Patterns of milk transmission of Strongyloides ratti

Strongyloides questions-a research agenda for the future

The Strongyloides genus of parasitic nematodes have a fascinating life cycle and biology, but are also important pathogens of people and a World Health Organization-defined neglected tropical disease. Here, a community of Strongyloides researchers have posed thirteen major questions about Strongyloides biology and infection that sets a Strongyloides research agenda for the future. This article is part of the Theo Murphy meeting issue 'Strongyloides: omics to worm-free populations'.

Strongyloides papillosus causes sudden death in weaned calves on New York dairies

CASE DESCRIPTION

Outbreaks of sudden death in apparently healthy weaned dairy calves due to Strongyloides papillosus parasitism were diagnosed on 2 separate and independent New York (NY) dairies.

CLINICAL FINDINGS

Most calves were found dead; however, 1 calf observed while dying showed signs of tachycardia, tachypnea, vocalization, and convulsions shortly before death. In 6 affected heifers that underwent post-mortem examination, precocious bilaterally symmetric mammary gland enlargement was seen. A portion of their parasitized living cohorts also demonstrated similar mammary gland enlargement. A diagnosis of S papillosus hyperinfection was made based upon the presence of high numbers of S papillosus ova in feces, and confirmation by S papillosus-specific PCR assays. Consistent histopathological findings in affected calves included generalized mammary gland vascular congestion, interstitial edema and hemorrhage with ductal hyperplasia. Mild multifocal cardiomyocyte degeneration was found in 5 of 14 calves examined. Factors believed to contribute to the parasite's environmental amplification and host hyperinfection included group housing on wood shavings and high environmental temperatures and humidity.

TREATMENT AND OUTCOME

Treatment of calves with doramectin pour-on stopped mortality and resolved the udder enlargement.

CLINICAL RELEVANCE

Similar outbreaks have previously been described in Japan and South Bohemia (Czech Republic), where researchers hypothesized that sudden death may be due to fatal arrhythmia caused by a parasite-associated cardiotoxin. This report highlights the importance of including S papillosus among the differential diagnoses for sudden death alone or together with precocious udder enlargement in calves kept in confinement housing.

Prevention of Lactogenic Toxocara cati Infections in Kittens by Application of an Emodepside/Praziquantel Spot-on (Profender®) to the Pregnant Queen

This study aimed to evaluate the efficacy of an emodepside 2.1 % (w/v)/praziquantel 8.6 % (w/v) topical solution (Profender® spot-on for cats) in the prevention of lactogenic Toxocara cati infections. A controlled test was performed with two groups of 8 cats with confirmed pregnancy. All cats were infected with daily doses of 2000 T. cati eggs for 10 consecutive days starting 50 days post conception to produce an acute infection. Treatment was performed 60 days post conception. Queens in the treatment group received the emodepside/praziquantel solution at the minimum therapeutic dose (3 mg/kg emodepside and 12 mg/kg praziquantel), while the control group was treated with a placebo spot-on. Efficacy was evaluated 56 days post partum by necropsy of one randomly selected kitten of each litter and comparison of the worm burdens between the study groups. Additionally the necropsy results were supported by quantification of worms expelled with the faeces after deworming of the remaining kittens and all queens. The treatment in late pregnancy resulted in an efficacy of 98.7 % (p < 0.0001). All necropsied control kittens were infected (geometric mean 30.6). Seven of 8 kittens from treated mothers were free of T. cati (geometric mean 0.4). Worm counts after deworming reflected the results obtained at necropsy. No side effects of the treatment were observed. It is concluded that treatment with an emodepside/praziquantel spot-on solution during late pregnancy effectively prevents lactogenic transmission of T. cati to the offspring. The study design facilitated the generation of reliable data, while at the same time a minimum number of animals was sacrificed.

Dynamics of infection in rats given low doses of homogonic and heterogonic Strongyloides ratti

The results of control infections from 39 experiments using the ‘exact dose’ technique are analysed and compared with earlier large dose experiments with homogonic S. ratti. A smaller error variance and less added variance between experiments accompany the new method, which therefore provides a more precise experimental system. Using the exact dose technique, it is established that the migratory bahaviour of small numbers of L3 of the homogonic strain in lactating animals is the same as that of large numbers. In previous work the rate of migration of the homogonic strain estimated from conventional large dose experiments (Wilson, Cameron & Scott, 1978b) differed from that deduced from the use of radio-isotope labelled L3 (Wilson, 1979). ‘Exact dose’ data support results with the latter technique. There are significant differences between strains. The heterogonic larvae take longer to migrate in lactating hosts and appear to distribute themselves differently between mother and offspring. The consequences of these findings for theories of pathfinding in hosts are discussed. Experiments are also reported which failed to detect any artifact which might have resulted from ether anaesthesia of rats at injection of larval worms. This observation has implications for other studies in progress in this laboratory.

Doubt and certainty about the pathways of invasive juvenile parasites inside hosts

It is generally believed that the patterns of in-host migration of the infective stages of most invasive macroparasites of man and domestic animals are matters of established fact. In reality, the textbook treatment of this topic, and much of the experimental approach to it, are a legacy of an uncritical past. With few exceptions the true picture concerning particular host/parasite systems is confused by the acceptance of inadequate criteria of proof. In important instances these bogus 'proofs' have been generalized within a suspect inductive framework which employs the basic assumption that all migratory parasites that enter the same portal and travel to the same destination do so by the same route. The discussion of such issues serves as a background to the presentation in detail of a more rigorous conceptual and experimental framework.

The course of infection in rats given small primary doses of Strongyloides ratti and S. venezuelensis

Development of exact doses (less than 100) of Strongyloides venezuelensis third-stage larvae in adult Wistar rats was insignificant (mean proportion of 0.076 of the dose at day 8, n = 16) compared with a homogonic strain of S. ratti (0.538, n = 6; 0.726, n = 6) and heterogonic S. ratti (0.681, n = 6). Newly-weaned Wistars allowed development of a mean proportion of S. venezuelensis of 0.298 (n = 4) compared with 0.013 (n = 4) of the same sample of larvae in adult hosts. Experiments with 75Se-labelled larvae established that S. venezuelensis effectively failed to migrate from skin to intestine in adult animals, while mean proportions of 0.141 (n = 5) and 0.138 (n = 4) of the label was found in the intestines of newly-weaned rats 72 h after skin application. Labelled larvae of homogonic S. ratti migrated equally well in both age groups of host (0.350 and 0.358 in 12- and 3-week-olds respectively). Adult S. venezuelensis transferred surgically to the intestines of previously uninfected full-grown Wistars survived over a 21-day period to the same extent as either strain of S. ratti. Resistance of Wistar rats to S. venezuelensis therefore appears to affect the migratory stage preferentially. S. venezuelensis developed better in mature PVG inbred rats (mean = 0.301, n = 20). Studies of S. ratti showed that infections of both strains initiated by exact (less than 100) doses in Wistar rats had decayed to insignificance between days 26 and 32. The rate of loss of adults of the heterogonic strain was significantly greater than that for the homogonic. The egg content of worms declined as infection progressed and rats were idiosyncratic in their influence on parasite reproduction from the earliest time of sampling (8 d). It was established that 'autoinfection' was an unlikely feature of the biology of homogonic S. ratti following the surgical transfer of 450 first-stage larvae to the intestines of 8 adult Wistar rats. No evidence of infection appeared in the guts of these animals 8 days post-transfer. The significance of these results in terms of the biology of Strongyloides spp. naturally occurring in the rat is discussed.

Transmammary transmission of Strongyloides ratti

The rate of transmammary transmission of Stronglyloides ratti was examined in albino rats in terms of the route of subcutaneous (s.c.) migration from the infection site (the skin) to the cranium. Inoculation sites nearer the cranium resulted in less frequent transmammary infection. The maximum number of adult worms was recovered from the sucklings when the mother was inoculated in her hindquarter and sucklings were allowed to feed for 30-36 h after inoculation (AI). Few worms were recovered from sucklings when they were allowed to nurse during periods of less than 24 h AI or greater than 42 h AI. In lactating mothers, larval infection of the mammary glands was commonly observed, and these larvae showed an increased esophagus length. In nonlactating mothers, most larvae completed their migration to the cranium within 36 h AI.

The effect of method of infection on the pathway of juvenile Strongyloides ratti in the host

Subcutaneous injection of the larvae is the almost universally adopted means of initiating experimental infections of skin-invading roundworms but, so far, the possibility that this procedure introduces artefacts of one kind or another has not been critically studied. Experiments described in this paper were used to compare the effect of (a) injection and (b) skin application, of a small, precisely counted ('exact') dose of larvae. Results with two strains of S. ratti showed that the same proportion of the dose developed to adults in the intestines of rats irrespective of the method. With the same exact dose technique it has been shown that milk-borne infection of the pups of lactating rats is not an artefact produced by injection. Large doses (mean 4000) of larvae of the homogonic strain of S. ratti carrying a radioactive label of 75Se were tracked in their migration to the mammary gland following injection or skin application at two different sites on the right-hand side of nursing mother rats. The broad conclusion of earlier work in this laboratory using injection, that larvae move by a local route and not a systemic one, was supported by the results. The detailed distribution of the label and of unlabelled worms of the heterogonic strain in families was, however, different for the two methods, indicating that subtle variations in pathway can be brought about by the use of injection. If migration involves the lymphatic system, then the interpretation of immunological experiments in terms of lymphatic anatomy must take account of such procedural effects. The extent to which these results contribute to theories of migration in Strongyloides ratti is discussed.

Strongyloides ratti: studies of 75Se-labelled larvae of the homogonic strain in female hosts

A prediction of the hypothesis of Wilson (1977, 1980 a, b) to account for larval migration of homogonic Strongyloides ratti in the host is that the pattern of invasion of the mammary gland of a lactating rat will be quantitatively similar on both sides and independent of the point of entry into the body. Twenty-one suckled mother rats in 6 experiments in which live 75Se-labelled 3rd-stage homogonic larvae were injected under the skin of the upper flank had an overall distribution of label 30 h post-injection, as a percentage of the initial dose, in the quadrants, I (rear, injection side, II (rear, opposite injection side), III (front, injection side) and IV (front, opposite injection side) of the mammary gland as follows: 27.4%, 1.27%, 1.98% and 1.24%. Quantitative changes in mammary label between 30 and 48 h post-injection using live larvae, differences between mothers and virgins, and results after injection of heat-killed labelled larvae, confirm that the pattern is representative of the behaviour of normal (unlabelled) worms when injected. The theory is therefore disproved. The findings are put forward as the first quantitative evidence for major lymphatic involvement in migration of a skin-penetrating roundworm. They need confirmation in similar experiments in which worms are allowed to penetrate the skin naturally. The role of isotope-labelled larvae versus traditional methods of estimating parasite content of host tissue is discussed.

Helminths and the transmammary route of infection

The transfer of infective larval stages of helminths via the mammary glands is probably more common than generally recognized. Recent investigations of both natural and experimental infections of various animals have shown that the transmammary transmission of some helminths is a major avenue of infection. Other studies indicate that there are at least 13 helminth parasites which may be transmitted as prenatal infections and at least 17 transmitted via the mammary glands. The majority of these are nematodes. However, in one case the tetrathyridia of the cestode Mesocestoides was observed. In this report the life-cycle and transmission of 2 species of diplostomatid trematodes in the genus Pharyngostomoides is described. The raccoon, Procyon lotor, is the only definitive host; a planorbid snail, Menetus dilatatus, and a branchiobdellid annelid, Cambarincola osceola, a commensal on crayfishes, are intermediate hosts. Records for a period of 11 years are now available for the maternal transmission and longevity of this trematode. During this time one infected female raccoon was maintained in the laboratory on a diet of commercial dog food, sweet potatoes and corn. She produced 25 offspring, most of which were infected with Pharyngostomoides, through the 6th litter. There was a declining number of worms in each litter, ranging from nearly 2000 in one of the 1st litter, to none in the 7th litter. After nearly 12 years she continues to pass a few trematode ova. Rather than assume she has retained the same adult worms for 12 years, it is reasonable to conclude that mesocercariae move through her body and eventually mature in the intestine. Because the mesocercariae have a predilection for the lactating mammary gland, it seems likely that a hormonal influence is present. The transmammary transmission of larvae is a viable alternative in the life-cycles of a number of helminths, and in some instances it is probably the major route of infection.

Tracking radioactive larvae of Strongyloides ratti in the host

Infective larvae of homogonic Strongyloides ratti grown in faecal culture with 32P or 75Se acquired a significant amount of radioactivity which was firmly attached to them. Heating removed most of the 32P but left 75Se in place. Subcutaneous injection of virgin and nursing mother rats with living and heat-killed radioactive larvae resulted in a pattern of labelling in the small intestine of injected animals and, in the case of 75Se, those of suckling pups, which can only be explained if labelled worms follow the natural migratory routes. The use of this tool in migratory studies is discussed, with precautions to allow for flaws in the technique.