Dirofilaria repens infection in a dog imported to Norway

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.

Detection and cross-reaction of Dirofilaria repens using a commercial heartworm antigen test kit

Antigen enzyme-linked immunosorbent assay tests are widely used for the diagnosis of heartworm infection in dogs. While commercially-available heartworm antigen tests have high sensitivity and specificity, false-negative test results can occur in dogs with low worm burdens, female-only infections, or prior to patency. The use of immune complex dissociation (ICD) methods have demonstrated increased sensitivity in the detection of Dirofilaria immitis antigens and the reversal of false-negative antigen results. However, there are concerns pertaining to false-positive antigen results due to infections of other nematode parasites, especially post-ICD. Therefore, this study evaluated the effect of heat-treatment on serum samples of dogs experimentally-infected with Dirofilaria repens during the course of infection, to assess for potential cross-reactivity on heartworm antigen tests. Archived serum samples from three dogs experimentally-infected with D. repens were utilized. All samples were tested for cross-reactivity pre- and post-heat-treatment using the DiroCHEK® Heartworm Antigen test kit throughout infection (day -9 through 404 days post-infection; dpi). All heat-treated samples tested false-positive starting at 164 dpi and continuing through 404 dpi, thereby testing positive prior to patency. No cross-reactivity was observed for any dog at any time point prior to heat-treatment. Our results suggest that the ICD method decreased the specificity of heartworm antigen tests and caused cross-reactivity of serum from dogs experimentally infected with D. repens. In conclusion, heat-treatment of serum in areas co-endemic for D. repens and D. immitis has limited clinical value, and should be used with caution.

Parasites in the changing world - Ten timely examples from the Nordic-Baltic region

The world is changing, and parasites adapt. The Nordic-Baltic region in northern Europe - including the Nordic countries Denmark, Finland, Iceland, Norway and Sweden, and the Baltic States Estonia, Latvia and Lithuania - is facing new parasitological challenges due to changes in populations of parasites and their hosts and the spread of new parasites to the region due to climate change. Some changes can also be ascribed to increased awareness and detection. In this paper, we review and discuss a convenience selection of ten timely examples of recent observations that exemplify trends and challenges from different fields of parasitology, with particular focus on climate change and potential changes in epidemiology of pathogens in northern Europe. The examples illustrate how addressing parasitological challenges often requires both intersectoral and international collaboration, and how using both historical baseline data and modern methodologies are needed.

Knowledge About Emerging Zoonotic Vector-Borne Parasites Dirofilaria immitis and Dirofilaria repens in Finland: Questionnaire Survey to Medical Doctors and Veterinarians

Zoonotic vector-borne parasites Dirofilaria immitis and Dirofilaria repens have been spreading northwards in Europe. Awareness across sectors is a key factor for preparedness to zoonotic emerging diseases. In this study, an online questionnaire was used to survey the knowledge of medical doctors and veterinarians in Finland on whether D. immitis and D. repens can infect humans and dogs, and whether these infections have been detected in Finland. Participants were recruited via two social media discussion groups, and participation was voluntary. The questionnaire was completed by 198 medical doctors and 61 veterinarians in January 2019. Knowing that D. immitis can infect both humans and dogs was indicated by the answers of 7.1% of the medical doctors and 42.6% of the veterinarians-7.6% of the medical doctors and 42.6% of the veterinarians knew D. immitis can infect humans, 9.6% of the medical doctors and 98.4% of the veterinarians knew it can infect dogs. Knowing that D. repens can infect both humans and dogs was indicated by the answers of 3.0% of the medical doctors and 60.7% of the veterinarians-3.0% of the medical doctors and 60.7% of the veterinarians knew D. repens can infect humans; 8.1% of the medical doctors and 88.5% of the veterinarians knew it can infect dogs. Overall, 4.5% of the medical doctors and 59.0% of the veterinarians selected five or more correct "yes" answers. While the results of this survey should be interpreted with caution due to limited number of participants and participation bias, they not only suggest room for improvement but also show presence of cross-sectoral knowledge. Answering "I do not know" was common. Increasing awareness about these emerging zoonotic vector-borne parasites is needed across the sectors.

Subcutaneous Dirofilariasis in Female Pubic Region - Case Report

BACKGROUND:

Number of reported cases of human dirofilariasis in the last couple of decades has been increasing. Dogs are the main reservoir hosts, while various mosquito species represent/serve as vectors. Human infections are caused by two different parasites: Dirofilaria immitis and Dirofilaria repens. Dirofilaria repens is currently considered to be one of the most rapidly-spreading human and animal parasite species in Europe. Clinical features are characterised by subcutaneous or ocular lesions which can persist for months without any symptoms. The disease is considered to be endemic in Mediterranean countries, central Asia, Israel, and Sri Lanka with increased incidence in Central and East Europe. Apart from the local population, tourists are also susceptible to this disease. Export of domestic animals can transfer parasites between different countries. This disease is rare in Croatia.

CASE PRESENTATION:

We are presenting a case of a 58-year-old female patient with dirofilariasis of the genital region caused by Dirofilaria repens, confirmed with PCR and sequencing.

CONCLUSION:

From the clinician point of view, subcutaneous dirofilariasis should be considered as a differential diagnosis in cases of long-lasting subcutaneous swellings.

Dirofilaria repens-An etiological factor or an incidental finding in cytologic and histopathologic biopsies from dogs

Dirofilaria repens is an endemic, zoonotic parasite of carnivores, causing subcutaneous dirofilariasis, which is mostly asymptomatic. The aim of this study was to describe 22 cases of canine subcutaneous dirofilariasis. The cytologic and histopathologic samples were collected from dogs, which presented with various clinical signs such as cutaneous/subcutaneous nodules, hydropericardium, ascites, and lymphadenomegaly. The cytologic or histopathologic examination revealed purulent, pyogranulomatous, granulomatous or eosinophilic dermatitis/panniculitis, and the presence of D repens microfilariae or adults. The microfilariae or adults were also found incidentally in neoplastic cutaneous or subcutaneous tumors and in a sialocele. For the first time, microfilariae were also detected and described in pericardial and abdominal effusions and in enlarged reactive lymph nodes. Although it is well known that D repens can cause dermatitis and panniculitis in dogs, no previous reports of D repens microfilariae in body cavity fluids were found. The role of this parasite in the accumulation of body cavity fluid or in reactive lymphadenomegaly requires further investigation. Due to its zoonotic potential, and apparently underestimated pathogenicity, each case of canine subcutaneous dirofilariasis should be treated.

Vector-borne parasitic infections in dogs in the Baltic and Nordic countries: A questionnaire study to veterinarians on canine babesiosis and infections with Dirofilaria immitis and Dirofilaria repens

Canine vector-borne diseases have been spreading northwards in Europe, and canine babesiosis and infections with Dirofilaria immitis (heartworm) and Dirofilaria repens have been diagnosed also in the Baltic and the Nordic countries. We used an online questionnaire to survey how large a proportion of veterinarians in the Baltic (Estonia, Latvia, and Lithuania) and the Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden) saw canine babesiosis cases and dogs infected with D. immitis and D. repens in 2016. In addition, questions regarding transmission, zoonotic potential, clinical signs, and treatment of the infections were asked. The questionnaire was completed by 122 veterinarians. In 2016, 23% of them had seen at least one case of canine babesiosis, 15% at least one dog with D. immitis infection, and 9% at least one dog with D. repens infection. A veterinarian working in the Baltic countries had 12.2 times higher odds to have seen a canine babesiosis case and 9.3 times higher odds to have seen a dog with D. repens infection than a veterinarian working in the Nordic countries did. While 48% of the veterinarians knew that canine babesiosis is not considered a zoonosis, 26% knew that D. immitis is zoonotic and 34% knew that D. repens is zoonotic. The results suggested that autochthonous cases of the three vector-borne parasitic infections were seen by veterinarians in the Baltic countries, whereas most cases seen by veterinarians in the Nordic countries appeared to be imported. A substantial proportion of the veterinarians did not know whether the parasites are zoonotic.

First Molecular Identification of Dirofilaria repens in a Dog Blood Sample from Guanajuato, Mexico

Dirofilaria repens is the causative zoonotic agent of subcutaneous dirofilariosis. Although the American continent is considered currently free of D. repens infections, in the past few years there have been some reports suggesting the presence of this agent in the Americas. In Guanajuato, Mexico, there is a report of the presence of D. repens. To determine whether this parasite is really present in Guanajuato, a total of 177 EDTA blood samples from dogs were tested using the modified Knott's technique. Using this technique, we found 15 positive samples, which were then analyzed using the PCR technique, with a panfilarial set of primers and a specific primer pair for D. repens. In one sample, the expected band was present and the corresponding amplicon, sequenced, displayed a 100% identity to D. repens, confirming the presence of this exotic and zoonotic filarial species in the municipality of Silao, Guanajuato, Mexico.

First molecular identification of Dirofilaria spp. (Onchocercidae) in mosquitoes from Serbia

Dirofilariosis is a common and widespread veterinary health issue in several European countries with notable zoonotic potential. The causative agents are Dirofilaria immitis and Dirofilaria repens nematoda species which are transmitted by different mosquito vectors. Similar to other mosquito-borne infections, the knowledge about mosquito species involved in disease transmission is crucial for the complex understanding of local transmission cycles. Since there is no available data on mosquito species, potentially involved in disease transmission from Serbia, 6369 female mosquito individuals were retrospectively tested for Dirofilaria nematodes, collected from 13 localities in Vojvodina province, Serbia, in 2013. Altogether, 8.33 % of tested pools showed positivity, composed of five mosquito species, mainly, Culex pipiens and Aedes vexans. D. immitis and D. repens were both detected from multiple localities, during the whole period of mosquito breeding season, which provides the first data on local transmission characteristics regarding mosquitoes from the Balkans.

The Increase of Exotic Zoonotic Helminth Infections: The Impact of Urbanization, Climate Change and Globalization

Zoonotic parasitic diseases are increasingly impacting human populations due to the effects of globalization, urbanization and climate change. Here we review the recent literature on the most important helminth zoonoses, including reports of incidence and prevalence. We discuss those helminth diseases which are increasing in endemic areas and consider their geographical spread into new regions within the framework of globalization, urbanization and climate change to determine the effect these variables are having on disease incidence, transmission and the associated challenges presented for public health initiatives, including control and elimination.

Dirofilaria repens Microfilaremia in Three Dogs in Estonia

In Europe, the zoonotic parasite Dirofilaria repens continues to spread northward. We describe three likely autochthonous canine microfilaremic D. repens infections from Estonia, an European Union country located in the Baltic region of northern Europe. The parasite species was confirmed with sequencing. These are new northernmost D. repens findings in Europe and show that the zoonotic parasite has spread farther north. Infection with D. repens should be included in the list of differential diagnoses for human and animal hosts also in northern Europe.

Potential mosquito (Diptera:Culicidae) vector of Dirofilaria repens and Dirofilaria immitis in urban areas of Eastern Slovakia

This paper follows the study from 2013 focused on the molecular screening of mosquitoes as vectors of Dirofilaria spp. which provided the information on Aedes vexans as a potential vector of Dirofilaria repens in Slovakia. Current entomological and molecular research indicates that Ae. vexans can participate also in the transmission of Dirofilaria immitis within the region. Using the standard PCR method, we examined 10,500 mosquitoes (Ae. vexans, Ae. rossicus, Anopheles maculipennis s.l., Ochlerotatus sticticus, Ochlerotatus cantans, Ochlerotatus caspius, Culex pipiens/Culex torrentium, Coquillettidia richiardii), collected using CO2-baited traps at six locations in the Eastern Slovakia. Out of 105 pools, 6 pools of mosquitoes Ae. vexans were positive for D. repens DNA (minimum infective rate in Ae. vexas was 6:6.900, i.e. 0.8 per 1.000 mosquitoes), within which 4 were concurrently positive for D. immitis (minimum infective rate in Ae. vexans was 4:6.900 i.e. 0.5 per 1.000 mosquitoes).

Circulation of Dirofilaria repens, Setaria tundra, and Onchocercidae species in Hungary during the period 2011-2013

Dirofilaria repens and recently Dirofilaria immitis are known to be endemic in Hungary. Since there is no related research on Dirofilaria carrier mosquito species from Hungary, we conducted a three-year mosquito surveillance study between 2011 and 2013. During the study period we examined 23,139 female mosquitoes with a generic filaria-specific TaqMan PCR assay, and characterized them by sequencing a 500 bp segment of 12S rRNA. An important result of our study was the detection of Setaria tundra and D. repens along with an unidentified Onchocercidae nematode. D. repens is known to be endemic in Hungary, however, the detection of S. tundra in all sampling sites throughout the study period indicates for the first time the endemicity of this parasite in Hungary. The Onchocercidae sp. nematode showed 95% nucleotide identity with previously detected unidentified nematodes from Germany, indicating a broader geographical distribution of this nematode in Europe. D. immitis specific DNA was not detected among the screened mosquitoes in this study. Here we report 11 mosquito species as potential vector organisms for local filarial infections, including Aedes vexans, Ochlerotatus annulipes, Ochlerotatus sticticus, Coquillettidia richiardii, Anopheles hyrcanus and Ochlerotatus rusticus. Dirofilaria development unit was calculated and the potential transmission period was estimated, which ranged between 65 and 113 days between sampling seasons. A relatively high infection rate (36.8%) was identified, which is a notable finding for veterinary and human health professionals. Moreover, the results of our study widen the group of possible mosquito vector species for D. repens and S. tundra in Central Europe.