A Systematic Overview of Zoonotic Helminth Infections in North America

Stressed snails release Angiostrongylus cantonensis (rat lungworm) larvae in their slime

This study investigated the influence of stress on release of Angiostrongylus cantonensis larvae from a snail host, Parmarion martensi. We subjected 140 infected, wild-caught P. martensi to three stress-inducing treatments (heat, molluscicide, physical disturbance) and an unstressed control treatment for 24 h, after which larval presence and abundance in the slime were quantified by qPCR targeting the ITS1 region of the parasite's DNA, and compared among treatments. The significance of stress and host infection load on larval release was determined by generalized linear mixed models and permutation tests. The results indicated that stress significantly increased the probability of larval presence in slime and the number of larvae released, and highly infected snails were also more likely to release larvae. Among stressed snails, 13.3% released larvae into slime, the number of larvae present in the slime ranging from 45.5 to 4216. Unstressed controls released no larvae. This study offers a partial explanation for conflicting results from prior studies regarding A. cantonensis presence in snail slime and sheds light on the broader One Health implications. Stress-induced larval release highlights the potential role of slime as a medium for pathogen transmission to accidental, paratenic, definitive and other intermediate hosts. These findings emphasize the importance of considering stress-mediated interactions in host-parasite systems and their implications for zoonotic disease emergence. As stressors continue to escalate because of anthropogenic activities and climate change, understanding the role of stress in pathogen shedding and transmission becomes increasingly important for safeguarding human and wildlife health within the One Health framework.

Answer to the Photo Quiz: An unexpected visitor

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The Landscape of Parasitic Infections in the United States

The landscape of parasitic infections in the United States has shifted dramatically over the past century. Although infections such as malaria have been successfully eliminated, others remain endemic and pose a significant public health risk. Numerous parasitic infections are also imported each year. This article focuses on endemic parasitic infections that may be commonly seen in anatomical pathology preparations and discusses their biology, diagnostic histopathological features, and epidemiology.

Zoonotic helminths - why the challenge remains

Helminth zoonoses remain a global problem to public health and the economy of many countries. Polymerase chain reaction-based techniques and sequencing have resolved many taxonomic issues and are now essential to understanding the epidemiology of helminth zoonotic infections and the ecology of the causative agents. This is clearly demonstrated from research on Echinococcus (echinococcosis) and Trichinella (trichinosis). Unfortunately, a variety of anthropogenic factors are worsening the problems caused by helminth zoonoses. These include cultural factors, urbanization and climate change. Wildlife plays an increasingly important role in the maintenance of many helminth zoonoses making surveillance and control increasingly difficult. The emergence or re-emergence of helminth zoonoses such as Ancylostoma ceylanicum, Toxocara, Dracunculus and Thelazia exacerbate an already discouraging scenario compounding the control of a group of long neglected diseases.

Zoonotic intestinal helminthes diagnosed in a 6-year period (2015-2020) in privately owned dogs of sub-urban and urban areas of Italy

Intestinal helminthes of dogs have a relevant role for health and welfare of canine populations and many of them are zoonotic. Thus, a constant surveillance is pivotal to safeguard companion dogs and human health. Data from faecal examinations of pet dogs obtained in the last six years during the routine activity of the laboratory of Parasitology and Parasitic diseases of the University Teaching Veterinary Hospital of the University of Teramo, Italy, are here reported. From 2015 to 2020 a total of 1083 individual faecal samples from privately owned dogs were examined using conventional copro-microscopic techniques. Endoparasite elements were found in 278 (25.7%) dogs, and among them, eggs of intestinal zoonotic helminthes were detected in 184 (17%) samples. The most common zoonotic parasites were Toxocara canis and hookworms (8.9% positivity rate for both). Most dogs (88%) were positive for a single zoonotic parasite while 12% of the positive animals harbored two or more zoonotic helminthes. A statistical analysis showed a significant association between dogs with less than one year of age and positivity to at least one intestinal zoonotic helminth, and that infections by T. canis are significantly more prevalent in dogs under one year of age. Despite being well known in canine clinical practice, these results indicate that zoonotic helminthes are still frequent in owned dogs. Thus, increased awareness of veterinary practitioners and pet owners is necessary to implement current diagnostic and control strategies to minimize the risk of zoonotic transmission of intestinal helminthes.

Altered Offspring Immunity in Maternal Parasitic Infections

Maternal infection during pregnancy is known to alter the development and function of offspring's immune system, leading to inappropriate immune responses to common childhood infections and immunizations. Although this is an expanding field, maternal parasitic infections remain understudied. Millions of women of reproductive age are currently at risk for parasitic infection, whereas many pregnant, chronically infected women are excluded from mass drug administration due partially to a lack of resources, as well as fear of unknown adverse fetal developmental outcomes. In areas endemic for multiple parasitic infections, such as sub-Saharan Africa, there are increased rates of morbidity and mortality for various infections during early childhood in comparison with nonendemic areas. Despite evidence supporting similar immunomodulatory effects between various parasite species, there is no clear mechanistic understanding of how maternal infection reprograms offspring immunity. This brief review will compare the effects of selected maternal parasitic infections on offspring immunity.

Soil-Transmitted Helminths in the USA: a Review of Five Common Parasites and Future Directions for Avenues of Enhanced Epidemiologic Inquiry

PURPOSE OF REVIEW

The aim of this review is to present a comprehensive look at five intestinal soil-transmitted helminths (STHs) of global health importance that may continue to plague low-income and rural areas of the USA and argue the need for enhanced surveillance of these infections, which primarily affect the nation's most vulnerable groups.

RECENT FINDINGS

Human STH infections in middle- and high-income countries are at particular risk for being undiagnosed; as common symptoms are non-specific, differentials require a high index of clinical suspicion, and cases are concentrated in areas of poverty where access to care is limited. Although autochthonous STHs are thought to be rare in the USA, infections were once common in the American South and Appalachia and robust epidemiologic surveillance is limited post 1980s. However, recent community studies and case reports from small-scale farms and areas of high rural or inner-city poverty reveal the potential for persisting helminth infections in distinct populations of the country.

SUMMARY

STHs are among the most common neglected tropical diseases globally causing significant morbidity in underserved communities and contributing to the continuation of cycles of poverty within vulnerable populations. Due to possible severe disease sequalae and their ability to perpetuate poverty and poverty-associated health outcomes within already vulnerable groups, it is vital that surveillance for these infections is enhanced to bolster health equity in the USA.

The IL-33/ST2 Axis in Immune Responses Against Parasitic Disease: Potential Therapeutic Applications

Parasitic infections pose a wide and varying threat globally, impacting over 25% of the global population with many more at risk of infection. These infections are comprised of, but not limited to, toxoplasmosis, malaria, leishmaniasis and any one of a wide variety of helminthic infections. While a great deal is understood about the adaptive immune response to each of these parasites, there remains a need to further elucidate the early innate immune response. Interleukin-33 is being revealed as one of the earliest players in the cytokine milieu responding to parasitic invasion, and as such has been given the name "alarmin." A nuclear cytokine, interleukin-33 is housed primarily within epithelial and fibroblastic tissues and is released upon cellular damage or death. Evidence has shown that interleukin-33 seems to play a crucial role in priming the immune system toward a strong T helper type 2 immune response, necessary in the clearance of some parasites, while disease exacerbating in the context of others. With the possibility of being a double-edged sword, a great deal remains to be seen in how interleukin-33 and its receptor ST2 are involved in the immune response different parasites elicit, and how those parasites may manipulate or evade this host mechanism. In this review article we compile the current cutting-edge research into the interleukin-33 response to toxoplasmosis, malaria, leishmania, and helminthic infection. Furthermore, we provide insight into directions interleukin-33 research may take in the future, potential immunotherapeutic applications of interleukin-33 modulation and how a better clarity of early innate immune system responses involving interleukin-33/ST2 signaling may be applied in development of much needed treatment options against parasitic invaders.