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Gaca PJ, Nowak R, Rejdak R, Rejdak M, Nowak M, Flis B, Ali MJ. Human ocular dirofilariasis in Poland. J Ophthalmic Inflamm Infect 2024; 14:32. [PMID: 38985253 PMCID: PMC11236825 DOI: 10.1186/s12348-024-00401-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/18/2024] [Indexed: 07/11/2024] Open
Affiliation(s)
- Piotr J Gaca
- Chair and Department of General and Paediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
| | - Rafal Nowak
- Eye Department, Jozef Strus City Hospital, Poznan, Poland.
| | - Robert Rejdak
- Chair and Department of General and Paediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
| | - Magdalena Rejdak
- Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland
| | - Maja Nowak
- Eye Department, Jozef Strus City Hospital, Poznan, Poland
| | - Beata Flis
- Chair and Department of General and Paediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
| | - Mohammad Javed Ali
- Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad, India
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Momčilović S, Gabrielli S, Đenić N, Živković N, Stevanović G, Krstić M, Ranđelović M, Tasić-Otašević S. New cases of human dirofilariosis on the Balkan Peninsula - "Masked intruders" uncovered by a surgeon. Parasitol Int 2021; 86:102482. [PMID: 34673233 DOI: 10.1016/j.parint.2021.102482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/28/2021] [Accepted: 10/12/2021] [Indexed: 11/16/2022]
Abstract
Dirofilaria spp. nematodes are accidental parasites of humans causing mild to serious, superficial or visceral infections. Superficial dirofilariosis is rather common in Europe and is typically manifested as subcutaneous form. Herein we report 46 new cases of human dirofilariosis (19 patients with subcutaneous, 18 patients with ocular, 4 patients wih genital, 2 patients with submucosal, 2 patients with pulmonary and 1 patient with intramuscular form of infection) that were recorded from the beginning of 2015 to May 2021 on the Balkan Peninsula with a goal to update the prevalence of this parasitosis and point out potential problems in diagnosis and treatment. Besides, given the high possibility of misinterpretation as tumor, our second aim was to encourage the inclusion of this pathogen in the differential diagnosis of subcutaneous nodules. Although quite common forms, subcutaneous and ocular dirofilariosis can be very often misdiagnosed in clinical practice due to the absence of specific clinical manifestations. Therefore, raising awareness of clinicians about this zoonosis is needed as well as closer collaboration between physicians and veterinarians.
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Affiliation(s)
- Stefan Momčilović
- Plastic and Reconstructive Surgery Clinic, Clinical Center Niš, Blvd Zorana Djindjica 48, 18000 Niš, Serbia; Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Niš, Blvd Zorana Djindjica 81, 18000 Niš, Serbia.
| | - Simona Gabrielli
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Piazza le Aldo Moro 5, 00185 Rome, Italy
| | - Nebojša Đenić
- Department of Surgical Diseases, Military Hospital Niš, Blvd Zorana Djindjica bb, 18 000 Niš, Serbia
| | - Nataša Živković
- Department of Infectious Diseases, Military Hospital Niš, Blvd Zorana Djindjica bb, 18 000 Niš, Serbia
| | - Goran Stevanović
- Plastic and Reconstructive Surgery Clinic, Clinical Center Niš, Blvd Zorana Djindjica 48, 18000 Niš, Serbia; Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Niš, Blvd Zorana Djindjica 81, 18000 Niš, Serbia
| | - Miljan Krstić
- Department of Pathology, Faculty of Medicine, University of Niš, Blvd Zorana Djindjica 81, 18000 Niš, Serbia
| | - Marina Ranđelović
- Department of Microbiology and Immunology, Faculty of Medicine, University of Niš, Blvd Zorana Djindjica 81, 18000 Niš, Serbia; Center of Microbiology and Parasitology, Public Health Institute Niš, Blvd Zorana Djindjica 81, 18000 Niš, Serbia
| | - Suzana Tasić-Otašević
- Department of Microbiology and Immunology, Faculty of Medicine, University of Niš, Blvd Zorana Djindjica 81, 18000 Niš, Serbia; Center of Microbiology and Parasitology, Public Health Institute Niš, Blvd Zorana Djindjica 81, 18000 Niš, Serbia
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Riebenbauer K, Weber PB, Walochnik J, Karlhofer F, Winkler S, Dorfer S, Auer H, Valencak J, Laimer M, Handisurya A. Human dirofilariosis in Austria: the past, the present, the future. Parasit Vectors 2021; 14:227. [PMID: 33926526 PMCID: PMC8082911 DOI: 10.1186/s13071-021-04696-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/20/2021] [Indexed: 01/29/2023] Open
Abstract
Background Dirofilariosis is a vector-borne parasitosis caused by filarial nematodes of the genus Dirofilaria. In humans, who represent accidental hosts, dirofilariosis is mostly caused by Dirofilaria repens and Dirofilaria immitis. In Austria, the first reported case occurred in 1978. Since then, several (case) reports have been published. Methods A systematic and retrospective review of collected published cases and new, unpublished confirmed cases of human dirofilariosis occurring in Austria was performed. A nematode was extracted from the eyelid of a previously unreported case and subsequently characterized histologically and using molecular biology techniques. Results Data on a total of 39 cases of human dirofilariosis in Austria occurring between 1978 and 2020 are summarized. Over the past four decades the incidence has markedly increased, in particular after 1998. Of the 39 patients, men and women were equally affected, and the mean age was 47.1 years. The area most frequently affected was the head (38.5% of cases). Confined ocular involvement was observed in 23.1% of cases, and nematodes were isolated from the neck/trunk, extremities and the genito-inguinal area in 25.6, 15.4 and 15.4% of patients, respectively. Microfilariae were detected in two cases. Of the 39 patients, only 73.9% tested positive for anti-filarial antibodies and 56.3% for eosinophilia, despite successful isolation of a nematode; consequently, these measures did not represent reliable markers for dirofilariosis. Most patients had a travel history to countries endemic for Dirofilaria species. One patient who had not traveled abroad represented the only autochthonous case recorded to date. Dirofilaria repens was the predominant species, identified in 89.7% of cases. In the newly reported case of subcutaneous dirofilariosis, a live non-gravid Dirofilaria repens adult female of 12 cm length was isolated from the eyelid of the patient, and a video of the extraction is provided. Conclusions The incidence of human dirofilariosis cases has increased strikingly over the last four decades in Austria. More cases can be expected in the foreseeable future due to changes in human behavior and (travel) activities as well as climate changes and the associated alterations in the availability of the natural reservoir, the vectors and the intrinsic characteristics of the parasite. ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-04696-4.
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Affiliation(s)
- Katharina Riebenbauer
- Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Philipp B Weber
- Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Julia Walochnik
- Molecular Parasitology, Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Franz Karlhofer
- Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Stefan Winkler
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Sonja Dorfer
- Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Herbert Auer
- Molecular Parasitology, Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Julia Valencak
- Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Martin Laimer
- Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Alessandra Handisurya
- Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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Savić S, Stosic MZ, Marcic D, Hernández I, Potkonjak A, Otasevic S, Ruzic M, Morchón R. Seroepidemiological Study of Canine and Human Dirofilariasis in the Endemic Region of Northern Serbia. Front Vet Sci 2020; 7:571. [PMID: 33134332 PMCID: PMC7550424 DOI: 10.3389/fvets.2020.00571] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/17/2020] [Indexed: 11/13/2022] Open
Abstract
Dirofilariasis is a vector-borne zoonotic disease caused mainly by Dirofilaria immitis and Dirofilaria repens that affect dogs and humans all over the world. Serbia is considered an endemic country to both forms of dirofilariasis, although most of the population is concentrated in the north of the country. The aims of this study were to show the prevalence of D. immitis and D. repens in dogs and the seroprevalence in humans compared to previous studies in Northern Serbia. In total, 346 dog sera samples and 265 human samples were analyzed. Dog blood samples were analyzed using the modified Knott's method to check whether there were Dirofilaria spp. microfilariae and serum samples were checked by a commercial D. immitis antigen test. Human serum samples were analyzed with a non-commercial ELISA for detection of specific anti-D. immitis, anti-D. repens, and anti-Wolbachia IgG antibodies, and confirmed by western blotting. The overall prevalence for Dirofilaria spp. in dogs was 29.19%. The overall prevalence for D. immitis was 26.30%. The percentages of D. immitis and D. repens microfilaremia in dogs were 25.72 and 1.45%, respectively, while D. immitis./D. repens microfilaremia co-infections were also 1.45%. The overall seroprevalence for Dirofilaria spp. in humans was 3.77%. The overall seroprevalence for D. immitis was 1.51, 1.13% for D. repens, and for D. immitis/D. repens co-infections was 1.13%. The results indicate that D. immitis and D. repens are present in dogs and humans in the province of Vojvodina, in the northern part of Serbia. It is most likely associated with the presence of many rivers, the climate, and presence of mosquitoes in the area, so there could be a real public health risk.
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Affiliation(s)
- Sara Savić
- Scientific Veterinary Institute "Novi Sad", Novi Sad, Serbia
| | | | - Doroteja Marcic
- Scientific Veterinary Institute "Novi Sad", Novi Sad, Serbia
| | - Isabel Hernández
- Group of Animal and Human Dirofilariasis, Faculty of Pharmacy, Campus Miguel Unamuno, University of Salamanca, Salamanca, Spain
| | - Aleksandar Potkonjak
- Department of Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, Novi Sad, Serbia
| | | | - Maja Ruzic
- Clinic for Infectious Diseases, Faculty of Medicine, Clinical Center of Vojvodina, University of Novi Sad, Novi Sad, Serbia
| | - Rodrigo Morchón
- Group of Animal and Human Dirofilariasis, Faculty of Pharmacy, Campus Miguel Unamuno, University of Salamanca, Salamanca, Spain
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The Fatal Case of an Autochthonous Heartworm Disease in a Dog from a Non-endemic Region of South-eastern Slovakia. Helminthologia 2020; 57:154-157. [PMID: 32518491 PMCID: PMC7261026 DOI: 10.2478/helm-2020-0023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 03/16/2020] [Indexed: 11/20/2022] Open
Abstract
During the past few years, several localities with increasing Dirofilaria immitis occurrences have been identified in Slovakia; particularly in areas regarded as endemic for Dirofilaria repens up until now. In terms of that, dogs with clinically manifested heartworm disease have been referred to the veterinary ambulances more frequently. We report in this study, two autochthonous cases of D. immitisinfections diagnosed in two seven-year-old siblings of Tibetan Mastiff dogs from the Košice region of south-eastern Slovakia. The course of the disease in both dogs were very different. The female dog did not manifest any unusual findings, however the male dog exhibited severe clinical signs of heartworm disease that lead to his death. The subsequent autopsy revealed adult D. immitis worms in the right heart ventricle and pulmonary arteries.
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Stoyanova H, Carretón E, Montoya-Alonso JA. Stray Dogs of Sofia (Bulgaria) Could be an Important Reservoir of Heartworm ( Dirofilaria Immitis). Helminthologia 2019; 56:329-333. [PMID: 31708674 PMCID: PMC6818634 DOI: 10.2478/helm-2019-0033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 09/05/2019] [Indexed: 11/21/2022] Open
Abstract
Dirofilaria immitis (heartworm) is a zoonotic and an emerging disease, expanding in Europe. In Bulgaria, the presence of the parasite has been described in many regions. However, canine heartworm has hardly been evaluated in the capital of the country and, therefore, the aim of this study was to evaluate the prevalence and distribution of canine heartworm in Sofia. Eighty stray dogs from the city of Sofia and the metropolitan area were analysed for circulating D. immitis antigens. The prevalence was 31.25 %, being 34.7 % in the metropolitan area and 25.8 % in the city of Sofia. The current results are among the highest reported in the country. This could be due to the lack of prophylactic measures against infection in these dogs, but also to the spread of D. immitis into non-endemic countries. Stray dogs may act as an important reservoir of heartworm being a risk for client-owned animals and for the development of pulmonary dirofilariosis in inhabitants. The results show the need to establish further epidemiological studies and prophylactic campaigns for stray and client-owned animals, as well as to create awareness campaigns about the severity and importance of this disease for both animals and humans.
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Affiliation(s)
- H. Stoyanova
- Ashleigh Veterinary Centre, M16 0DE- Manchester, Manchester, United Kingdom
| | - E. Carretón
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35001-Las Palmas de Gran Canaria, Spain
| | - J. A. Montoya-Alonso
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35001-Las Palmas de Gran Canaria, Spain
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