The Incidence of Dirofilaria immitis in Shelter Dogs and Mosquitoes in Austria

Heartworm disease in domestic dogs in Estonia: indication of local circulation of the zoonotic parasite Dirofilaria immitis farther north than previously reported

BACKGROUND

The mosquito-borne zoonotic parasite Dirofilaria immitis continues to spread northwards in Europe. This parasite can cause potentially life-threatening heartworm disease in dogs and pulmonary dirofilariasis in humans and is, therefore, a major health concern in both the veterinary medicine and human medical fields. This is the first report of D. immitis infections and heartworm disease in the Baltic country Estonia.

METHODS

Data on canine D. immitis infections and heartworm disease were collected from the electronic patient records database of the Small Animal Clinic of Estonian University of Life Sciences, the only university clinic in Estonia. The patient records of dogs with confirmed diagnosis of D. immitis infection or heartworm disease were reviewed and summarised.

RESULTS

Six dogs had been diagnosed with confirmed D. immitis infection or heartworm disease at the university clinic in 2021-2022. The confirmed diagnoses had been reached following international guidelines, based on a combination of different tests. Molecular confirmation of the parasite species had not been performed. Two of the dogs had been imported while four had no travel history outside of the country.

CONCLUSIONS

Four of the dogs with a confirmed D. immitis infection or heartworm disease had no history of being imported or travelling outside of the country, indicating autochthonous infections and, consequently, local circulation of the parasite in Estonia. These findings represent the new northernmost autochthonous cases of D. immitis infection and canine heartworm disease reported in the European Union.

Haplotypes of Dirofilaria repens from Poland and selected countries of Central, North-Eastern Europe and the Middle East: An evaluation on the relation between the genetic diversity and the geographic distribution of the fast-spreading parasite

Subcutaneous dirofilariosis is a fast-spreading infection of dogs, and occasionally of other carnivores and humans. Several factors contribute to its spread, including climate change, which facilitates development and survival of Dirofilaria repens in the mosquito vector. Movement/relocation of infected definitive hosts (dogs) from endemic regions to non-endemic regions is another possible cause of local emergence and the presence of a wide variety of wild reservoirs of the parasite may also contribute to its spread. The main aim of this study was to evaluate the genetic diversity of D. repens from different regions of Europe and to evaluate the spread of identified haplotypes and their geographic origin. A total of 95 D. repens isolates were obtained from Central and Eastern Europe (Poland, Belarus, Ukraine, Austria, Romania), NE Europe (Lithuania, Latvia, Estonia), Italy and Israel. All but two positive samples were obtained from the blood of dogs while one positive sample was obtained from an adult worm from a human case from the Lublin area in SE Poland and one sample was obtained from Anopheles plumbeus mosquito from Austria. Genetic diversity in D. repens isolates was evaluated by PCR amplification and sequencing of three genetic markers, including two mitochondrial genes (mtDNA): the cytochrome c oxidase subunit I (COI) and dehydrogenase subunit I (NADH). Additionally, the genomic marker, internal transcribed spacer 1 (ITS-1) was amplified and sequenced. Haplotypes were differentiated based on sequence alignments by identifying Single Nucleotide Polymorphism (SNPs) using DnaSP and Mega X. PopArt was used to construct a haplotype network including all identified haplotypes. Both mtDNA sequences (COI and NADH) were combined together for phylogenetic and network analyses. Altogether 18 haplotypes (DR1-DR18) were identified in combined mtDNA markers among 95 analysed samples. Haplotype DR1 was the most common encompassing 66 isolates: 42 isolates from Poland (41 from dogs and one from a human), 13 from Lithuania, 4 from Latvia, 2 from Ukraine and 5 from Romania. All other haplotypes grouped around haplotype DR1 separated by 1-5 SNPs, forming a star-like shape. Haplotype DR2 was the second most common haplotype, formed by six isolates from Romania. Interestingly, haplotype DR3 was represented only by four isolates from Israel. The remaining 15 haplotypes were represented by 1-4 isolates of different origins. Our study showed that only minor genetic diversity was found in D. repens since all isolates appear to have clustered in or branched out from haplotype DR1 with 1-5 SNP differences. The genetic diversity appears to be governed by geographic origin since isolates from neighbouring populations (countries) appear to share unique haplotypes while other populations that are geographically distant from individual haplotypes.

What Has Happened to Heartworm Disease in Europe in the Last 10 Years?

Heartworm disease caused by Dirofilaria immitis is a vector-borne disease that affects canids and felids, both domestic and wild, throughout the world. It is a chronic disease which causes vascular damage in pulmonary arteries, and in advanced stages, the presence of pulmonary hypertension and right-sided congestive heart failure can be evidenced. Moreover, pulmonary thromboembolism is caused by the death of the worms, which can be lethal for the infected animal. Furthermore, it is the causative agent of human pulmonary dirofilariosis, being a zoonotic disease. The aim of this review was to update the current epidemiological situation of heartworm in Europe in dogs, cats, wild animals, and vectors insects, and to analyse the factors that may have contributed to the continuous spread of the disease in the last decade (2012–2021). In Europe, the disease has extended to eastern countries, being currently endemic in countries where previously only isolated or imported cases were reported. Furthermore, its prevalence has continued to increase in southern countries, traditionally endemic. This distribution trends and changes are influenced by several factors which are discussed in this review, such as the climate changes, presence of vectors in new areas, the appearance of new competent vector species in the continent, increased movement of pets that travelled to or originated from endemic countries, the urbanisation of rural areas leading to the formation of so-called “heat islands”, or the creation of extensive areas of irrigated crops. The continuous expansion of D. immitis must be monitored, and measures adapted to the situation of each country must be carried out for adequate control.

Strongyloides stercoralis infection in dogs in Austria: two case reports

Background

Strongyloides stercoralis is endemic in tropical and subtropical regions, but reports of infections in central and northern Europe have been recently increasing. Infections occur mainly in humans and dogs. In dogs, both dog-adapted and zoonotic S. stercoralis genotypes seem to occur. Clinical manifestations mainly include gastrointestinal and respiratory signs. The severity of the disease can vary greatly and depends on the immune status of the host. The infection is potentially fatal in immunosuppressed individuals, either medically induced or due to an underlying disease, in which hyperinfections and disseminated infections with extraintestinal parasite dissemination may occur.

Methods

Diagnosis was based on coproscopy, including flotation and the Baermann funnel technique, histology of small intestinal biopsies and molecular analysis of mitochondrial cytochrome oxidase subunit I (COI) and hypervariable regions I and IV (HVR I and HVR IV) of the nuclear 18S rDNA loci.

Results

Two independent cases of severe canine S.stercoralis infection in Austria are presented. In both cases, S. stercoralis was detected in histological sections of the small intestine and with the Baermann funnel technique. Molecular analysis revealed strains with zoonotic potential. Case 1 was a 1-year-old female French bulldog with a long history of respiratory and gastrointestinal signs, severe emaciation and apathy before S.stercoralis infection was diagnosed. Treatment with moxidectin (2.5 mg/kg body weight [BW], oral route) did not eliminate the infection, but treatment with ivermectin (0.2 mg/kg BW, subcutaneously) was successful. Case 2 consisted of two 2-month-old Pomeranian puppies, one female and one male, from a litter of four, which died soon after presenting dyspnoea and haemorrhagic diarrhoea (female) or torticollis (male); S.stercoralis infection was first diagnosed post-mortem.

Conclusion

More attention should be paid to this nematode because although it appears to be rare in Austria, it is easily overlooked on standard coproscopy unless a Baermann funnel technique is used, and even then, it can be missed. Moxidectin is not always successful in eliminating the infection, and treatment with ivermectin should be considered in cases of infection.

Graphical Abstract

Vector Surveillance and Pathogen Detection in the Working Areas of Military Working Dogs in Eastern Austria

Vector-borne diseases play a major role in human and veterinary medicine worldwide. A previous study detected asymptomatic vector-borne pathogens in military working dogs stationed at a military base in eastern Austria, and a follow-up survey of potential arthropod vectors was conducted in spring 2019 and 2020 in the vicinity of the base to evaluate the presence of vectors and their carrier status for a range of canine and zoonotic pathogens. A total of 1324 ticks (nymphs and adults of Ixodes ricinus, comprising 92.9% of the collected specimens, and adults of Haemaphysalis inermis, a tick previously only rarely described in Austria, Haemaphysalis concinna, and Dermacentor reticulatus) were collected by flagging. In 44.1% (125/284) of all pools (n = 284), one infectious agent was found; in 27.8% (79/284) and in 1.1% (3/284), two and three different agents, respectively, could be identified. Overall, 72.9% of the pools contained at least one pathogen (Borrelia spp., Rickettsia spp., Bartonella spp., and Babesia microti). Borrelia mijamotoi, B. lustinaniae, and B. microti were previously only described in single cases in Austria. Mosquitoes were collected with BG-Sentinel traps monthly during the summer of 2019. A total of 71 individuals from 11 species were collected. No filarioid DNA was detected in the mosquito sample pools, although Dirofilaria repens had been present in the dogs from the military site. In conclusion, vector surveillance should be combined with the surveillance of an exposed population whenever possible to estimate the infection risks for dogs and their handlers.

Temporospatial distribution and country of origin of canine transmissible venereal tumours in the UK

OBJECTIVE

Transmissable venereal tumour (TVT) is a tumour transplanted by physical contact between dogs. Lesions typically affect the genitalia. TVT is not considered enzootic in the United Kingdom (UK), with cases seen in imported dogs. We sought to determine the patient characteristics, temporal and spatial distribution and country of origin of affected dogs in the UK.

METHODS

Electronic pathology records (EPRs) from four UK veterinary diagnostic laboratories collected between 2010 and 2019 were searched for the terms 'venereal' or 'TVT'. Reports were reviewed for statements confirming a TVT and descriptive statistics collated.

RESULTS

Of 182 EPRs matching the search terms, a diagnosis of TVT was confirmed in 71. Country of origin was noted in 36 cases (50.7%) with Romania being the most common (n = 29). Cases were reported in each UK constituent country, with the majority being in England (64, 90.1%). The incidence of TVT diagnosis increased over the last decade (z = 2.78, p = 0.005).

CONCLUSIONS/DISCUSSION

The incidence of TVT diagnosed in the UK is increasing. The majority of cases were known to have been imported. Autochthonous transmission cannot be excluded due to study design. Vets are encouraged to carefully examine the genitalia of dogs imported to the UK from countries with enzootic TVT.

Identity of Microfilariae Circulating in Dogs from Western and South-Western Romania in the Last Decade

Dirofilaria infections in dogs are recognized as widespread mosquito-borne diseases with zoonotic potential, that are caused by the filarioid nematode (Onchocercidae) species Dirofilaria immitis and Dirofilaria repens. The long-term survey conducted in western and south-western Romania was undertaken in order to provide valuable data on the occurrence of Dirofilaria infections in dogs. Blood samples from 1088 dogs, originating from 73 localities of 11 western and south-western counties in Romania, were collected and examined using the modified Knott test. Subsequently, all of the microscopically positive samples were subjected to molecular analysis for confirmation. Altogether, the data obtained showed the percentage of dogs with circulating microfilariae to be 21.42% (233/1088) of dogs tested in the investigated region. The identified species, in cases of monoinfections, were D. immitis, D. repens, and Acanthocheilonema reconditum in 106 (9.74%) samples, 102 (9.38%) samples, and 1 (0.09%) sample, respectively. Twenty-four (2.21%) samples were simultaneously positive for D. immitis and D. repens. There was no association (p > 0.05) between infection status and breed; however, sex and lifestyle were positively associated (p < 0.05) with the percentage of dogs with circulating microfilariae and might be regarded as risk factors for infection. The results of the present investigation indicate potential zoonotic risks for humans living in the screened area and support the imperative to increase awareness among both veterinarians and physicians, regarding the continuous spread of these zoonotic filariae.

Differential diagnosis of Dirofilaria immitis nematodes (Nematoda, Onchocercidae)

Heartworm disease is a widespread anthropozoonotic disease of carnivorous animals, as well as humans. It is caused by nematodes belonging to the suborder Filariata, family Onchocercidae, genus Dirofilaria. There are about 26 species of heartworms in nature, the most common and pathogenic species in dogs and cats in most countries is Dirofilaria immitis Leidy, 1856. Mature helminths parasitize in the right ventricle and pulmonary arteries, large veins of animals and cause heart and vascular disorders, and death. Therefore, the aim of the study was to investigate the features of morphological and metric structure of adult nematodes of D. immitis isolated from the heart of dogs. Morphological studies have shown that in males the most characteristic differential features are the presence of two unequal spicules, specifically positioned relative to each other, as well as well-defined preanal and less pronounced adanal and postanal papillae. In female heartworms, the characteristic morphological features are the shape and location of the vulva. There is a difference in the structure of the esophagus in males and females. In females, the anterior and posterior parts of the esophagus are well expressed, with enlargements, in males these divisions are not pronounced. To increase the efficiency of species identification of D. immitis nematodes, it is proposed to use metric parameters that characterize the overall body size, body and width of esophagus in different areas, length of esophagus, and the location of the nerve ring. In males, 11 indicators are also suggested that characterize the size of the spicules and the location of the cloaca. In females, seven additional parameters are pointed out that characterize the location of the vulva, anus and body width in these areas. The obtained data expand the already existing data on the peculiarities of the morphological structure of parasitic nematodes of the species D. immitis and their identification.

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.

First Autochthonous Infection of a Cat with Dirofilaria immitis in Austria

This case report is about a seven-year-old male neutered European Shorthair cat infected by Dirofilaria immitis as the first reported autochthonous Dirofilaria immitis infection in Austria. There was no history of periods abroad. Echocardiography showed suspected D. immitis in the right cardiac chamber with increased pulmonary pressure and ascites. Surgical removal of the heartworms was performed. Twenty adult heartworms were removed by transvenous jugular approach under general anesthesia and stored in 4% formalin. Five out of 20 specimens were examined via light and stereomicroscopy and feline heartworm infection was confirmed. Amplification of a 203 bp or 724 bp fragment of the cytochrome c oxidase subunit I gene was unsuccessful. After surgery the cat developed acute renal failure but recovered quickly. One year later, the cat underwent a control examination including echocardiography and blood work. There were no more D. immitis detectable at echocardiography. Lung pressure was mildly increased. Complete blood count and creatinine were unremarkable. The Knott's test and Dirofilaria-Antigen-test produced negative results. The cat did not show any clinical signs during the follow-up period. The aim of this case report is to highlight the growing risk of acquiring infection with D. immitis not only for Austrian dogs, but also for cats. This case report represents the first report of autochthonous D. immitis infection in Austria. Moreover, even if the prognosis in cats with caval syndrome due to feline heartworm disease is guarded to poor, surgical removal of the filariae can be a successful treatment option.