Comparison of coprological, immunological and molecular methods for the detection of dogs infected with Angiostrongylus vasorum before and after anthelmintic treatment

A Taq-Man-based multiplex quantitative PCR for the simultaneous detection and quantification of Angiostrongylus vasorum, Crenosoma vulpis, and species of respiratory capillarids in canids

In recent years, Angiostrongylus vasorum, Crenosoma vulpis, Eucoleus aerophilus (syn. Capillaria aerophila) and Eucoleus boehmi (syn. Capillaria boehmi), commonly referred to as canine lungworms, have gained a growing interest worldwide as the result of their geographical expansion. Each of these nematode species differs considerably in its biology and pathogenicity. Despite their impact on dogs' health, these parasites are often underdiagnosed owing to diagnostic challenges. Here, we describe the development and validation of a Taq-Man-based multiplex quantitative PCR (qPCR) for the simultaneous detection of the main species of canine lungworms in faeces of infected dogs. Using 10-fold serial dilutions of synthetic gene block fragments containing individual sequence targets of each lungworm species, the analytical sensitivity of the assay ascertained was 1.84 ng/μl for A. vasorum, 3.08 ng/μl for C. vulpis and 0.79 ng/μl for Eucoleus spp. The sensitivity of the assays and their ability to detect mixed species infections were compared with microscopy-based techniques (faecal floatation and Baermann technique) applied to faecal samples submitted for lungworm testing through an accredited diagnostic laboratory at the Institute of Parasitology, University of Zurich, Switzerland, and from community dogs as part of a research project on canine endoparasites in Cambodia. The multiplex qPCR displayed high diagnostic sensitivity (42/46, 91.3%; 95% Confidence Interval (CI): 79.1-97.1%) and a diagnostic specificity of 100% (45/45, 95% CI: 90.6-100%), and was able to detect 42.9% additional mixed lungworm species infections compared with microscopy-based methods. Kappa statistics showed substantial agreement between the qPCRs and microscopy for mixed infections (κ = 0.72, 95% CI: 0.4-1) and Eucoleus spp. (κ = 0.65, 95% CI: 0.45-0.85) and almost perfect agreement for C. vulpis (κ = 0.85, 95% CI: 0.63-1) and A. vasorum (κ = 0.92, 95% CI: 0.84-1). This multiplex qPCR enables timely, accurate, and sensitive diagnosis of canine lungworm species in faecal samples and can be used to monitor the geographical distribution and emergence of these parasitic species, globally.

Comparative biology of parasitic nematodes in the genus Angiostrongylus and related genera

The rise to prominence of some Angiostrongylus species through associated emerging disease in humans and dogs has stimulated calls for a renewed focus on the biology of this genus and three related genera. Although significant research efforts have been made in recent years these have tended to focus on individual species and specific aspects such as diagnosis and treatment of disease or new records of occurrence and hosts. This comprehensive review takes a comparative approach, seeking commonalities and differences among species and asking such questions as: Which species belong to this and to closely related genera and how are they related? Why do only some species appear to be spreading geographically and what factors might underlie range expansion? Which animal species are involved in the life cycles as definitive, intermediate, paratenic and accidental hosts? How do parasite larvae find, infect and develop within these hosts? What are the consequences of infection for host health? How will climate change affect future spread and global health? Appreciating how species resemble and differ from each other shines a spotlight on knowledge gaps and provides provisional guidance on key species characteristics warranting detailed study. Similarities exist among species, including the basic life cycle and transmission processes, but important details such as host range, climatic requirements, migration patterns within hosts and disease mechanisms differ, with much more information available for A. cantonensis and A. vasorum than for other species. Nonetheless, comparison across Angiostrongylus reveals some common patterns. Historically narrow definitive host ranges are expanding with new knowledge, combining with very broad ranges of intermediate gastropod hosts and vertebrate and invertebrate paratenic and accidental hosts to provide the backdrop to complex interactions among climate, ecology and transmission that remain only partly understood, even for the species of dominant concern. Key outstanding questions concern larval dynamics and the potential for transmission outside trophic relations, relations between infection and disease severity in different hosts, and how global change is altering transmission beyond immediate impacts on development rate in gastropods. The concept of encounter and compatibility filters could help to explain differences in the relative importance of different gastropod species as intermediate hosts and determine the importance of host community composition and related environmental factors to transmission and range. Across the group, it remains unclear what, physiologically, immunologically or taxonomically, delimits definitive, accidental and paratenic hosts. Impacts of infection on definitive host fitness and consequences for population dynamics and transmission remain mostly unexplored across the genus. Continual updating and cross-referencing across species of Angiostrongylus and related genera is important to synthesise rapid advances in understanding of key traits and behaviours, especially in important Angiostrongylus species that are emerging causative agents of disease in humans and other animals.

Is the Angiostrongylus vasorum infection in domestic dogs underestimated or misdiagnosed? A comprehensive presentation of four lethal cases

Introduction

Angiostrongylus vasorum (A. vasorum) is a widely distributed gastropod-borne nematode, causing severe cardio-pulmonary disorders in dogs. In Romania, A. vasorum was detected in foxes and serologically confirmed in domestic dogs, but no clinical cases are currently diagnosed.

Methods

Four dogs with clinical history of respiratory distress, originating from different geographical regions of Romania, were included in the study. One dog (case 1) was clinically evaluated using thoracic radiology and cardiac ultrasound; examination of feces and PCR were also performed for the etiologic diagnosis. The postmortem exam was performed in the other three cases, followed by parasitological and molecular analyses.

Results

In the first case, parasitic pneumonia was suspected based on the radiographic examination of the thorax and the infection with A. vasorum was confirmed by L1 morphological identification and PCR. The main postmortem changes included large, coalescing, dark red areas of pulmonary consolidation (n = 3) and numerous adult nematodes in the pulmonary arteries (n = 2). The histopathological examination of the lungs showed necrotizing and granulomatous pneumonia with severe hemorrhages and chronic pulmonary arterial changes. Intralesional nematodes were seen in all necropsied cases. Additional inflammatory changes related to A. vasorum infection were identified in the brain and tracheobronchial and mediastinal lymph nodes (n = 2). Identification of larvae, histopathology and PCR confirmed the infection with A. vasorum.

Conclusions

This study describes the first cases of canine cardiopulmonary angiostrongylosis in domestic dogs in Romania, and focuses on clinical presentation, pathological findings and molecular analysis. Angiostrongylosis should be included on the list of differential diagnoses of canine cardiopulmonary distress and/or haemorrhagic diathesis in Romania and awareness should be raised among clinicians to avoid post-mortem diagnosis in the future.

Comparison of Antibody Isotype Response to Angiostrongylus cantonensis in Experimentally Infected Rats (Rattus norvegicus) Using Hawai'i 31 kDa Antigen in an Indirect ELISA

Neuroangiostrongyliasis (NAS) is an emerging tropical disease in humans and some animals which is caused by infection with the parasitic nematode Angiostrongylus cantonensis. It is the leading cause of eosinophilic meningitis worldwide. Diagnoses in humans and susceptible animals are generally presumptive and easily confused with other central nervous system disorders. The 31 kDa antigen is currently the only NAS immunodiagnostic assay that has achieved 100% sensitivity. However, little is known about the humoral immune response against the 31 kDa antigen in NAS infections, which would be critical for widespread adoption of this assay. We used the Hawai'i 31 kDa isolate in an indirect ELISA assay to confirm the presence of immunoglobulin IgG, IgM, IgA, and IgE isotypes in six-week post-infection plasma from lab-reared rats infected with 50 live, third-stage, A. cantonensis larvae isolated from a wild Parmarion martensi semi-slug. Our results confirmed the presence of all four isotypes against the Hawaii 31 kDa isolate, with sensitivity ranging from 22-100%. The IgG isotype showed 100% sensitivity in detecting A. cantonensis infection, which validates the use of IgG indirect ELISA with 31 kDa antigen as an effective immunodiagnostic assay for rats six weeks post-infection. Given each isotype may be present at different times during NAS infections, our data provides preliminary information on the humoral immune response to A. cantonensis infection in lab-reared rats and serves as a baseline for future studies.

Nationwide Seroprevalence Survey of Angiostrongylus vasorum-Derived Antigens and Specific Antibodies in Dogs from Colombia

Angiostrongylus vasorum is a cardiopulmonary nematode, causing several clinical manifestations in dogs, e.g., severe respiratory signs, coagulopathy, and gastrointestinal or neurological signs. In the last decades, this parasite has been described to spread and emerge in Europe and North America. Scant studies on A. vasorum occurrence in South America exist. Recently, A. vasorum was detected in gastropod intermediate hosts in Colombia, where data on definitive host prevalence, e.g., dogs and wild canids, are still limited. Therefore, the sera of 955 dogs, varying in age and breed from seven different departments all over Colombia, were collected and analysed for A. vasorum antigens and parasite-specific antibodies by ELISA. In total, 1.05 % (n = 10; 95 % CI 0.40–1.69) of the samples were antigen-positive and 2.62 % (n = 25; 95 % CI 1.61–3.63) were antibody-positive. These results confirm the presence of A. vasorum in Colombia, although positive results in antigen and antibody reactions in the same dog were not detected. This study is the first large-scale survey on A. vasorum seroprevalences in dogs from Colombia.

Hemostatic Dysfunction in Dogs Naturally Infected with Angiostrongylus vasorum—A Narrative Review

This narrative review aims to describe Angiostrongylus vasorum-induced hemostatic dysfunction of dogs with emphasis on clinical and laboratory findings as well as potential therapeutic strategies for the bleeding patient. Canine angiostrongylosis (CA) is a disease with potentially high morbidity and mortality in endemic areas and with fatal outcome often associated with either severe respiratory compromise, pulmonary hypertension and right-sided heart failure, or hemostatic dysfunction with severe bleeding. The most common signs of hemorrhage are hematomas, petecchiation, ecchymoses, oral mucosal membrane bleeding and scleral bleeding, while intracranial and pulmonary hemorrhage are among the most severe. The pathophysiological mechanisms underlying hemostatic dysfunction in these patients are presently researched. While the larval effect on platelets remains unknown, the parasite appears to induce dysregulation of hemostatic proteins, with studies suggesting a mixture of pro-coagulant protein consumption and hyperfibrinolysis. Importantly, not all dogs display the same hemostatic abnormalities. Consequently, characterizing the hemostatic state of the individual patient is necessary, but has proven difficult with traditional coagulation tests. Global viscoelastic testing shows promise, but has limited availability in general practice. Treatment of A. vasorum-infected dogs with hemostatic dysfunction relies on anthelmintic treatment as well as therapy directed at the individual dog’s specific hemostatic alterations.

Serological and faecal detection of Angiostrongylus vasorum in dogs from Austria

Canine angiostrongylosis is a potentially lethal parasitic disease that can manifest itself with a broad spectrum of clinical signs, including respiratory distress, neurological and bleeding disorders, or non-specific signs. The occurrence of Angiostrongylus vasorum is widely reported in Europe, but very little is known about its presence in Austria. In this first large-scale survey, 1279 sera were collected from Austrian dogs and tested by an ELISA for the detection of circulating antigen of A. vasorum (sensitivity: 95.7%, specificity 94.0%) and by a separate ELISA detecting specific antibodies (sensitivity 81.0%, specificity 98.8%). Furthermore, 1040 faecal samples were tested for the presence of lungworm first stage larvae (L1). One dog (0.1%, 95% confidence intervals [CI]: 0.0-0.4%) was positive in both ELISAs, while 1.2% (n = 15, CI: 0.7-1.9%) of the tested dogs were antigen-positive and 1.5% (n = 19, CI: 0.9-2.3%) were positive for specific antibodies. Overall, 13 dogs (1.3%; CI: 0.7-2.1%) were positive for A. vasorum L1 while 31 dogs were positive for Crenosoma vulpis L1 (3.0%; CI: 2.0-4.2%). One dog shed L1 from both A. vasorum and C. vulpis (0.1%, CI: 0.0-0.5%). Dogs positive for A. vasorum originated from northeast, southeast and south Austria (antigen and/or antibody detection), but also from north, west and southwest Austria (antibody detection) and from northeast and west Austria (L1 detection). One of 88 blood samples (1.1%, CI: 0.0-6.2%) submitted from the eastern part of Austria was positive by a rapid assay for A. vasorum antigen detection (Angio Detect™). Crenosoma vulpis positive samples originated from northwest, north, northeast, south and west Austria. These results confirm the very sporadic occurrence of A. vasorum in the investigated areas of the country. However, due to the substantial infectious pressure from the surrounding countries and the free circulation of dogs and foxes acting as wildlife reservoirs and due to clinical relevance for infected dogs, it is crucial to maintain disease awareness also in areas where the parasite has not yet been detected.

The current situation of Angiostrongylus vasorum in Romania: a national questionnaire-based survey

Background

Angiostrongylus vasorum (Nematoda, Metastrongyloidea) is a vascular nematode that resides in the pulmonary arteries and the right side of the heart of a wide variety of carnivores, with an indirect life cycle using coprophagic gastropods as intermediate hosts. For domestic dogs, the infection with A. vasorum can be asymptomatic, but more frequently, it is associated with a wide range of clinical manifestations like cardio-respiratory signs, bleedings, neurological signs, and ocular problems which can lead to death when not treated accordingly. Angiostrongylosis was confirmed for the first time in Romania in red foxes (Vulpes vulpes) in 2017 and two years later a seroepidemiologic study was conducted among domestic dogs. However, to this date, no clinical canine angiostrongylosis cases were published in Romania. The aim of the present paper was to evaluate the knowledge about canine angiostrongylosis among veterinarians in Romania and to update the distribution of this disease using a national wide anonymous questionnaire.

Results

Overall, 147 unique responses were submitted, from 31 out of 42 counties. Twelve veterinarians (8%) from 8 counties (26%) acknowledged diagnosing a case of angiostrongylosis including 5 from the Bucharest and 1 from each of the remaining seven counties. All affected dogs had respiratory distress, 75% suffered cardiopathy, 16% coagulopathies and 8% neurological signs. Case diagnosis was based mostly on larval detection by coprology (67%) and serological antigen detection test (42%).

Conclusions

Romanian veterinarians are aware of canine angiostrongylosis and a significant number have clinical experience with the disease. Epidemiological studies are now needed to assess its distribution in the country, and further efforts are required to improve understanding of the disease, its diagnostic and treatment methods among veterinarians.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12917-021-03034-1.

Dirofilaria spp. and Angiostrongylus vasorum: Current Risk of Spreading in Central and Northern Europe

In the past few decades, the relevance of Dirofilaria immitis and Dirofilaria repens, causing cardiopulmonary and subcutaneous dirofilariosis in dogs and cats, and of Angiostrongylus vasorum, causing canine angiostrongylosis, has steadily increased in Central and Northern Europe. In this review, a summary of published articles and additional reports dealing with imported or autochthonous cases of these parasites is provided for Central (Austria, Czechia, Germany, Hungary, Luxemburg, Poland, Slovakia, Slovenia, and Switzerland) and Northern (Denmark, Finland, Iceland, Norway, and Sweden) Europe. Research efforts focusing on Dirofilaria spp. and A. vasorum have varied by country, and cross-border studies are few. The housing conditions of dogs, pet movements, the spread of competent vectors, and climate change are important factors in the spread of these nematodes. Dogs kept outside overnight are a major factor for the establishment of Dirofilaria spp. However, the establishment of invasive, diurnal, synanthropic, competent mosquito vectors such as Aedes albopictus may also influence the establishment of Dirofilaria spp. The drivers of the spread of A. vasorum remain not fully understood, but it seems to be influenced by habitats shared with wild canids, dog relocation, and possibly climatic changes; its pattern of spreading appears to be similar in different countries. Both Dirofilaria spp. and A. vasorum merit further monitoring and research focus in Europe.

Simultaneous Exposure to Angiostrongylus vasorum and Vector-Borne Pathogens in Dogs from Italy

Several drivers have recently fostered the expansion of Angiostrongylus vasorum throughout Europe, where Vector-Borne Pathogens (VBPs) are also spreading. However, the level of simultaneous risk of infection is still unknown in canine populations. This study evaluated the simultaneous exposure to A. vasorum and major canine VBPs in dogs of Italy. Sera of 294 dogs were subjected to two ELISAs, detecting A. vasorum circulating antigens and antibodies against the parasite, and to the following assays: (i) SNAP® 4DX (IDEXX Laboratories Inc.) detecting Dirofilaria immitis antigens, and antibodies vs. Borrelia burgdorferi, Anaplasma spp. and Ehrlichia spp. and (ii) IFAT for the detection of antibodies vs. Leishmania infantum, Babesia canis and Rickettsia conorii. Twenty-two (7.5%, CI: 4.8-11.1%) and six (2%, CI: 0.7-4.4%) dogs scored positive for circulating A. vasorum antibodies and antigens, respectively. Seventeen dogs (5.8%, CI: 3.4-9.1%) were positive for A. vasorum antibodies + at least one VBP, three (1%, CI: 0.2-3%) for A. vasorum antigen + at least one VBP, while one dog (0.3%, CI: 0.01-1.88%) was positive for A. vasorum antigen + A. vasorum antibodies + B. canis antibodies. These results show that dogs living in different regions of Italy are at risk of simultaneous infections with both A. vasorum and VBPs. Despite the same scenario being likely in other countries of Europe, the current knowledge is scant. Therefore, further studies are warranted to amplify current epizootiological information and to understand whether control programs should be improved.

Coagulation Status in Dogs Naturally Infected with Angiostrongylus vasorum

Angiostrongylus vasorum infection has been associated with coagulopathies including hyperfibrinolysis. We compared coagulation status including thromboelastometry (ROTEM) parameters in dogs naturally infected with A. vasorum versus healthy dogs to determine clinicopathological parameters associated with bleeding, hypocoagulopathy, and hyperfibrinolysis. Clinical signs, white blood cell count, platelet count, hematocrit, plasmatic coagulation tests (PT, aPTT, fibrinogen concentration), D-dimer, and ROTEM S parameters (Ex-tem, In-tem, Fib-tem, Ap-tem) were analysed and compared between bleeding, nonbleeding, and control dogs and between hypo- and normocoagulable animals. Clinical signs of bleeding were present in 6/9 (67%) hypocoagulable and 1/9 (11%) normocoagulable dogs. PT, fibrinogen concentration, and several ROTEM parameters were significantly different between hypocoagulable and normocoagulabe A. vasorum infected dogs. Hyperfibrinolysis was identified in 44% of infected dogs and was significantly more common in bleeding and hypocoagulable dogs. Hyperfibrinolysis was significantly associated with low MCFFib-tem but not with low fibrinogen concentration or increased D-dimers. CFTEx-tem > 248 swas 100% sensitive and 89% specific to predict hyperfibrinolysis. Hyperfibrinolysis, hypocoagulability and bleeding are common in A. vasorum infected dogs. Only Ex-tem and Fib-tem parameters and potentially PT were associated with bleeding or hypocoagulability. Ex-tem analysis enables detection of bleeding, hypocoagulability and hyperfibrinolysis within minutes.

Angiostrongylus vasorum in Domestic Dogs in Castilla y León, Iberian Peninsula, Spain

Simple Summary

Canine angiostrongylosis is a vascular and pulmonary disease caused by Angiostrongylus vasorum. In Europe, there has been an increasing number of studies showing a rise in the studies in both domestic and wild canids. In Spain, angiostrongylosis is still little-known, and studies are scarce. The aim of this study was to analyze the presence of A. vasorum in 1475 domestic dogs from the autonomous region of Castilla y León (Spain). Antigens of this species were found in 0.75% of the tested dogs, most of which lived outdoors, a significant risk factor. The geographic information system (GIS) analysis showed that the infected animals mainly lived in areas with mild temperatures and climate during most of the year and close to water bodies: stagnant water; riverbanks or irrigated areas with a predominance of alder, holm oak and gall oak forests. One main conclusion was the need to carry out more studies in countries and areas with the presence of this parasite in order to know the prevalence in dogs and wild canids, as well as determine the environmental factors that influence its presence, to be able to take more effective measures to control this disease.

Abstract

Angiostrongylus vasorum is the causative agent of canine angiostrongylosis, a disease affecting domestic and wild canids. In Europe, it is an emerging disease, mainly reported in red foxes. In Spain, there are a few studies that address the prevalence and pathology of this disease. Castilla y León is the largest region of the Iberian Peninsula, whose extensive area is 94,224 km²; however, until now, there have been no epidemiological studies on this disease. Therefore, the aim of this study was to analyze the presence of antigens of A. vasorum in 1475 dogs from Castilla y León, showing an overall prevalence of 0.75%. The infected dogs were mainly outdoors, guard and hunting breed dogs and living in locations with mild climates close to areas of high edaphic humidity, such as stagnant water, irrigated crops or riverbanks, with the vegetation dominated by alders, holm oak and gall oak forests, where the intermediate hosts develop. It is necessary to carry out more in-depth studies on the epidemiology and pathology of this disease in Spain and Europe in order to carry out efficient control in both domestic and wild animals.

Investigation of the occurrence of Angiostrongylus vasorum in coyotes in southern Ontario, Canada

In North America, the only endemic focus for Angiostrongylus vasorum (French heartworm) was historically thought to occur in the southeastern part of the island of Newfoundland. However, reports of A. vasorum infection in wild canids in West Virginia, USA, and Nova Scotia, Canada, suggest the introduction of the parasite to mainland North America. We screened for A. vasorum in coyotes from across southern Ontario. Additionally, we evaluated the performance of ELISAs for detection of circulating A. vasorum antigen (Ag-ELISA) and antibodies against A. vasorum (Ab-ELISA) designed for use in sera or blood of foxes for use with coyotes in this region. Autopsies were performed on 397 coyotes, and lung tissue extract prepared from each carcass was tested via both ELISAs. The sensitivity and specificity for both tests were estimated in the absence of a gold standard using a 2-test single population Bayesian model; sensitivity and specificity priors were based on the performance of the assays in foxes in Switzerland. Eight coyotes tested positive for A. vasorum antigen; no animal was antibody positive. The estimated sensitivity and specificity of the Ag-ELISA were 90.8% (95% credible interval [CrI]: 83.8–95.6%) and 95.5% (95% CrI: 93.4–97.2%), respectively. For the Ab-ELISA, the estimated sensitivity and specificity were 41.9% (95% CrI: 32.1–51.9%) and 98.0% (95% CrI: 96.3–99.0%), respectively. Based on these findings and negative postmortem data for the same animals, there is insufficient evidence to suggest the presence of A. vasorum in southern Ontario coyotes.

Quantitative proteomics analysis of Angiostrongylus vasorum-induced alterations in dog serum sheds light on the pathogenesis of canine angiostrongylosis

Blood contains hundreds of proteins, reflecting ongoing cellular processes and immune reactions. Infections with the blood-dwelling cardiopulmonary nematode Angiostrongylus vasorum in dogs manifest with a broad spectrum of clinical signs including respiratory distress, bleeding diathesis and neurological signs, and are associated with a perturbed blood protein profile in dogs. However, current knowledge does not completely explain the observed pathologies induced by A. vasorum infections, including bleeding disorders. Using sera from experimentally infected dogs, dog serum proteome was analysed by quantitative mass spectrometry methods over several time points before and after inoculation. Following computational analysis, we identified 139 up- and downregulated proteins after infection (log2 ratio cut-off ≥ 1.0; q-value ≤ 0.05). Among upregulated proteins were chitinase 3-like 1 and pulmonary surfactant-associated protein B (log2 fold-changes ≥ 5). Pathway enrichment revealed the complement (especially the lectin pathway) and coagulation cascades as significantly affected upon analysis of downregulated proteins. Among them were mannan-binding lectin serine peptidases, ficolin, and coagulation factor XIII-B. These results bring new elements towards understanding the underlying pathomechanisms of bleeding diatheses observed in some A. vasorum-infected dogs.

Angiostrongylosis in northeastern Italy: First report of two autochthonous fatal cases in dogs and first detection in a wild red fox

Canine angiostrongylosis is an emergent cardio-pulmonary gastropod-borne helminthic infection caused by the metastrongyloid nematode Angiostrongylus vasorum. Clinically, it is characterized by a wide spectrum of non-specific signs and the red fox serves as the most important reservoir for dog infections. In Italy, this disease has been well documented both in northwestern and central-southern regions, whereas it is apparently poorly recognized in the northeastern area of the country. This report describes the diagnostic findings of two autochthonous cases of fatal canine angiostrongylosis and of one case in a wild red fox detected in northeastern Italy. Reporting cases is relevant to clinicians in order to increase their awareness for the prompt diagnosis of a potentially life-threatening disease that may go unnoticed or misdiagnosed.

Genetic diversity of the cardiopulmonary canid nematode Angiostrongylus vasorum within and between rural and urban fox populations

Angiostrongylus vasorum is an emerging parasitic cardiopulmonary nematode of dogs, foxes, and other canids. In dogs, the infection causes respiratory and bleeding disorders along with other clinical signs collectively known as canine angiostrongylosis, while foxes represent an important wildlife reservoir. Despite the spread of A. vasorum across various countries in Europe and the Americas, little is known about the genetic diversity of A. vasorum populations at a local level in a highly endemic area. Thus, in the present study, we investigated the genetic diversity of 323 adult A. vasorum nematodes from 64 foxes living in the canton of Zurich, Switzerland. Among those, 279 worms isolated from 20 foxes were analyzed separately to investigate the genetic diversity of multiple worms within individual foxes. Part of the mitochondrial cytochrome c oxidase subunit I (mtCOI) gene was amplified and sequenced. Overall, 16 mitochondrial haplotypes were identified. The analysis of multiple worms per host revealed 12 haplotypes, with up to 5 different haplotypes in single individuals. Higher haplotype diversity (n = 10) of nematodes from foxes of urban areas than in rural areas (n = 7) was observed, with 5 shared haplotypes. Comparing our data with published GenBank sequences, five haplotypes were found to be unique within the Zurich nematode population. Interestingly, A. vasorum nematodes obtained from foxes in London and Zurich shared the same dominating haplotype. Further studies are needed to clarify if this haplotype has a different pathogenicity that may contribute to its dominance. Our findings show the importance of foxes as a reservoir for genetic parasite recombination and indicate that high fox population densities in urban areas with small and overlapping home ranges allow multiple infection events that lead to high genetic variability of A. vasorum.

Field safety and efficacy of an orally administered combination of sarolaner, moxidectin and pyrantel (Simparica Trio®) for the prevention of angiostrongylosis in dogs presented as veterinary patients

Background

Infection with the cardiopulmonary nematode Angiostrongylus vasorum may cause severe disease in dogs, therefore prophylactic treatments are necessary to prevent infection in dogs at risk. A clinical field study was conducted to demonstrate the efficacy and safety of an oral combination of sarolaner, moxidectin and pyrantel (Simparica Trio^®) for the prevention of A. vasorum infection in dogs (prevention study). A survey study was conducted concurrently to determine the infection pressure in the same areas.

Methods

Prevention and survey studies were both conducted at the same veterinary clinics in endemic hot spots for A. vasorum in Denmark and Italy. The prevention study was a randomized, placebo controlled, double masked study where 622 client-owned dogs were treated and tested at 30 days intervals for 10 months. In the survey study 1628 dogs that were at risk of infection and/or were suspected to be infected were tested by fecal and/or serological methods, and the percent of dogs positive for A. vasorum was calculated.

Results

In the prevention study, there were no adverse events related to treatment with Simparica Trio^®. Two placebo-treated animals became infected with A. vasorum during the 10-month study period, while none of the dogs in the combination product-treated group became infected. In the survey study, 12.2% of the study dogs were found positive to A. vasorum, indicating high exposure to the parasite during the period of the prevention study.

Conclusions

Monthly oral treatment with the combination of sarolaner, moxidectin and pyrantel (Simparica Trio^®) was 100% effective in the prevention of natural infection with A. vasorum in dogs in highly endemic areas. In endemic areas, A. vasorum occurrence in dogs at risk is considerable.

Capillaria boehmi (syn. Eucoleus boehmi): Challenging treatment of a rarely diagnosed nasal nematode in dogs and high prevalence in Swiss foxes

Despite morphological differences of eggs and adults, Capillaria boehmi infections have been occasionally misdiagnosed as C. aerophila infections in the past. Capillaria boehmi is found in the nasal and paranasal sinuses of wild canids and dogs, which may suffer from nasal discharge, sneezing, epistaxis and, importantly, their scent can be impaired. In this study we present three challenging cases of nasal capillariosis in dogs, report and review the variable success of anthelmintic treatments and investigate C. boehmi prevalence in Swiss red foxes, considered as potential wild life reservoir. Out of two females and one male dog (all scent hounds, aged 3-9 years and weighing 19-31 kg), two dogs were previously coproscopically misdiagnosed with Trichuris infections. Two dogs showed clinical signs such as sneezing, coughing and impaired scent. From one dog adult living C. boehmi were obtained by nasal lavage. The identity of worms and eggs of all three dogs were genetically confirmed (18S rRNA, 100 % identity in 578 base pairs). Dogs 1-3 were followed-up for overall 54, 8, and 67 months, respectively. All dogs repeatedly excreted C. boehmi eggs in faecal samples despite treatments with the following compounds, in various dosage and retreatment protocols: fenbendazole, milbemycin oxime (orally), moxidectin/imidacloprid/ (spot-on) and levamisole (intramuscularly). The different anthelmintic compounds showed variable success regarding their effect on clinical outcome and on stopping egg excretion. Reinfections due to a contaminated environment could not be fully excluded. In winter 2016 and 2017, 218 foxes from the canton of Zurich, Switzerland, were examined. Tissues of nasal and paranasal sinuses were investigated for adult Capillaria specimens and eggs. We describe for the first time C. boehmi infections in Switzerland, observing a high prevalence (190/218, 87.2 %). Overall, 107 of 126 adults (84.9 %, 95 % Confidence Interval, CI: 77.5-90.7 %) and 83 of 92 youngsters (90.2 %, CI: 82.2-95.4 %) were infected. The presence of C. boehmi did not correlate with age (P = 0.209), but correlated significantly with sex: male foxes (102 of 107, 95.3 %, CI: 89.4-98.5 %) were significantly (P = 0.001) more often infected than females (88 of 111, 79.3 %, CI: 70.5-86.4 %). Worm burden ranged from 1 to 72 adult specimens (geometric mean: 5.7). In conclusion, C. boehmi infections can be mis- and/or underdiagnosed in dogs. Appropriate anthelmintic treatments, preventing coprophagia and egg contamination of the surroundings and performing coproscopic controls after treatments are fundamental aspects. Potentially, nasal washing may represent an auxiliary alternative. However, the successful elimination of C. boehmi infections in dogs remains challenging.

The 'French heartworm' in Greece: A countrywide serological survey of Angiostrongylus vasorum infection by combined detection of circulating antigens and specific antibodies

Angiostrongylus vasorum is a nematode of the superfamily Metastongyloidea and was first described in the south of France in the nineteenth century where its biology was extensively studied in the 1960ies, leading to the common use of the byname "the French heartworm". The life cycle of the parasite is indirect including slugs and snails as intermediate hosts, while the adults live in the right heart and pulmonary arteries. Since then, many studies have been conducted in different European countries. However, there is scant knowledge regarding the prevalence and distribution of this parasite in Greece. Therefore, the objective of the present study was to investigate the current seroprevalence of A. vasorum in dogs in Greece. Overall 1000 apparently healthy and randomly selected dogs, presented in veterinary clinics, were involved at national level (n = 66 locations). Individual serum samples were obtained and tested using two in-house ELISAs by combining the detection of specific antibodies against the parasite and of circulating antigens of A. vasorum. Overall, 3.0% (n = 30, CI 95% 2.1 to 4.3%) of the sampled dogs were seropositive to at least one of the two ELISAs: 0.4% (n = 4, CI 95% 0.2 to 1.0%) were positive by both ELISAs, while 1.0% (n = 10, CI 95% 0.5 to 1.8%) were seropositive only for specific antibodies and 1.6% (n = 16, CI 95% 1.0 to 2.6%) were antigen-positive only. This is the first multicentric seroepidemiological study about A. vasorum in dogs from Greece. We showed that this parasite circulates in the local canine population and further studies should be carried out to elucidate its significance in the country.

The first seroepidemiological survey for Angiostrongylus vasorum in domestic dogs from Romania

Background

Angiostrongylus vasorum is a metastrongyloid nematode localized in the right heart and the pulmonary arteries of domestic dogs. The number of reports in Europe has recently increased, presumably as a consequence of a growing awareness among clinicians, animal owners and researchers, but also due to a growing incidence and territorial spread. So far, no studies have been conducted to assess the prevalence and distribution of A. vasorum in domestic dogs in Romania, and the awareness among veterinarians is limited or absent. The aim of the present study was to evaluate the countrywide seroprevalence of circulating antigens of A. vasorum and specific antibodies against A. vasorum in domestic dogs from Romania.

Methods

Between November 2016 and July 2017, blood was sampled from a total of 1545 domestic dogs from 23 counties of Romania. Details about their gender, age, breed, housing, use and origin were collected. All serum samples were tested for the presence of A. vasorum circulating antigens (AG) using monoclonal and polyclonal antibodies in a sandwich ELISA. Additionally, a sandwich ELISA using A. vasorum adult somatic antigen purified by monoclonal antibodies was used for specific antibody (AB) detection.

Results

A total of 33 dogs (2.14%, 95% CI: 1.82–3.56%) were seropositive for A. vasorum antigen or antibodies against the parasite. Three dogs were positive for antigen only (0.19%, 95% CI: 0.07–0.57%) and 30 dogs (1.94%, 95% CI: 1.36–2.76%) were positive for antibodies only. No dog was positive for both tests. The overall prevalence (AB or AG) and the AB prevalence were significantly higher in pure breed dogs compared to mixed breeds and mongrel dogs (P < 0.05) and in shepherd dogs compared to other groups (P < 0.05). There was no significant difference between males and females, between urban and rural dogs, between dogs with unrestricted access and with restricted access to the environment, and between dogs living outdoors and indoors.

Conclusions

Our data suggest that the disease is present in Romania in dogs, as it was previously demonstrated in foxes. However, so far, no clinical case has been reported in the country and this may be related to a low awareness among vets.

Electronic supplementary material

The online version of this article (10.1186/s13071-019-3481-0) contains supplementary material, which is available to authorized users.

A grid-cell based fecal sampling scheme reveals: land-use and altitude affect prevalence rates of Angiostrongylus vasorum and other parasites of red foxes (Vulpes vulpes)

In view of the role of foxes as a reservoir for Angiostrongylus vasorum, a nematode of the heart and lungs of dogs and foxes, its occurrence across Switzerland was investigated in foxes applying a standardized sampling scheme for fox fecal samples. In 72 study areas, which consisted of three 1-km² grid cells, a total of 1481 samples were collected by walking transects following linear features in the terrain, and analyzed by a flotation-sieving method. The overall prevalence rate of A. vasorum in fecal samples was 8.8% (95% confidence interval, CI 7.4-10.3%), being significantly higher in the Swiss Plateau (11.4%, CI. 9.4-13.8%) compared with other bioregions, and more prevalent in areas with less than 50% of cultivated land (p = 0.043). Prevalence rates increased with decreasing altitudes being significantly higher below 400 m above sea level (20.6%, 95% CI 15.2-26.9%), while all samples collected above 900 m asl were negative. Eggs of Toxocara sp. (12.1%), Taeniidae (10.5%), Capillaria spp. (8.3%), Trichuris vulpis (5.5%), hookworms (5.3%), Toxascaris leonina (1.3%) and Strongyloides sp. (0.4%) were furthermore identified. Taeniid eggs were positively and Capillaria spp. negatively associated with the amount of cultivated land. The prevalence rates based on our fecal analyses were generally lower compared with previous studies from Switzerland which were based on fox necropsies. However, the grid cell-based sampling scheme with replicable transects for fox feces collection proved to be a suitable, non-invasive method for parasitic large-scale surveys providing information on the relative infectious pressure for the local dog population.

One-year parasitological screening of stray dogs and cats in County Dublin, Ireland

To date, there are no recent studies identifying the prevalence of parasites of human and veterinary importance in dogs and cats in Ireland. The interaction between pets and wildlife species in the environment is an important source of parasite exposure to canids and felines, and one likely to be heightened in the stray animal population. This study aimed to establish the prevalence of endoparasites in unowned dogs and cats in County Dublin, Ireland. Feces from stray dogs (n= 627) and cats (n= 289) entering a rehoming centre were collected immediately after defecation. The main parasitic agents detected were ascarids (15.52 and 30.26%),Cystoisospora(3.27 and 3.69%),Giardiaspp. (6.02 and 1.84%) and lungworms (0.64 and 2.08%), in dogs and cats respectively. Animals younger than 3 months of age were more likely to be infected with ascarids (P< 0.001) andCystoisosporaspp. (P= 0.008 andP= 0.014) than older animals. All lungworms were morphologically identified and dogs were infected withAngiostrongylus vasorum(0.48%) andCrenosoma vulpis(0.16%) whereas cats were only infected withAelurostrongylus abstrusus(2.08%). This represents the first prevalence study of stray animals in Ireland. Data collected will inform the treatment and in addition, the future monitoring and control studies of parasite populations.

Angiostrongylosis in dogs with negative fecal and in-clinic rapid serological tests: 7 Cases (2013-2017)

BACKGROUND

Angiostrongylosis is considered as emerging disease in dogs in Belgium. Detection of first-stage larvae in feces using the Baermann method has an imperfect sensitivity.

OBJECTIVES

Investigation of efficacy of noninvasive blood and fecal diagnostic tests in comparison with PCR on bronchoalveolar lavage (BAL) material in a small series of coughing or dyspnoeic dogs naturally infected with Angiostrongylus vasorum.

ANIMALS

Seven dogs with angiostrongylosis.

METHODS

Retrospective study. Dogs with cough, exercise intolerance and dyspnea of 2- to 8-week duration. Diagnostic methods used included Baermann analysis, AngioDetect rapid assay, ELISAs for detection of circulating antigen and specific antibodies and qPCR on BAL material.

RESULTS

Baermann analysis, AngioDetect rapid assay, antigen ELISA, antibody ELISA, and qPCR on BAL material were positive in 3/7, 2/7, 3/6, 6/6, and 7/7 dogs, respectively. ELISA for antibodies or qPCR on BAL material were essential for definitive diagnosis in 3 dogs. Relative sensitivities of AngioDetect rapid assay, Baermann analysis, and ELISA for antigen detection were lower than 50% compared with ELISA for antibodies or qPCR on BAL material.

CONCLUSION AND CLINICAL IMPORTANCE

In this small clinical series, Baermann analysis and AngioDetect rapid assay failed to confirm the diagnosis in some dogs. Therefore, ELISA for antibody detection and qPCR on BAL material should strongly be considered in clinically suspected dogs when antigen detection methods (AngioDetect or ELISA) and Baermann analysis are negative.

Angiostrongylus vasorum and Aelurostrongylus abstrusus: Neglected and underestimated parasites in South America

The gastropod-borne nematodes Angiostrongylus vasorum and Aelurostrongylus abstrusus are global causes of cardio/pulmonary diseases in dogs and cats. In the last decade, the number of reports on canine and feline lungworms has increased in several areas of Europe and North America. The unspecific clinical signs and prolonged course of these diseases often renders diagnosis challenging. Both infections are considered as emerging and underestimated causes of disease in domestic pets. In South America, little information is available on these diseases, apart from occasional reports proving the principle presence of A. vasorum and A. abstrusus. Thus, the purpose of this review is to summarize reports on infections in both domestic and wildlife animals in South America and to increase the awareness on gastropod-borne metastrongyloid parasites, which also include important zoonotic species, such as A. cantonensis and A. costaricensis. This review highlights the usefulness of diagnostic tools, such as the Baermann funnel technique, serology and PCR, and proposes to include these routinely on cases with clinical suspicion for lungworm infections. Future national epidemiological surveys are recommended to be conducted to gain a deeper insight into the actual epidemiological situation of gastropod-borne parasitoses in South America.

Determining resolution of Angiostrongylus vasorum in dogs following anthelmintic treatment with an imidacloprid 10 per cent/moxidectin 2.5 per cent spot-on

Objectives

To determine the time from treatment with a product containing imidacloprid 10 per cent/moxidectin 2.5 per cent spot-on (Advocate™), to dogs becoming negative for Angiostrongylus vasorum (A. vasorum). The authors hypothesised that most dogs would have resolution of A. vasorum within four weeks of treatment with Advocate™.

Design

Prospective, non-randomised, prepost treatment study.

Setting

Cases were enrolled from general practices along the southern coast of the United Kingdom.

Participants

Nine dogs completed the study and were enrolled if A. vasorum had been diagnosed based on a positive commercially available, in-clinic, serological A. vasorum antigen test (Angio Detect®) or Baermann performed at an external laboratory or both.

Interventions

The only treatment A. vasorum-positive dogs received was Advocate™ which was applied at the time of diagnosis and reapplied if necessary at four-weekly intervals until dogs tested negative by Angio Detect.

Primary outcome measures

Angio Detect® was performed and Advocate™ was reapplied at four-weekly intervals until dogs tested negative by this method.

Secondary outcome measures

Baermann was also performed at four-weekly intervals until dogs tested negative by this method.

Results

Application of Advocate™ was an effective treatment for A. vasorum infection in dogs and resulted in resolution of the infection, based on Angio Detect® testing and Baermann, within four weeks, in eight out of nine dogs. Post-treatment Angio Detect® testing was concordant with Baermann in seven of nine dogs.

Conclusions

Application of Advocate™ was an effective treatment for A. vasorum infection in dogs and resulted in resolution of the infection within four weeks in most dogs. Repeat Angio Detect® testing is recommended following treatment of A. vasorum to confirm resolution of the infection.

Faecal detection of the lungworms Crenosoma vulpis and Angiostrongylus vasorum and serological detection of A. vasorum in dogs from the Czech Republic

Dogs are definitive hosts for the lungworms Crenosoma vulpis and Angiostrongylus vasorum. Intermediate hosts are gasteropoda (Mollusca). In the past, lungworms in dogs were rarely identified in the Czech Republic and in neighbouring countries. A total of 253 dogs were sampled for faecal analysis performed by the Baermann method for isolation of first stage larvae (L1) of lungworms. A total of 193 serum samples were collected and analysed by ELISA for the detection of a circulating antigen and specific antibodies against A. vasorum. All dog owners were asked to fill out a questionnaire. Nine dogs (4.7%, 95% Confidence Interval, CI: 2.2–8.7%) were positive for the A. vasorum circulating antigen, seven dogs (3.6%, CI: 1.5–7.3%) had specific antibodies against A. vasorum; of these, three animals (1.6%, CI: 0.3–4.5%) were positive for both ELISAs. Most of them were under the age of three years. Only three of 13 seropositive dogs were not healthy, namely, in one dog vomitus was observed and two dogs were pyretic. Faecal samples of 5 dogs were positive for C. vulpis L1 (2.0%, CI: 0.6–4.6%). Angiostrongylus vasorum L1 were found in the faecal sample of one dog (0.4%, CI: 0.01–2.2%). This study illustrates the wide-spread occurrence of lungworms in the Czech Republic. Disease awareness of lungworms among animal owners and veterinarians should be implemented.

Dirofilaria immitis and Angiostrongylus vasorum: The current situation of two major canine heartworms in Portugal

Cardiopulmonary nematodes are life-threatening pet parasites increasingly reported throughout Europe, with overlapping endemic areas. Dirofilaria immitis is a mosquito-borne whilst Angiostrongylus vasorum is a snail-borne pathogen. Both adult nematodes reside in the pulmonary arteries and right cardiac ventricle of domestic and wild canids, causing a wide spectrum of clinical presentations ranging from cough, dyspnoea and exercise intolerance to severe vascular and pulmonary disease with hearth failure that may lead to death. Information about the prevalence and distribution of cardiopulmonary parasites is essential for the control of animal diseases and, in the case of D. immitis, for the control of potentially associated illnesses in humans. However, in Portugal, heartworm studies are limited to few surveys and case reports, possibly underestimating the relevance of these nematodes. The present work reviews the data on cardiopulmonary dirofilariosis and angiostrongylosis in dogs in Portugal, providing a comprehensive update of the epidemiological situation during the past 20 years.

Impact of heat treatment on antigen detection in sera of Angiostrongylus vasorum infected dogs

Background

In the last decade serological tests for detection of circulating Angiostrongylus vasorum antigen and specific antibodies have been developed and adopted for individual diagnosis and epidemiological studies in dogs. Although confirmed positive at necropsy, antigen detection was not possible in single experimentally, as well as naturally infected dogs, possibly due to immune complex formation. The aim of this study was to evaluate the effect of heat treatment on detection of A. vasorum antigen in sera of experimentally (n = 21, 119 follow-up sera) and naturally (n = 18) infected animals. In addition, sera of dogs showing clinical signs consistent with angiostrongylosis (n = 10), of randomly selected dogs (n = 58) and of dogs with other parasitic infections (n = 15) were evaluated. Sera were subjected to heat treatment at 100 °C after addition of 0.5 M EDTA (dilution 1:5) and tested with ELISAs for detection of circulating A. vasorum antigen before and after treatment.

Results

Between 5 and 11 weeks post-inoculation (wpi) the percentage of positive untreated samples (experimentally infected dogs) increased over time from 33.3 to 90%. Single samples were still negative between 12 and 15 wpi. Overall, between 5 and 15 wpi, 50.6% (45/89) of the available samples were seropositive. From 3 to 6 wpi EDTA/heat treatment caused a change in 8/34 (23.5%) of the samples, with most (n = 6, 17.6%) converting from positive to negative. In contrast, from 7 to 10 wpi, treatment induced a change in 19/52 (36.5%) samples, with all but one converting from negative to positive. Thirteen of 18 naturally infected dogs were antigen positive before and 15 after EDTA/heat treatment, respectively. Untreated samples of 3 dogs with suspected angiostrongylosis were antigen positive, of which only one remained positive after EDTA/heat treatment. One of 58 untreated random samples was antigen positive; this sample became negative after treatment, while another turned positive. One of 15 dogs infected with other parasites than A. vasorum was positive before but negative after treatment.

Conclusion

Although heat treatment improves A. vasorum antigen detection between 7 and 10 wpi by immune complex disruption, we do not recommend systematic pretreating sera because of reduced antigen detection between 3 and 6 wpi and impairment of antibody detection, if performed contemporaneously.

Repeated inoculations with the lung and heartworm nematode Angiostrongylus vasorum result in increasing larval excretion and worm burden in the red fox (Vulpes vulpes)

The French heartworm Angiostongylus vasorum is found in European red fox (Vulpes vulpes) and dog populations, where it appears to be spreading geographically. Once introduced into new areas, it establishes in local fox populations, typically to over 50% prevalence in a few years. High susceptibility and constant excretion of first stage larvae (L1) by the definitive hosts are prerequisites for sustaining high parasite biomass in a particular habitat. The present study explores the hypothesis that repeated ingestion of gastropods in nature will result in accumulation of adult worms and elevated excretion of L1 in feces. Experimentally infected foxes were subsequently inoculated via stomach tube once (9 weeks post initial inoculation) or twice (9 and 13 weeks post inoculation (wpi)) with 100 third stage A. vasorum larvae (L3) previously isolated from aquatic snails infected with L1 from a naturally infected dog. Despite large variation in fecal larval excretion for the individual animals within the groups, excretion of L1 was significantly higher in foxes twice inoculated as compared to foxes inoculated only once. With an outlier in the once inoculated group removed, excretion became significantly higher in the three times inoculated group. Establishment of adult worms varied and only a trend to higher worm burdens was found in the group of foxes inoculated three times. However, this became significant with the same single outlier removed. Overall, it appears that protective immunity to A. vasorum does not appear to occur in V. vulpes with animals exhibiting high infection intensities without obvious clinical signs. The increasing larval excretion in foxes being repeatedly exposed to A. vasorum L3 support the hypothesis that foxes under natural conditions may repeatedly ingest infected gastropods and remain a source of environmental contamination for several months, potentially contributing to the establishment of endemic foci through increasing L1 excretion.

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Foxes were experimentally infected with 100 Angiostrongylus vasorum larvae (L3).

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Two groups were later challenged once or twice.

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Increasing larval counts linked to time post infection and repeated inoculation.

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Data suggests role of foxes in rapid establishment of the parasite in new areas.

Host-specific serological response to Angiostrongylus vasorum infection in red foxes (Vulpes vulpes): implications for parasite epidemiology

Angiostrongylus vasorum is a cardiovascular nematode increasingly found in dogs and foxes in endemic foci throughout Europe. The present study evaluates ELISAs for detection of circulating antigens and specific antibodies against A. vasorum in foxes. Blood and worm burdens (WBs) from carcasses of 215 Swiss wild red foxes (Vulpes vulpes) and from 75 farmed foxes of different age groups experimentally inoculated once or repeatedly with infective doses of 50, 100 or 200 third-stage larvae were obtained. Antigen detection in the naturally infected Swiss foxes had 91·2% sensitivity and 89·4% specificity, whereas the corresponding figures for antibody detection were 42·2 and 92·0%. The experimentally infected foxes became positive for circulating antigens 5–10 weeks post-inoculation (wpi) and remained highly positive up to 22 wpi, irrespectively of further challenge inoculation. The antibody responses in the same foxes were highly variable: high optical density (OD) values were reached 5–7 wpi in all animals, followed by a decrease in over half of the animals despite accumulating and consequently high WBs resulting in persistent infections. After each challenge, a slight increase of OD values was observed 7 weeks later. We hypothesize that infected foxes develop a variable and non-protective immunity. Such parasite tolerance allows long-term survival of A. vasorum in the animals, and may explain why the parasite appears to spread rapidly within a fox population, an epidemiological dynamic that is evident in many parts of Europe where A. vasorum has been found over the last decades.

The effect of host age and inoculation dose on infection dynamics of Angiostrongylus vasorum in red foxes (Vulpes vulpes)

BACKGROUND

Infections and clinical cases of Angiostrongylus vasorum in dogs are found increasingly across Europe, thus rendering knowledge on its infection biology more important. We used red foxes as a carnivore model to examine the effect of host age and infection dose on the establishment of adult A. vasorum in single experimental infections.

METHODS

Fourteen juvenile and fourteen adult red foxes, free of metastrongyloid infections, were given a low (50) or high (200) dose of third-stage larvae (L3) of A. vasorum. Two groups of three foxes of each age group served as uninfected controls. Larval excretion by Baermann and blood parameters were followed for ten weeks. Worm counts were performed at necropsy by sequential perfusion, dissection and Baermann method.

RESULTS

The establishment rate (i.e. recovery in percentage of inoculation dose) of A. vasorum primary infections in red foxes was associated with host age and inoculation dose. In the low dose juveniles, 61% (range 52-72%) of the infection dose was recovered as worms in the pulmonary arteries and heart at necropsy while only 35% (21-50%) were recovered in the high dose. Corresponding establishment rates for adults were 39% (18-98%) and 8% (1-21%). In juveniles, a higher dose resulted in significantly higher adult worm counts, higher larval excretion and more pronounced pathophysiological changes, particularly in coagulation parameters. Earlier onset of patency was also found in the juveniles. In contrast, the larval excretion in high dose adults was very low and two infected animals never reached patency. However, a few adults showed only limited resistance as judged by excretion of larvae. The increase to very high larval excretion levels (> 4,000 larvae per g of faeces) after several months in a single animal, indicated that any potential acquired immunity does not affect worm fecundity.

CONCLUSIONS

Resistance to a primary A. vasorum infection was generally higher in older animals, and this age resistance was reflected in lower worm counts and reduced excretion of larvae. The juvenile red foxes were fully susceptible, as reflected in high establishment rates. Although severe clinical disease was never observed in the foxes, A. vasorum infections in red foxes appear to be chronic and moreover, to resemble infections in dogs. The results underline the red fox as a suitable model as well as natural reservoir for the parasite.

Prevalence of Angiostrongylus vasorum in southern Belgium, a coprological and serological survey

Background

Canine angiostrongylosis, a gastropod-borne helminthic infection, is increasingly being described in North America and is now reported in many European countries. In dogs, Angiostrongylus vasorum may cause a wide spectrum of clinical signs. Respiratory distress such as coughing and dyspnoea are the most frequently described manifestations. The aim of the present study was to gain additional information on the distribution, prevalence and risk factors associated with A. vasorum infection in dog from southern Belgium through the combined used of a commercially available in-clinic assay for detection of circulating antigen (Angio Detect™, IDEXX, Westbrook, USA) and coprology in two different canine populations: dogs with clinical signs compatible with angiostrongylosis and asymptomatic dogs or dogs presented for unrelated conditions (control).

Results

A total of 979 dogs were enrolled in the study from November 2014 until February 2016. Seven hundred fifty-seven dogs were included in the control group, whereas 222 dogs had clinical signs compatible with angiostrongylosis. Forty-six dogs out of 979 (4.7 %) had A. vasorum circulating antigen. There was a highly significant difference between the two populations (3.6 % (27/747) and 8.6 % (19/222) in control and symptomatic dogs, respectively) (P = 0.00379). First stage larvae (L1) of A. vasorum were found in seven out of 24 serologically positive control dogs and in six out of 17 serologically positive symptomatic dogs. Interestingly, L1 of Crenosoma vulpis were detected by Baermann technique in one control and nine symptomatic dogs, respectively. Out of 17 Angio Detect™ (IDEXX, Westbrook, USA) positive dogs with negative (14) or not performed Baermann test (three), one dog was positive in both in-house ELISAs (Ag and Ab) and one dog was positive for Ag. Statistical analysis was unable to detect any risk factors associated with the direct and/or indirect detection of A. vasorum.

Conclusions

This seroepidemiological study demonstrated for the first time a high seroprevalence in Southern Belgium for A. vasorum. The Angio Detect™ was found to be suitable in this context as the collection, preservation and examination of stools were difficult. Nevertheless, discrepancies were observed between the different available tests. Additional research is clearly needed. Also, coproscopy remains a very useful tool in dogs infected for less than nine weeks and for the identification of other canine lung nematodes such as C. vulpis. This study also demonstrates that asymptomatic dogs may shed A. vasorum L1 in their faeces and therefore contribute to the maintenance of A. vasorum life-cycle.

Seroprevalence of circulating Angiostrongylus vasorum antigen and parasite-specific antibodies in dogs from Portugal

Angiostrongylus vasorum is a nematode that lives in the pulmonary arteries and right cardiac ventricle of domestic dogs and wild canids. It is increasingly being reported in several European countries and North America. This parasite induces inflammatory verminous pneumonia, causing severe respiratory disease in dogs. In some instances, coagulopathies, neurological signs and even death may occur. Scant data are available regarding the occurrence of A. vasorum in Portugal. Therefore, sera of 906 shelter dogs from North to South mainland Portugal were collected. ELISAs to detect A. vasorum circulating antigen and specific antibodies against this parasite were performed. A total of six dogs [0.66 %, 95 % confidence intervals (CI) 0.24–1.43] were positive for both A. vasorum antigen and antibody detection, indicating an active infection, and 12 dogs (1.32 %, CI 0.68–2.30) were A. vasorum antibody-positive only. Regions with antigen- and antibody-positive animals overlapped and were distributed over nearly all sampled areas in the country. This is the first large-scale ELISA-based serological survey for A. vasorum in dogs from Portugal. The endemic occurrence of A. vasorum in dogs from different geographical areas of Portugal is therefore confirmed.

Comparison of three methods for the detection of Angiostrongylus vasorum in the final host

Angiostrongylosis is potentially fatal parasitic nematode infection affecting dogs which can be difficult to diagnose. In recent years several microscopical, serological and molecular detection methods have been developed, however there are few studies that have compared the relative performance of these methods. Screening necropsy material from an opportunistic sample of 140 foxes (82 of which were considered to be infected with Angiostrongylus vasorum), indicated sensitivities of 84.1% for dissection and visual examination of plucks, 69.5% for nested PCR of an 18S rRNA fragment and 76.8% for a canine A. vasorum antigen detection test (IDEXX Angio Detect) of tissue fluid samples respectively. Agreement between the tests ranged from 45.6 to 79.7%. A novel nested PCR-RFLP for the detection and identification of canid lungworm spp. is described.