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Riebenbauer K, Czerny S, Egg M, Urban N, Kinaciyan T, Hampel A, Fidelsberger L, Karlhofer F, Porkert S, Walochnik J, Handisurya A. The changing epidemiology of human leishmaniasis in the non-endemic country of Austria between 2000 to 2021, including a congenital case. PLoS Negl Trop Dis 2024; 18:e0011875. [PMID: 38198499 PMCID: PMC10805284 DOI: 10.1371/journal.pntd.0011875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/23/2024] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Leishmaniasis is caused by infection with intracellular protozoans of the genus Leishmania. Transmission occurs predominantly by the bite of phlebotomine sandflies, other routes, including congenital transmission, are rare. The disease manifests as either cutaneous, visceral or mucosal/mucocutaneous leishmaniasis. In recent years, changes in the epidemiological pattern have been reported from Europe. PRINCIPAL FINDINGS A total of 311 new and 29 published leishmaniasis cases occurring between 01/01/2000 and 12/31/2021 in Austria were collected and analyzed. These encompassed 146 cutaneous (CL), 14 visceral (VL), 4 mucosal, and 3 cases with concurrent VL and CL. In addition, asymptomatic infections, comprising 11 unspecified cases with Leishmania DNA detectable only in the blood and 162 cases with anti-Leishmania antibodies were reported. Particularly since 2016, the incidence of leishmaniasis has steadily risen, mainly attributable to increasing numbers of CL and cases with positive serology against Leishmania species, whereas the incidence of VL has slowly decreased. Analysis revealed that a shift in the causative species spectrum had occurred and that a substantial number of CL cases were caused by members of the Leishmania donovani/infantum complex. Simultaneous occurrence of VL and CL was identified in immunocompromised individuals, but also in a not yet reported case of an immunocompetent child after vertical transmission. CONCLUSIONS The incidence of leishmaniasis has risen in the recent years. The numbers are anticipated to keep rising due to increasing human mobility, including travel and forced migration, growing reservoir host populations as well as expansion and dispersal of vector species caused by climate and habitat changes, urbanization and globalization. Hence, elevated awareness for the disease, including possible transmission in previously non-endemic regions and non-vector transmission modes, support of sandfly surveillance efforts and implementation and establishment of public health interventions in a One Health approach are pivotal in the global efforts to control and reduce leishmaniasis.
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Affiliation(s)
| | - Stefan Czerny
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Maximilian Egg
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Nikolaus Urban
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Tamar Kinaciyan
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Amélie Hampel
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Luise Fidelsberger
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Franz Karlhofer
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Stefanie Porkert
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Julia Walochnik
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
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Aghakhani N, Azami M, Mohaghegh MA. Cutaneous leishmaniasis lowers the quality of life: a neglected truth. GMS HYGIENE AND INFECTION CONTROL 2023; 18:Doc21. [PMID: 37829252 PMCID: PMC10566011 DOI: 10.3205/dgkh000447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Affiliation(s)
- Nader Aghakhani
- Food and Beverages Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Mehdi Azami
- Skin Diseases and Leishmaniosis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Medical Parasitology and Microbiology, Hojjatieh Medical Diagnostic Laboratory, Hojjatieh Hospital, Isfahan, Iran
- Basir Laboratory Research and Development Center, Basir Medical Diagnostic Laboratory, Isfahan, Iran
| | - Mohammad Ali Mohaghegh
- Department of Laboratory Sciences, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
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3
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Li LQ, He Y, Liu T, Zhou J, Chen EQ. Fever of unknown origin and splenomegaly: a case report of visceral leishmaniasis diagnosed by metagenomic next-generation sequencing. Future Microbiol 2023; 18:699-705. [PMID: 37522175 DOI: 10.2217/fmb-2023-0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Abstract
Visceral leishmaniasis (VL) is a parasitic disease caused by Leishmania spp., which is transmitted by sandflies. As China is not the main epidemic area and VL has complex and atypical clinical manifestations, it is easily misdiagnosed or even missed in clinical practice. Without prompt and efficient treatment, the mortality rate of VL is extremely high; therefore early diagnosis of VL is crucial. Herein we describe a case of fever and splenomegaly of unknown origin, which was finally diagnosed as VL by metagenomic next-generation sequencing.
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Affiliation(s)
- Lan-Qing Li
- Center for Infectious Diseases, West China Hospital, Sichuan University, Chengdu, 610044, PR China
| | - Yiju He
- Department of Infectious Disease, People's Hospital of Aba Tibetan & Qiang Autonomous Prefecture, Aba State, 624099, PR China
| | - Ting Liu
- Department of Infectious Disease, The People's Hospital of Jianyang City, Jianyang, 641499, PR China
| | - Jing Zhou
- Center for Infectious Diseases, West China Hospital, Sichuan University, Chengdu, 610044, PR China
| | - En-Qiang Chen
- Center for Infectious Diseases, West China Hospital, Sichuan University, Chengdu, 610044, PR China
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4
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Pereira LQ, Tanaka SCSV, Ferreira-Silva MM, Gomes FVBAF, Santana MP, Aguiar PR, de Araújo Pereira G, Gómez-Hernández C, Junior VR, De Vito FB, Moraes-Souza H. Leukoreduction as a control measure in transfusion transmission of visceral leishmaniasis. Transfusion 2023; 63:1044-1049. [PMID: 36929836 DOI: 10.1111/trf.17308] [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: 01/19/2022] [Revised: 01/18/2023] [Accepted: 01/30/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Asymptomatic visceral leishmaniasis (VL) infection is a risk for transfusion safety. Leukoreduction has been an alternative for the prevention of some blood-borne diseases, including VL. This study aimed to evaluate the role of leukoreduction of cellular blood components as a control measure for transfusional VL transmission. RESEARCH DESIGN AND METHODS A total of 161 polytransfused patients with non-leukoreduced blood components (HNL), 95 polytransfused with leukoreduced blood components (LH), and 202 non-transfused (NT) from endemic regions for VL and with a similar epidemiological profile. The detection of antibodies against VL was performed by ELISA and the presence of the parasite was investigated by real-time PCR. Statistical significance was defined as p < .05. RESULTS When comparing three groups, ELISA results were statistically significant (p = .0065). The residual analysis of ELISA showed statistically significant for the HNL group compared to the general group (p = .002; OR: 5.6; CI: 1.7-25.8), demonstrating that individuals who received non-leukoreduced transfusions are five times more likely to acquire Leishmania infantum infection than the general. DISCUSSION Higher prevalence in the group with HNL and low prevalence in those who received LH, similar to NT patients, highlight the risk of transfusional VL transmission and reinforce the role of leukoreduction in its prevention.
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Affiliation(s)
- Loren Queli Pereira
- Laboratory of Hematological Research, Triângulo Mineiro Federal University, Uberaba, Brazil
| | | | | | | | - Melissa Palis Santana
- Government of Piauí, Hemopi - Hematology and Hemotherapy Center of the State of Piauí, Teresina, Brazil
| | - Paulo Roberto Aguiar
- Hemominas Foundation, Regional Blood Center of Montes Claros (Minas Gerais), Montes Claros, Brazil
| | - Gilberto de Araújo Pereira
- Department of Nursing in Education and Community Health, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | | | | | | | - Helio Moraes-Souza
- Laboratory of Hematological Research, Triângulo Mineiro Federal University, Uberaba, Brazil
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Lai C, Heinemann J, Schleicher U, Schett G, Bogdan C, Bozec A, Soulat D. Chronic Systemic Infection of Mice with Leishmania infantum Leads to Increased Bone Mass. J Bone Miner Res 2023; 38:86-102. [PMID: 36332102 DOI: 10.1002/jbmr.4733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 10/20/2022] [Accepted: 10/29/2022] [Indexed: 11/06/2022]
Abstract
Vector-borne infections of humans with the protozoan parasite Leishmania (L.) infantum can cause a systemic and potentially lethal disease termed visceral leishmaniasis. In the corresponding mouse model, an intravenous infection with L. infantum leads to the persistence of parasites in various organs, including bone marrow (BM). Considering the anatomical proximity between the BM and the cortical bone, we investigated whether a chronic infection with L. infantum affected bone homeostasis. Unexpectedly, chronic infection with L. infantum caused an increase in bone mass in mice. In vivo, an increased number of osteoblasts and osteocytes and a decreased maturation of osteoclasts characterized the phenotype. Confocal laser scanning fluorescence microscopy confirmed the infection of BM macrophages but also revealed the presence of parasites in osteoclasts. In vitro, mature osteoclasts took up L. infantum parasites. However, infection of osteoclast progenitors abolished their differentiation and function. In addition, secretory products of infected BM-derived macrophages inhibited the maturation of osteoclasts. Both in vitro and in vivo, infected macrophages and osteoclasts showed an enhanced expression of the anti-osteoclastogenic chemokine CCL5 (RANTES). Neutralization of CCL5 prevented the inhibition of osteoclast generation seen in the presence of culture supernatants from L. infantum-infected macrophages. Altogether, our study shows that chronic infection with Leishmania increases bone mass by inducing bone formation and impairing osteoclast differentiation and function. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Chaobo Lai
- Mikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
- Department of Internal Medicine 3, Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Jennifer Heinemann
- Mikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Ulrike Schleicher
- Mikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
- Medical Immunology Campus Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Georg Schett
- Department of Internal Medicine 3, Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
- Medical Immunology Campus Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Christian Bogdan
- Mikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
- Medical Immunology Campus Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Aline Bozec
- Department of Internal Medicine 3, Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
- Medical Immunology Campus Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Didier Soulat
- Mikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
- Medical Immunology Campus Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
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6
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Miró G, Wright I, Michael H, Burton W, Hegarty E, Rodón J, Buch J, Pantchev N, von Samson-Himmelstjerna G. Seropositivity of main vector-borne pathogens in dogs across Europe. Parasit Vectors 2022; 15:189. [PMID: 35668469 PMCID: PMC9169295 DOI: 10.1186/s13071-022-05316-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 05/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Canine vector-borne disease (CVBD) has been an area of increasing interest in Europe over the last few decades, and there have been changes in the prevalence and distribution of many of these diseases. Monitoring CVBD infections in Europe is often done by individual countries, but aggregated data for the European countries are helpful to understand the distribution of CVBDs. METHODS We used an extensive retrospective database of results from point-of-care rapid enzyme-linked immunosorbent assay (ELISA) tests on dogs across Europe to identify distribution and seropositivity in animals tested for selected CVBDs (Anaplasma spp., Ehrlichia spp., Borrelia burgdorferi, Leishmania spp., and Dirofilaria immitis) from 2016 through 2020. Geographic distribution of positive tests and relative percent positive values were mapped by the Nomenclature of Territorial Units for Statistics classification for regions with sufficient test results for reporting. RESULTS A total of 404,617 samples corresponding to 1,134,648 canine results were available from dogs tested in 35 countries over the 5-year study period. Over this period the number of test results per year increased whereas test positivity decreased. Leishmania spp. had the largest increase in total test results from 25,000 results in 2016 to over 60,000 results in 2020. Test positivity for Leishmania spp. fell from 13.9% in 2016 to 9.4% in 2020. Test positivity fell for Anaplasma spp. (7.3 to 5.3%), Ehrlichia spp. (4.3 to 3.4%), and Borrelia burgdorferi (3.3 to 2.4%). Dirofilaria immitis test positivity trended down with a high of 2.7% in 2016 and low of 1.8% in 2018. Leishmania spp. test positivity was highest in endemic areas and in several non-endemic countries with low numbers of test results. Co-positivity rates were significantly higher than expected for all pathogen test positive pairs except for Ehrlichia spp. with Borrelia burgdorferi and D. immitis with Borrelia burgdorferi. CONCLUSIONS This study represents the largest data set on CVBD seropositivity in Europe to date. The increase in the number of test results and decreasing test positivity over the study period may reflect changes in testing behavior and increased screening of healthy animals. The Europe-wide mapping of CVBD provides expected test positivity that can help inform veterinarians' decisions on screening and improve prevention and identification of these important, sometimes zoonotic, diseases.
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Affiliation(s)
- Guadalupe Miró
- Department of Animal Health, Veterinary Faculty, Universidad Complutense de Madrid, Madrid, Spain.
| | - Ian Wright
- Mount Veterinary Practice, Fleetwood, UK
| | | | | | | | | | - Jesse Buch
- IDEXX Laboratories, Inc, Westbrook, ME, USA
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7
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Parkash V, Kaye PM, Layton AM, Lacey CJ. Vaccines against leishmaniasis: using controlled human infection models to accelerate development. Expert Rev Vaccines 2021; 20:1407-1418. [PMID: 34664543 PMCID: PMC9835556 DOI: 10.1080/14760584.2021.1991795] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Leishmaniasis is a neglected tropical disease that is defined by the World Health Organization as vaccine preventable. Although several new candidate vaccines are in development, no vaccine has successfully reached the market for human use. Several species of Leishmania cause human disease and have co-evolved with their respective sand fly vectors. These unique relationships have implications for initiation of infection and vaccine development. An approach to vaccine development for many infectious diseases is the use of controlled human infection models (CHIMs). AREAS COVERED We describe the history and recent development of experimental and deliberate infection using Leishmania in humans and the rationale for developing a new sand fly-initiated CHIM to progress leishmaniasis vaccine development. Examples from other infectious diseases are discussed in the context of the development of a new leishmaniasis CHIM. We also reflect upon the manufacture of the challenge agent, practical considerations, safety, ethics, and regulatory issues. EXPERT OPINION A new cutaneous Leishmania CHIM is being developed to enable testing of vaccines in the development pipeline. Questions remain about the use of such CHIMs to determine effectiveness of vaccines against visceral leishmaniasis. However, such a CHIM will be invaluable in expediting time to market for vaccines.
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Affiliation(s)
- Vivak Parkash
- York Biomedical Research Institute, Hull York Medical School, University of York, York, UK,Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, UK
| | - Paul M. Kaye
- York Biomedical Research Institute, Hull York Medical School, University of York, York, UK
| | - Alison M Layton
- York Biomedical Research Institute, Hull York Medical School, University of York, York, UK
| | - Charles J Lacey
- York Biomedical Research Institute, Hull York Medical School, University of York, York, UK,CONTACT Charles J Lacey York Biomedical Research Institute, Hull York Medical School, University of York, York, UK
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García Oronoz G, Pedraza-Arévalo LC, Henao-Martínez AF, Franco-Paredes C, Suarez JA. Visceral leishmaniasis in the island of Margarita, Venezuela: a neglected parasitic infection in the Caribbean. Ther Adv Infect Dis 2021; 8:20499361211031714. [PMID: 34377462 PMCID: PMC8320547 DOI: 10.1177/20499361211031714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/17/2021] [Indexed: 11/18/2022] Open
Abstract
Visceral leishmaniasis carries a significant burden of disease in the Americas with up to 7000 cases reported annually. There are several reports of autochthonous visceral leishmaniasis cases in the Caribbean, including the Dominican Republic, Guadalupe, Martinique, and Trinidad and Tobago. However, we lack recent clinical description and epidemiologic data of visceral leishmaniasis in other islands in the Caribbean. Herein, we describe an autochthonous case of visceral leishmaniasis in the Caribbean Island of Margarita in Venezuela. This index case of visceral leishmaniasis highlights the need for further regional surveillance efforts to identify animal reservoirs and to monitor the occurrence of further clinical cases. Additionally, there is an urgent need for implementing vector control strategies.
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Affiliation(s)
- Gerardine García Oronoz
- Pediatric Infectious Diseases Service, Hospital Dr. Jesus Garcia Coello, Judibana, Venezuela
| | | | - Andrés F Henao-Martínez
- Infectious Diseases Division, University of Colorado Anschutz Medical Campus, 12700 E. 19th Avenue, Mail Stop B168, Aurora, CO 80045, USA
| | - Carlos Franco-Paredes
- Infectious Diseases Division, University of Colorado Anschutz Medical Campus, Aurora CO, USA
| | - José A Suarez
- Instituto Conmemorativo Gorgas de Estudios de la Salud (ICGES), Panamá City, Panamá
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Davies-Bolorunduro O, Osuolale O, Saibu S, Adeleye I, Aminah N. Bioprospecting marine actinomycetes for antileishmanial drugs: current perspectives and future prospects. Heliyon 2021; 7:e07710. [PMID: 34409179 PMCID: PMC8361068 DOI: 10.1016/j.heliyon.2021.e07710] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/25/2021] [Accepted: 07/30/2021] [Indexed: 01/01/2023] Open
Abstract
Revived analysis interests in natural products in the hope of discovering new and novel antileishmanial drug leads have been driven partially by the increasing incidence of drug resistance. However, the search for novel chemotherapeutics to combat drug resistance had previously concentrated on the terrestrial environment. As a result, the marine environment was often overlooked. For example, actinomycetes are an immensely important group of bacteria for antibiotic production, producing two-thirds of the known antibiotics. However, these bacteria have been isolated primarily from terrestrial sources. Consequently, there have been revived efforts to discover new compounds from uncharted or uncommon environments like the marine ecosystem. Isolation, purification and structure elucidation of target compounds from complex metabolic extract are major challenges in natural products chemistry. As a result, marine-derived natural products from actinomycetes that have antileishmanial bioactivity potentials have been understudied. This review highlights metagenomic and bioassay approaches which could help streamline the drug discovery process thereby greatly reducing time and cost of dereplication to identify suitable antileishmanial drug candidates.
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Affiliation(s)
- O.F. Davies-Bolorunduro
- Microbiology Department, Nigerian Institute of Medical Research, Lagos, Nigeria
- Postdoc Fellow Department of Chemistry, Faculty of Science and Technology, Universitas Airlangga, Komplek Kampus C, Jl. Mulyorejo, Surabaya, 60115, Indonesia
| | - O. Osuolale
- Applied Environmental Metagenomics and Infectious Diseases Research Group (AEMIDR), Department of Biological Sciences, Elizade University, Ilara Mokin, Nigeria
| | - S. Saibu
- Department of Microbiology, University of Lagos, Akoka, Lagos, Nigeria
| | - I.A. Adeleye
- Department of Microbiology, University of Lagos, Akoka, Lagos, Nigeria
| | - N.S. Aminah
- Department of Chemistry, Faculty of Science and Technology, Universitas Airlangga, Komplek Kampus C UNAIR, Jl. Mulyorejo, Surabaya, 60115, Indonesia
- Biotechnology of Tropical Medicinal Plants Research Group, Universitas Airlangga, Indonesia
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Kniha E, Milchram M, Dvořák V, Halada P, Obwaller AG, Poeppl W, Mooseder G, Volf P, Walochnik J. Ecology, seasonality and host preferences of Austrian Phlebotomus (Transphlebotomus) mascittii Grassi, 1908, populations. Parasit Vectors 2021; 14:291. [PMID: 34051839 PMCID: PMC8164323 DOI: 10.1186/s13071-021-04787-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 05/11/2021] [Indexed: 01/05/2023] Open
Abstract
Background Sand flies are principal vectors of the protozoan parasites Leishmania spp. and are widely distributed in all warmer regions of the world, including the Mediterranean parts of Europe. In Central European countries, the sand fly fauna is still under investigation. Phlebotomus mascittii, a suspected but unproven vector of Leishmania infantum, is regarded as the most widely distributed species in Europe. However, many aspects of its biology and ecology remain poorly known. The aim of this study was to provide new data on the biology and ecology of Ph. mascittii in Austria to better understand its current distribution and potential dispersal. Methods Sand flies were collected by CDC light traps at four localities in Austria for 11 (2018) and 15 weeks (2019) during the active sand fly season. Climatic parameters (temperature, relative humidity, barometric pressure and wind speed) were retrospectively obtained for the trapping periods. Sand flies were identified by a combined approach (morphology, DNA barcoding, MALDI-TOF protein profiling), and blood meals of engorged females were analysed by DNA sequencing and MALDI-TOF mass spectrometry. Results In total, 450 individuals of Ph. mascittii were caught. Activity was observed to start at the beginning of June and end at the end of August with peaks in mid-July at three locations and early August at one location. Increased activity was associated with relatively high temperatures and humidity. Also, more individuals were caught on nights with low barometric pressure. Analysis of five identified blood meals revealed chicken (Gallus gallus) and equine (Equus spp.) hosts. Sand fly abundance was generally associated with availability of hosts. Conclusion This study reports unexpectedly high numbers of Ph. mascittii at selected Austrian localities and provides the first detailed analysis of its ecology to date. Temperature and humidity were shown to be good predictors for sand fly activity. Blood meal analyses support the assumption that Ph. mascittii feeds on mammals as well as birds. The study significantly contributes to understanding the ecology of this sand fly species in Central Europe and facilitates prospective entomological surveys. ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-04787-2.
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Affiliation(s)
- Edwin Kniha
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Markus Milchram
- Institute of Zoology, Department of Integrative Biology and Biodiversity Research, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Vít Dvořák
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czech Republic
| | - Petr Halada
- BioCeV, Institute of Microbiology of the Czech Academy of Sciences, Vestec, Czech Republic
| | - Adelheid G Obwaller
- Division of Science, Research and Development, Federal Ministry of Defence, Vienna, Austria
| | - Wolfgang Poeppl
- Department of Dermatology and Tropical Medicine, Military Medical Cluster East, Austrian Armed Forces, Vienna, Austria
| | - Gerhard Mooseder
- Department of Dermatology and Tropical Medicine, Military Medical Cluster East, Austrian Armed Forces, Vienna, Austria
| | - Petr Volf
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czech Republic
| | - Julia Walochnik
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
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A Brief Report and Mini-Review of Visceral Leishmaniasis-associated Hemophagocytic Lymphohistiocytosis in Children. J Pediatr Hematol Oncol 2021; 43:e223-e226. [PMID: 32049769 DOI: 10.1097/mph.0000000000001747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 01/23/2020] [Indexed: 12/29/2022]
Abstract
We present the case of a 7-year-old boy who fulfilled the diagnostic criteria for hemophagocytic lymphohistiocytosis (HLH). Prompt visualization of his bone marrow confirmed the diagnosis of visceral leishmaniasis (VL). He responded well to treatment with liposomal amphotericin-B. The patient had a false-negative enzyme-linked immunosorbent assay for Leishmania infantum and a false-positive immunoglobulin M test for Epstein Barr virus (EBV). Because age at presentation is similar in children with VL and familial HLH for whom EBV is the usual trigger, ruling out VL is extremely important because nonspecific serologic tests for EBV can lead to the inappropriate diagnosis of EBV-driven primary HLH and to the administration of unnecessary immunochemotherapy.
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12
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Jones CM, Welburn SC. Leishmaniasis Beyond East Africa. Front Vet Sci 2021; 8:618766. [PMID: 33732738 PMCID: PMC7959848 DOI: 10.3389/fvets.2021.618766] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 01/15/2021] [Indexed: 01/25/2023] Open
Abstract
Climate change is having a substantial impact on our environment and ecosystems and has altered the way humans live, access, and utilize resources with increased risk of zoonotic infectious disease encounters. As global temperatures continue to increase, they impact on public health, migration, food security and land conflict, and as new environments become favorable, exposure to disease carrying vectors. Increased forests or natural habitat clearance for land repurposing, urbanization, road building, and water management are related to an increase in emerging vector borne parasitic diseases. The East African region remains one of the most impacted regions globally for leishmaniasis, a vector borne disease that impacts significantly on the health, wellbeing and livelihoods of affected communities and for which a lack of reporting and control interventions hinder progress toward elimination of this neglected tropical disease. As our world continues to transform, both politically and climatically, it is essential that measures are put in place to improve surveillance and disease management with implementation of control measures, including vector control, especially in low- and middle-income countries that are expected to be most impacted by changes in climate. Only through effective management, now, can we be sufficiently resilient to preventing the inevitable spread of vectors into suitable habitat and expansion of the geographical range of leishmaniasis. This review offers a current perspective on Leishmaniasis as an endemic disease in East Africa and examines the potential of the recent emergence of Leishmania infection in hitherto unaffected regions to become a public health concern if no disease management is achieved.
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Affiliation(s)
- Caitlin M Jones
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, International Campus, Zhejiang University, Haining, China.,Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
| | - Susan C Welburn
- Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, International Campus, Zhejiang University, Haining, China.,Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom
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13
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Kniha E, Dvořák V, Halada P, Milchram M, Obwaller AG, Kuhls K, Schlegel S, Köhsler M, Poeppl W, Bakran-Lebl K, Fuehrer HP, Volfová V, Mooseder G, Ivovic V, Volf P, Walochnik J. Integrative Approach to Phlebotomus mascittii Grassi, 1908: First Record in Vienna with New Morphological and Molecular Insights. Pathogens 2020; 9:E1032. [PMID: 33317097 PMCID: PMC7764109 DOI: 10.3390/pathogens9121032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/01/2020] [Accepted: 12/04/2020] [Indexed: 02/08/2023] Open
Abstract
Sand flies (Diptera: Psychodidae: Phlebotominae) are blood-feeding insects that transmit the protozoan parasites Leishmania spp. and various arthropod-borne (arbo) viruses. While in Mediterranean parts of Europe the sand fly fauna is diverse, in Central European countries including Austria mainly Phlebotomus mascittii is found, an assumed but unproven vector of Leishmania infantum. To update the currently understudied sand fly distribution in Austria, a sand fly survey was performed and other entomological catches were screened for sand flies. Seven new trapping locations of Ph. mascittii are reported including the first record in Vienna, representing also one of the first findings of this species in a city. Morphological identification, supported by fluorescence microscopy, was confirmed by two molecular approaches, including sequencing and matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) protein profiling. Sand fly occurrence and activity were evaluated based on surveyed locations, habitat requirements and climatic parameters. Moreover, a first comparison of European Ph. mascittii populations was made by two marker genes, cytochrome c oxidase subunit 1 (COI), and cytochrome b (cytb), as well as MALDI-TOF mass spectra. Our study provides new important records of Ph. mascittii in Austria and valuable data for prospective entomological surveys. MALDI-TOF MS protein profiling was shown to be a reliable tool for differentiation between sand fly species. Rising temperatures and globalization demand for regular entomological surveys to monitor changes in species distribution and composition. This is also important with respect to the possible vector competence of Ph. mascittii.
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Affiliation(s)
- Edwin Kniha
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria; (E.K.); (M.K.)
| | - Vít Dvořák
- Department of Parasitology, Faculty of Science, Charles University Prague, 128 43 Prague, Czech Republic; (V.D.); (V.V.); (P.V.)
| | - Petr Halada
- BioCeV, Institute of Microbiology of the Czech Academy of Sciences, 252 50 Vestec, Czech Republic;
| | - Markus Milchram
- Department of Integrative Biology and Biodiversity Research, Institute of Zoology, University of Natural Resources and Life Sciences Vienna, 1180 Vienna, Austria;
| | - Adelheid G. Obwaller
- Federal Ministry of Defence, Division of Science, Research and Development, 1090 Vienna, Austria;
| | - Katrin Kuhls
- Division Molecular Biotechnology and Functional Genomics, Technical University of Applied Sciences Wildau, 15745 Wildau, Germany; (K.K.); (S.S.)
- Research Platform “Models & Simulation”, Leibniz Centre for Agricultural Landscape Research (ZALF), 15374 Müncheberg, Germany
| | - Susanne Schlegel
- Division Molecular Biotechnology and Functional Genomics, Technical University of Applied Sciences Wildau, 15745 Wildau, Germany; (K.K.); (S.S.)
- Division Microsystems Engineering, Technical University of Applied Sciences Wildau, 15745 Wildau, Germany
| | - Martina Köhsler
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria; (E.K.); (M.K.)
| | - Wolfgang Poeppl
- Department of Dermatology and Tropical Medicine, Military Medical Cluster East, Austrian Armed Forces, 1210 Vienna, Austria; (W.P.); (G.M.)
| | - Karin Bakran-Lebl
- Department of Pathobiology, Institute of Parasitology, University of Veterinary Medicine Vienna, 1210 Vienna, Austria; (K.B.-L.); (H.-P.F.)
| | - Hans-Peter Fuehrer
- Department of Pathobiology, Institute of Parasitology, University of Veterinary Medicine Vienna, 1210 Vienna, Austria; (K.B.-L.); (H.-P.F.)
| | - Věra Volfová
- Department of Parasitology, Faculty of Science, Charles University Prague, 128 43 Prague, Czech Republic; (V.D.); (V.V.); (P.V.)
| | - Gerhard Mooseder
- Department of Dermatology and Tropical Medicine, Military Medical Cluster East, Austrian Armed Forces, 1210 Vienna, Austria; (W.P.); (G.M.)
| | - Vladimir Ivovic
- Department of Biodiversity, FAMNIT, University of Primorska, 6000 Koper-Capodistria, Slovenia;
| | - Petr Volf
- Department of Parasitology, Faculty of Science, Charles University Prague, 128 43 Prague, Czech Republic; (V.D.); (V.V.); (P.V.)
| | - Julia Walochnik
- Institute of Specific Prophylaxis and Tropical Medicine, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria; (E.K.); (M.K.)
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14
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Ahmadi-Hamedani M, Hosseinpour H, Eskafian H, Davarpanah S. The Hematological and Biochemical Manifestations of Cutaneous Leishmaniasis in a Shih Tzu-Terrier Dog with Severe Infection: A Case Report. IRANIAN JOURNAL OF PARASITOLOGY 2020; 15:457-462. [PMID: 33082813 PMCID: PMC7548457 DOI: 10.18502/ijpa.v15i3.4213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Cutaneous involvement in canine leishmaniasis, caused by Leishmania infantum, is the most frequent clinical manifestation of the zoonotic infectious disease. A 4-month-old female Shih Tzu-terrier dog with significant weight loss and depression and chronic erosive skin lesions around eyes and the area above the nose was presented to the Semnan University Veterinary Hospital teaching, Semnan, Iran. The main clinicopathological findings included marked leukocytosis, neutrophilia, left shift, monocytosis, mild hypoproteinemia, and hypoalbuminemia. The diagnosis of leishmaniasis was performed based on the presence of a large number of Leishmania amastigotes in skin Fine Needle Aspiration (FNA). The dog was euthanized and sent to the autopsy department for further investigation.
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Affiliation(s)
- Mahmooud Ahmadi-Hamedani
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Semnan University, Semnan, Iran
| | | | - Hesamodin Eskafian
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Semnan University, Semnan, Iran
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15
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Oerther S, Jöst H, Heitmann A, Lühken R, Krüger A, Steinhausen I, Brinker C, Lorentz S, Marx M, Schmidt-Chanasit J, Naucke T, Becker N. Phlebotomine sand flies in Southwest Germany: an update with records in new locations. Parasit Vectors 2020; 13:173. [PMID: 32312300 PMCID: PMC7171781 DOI: 10.1186/s13071-020-04058-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 04/01/2020] [Indexed: 12/20/2022] Open
Abstract
Background Vector-borne diseases (VBD) are of growing global importance. Sand flies are potential vectors for phleboviruses (family Phenuiviridae) including Toscana virus (TOSV), Sicilian virus, Sandfly fever, Naples virus, and Leishmania parasites in Europe. To date, only two phlebotomine species have been recorded for Germany: Phlebotomus perniciosus and Phlebotomus mascittii. This study updates the distribution and abundance of the two occurring species. Methods An entomological field study was carried out during 2015–2018 to assess the abundance of sand flies in Southwest Germany within the federal states Baden-Wuerttemberg (BW) and Rhineland-Palatinate (RLP). A total of 176 collection sites were examined using CDC light traps. Results A total of 149 individuals of P. mascittii were collected. During 2015–2018, P. mascittii was found at all sites known positive from previous studies and was detected at 15 additional sites previously unknown for the presence of sand flies. Although the environment has changed considerably in 30 years, no significant difference in sand fly dynamics and distribution was found. Phlebotomus perniciosus has only been trapped once since 2001. Conclusions This study showed that sand flies occur in different areas in Southern Germany where they had not been recorded previously. Therefore, it can be assumed that they are more widespread than expected. In addition, sand flies could be found over several years at the same trapping sites, indicating population stability. This supports the need for continued surveillance of possible vector populations and urgent clarification of the vector competence of P. mascittii.![]()
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Affiliation(s)
- Sandra Oerther
- Institute of Global Health, Heidelberg University, Heidelberg, Germany.,German Mosquito Control Association (KABS), Speyer, Germany.,Institute for Dipterology (IfD), Speyer, Germany
| | - Hanna Jöst
- Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
| | - Anna Heitmann
- Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany.,Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald-Insel Riems, Germany
| | - Renke Lühken
- Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany.,Faculty of Mathematics, Informatics and Natural Sciences, University Hamburg, Hamburg, Germany
| | - Andreas Krüger
- Bundeswehr Hospital Hamburg-Branch Tropical Microbiology & Entomology, Hamburg, Germany
| | | | | | | | - Michael Marx
- Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | - Jonas Schmidt-Chanasit
- Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany.,Faculty of Mathematics, Informatics and Natural Sciences, University Hamburg, Hamburg, Germany
| | - Torsten Naucke
- Parasitus Ex e.V., Niederkassel, Germany. .,Laboklin GmbH & Co. KG, Bad Kissingen, Germany.
| | - Norbert Becker
- German Mosquito Control Association (KABS), Speyer, Germany.,Institute for Dipterology (IfD), Speyer, Germany
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16
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Martín-Sánchez J, Torres-Medina N, Corpas-López V, Morillas-Márquez F, Díaz-Sáez V. Vertical transmission may play a greater role in the spread of Leishmania infantum in synanthropic Mus musculus rodents than previously believed. Transbound Emerg Dis 2019; 67:1113-1118. [PMID: 31765072 DOI: 10.1111/tbed.13436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 11/05/2019] [Accepted: 11/20/2019] [Indexed: 12/27/2022]
Abstract
Vertical transmission of Leishmania infantum was demonstrated in domestic mice captured close to the home of a patient with leishmaniasis. Leishmania infantum DNA was detected in 88.9% of synanthropic Mus musculus adult rodents and 29.2% of their unborn foetuses. Mother-to-infant transmission was observed in all females whose gestational stage was sufficiently advanced to allow foetal analysis (foetal length 2-2.5 cm). The infection rate in foetal samples ranged from 11.1% to 50.0%, with parasite loads of up to 6,481 parasites/5 mg tissue. A low density of Phlebotomus perniciosus was also found (0.2 specimen/CDC trap). Six infected mice captured in March were only 1.5 months old and could thus not have had contact with the vector. Vertical transmission thus appears to play a greater role in the spread of leishmaniasis than previously thought, particularly since rodents are natural hosts for the parasite and are prolific in nature.
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Affiliation(s)
- Joaquina Martín-Sánchez
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Granada, Campus Universitario de Cartuja, Granada, Spain
| | - Nieves Torres-Medina
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Granada, Campus Universitario de Cartuja, Granada, Spain
| | - Victoriano Corpas-López
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Granada, Campus Universitario de Cartuja, Granada, Spain
| | - Francisco Morillas-Márquez
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Granada, Campus Universitario de Cartuja, Granada, Spain
| | - Victoriano Díaz-Sáez
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Granada, Campus Universitario de Cartuja, Granada, Spain
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17
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Cazan CD, Păstrav IR, Györke A, Oguz G, Alten B, Mihalca AD. Seasonal dynamics of a population of Phlebotomus (Larroussius) perfiliewi Parrot, 1930 (Diptera: Psychodidae) in North-Eastern Romania. Parasitol Res 2019; 118:1371-1384. [PMID: 30911912 DOI: 10.1007/s00436-019-06296-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 03/14/2019] [Indexed: 01/21/2023]
Abstract
Sand flies were collected in a location from Romania in order to estimate their abundance and seasonal variation in correlation with environmental and anthropic factors. From May to October 2017, eight premises with different animal species were sampled for sand flies in a household from Fundătura village, Vaslui County, in North-Eastern Romania. Animal-related data, shelter-related data, and climatic parameters were recorded. All (n = 150) collected sand flies were Phlebotomus perfiliewi. A mono-modal type of abundance trend has been recorded (a single peak at the beginning of August). The first day of capture was in mid-July. The total number of females during the peak season was significantly higher than the total number of males. The highest percentage of males was recorded at the beginning and at the end of the sand fly activity. Only the traps placed in the poultry enclosure built from clay and wood were positive. A strong positive correlation was recorded between the total number of collected sand flies and the minimum and the maximum temperature. The analysis of the climatic data shows that the first presence of sand flies was registered only after the average minimum temperature for the previous 7 days was above 15 °C.
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Affiliation(s)
- Cristina Daniela Cazan
- Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania.
| | - Ioana Raluca Păstrav
- Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Adriana Györke
- Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Gizem Oguz
- Department of Biology, Ecology Section, Faculty of Science, VERG Laboratories, Hacettepe University, Ankara, Turkey
| | - Bulent Alten
- Department of Biology, Ecology Section, Faculty of Science, VERG Laboratories, Hacettepe University, Ankara, Turkey
| | - Andrei Daniel Mihalca
- Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
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18
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Ferreira‐Silva MM, Teixeira LAS, Tibúrcio MS, Pereira GA, Rodrigues V, Palis M, Afonso P, Alves M, Feitosa JM, Urias E, Santos EM, Carvalho SFG, Moraes‐Souza H. Socio‐epidemiological characterisation of blood donors with asymptomaticLeishmania infantuminfection from three Brazilian endemic regions and analysis of the transfusional transmission risk of visceral leishmaniasis. Transfus Med 2018; 28:433-439. [DOI: 10.1111/tme.12553] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 07/16/2018] [Accepted: 07/25/2018] [Indexed: 11/26/2022]
Affiliation(s)
| | | | - M. S. Tibúrcio
- Federal University of the Triângulo Mineiro, MG Uberaba Brazil
| | - G. A. Pereira
- Federal University of the Triângulo Mineiro, MG Uberaba Brazil
| | - V. Rodrigues
- Federal University of the Triângulo Mineiro, MG Uberaba Brazil
| | - M. Palis
- Hemocenter Foundation of Piauí – Hemopi Teresina Brazil
| | - P. Afonso
- Hemocenter Foundation of Piauí – Hemopi Teresina Brazil
| | - M. Alves
- Hemocenter Foundation of Ceará‐ HEMOCE Fortaleza Brazil
| | - J. M. Feitosa
- Hemocenter Foundation of Ceará‐ HEMOCE Fortaleza Brazil
| | - E. Urias
- Regional Hemocenter of Montes Claros, MG Montes Claros Brazil
| | - E. M. Santos
- Regional Hemocenter of Montes Claros, MG Montes Claros Brazil
| | | | - H. Moraes‐Souza
- Federal University of the Triângulo Mineiro, MG Uberaba Brazil
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19
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Galindo-Sevilla N, Mancilla-Ramírez J. T-cell tolerance as a potential effect of congenital leishmaniasis on offspring immunity. Parasite Immunol 2018; 41:e12540. [PMID: 29888463 DOI: 10.1111/pim.12540] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 05/29/2018] [Indexed: 12/16/2022]
Abstract
Congenital transmission of leishmaniasis is recognized in cases detected by passive surveillance. Most cases are from low-resource countries, limiting the study of several important aspects of this route of infection, including the offspring's immune response. Studies on natural and experimentally infected animals suggest that parasites might be transmitted to the embryo or foetus at any time during pregnancy. As immune system undergoes sequential stages of development, an infection before the time of self-recognition could lead to central tolerance, making an individual specifically tolerant and susceptible to infection. In the alternative scenario, infection after self-recognition would allow the proper development of T-lymphocyte clones in response to Leishmania antigens, providing resistance to the disease. Newborns undergo a transient period of low expression of several immune surface molecules and a naïve adaptive immune response with no memory, which together might contribute to slow elimination of the parasite over several months. This insight is a proposed independent mechanism of the previously proven T-cell exhaustion and must be investigated. Analyses of infected placenta, cord blood and infant immunity are required for a better understanding of immunity in congenital leishmaniasis infection.
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Affiliation(s)
- N Galindo-Sevilla
- Departamento de Infectología e Inmunología, Instituto Nacional de Perinatología, Secretaria de Salud, Mexico City, Mexico
| | - J Mancilla-Ramírez
- Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico.,Hospital de la Mujer, Secretaria de Salud, Mexico City, Mexico
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20
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Messlinger H, Sebald H, Heger L, Dudziak D, Bogdan C, Schleicher U. Monocyte-Derived Signals Activate Human Natural Killer Cells in Response to Leishmania Parasites. Front Immunol 2018; 9:24. [PMID: 29472914 PMCID: PMC5810259 DOI: 10.3389/fimmu.2018.00024] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 01/04/2018] [Indexed: 12/21/2022] Open
Abstract
Activated natural killer (NK) cells release interferon (IFN)-γ, which is crucial for the control of intracellular pathogens such as Leishmania. In contrast to experimental murine leishmaniasis, the human NK cell response to Leishmania is still poorly characterized. Here, we investigated the interaction of human blood NK cells with promastigotes of different Leishmania species (Leishmania major, Leishmania mexicana, Leishmania infantum, and Leishmania donovani). When peripheral blood mononuclear cells or purified NK cells and monocytes (all derived from healthy blood donors from Germany without a history of leishmaniasis) were exposed to promastigotes, NK cells showed increased surface expression of the activation marker CD69. The extent of this effect varied depending on the Leishmania species; differences between dermotropic and viscerotropic L. infantum strains were not observed. Upregulation of CD69 required direct contact between monocytes and Leishmania and was partly inhibitable by anti-interleukin (IL)-18. Unexpectedly, IL-18 was undetectable in most of the supernatants (SNs) of monocyte/parasite cocultures. Confocal fluorescence microscopy of non-permeabilized cells revealed that Leishmania-infected monocytes trans-presented IL-18 to NK cells. Native, but not heat-treated SNs of monocyte/Leishmania cocultures also induced CD69 on NK cells, indicating the involvement of a soluble heat-labile factor other than IL-18. A role for the NK cell-activating cytokines IL-1β, IL-2, IL-12, IL-15, IL-21, and IFN-α/β was excluded. The increase of CD69 was not paralleled by NK cell IFN-γ production or enhanced cytotoxicity. However, prior exposure of NK cells to Leishmania parasites synergistically increased their IFN-γ release in response to IL-12, which was dependent on endogenous IL-18. CD1c+ dendritic cells were identified as possible source of Leishmania-induced IL-12. Finally, we observed that direct contact between Leishmania and NK cells reduced the expression of CD56 mRNA and protein on NK cells. We conclude that Leishmania activate NK cells via trans-presentation of IL-18 by monocytes and by a monocyte-derived soluble factor. IL-12 is needed to elicit the IFN-γ-response of NK cells, which is likely to be an important component of the innate control of the parasite.
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Affiliation(s)
- Helena Messlinger
- Mikrobiologisches Institut – Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Heidi Sebald
- Mikrobiologisches Institut – Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Lukas Heger
- Laboratory of DC Biology, Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Diana Dudziak
- Laboratory of DC Biology, Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
- Medical Immunology Campus Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Christian Bogdan
- Mikrobiologisches Institut – Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
- Medical Immunology Campus Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Ulrike Schleicher
- Mikrobiologisches Institut – Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
- Medical Immunology Campus Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
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21
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Silvestrini P, Batchelor D, Allenspach K, Maunder C, Seth M, Mas A, Hill T, Serrano G, Roura X, Planellas M, German AJ, Pastor J. Clinical leishmaniasis in dogs living in the UK. J Small Anim Pract 2016; 57:453-8. [PMID: 27251904 DOI: 10.1111/jsap.12503] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Revised: 03/15/2016] [Accepted: 03/18/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To investigate the prevalence of leishmaniasis in dogs in the UK and to describe clinical presentation, clinicopathological abnormalities, therapeutic protocols and outcome in this non-endemic country. MATERIALS AND METHODS Medical records of dogs diagnosed with leishmaniasis at seven referral centres in the UK were retrospectively reviewed. RESULTS The prevalence was between 0·007 and 0·04% with a higher number of cases in southern England. All dogs had a history of travel to or from an endemic country. Lethargy, dermatological disease, decreased appetite and lameness were the most common reasons for presentation. Allopurinol was used alone for treatment in the majority of cases. CLINICAL SIGNIFICANCE Although rare, leishmaniasis should be considered in dogs in the UK if they have compatible clinical signs and history of travel to or from endemic areas.
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Affiliation(s)
- P Silvestrini
- Department of Small Animal Internal Medicine, School of Veterinary Science, University of Liverpool, Neston CH64 7TE
| | - D Batchelor
- Department of Small Animal Internal Medicine, School of Veterinary Science, University of Liverpool, Neston CH64 7TE
| | - K Allenspach
- Department of Veterinary Clinical Services, Royal Veterinary College of London, North Mymms, Herts NW1 0TU
| | - C Maunder
- Department of Small Animal Medicine, University of Bristol, Bristol, North Somerset BS40 5DU
| | - M Seth
- Department of Small Animal Internal Medicine, Animal Health Trust, Newmarket, Suffolk CB8 7UU
| | - A Mas
- Anderson Moores Veterinary Specialists Ltd, Winchester SO212LL
| | - T Hill
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh EH25 9RG
| | - G Serrano
- Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES
| | - X Roura
- Hospital Clinic Veterinari, Universitat Autonoma de Barcelona, 08193 Barcelona, Spain
| | - M Planellas
- Hospital Clinic Veterinari, Universitat Autonoma de Barcelona, 08193 Barcelona, Spain
| | - A J German
- Department of Small Animal Internal Medicine, School of Veterinary Science, University of Liverpool, Neston CH64 7TE
| | - J Pastor
- Hospital Clinic Veterinari, Universitat Autonoma de Barcelona, 08193 Barcelona, Spain
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22
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Tsirigotakis N, Christodoulou V, Ntais P, Mazeris A, Koutala E, Messaritakis I, Antoniou M. Geographical Distribution of MDR1 Expression in Leishmania Isolates, from Greece and Cyprus, Measured by the Rhodamine-123 Efflux Potential of the Isolates, Using Flow Cytometry. Am J Trop Med Hyg 2016; 94:987-92. [PMID: 27001764 DOI: 10.4269/ajtmh.15-0658] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 01/05/2016] [Indexed: 11/07/2022] Open
Abstract
Leishmaniasis, a neglected vector-borne disease caused by the protozoan parasite Leishmania, is encountered in 98 countries causing serious concerns to public health. The most alarming is the development of parasite drug resistance, a phenomenon increasingly encountered in the field rendering chemotherapy ineffective. Although resistance to drugs is a complex phenomenon, the rate of efflux of the fluorescent dye Rhodamine-123 from the parasite body, using flow cytometry, is an indication of the isolate's ability to efflux the drug, thus avoiding death. The rate of efflux measured 275 Leishmania strains, isolated from patients and dogs from Greece and Cyprus, was measured and mapped to study the geographical distribution of the multidrug resistance (MDR) gene expression as an indication of the drug resistance of the parasite. The map showed that out of the seven prefectures, where dogs presented high efflux rates, five also had patients with high efflux rates. In one, out of the 59 prefectures studied, the highest number of isolates with efflux slope α > 1, in both human and dog isolates, was found; a fact which may suggest that spread of drug resistance is taking place. The virulence of the Leishmania strains, assessed after infecting human macrophages of the THP-1 cell line, fluctuated from 1% to 59.3% with only 2.5% of the isolates showing infectivity > 50%. The most virulent strains were isolated from Attica and Crete.
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Affiliation(s)
- Nikolaos Tsirigotakis
- Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, Crete, Greece; Veterinary Services of Cyprus, Nicosia, Cyprus; Veterinary Services of Lasithi prefecture, Crete, Greece; Laboratory of Flow Cytometry, Faculty of Medicine, University of Crete, Crete, Greece
| | - Vasiliki Christodoulou
- Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, Crete, Greece; Veterinary Services of Cyprus, Nicosia, Cyprus; Veterinary Services of Lasithi prefecture, Crete, Greece; Laboratory of Flow Cytometry, Faculty of Medicine, University of Crete, Crete, Greece
| | - Pantelis Ntais
- Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, Crete, Greece; Veterinary Services of Cyprus, Nicosia, Cyprus; Veterinary Services of Lasithi prefecture, Crete, Greece; Laboratory of Flow Cytometry, Faculty of Medicine, University of Crete, Crete, Greece
| | - Apostolos Mazeris
- Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, Crete, Greece; Veterinary Services of Cyprus, Nicosia, Cyprus; Veterinary Services of Lasithi prefecture, Crete, Greece; Laboratory of Flow Cytometry, Faculty of Medicine, University of Crete, Crete, Greece
| | - Eleni Koutala
- Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, Crete, Greece; Veterinary Services of Cyprus, Nicosia, Cyprus; Veterinary Services of Lasithi prefecture, Crete, Greece; Laboratory of Flow Cytometry, Faculty of Medicine, University of Crete, Crete, Greece
| | - Ippokratis Messaritakis
- Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, Crete, Greece; Veterinary Services of Cyprus, Nicosia, Cyprus; Veterinary Services of Lasithi prefecture, Crete, Greece; Laboratory of Flow Cytometry, Faculty of Medicine, University of Crete, Crete, Greece
| | - Maria Antoniou
- Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, Crete, Greece; Veterinary Services of Cyprus, Nicosia, Cyprus; Veterinary Services of Lasithi prefecture, Crete, Greece; Laboratory of Flow Cytometry, Faculty of Medicine, University of Crete, Crete, Greece
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23
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Acute anuria after a family vacation to Corsica/France. Parasitol Res 2016; 115:1733-5. [PMID: 26852123 DOI: 10.1007/s00436-016-4944-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 01/26/2016] [Indexed: 01/07/2023]
Abstract
A 12-year-old male patient suffered hematuria. Histopathology of a biopsy showed granulomata suspicious for schistosomiasis. The patient had never travelled outside Europe during his entire lifetime. He had taken frequent bathes in various rivers during his last family holidays 5 months earlier in Corsica. Microfiltration of urine revealed viable ova of Schistosoma haematobium with alterated size and shape. Ultrasonography showed a large focal echopoor mass attached to the bladder roof. Four days after antihelminthic therapy, the patient suffered inferior abdominal pain and acute anuria. Ultrasound revealed an approximately 5-cm mass in the bladder lumen suspicious for a large blood clot. After taking non-invasive measures such as drinking high amounts of fluid and treating the lower abdomen with a warm water bag and massage, the clot was excreted with urine and symptoms subsided. The further course was uneventful until 11 months later when hematuria recurred. This time, parasitological urine examination confirmed non-viable schistosome ova. Hematuria was likely due to erosion of the bladder mucosa by calcified non-viable ova.
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24
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Bafghi AF, Shahcheraghi SH, Nematollahi S. Comparison of hematological aspects: Visceral leishmaniasis and healthy children. Trop Parasitol 2015; 5:133-5. [PMID: 26629459 PMCID: PMC4557155 DOI: 10.4103/2229-5070.145597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Ali Fattahi Bafghi
- Department of Medical Parasitology and Mycology, The School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed Hossein Shahcheraghi
- Department of infectious Diseases, Infectious and Tropical Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sedigheh Nematollahi
- Department of Microbiology, The International Campus, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran. E-mail:
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25
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Gebhardt M, Ertas B, Falk T, Blödorn-Schlicht N, Metze D, Böer-Auer A. Fast, sensitive and specific diagnosis of infections withLeishmaniaspp. in formalin-fixed, paraffin-embedded skin biopsies by cytochrome b polymerase chain reaction. Br J Dermatol 2015; 173:1239-49. [DOI: 10.1111/bjd.14088] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2015] [Indexed: 11/29/2022]
Affiliation(s)
- M. Gebhardt
- Dermatologikum Hamburg; Stephansplatz 5 20354 Hamburg Germany
| | - B. Ertas
- Dermatologikum Hamburg; Stephansplatz 5 20354 Hamburg Germany
| | - T.M. Falk
- Dermatologikum Hamburg; Stephansplatz 5 20354 Hamburg Germany
| | | | - D. Metze
- Department of Dermatology; Münster University; Von Esmarch Strasse 58 48149 Münster Germany
| | - A. Böer-Auer
- Dermatologikum Hamburg; Stephansplatz 5 20354 Hamburg Germany
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26
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Spread of Leishmania infantum in Europe with dog travelling. Vet Parasitol 2015; 213:2-11. [DOI: 10.1016/j.vetpar.2015.05.003] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 04/27/2015] [Accepted: 05/05/2015] [Indexed: 11/22/2022]
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27
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A case report of typical leishmaniasis in dog. J Parasit Dis 2015; 39:339-41. [PMID: 26064032 DOI: 10.1007/s12639-013-0340-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 06/19/2013] [Indexed: 10/26/2022] Open
Abstract
Leishmania spp. are vector-borne flagellates transferred by sand flies. They cause cutaneous, mucocutaneous and visceral infections in mammals, especially in humans and dogs. A mature male boxer with ulcerative nodules around his eyes and snout was referred to Small Animal Hospital, Faculty of Veterinary Medicine, University of Tehran. Multiple cutaneous lesions were seen in physical examination. Mild leukocytosis, neutrophilia, left shift, lymphopenia, and thrombocytopenia were reported by the laboratory. Diagnosis was confirmed by the observation of amastigotes in blood samples and inside tissue macrophages. The infection was treated using pentavalent antimonial drug for four weeks.
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28
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The Utility of Blood and Bone Marrow Films and Trephine Biopsy Sections in the Diagnosis of Parasitic Infections. Mediterr J Hematol Infect Dis 2015; 7:e2015039. [PMID: 26075046 PMCID: PMC4450651 DOI: 10.4084/mjhid.2015.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Accepted: 04/29/2015] [Indexed: 12/18/2022] Open
Abstract
The laboratory haematologist has a role in the diagnosis of parasitic infections. Peripheral blood examination is critical in the diagnosis of malaria, babesiosis, filariasis and trypanosomiasis. Bone marrow examination is important in the diagnosis of leishmaniasis and occasionally leads to the diagnosis of other parasitic infections. The detection of eosinophilia or iron deficiency anaemia can alert the laboratory haematologist or physician to the possibility of parasitic infection. In addition to morphological skills, an adequate clinical history is important for speedy and accurate diagnosis, particularly in non-endemic areas.
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29
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Christopoulos P, Dopfer EP, Malkovsky M, Esser PR, Schaefer HE, Marx A, Kock S, Rupp N, Lorenz MR, Schwarz K, Harder J, Martin SF, Werner M, Bogdan C, Schamel WWA, Fisch P. A novel thymoma-associated immunodeficiency with increased naive T cells and reduced CD247 expression. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2015; 194:3045-53. [PMID: 25732729 DOI: 10.4049/jimmunol.1402805] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The mechanisms underlying thymoma-associated immunodeficiency are largely unknown, and the significance of increased blood γδ Τ cells often remains elusive. In this study we address these questions based on an index patient with thymoma, chronic visceral leishmaniasis, myasthenia gravis, and a marked increase of rare γδ T cell subsets in the peripheral blood. This patient showed cutaneous anergy, even though he had normal numbers of peripheral blood total lymphocytes as well as CD4(+) and CD8(+) T cells. Despite his chronic infection, analyses of immunophenotypes and spectratyping of his lymphocytes revealed an unusual accumulation of naive γδ and αβ T cells, suggesting a generalized T cell activation defect. Functional studies in vitro demonstrated substantially diminished IL-2 and IFN-γ production following TCR stimulation of his "untouched" naive CD4(+) T cells. Biochemical analysis revealed that his γδ and αβ T cells carried an altered TCR complex with reduced amounts of the ζ-chain (CD247). No mutations were found in the CD247 gene that encodes the homodimeric ζ protein. The diminished presence of CD247 and increased numbers of γδ T cells were also observed in thymocyte populations obtained from three other thymoma patients. Thus, our findings describe a novel type of a clinically relevant acquired T cell immunodeficiency in thymoma patients that is distinct from Good's syndrome. Its characteristics are an accumulation of CD247-deficient, hyporresponsive naive γδ and αβ T cells and an increased susceptibility to infections.
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Affiliation(s)
- Petros Christopoulos
- Department of Pathology, University of Freiburg Medical Center, 79106 Freiburg, Germany
| | - Elaine P Dopfer
- Department of Molecular Immunology, BIOSS Centre for Biological Signalling Studies, Faculty of Biology, University of Freiburg Medical Center, 79106 Freiburg, Germany; Center for Chronic Immunodeficiency CCI, University of Freiburg Medical Center, 79106 Freiburg, Germany; Max-Planck-Institute of Immunobiology and Epigenetics, 79108 Freiburg, Germany
| | - Miroslav Malkovsky
- Department of Medical Microbiology and Immunology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726
| | - Philipp R Esser
- Department of Dermatology and Venereology (Allergy Research Group), University of Freiburg Medical Center, 79106 Freiburg, Germany
| | - Hans-Eckart Schaefer
- Department of Pathology, University of Freiburg Medical Center, 79106 Freiburg, Germany
| | - Alexander Marx
- Institute of Pathology, University Medical Center Mannheim, 68167 Mannheim, Germany
| | - Sylvia Kock
- Department of Pathology, University of Freiburg Medical Center, 79106 Freiburg, Germany
| | - Nicole Rupp
- Department of Pathology, University of Freiburg Medical Center, 79106 Freiburg, Germany
| | - Myriam R Lorenz
- Institute for Transfusion Medicine, University Ulm, 89081 Ulm, Germany
| | - Klaus Schwarz
- Institute for Transfusion Medicine, University Ulm, 89081 Ulm, Germany; Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service, Baden-Württemberg-Hessen, 89081 Ulm, Germany
| | - Jan Harder
- Department of Gastroenterology, University of Freiburg Medical Center, 79106 Freiburg, Germany; and
| | - Stefan F Martin
- Department of Dermatology and Venereology (Allergy Research Group), University of Freiburg Medical Center, 79106 Freiburg, Germany
| | - Martin Werner
- Department of Pathology, University of Freiburg Medical Center, 79106 Freiburg, Germany
| | - Christian Bogdan
- Institute of Clinical Microbiology, Immunology and Hygiene, Friedrich Alexander University Erlangen-Nuremberg and University Hospital Erlangen, 91054 Erlangen, Germany
| | - Wolfgang W A Schamel
- Department of Molecular Immunology, BIOSS Centre for Biological Signalling Studies, Faculty of Biology, University of Freiburg Medical Center, 79106 Freiburg, Germany; Center for Chronic Immunodeficiency CCI, University of Freiburg Medical Center, 79106 Freiburg, Germany; Max-Planck-Institute of Immunobiology and Epigenetics, 79108 Freiburg, Germany
| | - Paul Fisch
- Department of Pathology, University of Freiburg Medical Center, 79106 Freiburg, Germany;
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30
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Vilas VJDR, Maia-Elkhoury ANS, Yadon ZE, Cosivi O, Sanchez-Vazquez MJ. Visceral leishmaniasis: a One Health approach. Vet Rec 2014; 175:42-4. [PMID: 25013197 DOI: 10.1136/vr.g4378] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Victor J Del Rio Vilas
- Communicable Diseases and Health Analysis, Panaftosa, Pan American Health Organization, Duque de Caxias, Rio de Janeiro, Brazil
| | - Ana N S Maia-Elkhoury
- Communicable Diseases and Health Analysis, Panaftosa, Pan American Health Organization, Duque de Caxias, Rio de Janeiro, Brazil
| | - Zaida E Yadon
- Communicable Diseases and Health Analysis, Panaftosa, Pan American Health Organization, Duque de Caxias, Rio de Janeiro, Brazil
| | - Ottorino Cosivi
- Communicable Diseases and Health Analysis, Panaftosa, Pan American Health Organization, Duque de Caxias, Rio de Janeiro, Brazil
| | - Manuel J Sanchez-Vazquez
- Communicable Diseases and Health Analysis, Panaftosa, Pan American Health Organization, Duque de Caxias, Rio de Janeiro, Brazil
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31
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Hemophagocytic lymphohistiocytosis in imported pediatric visceral leishmaniasis in a nonendemic area. J Pediatr 2014; 165:147-153.e1. [PMID: 24797953 DOI: 10.1016/j.jpeds.2014.03.047] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 02/28/2014] [Accepted: 03/26/2014] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To describe characteristics of visceral leishmaniasis-associated hemophagocytic lymphohistiocytosis (HLH) with focus on diagnostic clues and pitfalls, including the frequency of central nervous system (CNS) involvement, and to determine the efficacy of liposomal amphotericin B (L-AmB). STUDY DESIGN We retrospectively analyzed clinical and laboratory features, diagnostic procedures, and treatment of 13 patients with HLH with imported visceral leishmaniasis, reported to the German HLH reference center (1999-2012). RESULTS The spectrum of presentations was indistinguishable from patients with hereditary HLH or with acquired HLH because of infections with other pathogens. In 8 patients, disease onset occurred before the age of 2 years, coinciding with the typical age of manifestation of primary HLH. Two patients had mild nonspecific CNS findings. Misleading antiviral IgM (n = 6) and autoantibodies (n = 2) led to inaccurate interpretation of the etiology of HLH, sometimes with inappropriate therapeutic consequences. False negative results for Leishmania were obtained by initial bone marrow microscopy in 6/13, serology in 1/12, bone marrow culture in 2/5, and polymerase chain reaction of peripheral blood in 1/3 patients, and all bone marrow samples tested were Leishmania-positive by polymerase chain reaction (n = 7). L-AmB was administered to 12 patients, 5 of whom had no prior HLH-directed immunosuppressive therapy; sodium stibogluconate was administered to 1 patient. Persistent remission was achieved in 11 cases. Two patients required repeated or prolonged L-AmB therapy. CONCLUSIONS Awareness of diagnostic pitfalls may save patients from unnecessary toxic treatment. CNS involvement is rare. L-AmB shows efficacy in visceral leishmaniasis-associated HLH.
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32
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Sifaki-Pistola D, Ntais P, Christodoulou V, Mazeris A, Antoniou M. The use of spatial analysis to estimate the prevalence of canine leishmaniasis in Greece and Cyprus to predict its future variation and relate it to human disease. Am J Trop Med Hyg 2014; 91:336-41. [PMID: 24957543 DOI: 10.4269/ajtmh.13-0459] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Climatic, environmental, and demographic changes favor the emergence of neglected vector-borne diseases like leishmaniasis, which is spreading through dogs, the principle host of the protozoan Leishmania infantum. Surveillance of the disease in dogs is important, because the number of infected animals in an area determines the local risk of human infection. However, dog epidemiological studies are costly. Our aim was to evaluate the Emerging Diseases in a Changing European Environment (EDEN) veterinary questionnaire as a cost-effective tool in providing reliable, spatially explicit indicators of canine leishmaniasis prevalence. For this purpose, the data from the questionnaire were compared with data from two epidemiological studies on leishmaniasis carried out in Greece and Cyprus at the same time using statistical methods and spatial statistics. Although the questionnaire data cannot provide a quantitative measure of leishmaniasis in an area, it indicates the dynamic of the disease; information is obtained in a short period of time at low cost.
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Affiliation(s)
- Dimitra Sifaki-Pistola
- Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece; Veterinary Services of Cyprus, Nicosia, Cyprus
| | - Pantelis Ntais
- Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece; Veterinary Services of Cyprus, Nicosia, Cyprus
| | - Vasiliki Christodoulou
- Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece; Veterinary Services of Cyprus, Nicosia, Cyprus
| | - Apostolos Mazeris
- Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece; Veterinary Services of Cyprus, Nicosia, Cyprus
| | - Maria Antoniou
- Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece; Veterinary Services of Cyprus, Nicosia, Cyprus
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33
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Maciel DB, Silva TAM, Gomes LI, de Oliveira E, Tibúrcio MGS, de Oliveira RF, Avelar D, Barbosa JR, Furtado E, Rabello A, Silva LDA. Infection with Leishmania (Leishmania) infantum of 0 to 18-Month-old children living in a visceral leishmaniasis-endemic area in Brazil. Am J Trop Med Hyg 2014; 91:329-35. [PMID: 24935952 DOI: 10.4269/ajtmh.13-0418] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The diagnosis of Leishmania (Leishmania) infantum infection in children from birth may serve as a reference for the early identification of cases that would progress to classical visceral leishmaniasis (VL) in endemic areas. This study prospectively evaluated newborns of mothers living in the municipality of Paracatu, Minas Gerais, Brazil. The infants were followed up at 6-month intervals by clinical examination, serological tests (immunofluorescence [IIF] and enzyme-linked immunosorbent assay with rK39 [ELISA-rK39]) and polymerase chain reaction (PCR) until they had completed 18 months of age. A total of 166 pregnant women were included to evaluate the possible transfer of antibodies or even congenital transmission. Twenty-two of the women tested positive by IIF, four by ELISA-rK39, and one by PCR. Three infants of the 25 women with some positive test results were also positive in the first test (one by IIF, one by ELISA-rK39, and the third by ELISA-rK39 and PCR). One hundred and sixty infants were included in the study; of these, 43 had at least one positive sample over time. However, agreement between tests was low. Follow-up of children with a positive result in the tests studied revealed no progression to classical disease within a period of 18 months. In contrast, two children with negative IIF, PCR, and ELISA-rK39 results developed classical VL at 9 and 12 months of age. In conclusion, a positive test result was variable and sometimes temporary and agreement between tests was low. Therefore, the early diagnosis of Leishmania infection was not associated with the early identification of cases that would progress to classical VL in the endemic area studied.
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Affiliation(s)
- Danielle Borges Maciel
- Pós-graduação em Medicina Tropical e Infectologia da Universidade Federal do Triângulo Mineiro, Uberaba, Brasil; Fundação Ezequiel Dias, Belo Horizonte, Brasil; Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou (CPqRR), Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Brasil
| | - Thaís Almeida M Silva
- Pós-graduação em Medicina Tropical e Infectologia da Universidade Federal do Triângulo Mineiro, Uberaba, Brasil; Fundação Ezequiel Dias, Belo Horizonte, Brasil; Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou (CPqRR), Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Brasil
| | - Luciana Inácia Gomes
- Pós-graduação em Medicina Tropical e Infectologia da Universidade Federal do Triângulo Mineiro, Uberaba, Brasil; Fundação Ezequiel Dias, Belo Horizonte, Brasil; Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou (CPqRR), Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Brasil
| | - Edward de Oliveira
- Pós-graduação em Medicina Tropical e Infectologia da Universidade Federal do Triângulo Mineiro, Uberaba, Brasil; Fundação Ezequiel Dias, Belo Horizonte, Brasil; Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou (CPqRR), Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Brasil
| | - Monique Gomes Salles Tibúrcio
- Pós-graduação em Medicina Tropical e Infectologia da Universidade Federal do Triângulo Mineiro, Uberaba, Brasil; Fundação Ezequiel Dias, Belo Horizonte, Brasil; Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou (CPqRR), Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Brasil
| | - Rafael Faria de Oliveira
- Pós-graduação em Medicina Tropical e Infectologia da Universidade Federal do Triângulo Mineiro, Uberaba, Brasil; Fundação Ezequiel Dias, Belo Horizonte, Brasil; Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou (CPqRR), Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Brasil
| | - Daniel Avelar
- Pós-graduação em Medicina Tropical e Infectologia da Universidade Federal do Triângulo Mineiro, Uberaba, Brasil; Fundação Ezequiel Dias, Belo Horizonte, Brasil; Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou (CPqRR), Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Brasil
| | - José Ronaldo Barbosa
- Pós-graduação em Medicina Tropical e Infectologia da Universidade Federal do Triângulo Mineiro, Uberaba, Brasil; Fundação Ezequiel Dias, Belo Horizonte, Brasil; Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou (CPqRR), Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Brasil
| | - Eliana Furtado
- Pós-graduação em Medicina Tropical e Infectologia da Universidade Federal do Triângulo Mineiro, Uberaba, Brasil; Fundação Ezequiel Dias, Belo Horizonte, Brasil; Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou (CPqRR), Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Brasil
| | - Ana Rabello
- Pós-graduação em Medicina Tropical e Infectologia da Universidade Federal do Triângulo Mineiro, Uberaba, Brasil; Fundação Ezequiel Dias, Belo Horizonte, Brasil; Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou (CPqRR), Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Brasil
| | - Luciana de Almeida Silva
- Pós-graduação em Medicina Tropical e Infectologia da Universidade Federal do Triângulo Mineiro, Uberaba, Brasil; Fundação Ezequiel Dias, Belo Horizonte, Brasil; Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou (CPqRR), Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, Brasil
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34
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Roatt BM, Aguiar-Soares RDDO, Coura-Vital W, Ker HG, Moreira NDD, Vitoriano-Souza J, Giunchetti RC, Carneiro CM, Reis AB. Immunotherapy and Immunochemotherapy in Visceral Leishmaniasis: Promising Treatments for this Neglected Disease. Front Immunol 2014; 5:272. [PMID: 24982655 PMCID: PMC4055865 DOI: 10.3389/fimmu.2014.00272] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 05/27/2014] [Indexed: 11/25/2022] Open
Abstract
Leishmaniasis has several clinical forms: self-healing or chronic cutaneous leishmaniasis or post-kala-azar dermal leishmaniasis; mucosal leishmaniasis; visceral leishmaniasis (VL), which is fatal if left untreated. The epidemiology and clinical features of VL vary greatly due to the interaction of multiple factors including parasite strains, vectors, host genetics, and the environment. Human immunodeficiency virus infection augments the severity of VL increasing the risk of developing active disease by 100–2320 times. An effective vaccine for humans is not yet available. Resistance to chemotherapy is a growing problem in many regions, and the costs associated with drug identification and development, make commercial production for leishmaniasis, unattractive. The toxicity of currently drugs, their long treatment course, and limited efficacy are significant concerns. For cutaneous disease, many studies have shown promising results with immunotherapy/immunochemotherapy, aimed to modulate and activate the immune response to obtain a therapeutic cure. Nowadays, the focus of many groups centers on treating canine VL by using vaccines and immunomodulators with or without chemotherapy. In human disease, the use of cytokines like interferon-γ associated with pentavalent antimonials demonstrated promising results in patients that did not respond to conventional treatment. In mice, immunomodulation based on monoclonal antibodies to remove endogenous immunosuppressive cytokines (interleukin-10) or block their receptors, antigen-pulsed syngeneic dendritic cells, or biological products like Pam3Cys (TLR ligand) has already been shown as a prospective treatment of the disease. This review addresses VL treatment, particularly immunotherapy and/or immunochemotherapy as an alternative to conventional drug treatment in experimental models, canine VL, and human disease.
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Affiliation(s)
- Bruno Mendes Roatt
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto , Ouro Preto , Brazil ; Laboratório de Pesquisas Clínicas, Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto , Ouro Preto , Brazil ; Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais , Belo Horizonte , Brazil
| | | | - Wendel Coura-Vital
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto , Ouro Preto , Brazil ; Laboratório de Pesquisas Clínicas, Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto , Ouro Preto , Brazil
| | - Henrique Gama Ker
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto , Ouro Preto , Brazil ; Laboratório de Pesquisas Clínicas, Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto , Ouro Preto , Brazil
| | - Nádia das Dores Moreira
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto , Ouro Preto , Brazil
| | - Juliana Vitoriano-Souza
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto , Ouro Preto , Brazil
| | - Rodolfo Cordeiro Giunchetti
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto , Ouro Preto , Brazil ; Laboratório de Biologia das Interações Celulares, Departamento de Morfologia, Universidade Federal de Minas Gerais , Belo Horizonte , Brazil
| | - Cláudia Martins Carneiro
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto , Ouro Preto , Brazil ; Laboratório de Pesquisas Clínicas, Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto , Ouro Preto , Brazil
| | - Alexandre Barbosa Reis
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto , Ouro Preto , Brazil ; Laboratório de Pesquisas Clínicas, Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto , Ouro Preto , Brazil ; Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais , Belo Horizonte , Brazil
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Medlock JM, Hansford KM, Van Bortel W, Zeller H, Alten B. A summary of the evidence for the change in European distribution of phlebotomine sand flies (Diptera: Psychodidae) of public health importance. JOURNAL OF VECTOR ECOLOGY : JOURNAL OF THE SOCIETY FOR VECTOR ECOLOGY 2014; 39:72-7. [PMID: 24820558 DOI: 10.1111/j.1948-7134.2014.12072.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 11/05/2013] [Indexed: 05/07/2023]
Abstract
The phlebotomine sand flies (Diptera: Psychodidae, Phlebotominae) are vectors of several infectious pathogens. The presence of a sand fly vector is considered to be a risk factor for the emergence of leishmaniasis in temperate Europe. Hence, the occurrence of phlebotomine sand flies and any changes in their distribution is important in determining the potential change in distribution of leishmaniasis in Europe. Therefore, published evidence for a changing distribution of the important phlebotomine sand fly vectors of leishmaniasis and phlebovirus infection in Europe is reviewed. This paper presents evidence of an increasing risk of establishment by sand fly species, especially for the Atlantic Coast and inland parts of Germany, Switzerland, and Austria. In addition to detection in potentially appropriate areas, the findings show areas of potential future establishment of the species. The most important and urgent necessity within the community of entomologists working on phlebotomines is the need to record the extremes of distribution of each species and obtain data on their regional presence/absence along with increased sharing of the data throughout European projects.
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Affiliation(s)
- Jolyon M Medlock
- Medical Entomology group, Emergency Response Department, Public Health England, Porton Down, Salisbury, Wiltshire, United Kingdom.
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Douvoyiannis M, Khromachou T, Byers N, Hargreaves J, Murray HW. Cutaneous leishmaniasis in North Dakota. Clin Infect Dis 2014; 59:e73-5. [PMID: 24850800 DOI: 10.1093/cid/ciu386] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
In the United States, autochthonous cutaneous leishmaniasis caused by infection with Leishmania mexicana has been reported from Texas and Oklahoma. Here, we describe a child with 2 new features: cutaneous infection acquired outside of the south-central United States (in North Dakota) and infection caused by Leishmania donovani species complex.
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Affiliation(s)
| | | | - Norman Byers
- Department of Ophthalmology, Altru Health System, Grand Forks, North Dakota Department of Ophthalmology
| | - James Hargreaves
- Division ofInfectious Diseases Division of Infectious Diseases, University of North Dakota School of Medicine, Grand Forks
| | - Henry W Murray
- Division of Infectious Diseases, Weill Cornell Medical College, New York, New York
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Melaun C, Krüger A, Werblow A, Klimpel S. New record of the suspected leishmaniasis vector Phlebotomus (Transphlebotomus) mascittii Grassi, 1908 (Diptera: Psychodidae: Phlebotominae) — the northernmost phlebotomine sandfly occurrence in the Palearctic region. Parasitol Res 2014; 113:2295-301. [DOI: 10.1007/s00436-014-3884-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 03/24/2014] [Indexed: 11/24/2022]
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Leishmaniasis acquired by travellers to endemic regions in Europe: A EuroTravNet multi-centre study. Travel Med Infect Dis 2014; 12:167-72. [DOI: 10.1016/j.tmaid.2013.12.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 12/02/2013] [Accepted: 12/03/2013] [Indexed: 01/09/2023]
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Haeberlein S, Fischer D, Thomas SM, Schleicher U, Beierkuhnlein C, Bogdan C. First assessment for the presence of phlebotomine vectors in Bavaria, Southern Germany, by combined distribution modeling and field surveys. PLoS One 2013; 8:e81088. [PMID: 24260539 PMCID: PMC3832422 DOI: 10.1371/journal.pone.0081088] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 10/17/2013] [Indexed: 11/19/2022] Open
Abstract
Leishmaniasis is caused by protozoa of the genus Leishmania and transmitted by sand flies from mammalian reservoirs to humans. In recent years, a northward spread of L. infantum from highly endemic Mediterranean countries into previously non-endemic Central European areas has been suspected based on presumed sporadic cases of autochthonous leishmaniasis. Here, we investigated whether sand flies are prevalent in Bavaria in Southern Germany, a federal state in which autochthonous cases have previously been reported. Considering the present and future climatic conditions, we determined whether Bavaria is suitable for five sand fly species with assumed spreading tendencies towards Central Europe: Phlebotomus ariasi, P. neglectus, P. perfiliewi and P. perniciosus that are known vectors for Leishmania in Europe, and P. mascittii, a suspected but not proven vector. Within Bavaria we defined sampling regions based on their climatic suitability and their spatial distance to the sites of the autochthonous cases and/or to areas of reported sand fly detection in states adjacent to Bavaria. At 155 locations in 7 sampling regions, CDC light traps were placed during 38 nights in the summers of 2009 and 2010, resulting in 202 trap-nights. All traps were negative for sand flies. The results suggest that Bavaria is not yet endemic for sand flies, but do not exclude the possibility of sporadic cases of autochthonous human or zoonotic Leishmania infections. This study, which combined methodological approaches from different disciplines, serves as reference for future surveys and risk analyses of sand flies and leishmaniasis in so far non-endemic areas of Europe.
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Affiliation(s)
- Simone Haeberlein
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Dominik Fischer
- Department of Biogeography, University of Bayreuth, Bayreuth, Germany
| | | | - Ulrike Schleicher
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | | | - Christian Bogdan
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- * E-mail:
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Poeppl W, Obwaller AG, Weiler M, Burgmann H, Mooseder G, Lorentz S, Rauchenwald F, Aspöck H, Walochnik J, Naucke TJ. Emergence of sandflies (Phlebotominae) in Austria, a Central European country. Parasitol Res 2013; 112:4231-7. [PMID: 24126902 PMCID: PMC3898358 DOI: 10.1007/s00436-013-3615-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 09/19/2013] [Indexed: 11/29/2022]
Abstract
The possible existence of autochthonous sandfly populations in Central Europe north of the Alps has long been excluded. However, in the past years, sandflies have been documented in Germany, Belgium, and recently, also in Austria, close to the Slovenian border. Moreover, autochthonous human Leishmania and Phlebovirus infections have been reported in Central Europe, particularly in Germany. From 2010 to 2012, sandfly trapping (740 trap nights) was performed at 53 different capture sites in Austria using battery-operated CDC miniature light traps. Sites were chosen on the basis of their climate profile in the federal states Styria, Burgenland, and Lower Austria. Sandfly specimens found were transferred to 70 % ethanol for conservation. Identification was based on morphological characters of the male genitalia and the female spermathecae, respectively. Altogether, 24 specimens, 22 females and 2 males, all identified as Phlebotomus (Transphlebotomus) mascittii Grassi, 1908, were found at six different sampling sites in all three federal states investigated. The highest number of catches was made on a farm in Lower Austria. Altogether, the period of sandfly activity in Austria was shown to be much longer than presumed, the earliest capture was made on July 3rd and the latest on August 28th. Sandflies have been autochthonous in Austria in small foci probably for long, but in the course of global warming, further spreading may be expected. Although P. mascittii is only an assumed vector of Leishmania spp.—data on its experimental transmission capacity are still lacking—the wide distribution of sandflies in Austria, a country thought to be free of sandflies, further supports a potential emergence of sandflies in Central Europe. This is of medical relevance, not only with respect to the transmission of Leishmania spp. for which a reservoir is given in dogs, but also with respect to the phleboviruses.
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Affiliation(s)
- Wolfgang Poeppl
- Department of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
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Ntais P, Sifaki-Pistola D, Christodoulou V, Messaritakis I, Pratlong F, Poupalos G, Antoniou M. Leishmaniases in Greece. Am J Trop Med Hyg 2013; 89:906-15. [PMID: 24062479 DOI: 10.4269/ajtmh.13-0070] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Abstract. During the last 35 years, visceral leishmaniasis has spread in Greece with autochthonous human cases appearing in 41 of the 54 prefectures. The occurrence of the disease was mapped and related to dog seropositivity, environmental and geospatial risk factors. Average dog seropositivity was 22.1% and positive animals were found in 43 of 54 prefectures. Factors like: altitude, presence of water bodies, land use, wind speed, mean land surface temperature, mean relative humidity, and mean annual rainfall were found to affect dog seropositivity. Cases of cutaneous leishmaniasis, caused by Leishmania tropica are also increasing. Phlebotomus similis believed to be the potential vector of L. tropica in Greece, was found in areas where the disease is widespread but also where cases have never been reported implying a danger of introduction of this anthroponotic parasite to new regions.
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Affiliation(s)
- Pantelis Ntais
- Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, Crete, Greece; Veterinary Services of Cyprus, Nicosia, Cyprus; University Montpellier 1, Faculty of Medicine, Laboratory of Parasitology-Mycology, Hospital University Centre (CHRU) of Montpellier and French National Reference Centre for Leishmaniases, CNRS 5290 - IRD 224 - University Montpellier 1&2 (UMR "MIVEGEC")
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Spada E, Proverbio D, Migliazzo A, Della Pepa A, Perego R, Bagnagatti De Giorgi G. Serological and Molecular Evaluation of Leishmania infantum Infection in Stray Cats in a Nonendemic Area in Northern Italy. ISRN PARASITOLOGY 2013; 2013:916376. [PMID: 27335864 PMCID: PMC4890919 DOI: 10.5402/2013/916376] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 06/05/2013] [Indexed: 11/23/2022]
Abstract
Infection by Leishmania species is increasing worldwide. It was hypothesized recently that cats act as a secondary reservoir for Leishmania infection. The aim of the present study was to assess the prevalence of Leishmania infantum antibodies and DNA in blood samples collected in a sample of stray cats in metropolitan area of Milan in northern Italy, which is a nonendemic area for leishmaniasis. An indirect immunofluorescence antibody test for L. infantum showed that 59 of 233 cats (25.3%) were seroreactive, 38 samples (16.3%) had antibody titers of 1 : 40, 15 (6.4%) had antibody titers of 1 : 80, and 6 (2.6%) had antibody titers of 1 : 160. Feline immunodeficiency virus (FIV) seropositive status was statistically associated with seroreactivity to L. infantum (P = 0.01) as shown by univariate and multivariate logistic regression (P = 0.0098; OR = 7.34). All blood samples that were tested using real-time PCR were negative for parasite DNA. These results were surprising, since no autochthonous human or canine cases of leishmaniasis have ever been reported in this region of northern Italy. It is possible that this high seroreactivity to L. infantum could be due to cross-reaction with antigens from other parasites. Additional studies that include parasite isolation are needed to clarify our findings on feline leishmaniasis in this region.
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Affiliation(s)
- Eva Spada
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare, Università degli Studi di Milano, Via G. Celoria 10, 20133 Milano, Italy
| | - Daniela Proverbio
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare, Università degli Studi di Milano, Via G. Celoria 10, 20133 Milano, Italy
| | - Antonella Migliazzo
- Centro di Referenza Nazionale per le Leishmaniosi, Istituto Zooprofilattico Sperimentale della Sicilia, Via R. Dicillo 4, 90129 Palermo, Italy
| | - Alessandra Della Pepa
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare, Università degli Studi di Milano, Via G. Celoria 10, 20133 Milano, Italy
| | - Roberta Perego
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare, Università degli Studi di Milano, Via G. Celoria 10, 20133 Milano, Italy
| | - Giada Bagnagatti De Giorgi
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare, Università degli Studi di Milano, Via G. Celoria 10, 20133 Milano, Italy
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Avila-García M, Mancilla-Ramírez J, Segura-Cervantes E, Farfan-Labonne B, Ramírez-Ramírez A, Galindo-Sevilla N. Transplacental transmission of cutaneous Leishmania mexicana strain in BALB/c mice. Am J Trop Med Hyg 2013; 89:354-8. [PMID: 23798582 DOI: 10.4269/ajtmh.12-0716] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The vertical transmission of leishmaniasis has been reported in species that cause visceral leishmaniasis. However, this condition has scarcely been documented in species that cause cutaneous leishmaniasis. The aim of this study was to determine experimentally whether L. mexicana is transmitted vertically. A control group of BALB/c mice and a group infected with L. mexicana were mated, the gestation was monitored, and females were killed before delivery. Four resorptions (P = 0.023) and eight fetal deaths (P = 0.010) were observed in the infected female group; furthermore, the offspring body weight of the infected group was lower than the body weight of the healthy group (P = 0.009). DNA amplification by polymerase chain reaction (PCR) revealed that all placentas and maternal spleens as well as 39 of 110 fetal spleens obtained from the offspring of infected mothers tested positive for Leishmania. In conclusion, L. mexicana is transmitted transplacentally and causes fetal death, resorption, and reduction in offspring body weight.
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Affiliation(s)
- Miroslava Avila-García
- Departamento de Infectologia e Inmunologia Perinatal, Instituto Nacional de Perinatologia, Mexico City, Mexico.
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Cenderello G, Pasa A, Dusi A, Dentone C, Toscanini F, Bobbio N, Bondi E, Del Bono V, Izzo M, Riccio G, Anselmo M, Giacchino R, Marazzi MG, Pagano G, Cassola G, Viscoli C, Ferrea G, De Maria A. Varied spectrum of clinical presentation and mortality in a prospective registry of visceral leishmaniasis in a low endemicity area of Northern Italy. BMC Infect Dis 2013; 13:248. [PMID: 23718708 PMCID: PMC3674923 DOI: 10.1186/1471-2334-13-248] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 05/22/2013] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Visceral Leishmaniasis (VL) is endemic in 88 countries, in areas of relatively low incidence with a relevant proportion of immune suppressed patients clinical presentation, diagnosis and management may present difficulties and pitfalls. METHODS Demographic data, clinical, laboratory features and therapeutic findings were recorded in patients identified by a regional VL disease registry from January 2007 to December 2010. RESULTS A total of 55 patients (36 adults mean age 48.7 years, 19 children median age 37.5 months) were observed presenting with 65 episodes. All childen were immunocompetent, whereas adults affected by VL included both immunocompetent (n°17) and immunesuppressed (n°19) patients. The clinical presentation was homogeneous in children with predominance of fever and hepato-splenomegaly. A wider spectrum of clinical presentations was observed in immunocompromised adults. Bone marrow detection of intracellular parasites (Giemsa staining) and serology (IFAT) were the most frequently used diagnostic tools. In addition, detection of urinary antigen was used in adult patients with good specificity (90%). Liposomal amphotericin B was the most frequently prescribed first line drug (98.2% of cases) with 100% clinical cure. VL relapses (n°10) represented a crucial finding: they occurred only in adult patients, mainly in immunocompromised patients (40% of HIV, 22% of non-HIV immunocompromised patients, 5,9% of immunocompetent patients). Furthermore, three deaths with VL were reported, all occurring in relapsing immunocompromised patients accounting for a still high overall mortality in this group (15.8%). CONCLUSIONS The wide spectrum of clinical presentation in immunesuppresed patients and high recurrence rates still represent a clinical challenge accounting for high mortality. Early clinical identification and satisfactory treatment performance with liposomal amphotericin B are confirmed in areas with low-level endemicity and good clinical standards. VL needs continuing attention in endemic areas where increasing numbers of immunocompromised patients at risk are dwelling.
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Affiliation(s)
| | - Ambra Pasa
- S.C. Oncologia Ente Ospedaliero Ospedali Galliera, Genova, Italy
| | - Andrea Dusi
- SSD Microbiologia ASL1 Imperiese-Ospedale Sanremo, Sanremo (IM), Italy
| | - Chiara Dentone
- SC. Malattie Infettive, ASL1 Imperiese-Ospedale Sanremo, Sanremo (IM), Italy
| | | | - Nicoletta Bobbio
- S.C. Malattie Infettive Ente Ospedaliero Ospedali Galliera, Genova, Italy
| | - Elisabetta Bondi
- Dipartimento di Scienze della Salute (DISSAL), University of Genova, Genova, Italy
- Istituto G. Gaslini, Genova, Italy
| | - Valerio Del Bono
- Clinica Malattie Infettive, IRCCS AOU San Martino-IST Genova, Genova, Italy
| | - Manuela Izzo
- SC Malattie infettive Ospedale Santa Maria della Misericordia Albenga ASL-2, Albenga (SV), Italy
| | - Giovanni Riccio
- SC Malattie infettive Ospedale Santa Maria della Misericordia Albenga ASL-2, Albenga (SV), Italy
| | - Marco Anselmo
- SC Malattie Infettive Ospedale San Paolo ASL2, Savona, Italy
| | - Raffaella Giacchino
- Dipartimento di Scienze della Salute (DISSAL), University of Genova, Genova, Italy
- Istituto G. Gaslini, Genova, Italy
| | - Maria Grazia Marazzi
- Dipartimento di Scienze della Salute (DISSAL), University of Genova, Genova, Italy
- Istituto G. Gaslini, Genova, Italy
| | - Gabriella Pagano
- Clinica Malattie Infettive, IRCCS AOU San Martino-IST Genova, Genova, Italy
| | - Giovanni Cassola
- S.C. Malattie Infettive Ente Ospedaliero Ospedali Galliera, Genova, Italy
| | - Claudio Viscoli
- Clinica Malattie Infettive, IRCCS AOU San Martino-IST Genova, Genova, Italy
| | - Giuseppe Ferrea
- SC. Malattie Infettive, ASL1 Imperiese-Ospedale Sanremo, Sanremo (IM), Italy
| | - Andrea De Maria
- Dipartimento di Scienze della Salute (DISSAL), University of Genova, Genova, Italy
- Istituto G. Gaslini, Genova, Italy
- S.S.Infettivologia, IRCCS AOU San Martino-IST Genova, Genova, Italy
- A.D.M, University of Genova, Largo R.Benzi 10, Genova, 16132, Italy
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Mencke N. Future challenges for parasitology: vector control and 'One health' in Europe: the veterinary medicinal view on CVBDs such as tick borreliosis, rickettsiosis and canine leishmaniosis. Vet Parasitol 2013; 195:256-71. [PMID: 23680539 DOI: 10.1016/j.vetpar.2013.04.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The medical as well as the veterinary importance of parasitic arthropods or ectoparasites in general terms, is characterized by the primary or secondary impact on the health of humans and companion animals alike. The parasitic arthropods addressed here are those ectoparasites belong to the class of insects, such as fleas and sand flies, or the subclass of acarids, such as ticks. These parasitic arthropods interact intensively with their hosts by blood feeding. Fleas, sand flies and ticks hold the vector capacity to transmit pathogens such as virus, bacteria or protozoa to cats, dogs and humans. The diseases caused by these pathogens are summarized under the terms canine vector-borne diseases (CVBD), feline vector-borne diseases (FVBD) or metazoonoses. In small animal practice, it is important to understand that the transmitted pathogen may either lead to a disease with clinical signs, or more often to asymptomatic, clinically healthy, or silent infections. Blocking of the vector-host interactions, the blood feeding and subsequently the transmission of pathogens during blood feeding is a key element of CVBD control. The focus of this review is on the current knowledge of the epidemiology of parasitic vectors and three important CVBDs they transmit; rickettsiosis, tick borreliosis and canine leishmaniosis from a European perspective, and how veterinary medicine may contribute to the challenges of CVBDs and their control. Prevention of CVBDs is fundamentally based on ectoparasite control. Ectoparasite management in cats and dogs is important not only for the health and well-being of the individual companion animal but for public health in general and is therefore a perfect example of the 'One health' approach.
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Affiliation(s)
- Norbert Mencke
- Bayer Animal Health GmbH, Kaiser-Wilhelm-Allee 50, 51373 Leverkusen, Germany.
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Abstract
Hemophagocytic lymphohistiocytosis (HLH) associated with visceral leishmaniasis (VL) is a very rare phenomenon. We report the first known North American case in a 21 month old boy. He was initially diagnosed with Epstein Barr virus (EBV) triggered HLH and treated with the international treatment protocol, HLH-2004. Stem cell transplant was planned due to repeated reactivations of disease, but his pretransplant bone marrow revealed an unexpected protozoan-Leishmania donovani. Treatment with liposomal amphotericin B led to resolution of all manifestations of HLH. We discuss how the clinical and laboratory features of both entities can closely mimic each other and are extremely difficult to differentiate. This case also raises the question of whether to screen all children with suspected HLH for Leishmania in a non endemic area.
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Entomological and ecological studies in a new potential zoonotic leishmaniasis focus in Torres Novas municipality, Central Region, Portugal. Acta Trop 2013; 125:339-48. [PMID: 23262215 DOI: 10.1016/j.actatropica.2012.12.008] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 12/05/2012] [Accepted: 12/08/2012] [Indexed: 11/22/2022]
Abstract
In Portugal human and canine leishmaniasis are caused by Leishmania infantum, and Phlebotomus perniciosus and P. ariasi are the proven vectors. Three main foci were identified in eighty's decade: Trás-os-Montes and Alto Douro region, Lisbon region and Algarve region, but according to OnLeish observatory data, canine leishmaniasis cases have been reported from several other regions, for which sand fly species and their infection rates are unknown. This study is the first phlebotomine survey in Torres Novas municipality, Santarém District, Portugal. The main objectives were to identify the phlebotomine species, their bioecological aspects, Leishmania infection rate and the risk factors for the presence of phlebotomine species in the municipality. From June to November, 2010, 275 biotopes were surveyed with CDC light-traps. Captures covered the 17 parishes of the municipality and included domestic, peridomestic and sylvatic biotopes. Specimens were identified morphologically and females were used for molecular detection of Leishmania and bloodmeal identification. Simple and multiple logistic regression analysis were used to identify risk factors for phlebotomine presence. Nonparametric tests were used to compare densities of independent groups. A total of 1262 sand flies were captured and identified, and four species detected: P. perniciosus (73.69%), P. ariasi (8.16%), P. sergenti (6.58%) and Sergentomyia minuta (11.57%). In 71.4% localities at least one L. infantum proven vector species was present. Risk factors were identified as: high average temperatures and low relative humidities, sheltered locations and absence of strong wind, presence of pine trees as dominant vegetation, peridomestic biotopes, particularly sheep pens or proximity of sheep, poultry and house martin nests. L. infantum infection rate was 4% for P. ariasi and 0.48% for the total of Larroussius females. P. perniciosus females exhibited an opportunistic behavior, feeding in a wide variety of vertebrate hosts. The high abundance and distribution of proven vector species, together with a canine leishmaniasis seroprevalence of 7.93% in the District, and the capture of a gravid infective sand fly female, suggests that Torres Novas municipality is a potential zoonotic leishmaniasis focus in the country.
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von Stebut E, Schleicher U, Bogdan C. [Cutaneous leishmaniasis as travelers' disease. Clinical presentation, diagnostics and therapy]. Hautarzt 2012; 63:233-46; quiz 247-8. [PMID: 22422121 DOI: 10.1007/s00105-012-2327-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Leishmaniasis is a disease with worldwide increasing incidence, which in Germany is almost exclusively observed in patients who have travelled to classical endemic regions such as the Mediterranean basin. Cause of the disease is an infection with protozoan parasites of the genus Leishmania, which are transmitted by sand flies and replicate intracellularly within mammalian hosts. Depending on the inoculated parasite (sub-) species and the immune status of the host, a local cutaneous, diffuse cutaneous, mucocutaneous or visceral form of leishmaniasis will develop. Cutaneous leishmaniasis, which frequently appears only weeks after the bite of a sand fly, starts with the formation of a papule, which subsequently can turn into a skin ulcer. The latter may heal spontaneously after months leaving behind a scar or persist as chronic, non-healing cutaneous leishmaniasis. If cutaneous leishmaniasis is suspected, a sterile skin biopsy followed by appropriate diagnostic measures in a specialized laboratory to identify the pathogen should be performed. For the decision on the type of therapy, several clinical parameters (e.g. number and localization of lesions, immune status) and, most importantly, the underlying parasite (sub-) species need to be considered. Therapy can consist of a variety of topical measures or systemic drug treatment. A modern and safe vaccine does not yet exist.
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Affiliation(s)
- E von Stebut
- Hautklinik, Universitätsmedizin Mainz, Johannes Gutenberg Universität, Langenbeckstr. 1, 55131, Mainz, Deutschland.
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Geisweid K, Mueller R, Sauter-Louis C, Hartmann K. Prognostic analytes in dogs with Leishmania infantum infection living in a non-endemic area. Vet Rec 2012; 171:399. [PMID: 22915680 DOI: 10.1136/vr.100637] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Due to increasing numbers of dogs that are imported from, or have been visiting Mediterranean countries, canine leishmaniasis has become a very important infectious disease in Germany. The aim of this study was to determine which laboratory and clinical parameters can be used as prognostic factors, whether level of antibody titre is a prognostic factor, and whether treatment leads to a better prognosis in a country in which reinfection is extremely unlikely. Data of 72 dogs infected with Leishmania infantum that had been presented to the Clinic of Small Animal Medicine of the LMU University of Munich, Germany, and whose owners answered a detailed questionnaire, were reviewed retrospectively. All dogs included in the study had clinical signs compatible with canine leishmaniasis. No correlation between the level of antibody titres (carried out by immunofluorescence assay) and survival time was found (p = 0.982). However, there was a significant correlation between survival time and presence of proteinuria (p < 0.001), hypoalbuminemia (p = 0.002), and lymphopenia (p = 0.040) in all treated dogs. Furthermore, treatment of diseased dogs resulted in a longer survival time (p = 0.003). In conclusion, levels of antibody titres did not correlate with prognosis. More useful parameters to predict shorter survival were proteinuria, hypoalbuminemia and lymphopenia. Also, treatment was correlated with a longer survival of almost two years.
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Affiliation(s)
- K Geisweid
- Clinic of Small Animal Medicine, LMU University of Munich, Veterinärstr. 13, Munich 80539, Germany
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Osorio Y, Rodriguez LD, Bonilla DL, Peniche AG, Henao H, Saldarriaga O, Travi BL. Congenital transmission of experimental leishmaniasis in a hamster model. Am J Trop Med Hyg 2012; 86:812-20. [PMID: 22556079 DOI: 10.4269/ajtmh.2012.11-0458] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Little information is available on transplacental transmission of Leishmania spp. We determined the frequency and impact of congenital infection caused by Leishmania panamensis or L. donovani in experimentally infected hamsters. A polymerase chain reaction showed that congenital transmission occurred in 25.8% (24 of 93) of offspring born to L. panamensis-infected hamsters and 14.6% (11 of 75) offspring born to L. donovani-infected hamsters. Mortality during lactation was higher in offspring born to L. panamensis-infected hamsters and offspring born to L. donovani-infected hamsters than controls, and lymphoproliferation to Leishmania was more frequent in offspring born to L. panamensis-infected hamsters (17.4%, 11 of 63) than in offspring born to L. donovani-infected hamsters (8.5%, 3 of 35). After weaning, only offspring born to L. donovani-infected hamsters had lower weight gain (P < 0.001) and hematocrit levels (P = 0.0045) than controls. Challenge of offspring born to L. panamensis-infected hamsters with L. panamensis showed no differences in lesion evolution, and offspring born to L. donovani-infected hamsters were more susceptible to L. donovani challenge than controls. Consequently, prenatal exposure of hamsters to L. donovani significantly increased the mortality risk and susceptibility to secondary homologous infection.
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Affiliation(s)
- Yaneth Osorio
- Department of Internal Medicine, Division of Infectious Diseases, University of Texas Medical Branch, Galveston, Texas 77555, USA.
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