Hepatozoon americanum: an emerging disease in the south-central/southeastern United States

Efficacy of a topical combination of esafoxolaner, eprinomectin and praziquantel against Amblyomma maculatum infestations in cats

Amblyomma maculatum, the Gulf Coast tick, infests a wide range of vertebrate species including livestock, dogs, cats, and humans. It is a species of significant veterinary and public health importance, especially as a vector of diseases, for instance American canine hepatozoonosis or tidewater spotted fever. An experimental study was conducted to evaluate the efficacy of NexGard® Combo, a topical endectoparasiticide product for cats combining eprinomectin, praziquantel and esafoxolaner, against induced infestations of A. maculatum in cats. This Good Clinical Practice (GCP) study used a randomized, negative controlled, masked design. Ten cats were allocated to an untreated group and ten to a treated group, dosed once on Day 0 at the minimum label dose. On Days -2, 7, 14, 21, 28, 35, and 42, cats were infested with ~50 unfed adult A. maculatum. On Days 3, 10, 17, 24, 31, 38, and 45, i.e., 72 h after treatment and subsequent infestations, ticks were removed, counted and the numbers of live attached tick in each group were used for efficacy calculations. At each time-point, all untreated cats were adequately infested, demonstrating a vigorous tick population and an adequate study model. The curative efficacy after a single application against existing tick infestation, 72 h after treatment, was 98.7%. The preventive efficacy, 72 h after weekly infestations, over the following five weeks ranged from 93.8% to 99.4%.

Hepatozoon (Eucoccidiorida: Hepatozoidae) in wild mammals of the Americas: a systematic review

BACKGROUND

The study of parasites provides insight into intricate ecological relationships in ecosystem dynamics, food web structures, and evolution on multiple scales. Hepatozoon Eucoccidiorida: Hepatozoidae) is a genus of protozoan hemoparasites with heteroxenous life cycles that switch infections between vertebrates and blood-feeding invertebrates. The most comprehensive review of the genus was published 26 years ago, and currently there are no harmonized data on the epizootiology, diagnostics, genotyping methods, evolutionary relationships, and genetic diversity of Hepatozoon in the Americas.

METHODS

Here, we provide a comprehensive review based on the PRISMA method regarding Hepatozoon in wild mammals within the American continent, in order to generate a framework for future research.

RESULTS

11 out of the 35 countries of the Americas (31.4%) had data on Hepatozoon, with Carnivora and Rodentia orders having the most characterizations. Bats, ungulates, and shrews were the least affected groups. While Hepatozoon americanum, H. americanum-like, H. canis, H. didelphydis, H. felis, H. milleri, H. griseisciuri, and H. procyonis correspond to the identified species, a plethora of genospecies is pending for a formal description combining morphology and genetics. Most of the vectors of Hepatozoon in the Americas are unknown, but some flea, mite, and tick species have been confirmed. The detection of Hepatozoon has relied mostly on conventional polymerase chain reaction (PCR), and the implementation of specific real time PCR for the genus needs to be employed to improve its diagnosis in wild animals in the future. From a genetic perspective, the V4 region of the 18S rRNA gene has been widely sequenced for the identification of Hepatozoon in wild animals. However, mitochondrial and apicoplast markers should also be targeted to truly determine different species in the genus. A phylogenetic analysis of herein retrieved 18S ribosomal DNA (rDNA) sequences showed two main clades of Hepatozoon: Clade I associated with small mammals, birds, and herpetozoa, and Clade II associated with Carnivora. The topology of the tree is also reflected in the haplotype network.

CONCLUSIONS

Finally, our review emphasizes Hepatozoon as a potential disease agent in threatened wild mammals and the role of wild canids as spreaders of Hepatozoon infections in the Americas.

Epidemiological survey of tick-borne pathogens in dogs in Anhui Province, China

Tick-borne diseases have continued to increase worldwide in both developing and many developed countries due to the widespread of different tick species and tick's adaptability to different climatic weather. In order to investigate the prevalence of the tick-borne pathogens, EDTA-anticoagulated whole blood samples were aseptically collected from 765 pet dogs in twenty veterinary clinics located in sixteen prefecture-level cities in Anhui Province, China, and the samples were examined and analyzed for tick-borne pathogens using both microscopy and PCR. Our result analysis revealed 17(2.22%) positive samples to Babesia spp and 4(0.52%) positive samples to Hepatozoon spp, of which case of co-infection was recorded in Lu'An and Chuzhou. The BLAST analysis results of the 18S rRNA gene revealed that the dogs were infected with Babesia gibsoni and Hepatozoon canis. All samples were negative for Anaplasma spp., Ehrlichia spp., and Rickettsia spp. This is the first molecular report of B. gibsoni and H. canis in dogs in Anhui, China.

Potential Role of Birds in the Epidemiology of Coxiella burnetii, Coxiella-like Agents and Hepatozoon spp

Birds may be involved in the epidemiology of infectious and/or parasitic diseases which affect mammals, including humans. Q fever, caused by Coxiella burnetii, is an important zoonosis causing economic losses mainly due to pathologies induced in ruminants. Even though birds are known to be potential reservoirs of C. burnetii, their role in the epidemiological cycle of the pathogen is not completely verified. In recent years, new bacteria identified as Coxiella-like agents, have been detected in birds affected by different pathologies; the potential role of these bacteria as pathogens for mammals is not currently known. Hepatozoon spp. are haemoprotozoa, causing arthropod borne affections within several vertebrate classes. The infection of vertebrate host develops after ingestion of the arthropod final hosts containing oocysts; different tissues and blood cells are then colonized by other parasite stages, such as merozoites and gamonts. In avian hosts, there are several recognized Hepatozoon species; however, their life cycle and pathogenicity have not been fully elucidated. Referring to a carrier role by avian species and their ticks in the epidemiology of canine hepatozoonosis, the only clinically relevant affection caused by this parasite genus, they would act as carriers of infected ticks and, when Hepatozoon americanum is involved, as paratenic hosts, as well.

Molecular detection of Hepatozoon canis in dogs and ticks in Shaanxi province, China

Hepatozoon canis, transmitted by Rhipicephalus sanguineus, is a tick-borne pathogen and causes canine hepatozoonosis. Until now, only limited previous studies were conducted on the molecular detection and characterization of Hepatozoon sp. in dogs in China. Blood samples were collected from 93 sick dogs that were clinically diagnosed as babesiosis but tested negative for Babesia, and 103 apparently healthy dogs, as well as their infesting ticks in Xi'an and Hanzhong cities, Shaanxi province of China. PCR amplifying partial 18S rRNA gene was used to detect the DNA of Hepatozoon sp. Genetic and phylogenetic analysis were performed to determine the Hepatozoon species. Our results demonstrated that H. canis was identified from the sick dogs and the infested ticks in Hanzhong, with no significant differences of prevalence between both genders and ages. No positive blood or tick samples were found in Xi'an. Moreover, all the 18S rRNA gene sequences recovered from both dogs and the infested ticks showed a high genetic similarity with each other, and also presented a close relationship with other known sequences in and outside China. In conclusion, H. canis was identified in babesiosis-suspected dogs and ticks infesting them in Shaanxi, China, although the association between clinical signs and H. canis need further study.

Molecular characterization of Hepatozoon canis from farm dogs in Pakistan

Hepatozoon canis is a tick-borne pathogen of canids, which is distributed worldwide. However, very little is known about this protozoan parasite in Pakistan. This study provides the first molecular evidence of H. canis from farm dogs from three agro-ecological zones of Punjab, Pakistan. A conventional PCR targeting the 18S rRNA gene was used to characterize H. canis from farm dogs from three districts, namely Kasur, Rawalpindi, and Muzaffargarh, in Punjab. Of 341 blood samples tested, 155 (45.5%) were positive for H. canis, 73 (61.3%) from Kasur, 46 (42.5%) from Rawalpindi, and 36 (31.5%) from Muzaffargarh. Phylogenetic analyses revealed that 18S rRNA sequences of H. canis from this study clustered in three clades with those of H. canis from previously published studies to the exclusion of all other Hepatozoon spp. included in the analysis. This study provides the first insight into H. canis from farm dogs in Pakistan. Furthermore, it lays a foundation for future studies of the parasite to assess the impact of canine hepatozoonosis in dogs from various agro-ecological zones in Pakistan where pet ownership of dogs is increasing.

The Evolving Medical and Veterinary Importance of the Gulf Coast tick (Acari: Ixodidae)

Amblyomma maculatum Koch (the Gulf Coast tick) is a three-host, ixodid tick that is distributed throughout much of the southeastern and south-central United States, as well as several countries throughout Central and South America. A considerable amount of scientific literature followed the original description of A. maculatum in 1844; nonetheless, the Gulf Coast tick was not recognized as a vector of any known pathogen of animals or humans for >150 years. It is now identified as the principal vector of Hepatozoon americanum, the agent responsible for American canine hepatozoonosis, and Rickettsia parkeri, the cause of an emerging, eschar-associated spotted fever group rickettsiosis identified throughout much of the Western Hemisphere. Coincident with these discoveries has been recognition that the geographical distribution of A. maculatum in the United States is far more extensive than described 70 yr ago, supporting the idea that range and abundance of certain tick species, particularly those with diverse host preferences, are not fixed in time or space, and may change over relatively short intervals. Renewed interest in the Gulf Coast tick reinforces the notion that the perceived importance of a particular tick species to human or animal health can be relatively fluid, and may shift dramatically with changes in the distribution and abundance of the arthropod, its vertebrate hosts, or the microbial agents that transit among these organisms.

Investigation of tick vectors of Hepatozoon canis in Brazil

Hepatozoon canis is a common apicomplexan parasite of dogs. In Brazil, in addition to Rhipicephalus sanguineus, Amblyomma ovale, Amblyomma cajennense, and Rhipicephalus (Boophilus) microplus have been suggested to act as vectors. The present study aimed to evaluate, under controlled conditions, the acquisition of H. canis by A. ovale, R. sanguineus, and A. cajennense after feeding on naturally infected dogs. Cytological and histophatological examinations were performed to recover oocysts and other sporogonic stages of the protozoan from the experimentally infected nymphs and adults. None of the R. sanguineus (n=30) or A. cajennense nymphs (n=15) that were dissected after feeding on H. canis naturally infected dogs became infected by the hemoparasite. Likewise, none of the R. sanguineus (n=165) and A. cajennense (n=114) adult ticks that were fed as nymphs on dogs demonstrated infection. Additionally, A. cajennense adult ticks were incapable of acquiring the infection, since no parasite was found in 62 adults that fed on H. canis-infected dogs. With regard to A. ovale ticks, 2 different infestations were carried out. Firstly, a dog with naturally occurring hepatozoonosis was infested with A. ovale adults originating from Rondônia, Brazil. Ticks fed to full engorgement. A total of 31 adults was collected from the dog and dissected on the third day after natural detachment. Oocysts were detected in 13 (42%) of the ticks. The second experimental infestation was carried out using adult ticks originating from São Paulo, Brazil. Surprisingly, of the 103 dissected ticks, only one (1%) contained oocysts in the hemocoel. No other sporogonic stage was found. Results indicate that different strains of A. ovale ticks may exist in Brazil with different susceptibilities to pathogens. Furthermore, it is possible that R. sanguineus and A. cajennense have little or no importance in the transmission of H. canis in rural areas of Brazil.

Tick-borne infections in dogs-an emerging infectious threat

Many viral, bacterial and parasitic pathogens have been associated with tick transmission, including several recently identified pathogens in both humans and domestic animals, especially dogs. The emergence in dogs of these tick-borne infections has a multi factorial origin. Better animal care, better diagnostic tools, and a broader distribution of the vectors in favorable habitats through population migrations including travel with owned pets, translocation or commercial trade of pet dogs, are some of the factors contributing to the emergence and recognition of these new pathogens. The present review focuses on the recent epidemiological studies which support the emergence or re-emergence of tick-borne pathogens in dogs around the world, as well as give some insight on newly recognized potentially tick-borne pathogens, such as Bartonella infections.

Perspectives on canine and feline hepatozoonosis

Two species of Hepatozoon are currently known to infect dogs and cause distinct diseases. Hepatozoon canis prevalent in Africa, Asia, southern Europe, South America and recently shown to be present also in the USA causes infection mainly of hemolymphoid organs, whereas Hepatozoon americanum prevalent in the southeastern USA causes myositis and severe lameness. H. americanum is transmitted by ingestion of the Gulf Coast tick Amblyomma maculatum and also by predation on infected prey. H. canis is transmitted by Rhipicephalus sanguineus, in South America also by Amblyomma ovale, and has also been shown to be transmitted transplacentally. Hepatozoonosis of domestic cats has been described mostly from the same areas where canine infection is present and the exact identity of the species which infect cats, their pathogenicity and vectors have not been elucidated. The diagnosis of hepatozoonosis is made by observation of gamonts in blood smears, histopathology, PCR or serology. The main treatment for H. canis is with imidocarb dipropionate whereas H. americanum infection is treated with an initial combination of trimethoprim-sulfadiazine, pyrimethamine and clindamycin followed by maintenance with decoquinate. Treatment for both diseases has not been reported to facilitate complete parasite elimination and new effective drugs are needed for the management of these infections. Prevention of hepatozoonosis should be based on avoidance of oral ingestion of infected tick vectors and infected prey.