosis of microfilariae and thick and thin stained blood smears for diagnosis of Babesia sp, Haemobartonella sp, Cytauxzoon felis, Hepatozoon canis, and Trypanosoma cruzi. Tissue impression smears are used commonly for the diagnosis of Leishmania sp in dogs and biopsy specimens or aspirates are used for the diagnosis of Pneumocystis carinii. Diagnosis of acute toxoplasmosis can be accomplished with peritoneal and thoracic fluids, and organisms occasionally are detected in blood or spinal fluid. Serological tests for many parasitic diseases have been developed and often are used as supportive diagnostic tests.