Co-infection with arthropod-borne pathogens in domestic cats

Parasitism on domestic cats by Amblyomma auricularium and serological evidence of exposure to Rickettsia amblyommatis

The domestic cat is not considered a primary host for any specific tick species; however, it can be affected by some Ixodidae species, such as Rhipicephalus sanguineus sensu lato and Amblyomma spp. The study reports parasitism by Amblyomma auricularium and the detection of anti-Rickettsia spp. antibodies in domestic cats from a rural property in the Afrânio municipality, Pernambuco, Brazil. Amblyomma auricularium (24 nymphs, six females, and four males) and Amblyomma sp. (42 larvae) parasitized three cats, and 73 free-living ticks were captured in armadillo burrows: A. auricularium (36 nymphs, six females, five males) and Amblyomma sp. (26 larvae). Blood samples from cats were collected and the obtained plasma were subjected to indirect immunofluorescence assay (IFA) to detect antibodies against Rickettsia antigens. Thus, anti-Rickettsia spp. antibodies were determined (titers ranging from 128 to 512) and showed a predominant antibody response to Rickettsia amblyommatis or a very closely related genotype. This study reports the first infestation of nymphs and adults of A. auricularium on cats in a new area of occurrence in the semi-arid region of Northeastern Brazil and reports for the first time the presence of anti-Ricketsia antibodies in cats in the region, with R. amblyommatis as the probable infectious agent.

Molecular detection of vector-borne pathogens in cats tested for FIV and FeLV

The aim of this study was to detect molecularly vector borne pathogens (VBPs) in domiciled cats tested for Feline immunodeficiency virus (FIV) and Feline leukemia virus (FeLV). Blood samples (n = 119) were analyzed microscopically and molecularly through PCR and sequenced for the detection of the following pathogens: piroplasmids., Bartonella henselae, Cytauxzoon felis, Ehrlichia canis, Leishmania spp., hemotropic Mycoplasma spp., Trypanosoma spp., and Ricketssia spp. Animals were also serological assessed for detection of antibodies against FIV and FeLV. Out of all animals, 20.16% (24/119) tested positive for at least one VBPs at molecular examination. Conversely, no animal resulted positive at microscopic analysis. The most prevalent pathogen was hemotropic Mycoplasma haemofelis (8.40%; 10/119), followed by Candidatus Mycoplasma haemominutum (5.88%; 7/119), E. canis (5.04%; 6/119), C. felis (0.84%; 1/119) and B. henselae (0.84%; 1/119). One animal (0.84%; 1/119) was co-infected with. E. canis and B. henselae. A total of 5.88% (7/119) and 1.68% (2/119) tested positive for FIV and FeLV, respectively. Data of this study demonstrate that owned cats can be at risk of hemotropic Mycoplasma spp., E. canis, C. felis and B. henselae. Therefore, preventive measures against vectors of these pathogens should be implemented in order to reduce the risk of exposition and consequently infection. Additionally, aggressive behaviors among cats should be avoided, especially because hemotropic Mycoplasma spp. may be transmitted through the bite of animals.

Molecular detection of feline hemoplasmas and retroviruses in free-roaming and shelter cats within a university campus

Objectives

The aim of the present study was to assess the frequency of hemoplasma, feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV) infections in cats living in an on-campus shelter and free-roaming cats within a university campus in Brazil.

Methods

Blood samples were tested using quantitative PCR for hemoplasma, FIV and FeLV. Positive hemoplasma samples were sequenced. Associations between hemoplasma detection and living situation, sex, flea and/or tick parasitism, and coinfection with FIV and FeLV, were assessed using Fisher's exact test and the respective odds ratios were calculated.

Results

Overall, 6/45 (13.3%) cats tested positive: four (8.9%) were infected with 'Candidatus Mycoplasma haemominutum' and two (4.4%) with Mycoplasma haemofelis. All positive samples were from free-roaming cats (6/15; 40.0%) and had statistically significantly lower packed cell volumes (P = 0.037). Although 5/23 (21.7%) males and 1/22 (4.6%) females were positive, no statistically significant association between sex and hemoplasma infection was found (P = 0.19). Viral quantitative PCR (qPCR) was performed on 43/45 samples, among which 2/43 (4.7%) were positive for FIV and none for FeLV. Only one cat (2.3%) was coinfected with hemoplasma and FIV (P = 0.26). In addition, 4/6 (66.7%) cats that tested positive for hemoplasmas were infested by fleas (P = 0.0014) and/or ticks (P = 0.25).

Conclusions and relevance

These results show that even if the free-roaming cat population is clinically healthy and has adequate access to food, it may present flea infestation and hemoplasma infection with lower packed cell volume values.

Piroplasmid infection is not associated with clinicopathological and laboratory abnormalities in cats from Midwestern Brazil

Feline piroplasmids include the genera Babesia spp., Cytauxzoon spp., and Theileria spp. In Brazil, there are few reports regarding these hemoprotozoans; however, clinicopathological and molecular data are scarce. This study aimed to characterize the clinical relevance of these parasites through hematological, biochemical, and molecular approaches. For this purpose, 166 cats from Brasilia, Federal District, Midwestern Brazil, were screened using a quantitative polymerase chain reaction (qPCR) for piroplasmids based on the LSU4 mitochondrial gene, which resulted in an overall prevalence of 36/166 (21.7%). Twelve of 166 samples (7.2%) were positive for C. felis, while 19/166 (11.4%) were positive for Babesia vogeli. No samples tested positive for Theileria spp. Babesia vogeli and Cytauxzoon spp. LSU4 sequences showed identities of 97-100% and 99.3%, respectively, to US isolates. The hematological and biochemical findings did not differ significantly between the cats that tested positive and negative for piroplasmids. Although the lack of abnormalities in clinical and laboratory parameters does not eliminate the possibility that these cats were sick and recovered, it may suggest that the Brazilian strain of Cytauxzoon spp. is not as pathogenic as that from the USA, despite the high molecular identity with North American isolates.

Piroplasm Infection in Domestic Cats in the Mountainous Region of Rio de Janeiro, Brazil

Piroplasm infections in domestic cats have been reported with increasing frequency in numerous countries. However, in some states of Brazil, little information is available about the occurrence of these parasites. Blood samples were collected from 250 cats treated at a private clinic in the mountainous region of Rio de Janeiro. The samples were each subjected to a blood count, microscopic examination, and molecular research on piroplasms. The animals’ clinical histories and epidemiological information were analyzed to identify the risk factors associated with infection. Ticks were recovered during the clinical care and were identified and subjected to molecular analyses to determine the presence of piroplasm DNA. Piroplasms were detected in 2.7% (7/250) of the cats. Nucleotide sequences of Babesia vogeli were identified in six cats, while the Cytauxzoon sp. was identified in one cat. Cats displaying apathy/weakness/prostration and hemorrhage/bleeding were more likely to be infected. In addition, Amblyomma aureolatum was recovered from a cat PCR-negative for piroplasms. This is the first study in Rio de Janeiro that has detected Babesia vogeli in cats. The results obtained here underscore the need for further studies in Rio de Janeiro to investigate the dynamics of such infections and the vectors involved.

Cytauxzoon sp. Infection and Coinfections in Three Domestic Cats in Central Italy

Cytauxzoonosis is an emerging disease caused by a tick-transmitted haemoprotozoan affecting domestic and wild felids. The clinical and biomolecular findings of the infection due to Cytauxzoon sp. and concomitant coinfections are described in three cats in central Italy. Three domestic cats were referred for different clinical conditions (impact trauma, lameness, and weight loss and lethargy). They presented different hematobiochemical profiles. Only two cats were anemic, but in all three cats, endo erythrocyte inclusions suggestive of piroplasmids were found at blood smear evaluation. EDTA blood samples were submitted to rapid ELISA test for feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV), and to biomolecular investigations for Piroplasmida (Babesia spp., Theileria spp., Cytauxzoon spp.) and Mycoplasma spp. All three cats were positive for Cytauxzoon sp. (European Cytauxzoon species) and two cases were also coinfected by Candidatus Mycoplasma turicensis and FIV. This report suggests that cytauxzoonosis should be included among differential diagnoses in subjects with possibility of contact with ticks and with presence of coinfections by tick-borne parasites, including in non-endemic areas.

Molecular Detection of Tick-Borne Agents in Cats from Southeastern and Northern Brazil

Even though the epidemiology of tick-borne agents (TBA) in dogs has been extensively investigated around the world, the occurrence, vectors involved, and molecular identity of these agents in cats remains elusive in many regions. Among TBA, Ehrlichia, Anaplasma, Babesia, Cytauxzoon, and Hepatozoon are responsible for diseases with non-specific clinical signs in cats, making essential the use of molecular techniques for accurate diagnosis and proper treatment. The present work aimed to investigate the occurrence and molecular identity of tick-borne agents (Ehrlichia, Anaplasma, Babesia/Theileria, Cytauxzoon, and Hepatozoon) in cats from southeastern (states of São Paulo (SP) and Minas Gerais (MG)) and northern (state of Rondônia (RO)) Brazil. For this purpose, 390 blood samples were collected from domiciled cats in MG (n = 155), SP (n = 151), and RO(n = 84) states, submitted to DNA extraction and PCR assays for Ehrlichia spp. (dsb gene), Anaplasma spp. (rrs gene), piroplasmids (18S rRNA gene), and Hepatozoon spp. (18S rRNA gene), sequencing, and phylogenetic inferences. The overall positivity for Anaplasma spp., Ehrlichia spp., Babesia/Theileria spp., Cytauxzoon spp., and Hepatozoon spp. were 7.4% (12.3% (MG) and 6.6% (SP)), 2% (4.5% (MG) and 0.6% (SP)), 0.7% (0.6% (MG), 0.6% (SP) and 1.2% (RO)), 27.2% (41.9% (MG), 24.5% (SP) and 4.8% (RO), and 0%, respectively. The phylogenetic analysis grouped the obtained sequences with ‘Candidatus Anaplasma amazonensis’, A. platys, B. vogeli, and Cytauxzoon sp. previously detected in wild felids from Brazil. qPCR specific for E. canis based on the dsb gene confirmed the molecular identity of the detected ehrlichial agent. The present study expanded the list and geographical distribution of hemoparasites in cats. ‘Candidatus Anaplasma amazonensis’, recently detected in sloths from northern Brazil, was described for the first time in cats. This is the first report of piroplasmids infecting cats in northern Brazil. Coinfection by Cytauxzoon and other TBA (Ehrlichia, Anaplasma, and B. vogeli) reported in the present study raises the need for veterinary practitioners’ awareness of cats parasitized by multiple TBA.

Exposure of Domestic Cats to Distinct Ehrlichia canis TRP Genotypes

Cats naturally exposed to Ehrlichia canis have been described in different regions of the world, but little is known about the genotypes associated with infection in these animals. To detect E. canis-specific antibodies and investigate the E. canis TRP genotypes in cats, serum samples from 76 domestic cats reactive to crude E. canis antigens by the indirect fluorescence antibody test (IFAT) were analyzed by ELISA, using E. canis-specific peptides (i.e., TRP19 and TRP36 /BR/US/CR). Of these, 25 (32.9%) cats reacted to at least one TRP peptide, confirming their specific exposure to E. canis. Eighteen (23.7%) cats reacted to TRP19, 15 (19.8%) to BRTRP36, and 11 (14.5%) to USTRP36, but none of them reacted to CRTRP36. Eight (10.5%) cats reacted to TRP19 but not to any TRP36 genotype, demonstrating the possible existence of a new E. canis genotype infecting felines. Nevertheless, this study provides the first report of anti-E. canis-specific antibodies in domestic cats.

Fatal infection caused by Cytauxzoon felis in a captive-reared jaguar (Panthera onca)

Fatal infections with Cytauxzoon felis are common in domestic cats, and jaguars (Panthera onca) are believed carriers of this protozoan. Fatal C. felis infections have never been described in jaguars before. Thus, this study describes such an infection in a 5-month-old captive-reared jaguar that presented hyporexia and died at 26 days after the first clinical signs. During necropsy, samples were taken from several tissues, some were fixed in 10% formalin and process for histopathological diagnosis, and some samples were used for DNA extraction, amplification via PCR and sequencing of the potential pathogens. Grossly, marked splenomegaly and icterus were observed. Histologically, numerous structures that are morphologically compatible with Cytauxzoon spp. schizonts obliterated multiple blood vessels in the brain, leptomeninges, spinal cord, lungs, heart, skeletal muscle, adrenal gland, kidneys, spleen, small intestine and pancreas. C. felis was identified by PCR in many organs. Thus, C. felis infection in jaguars can be fatal, and the clinicopathological findings are similar to those of cytauxzoonosis in other wild and domestic felid species.

CYTAUXZOON FELIS DNA DETECTION IN HEALTHY CATS FROM RIO DE JANEIRO, BRAZIL

Feline cytauxzoonosis is a disease caused by Cytauxzoon felis, a protozoan that infects the red blood cells and macrophages. It is responsible for an acute and often fatal disease in domestic cats. The purpose of this study was to investigate the occurrence of C. felis infections in healthy cats. Piroplasm forms were seen in the erythrocytes of 2 cats, and C. felis DNA was identified by polymerase chain reaction (PCR) in one of them. The results demonstrate that erythrocytic piroplasmids associated with tick-borne parasitic protozoa may be found circulating in the blood of healthy cats in Rio de Janeiro. These can be differentiated from the morphologically similar forms of species such as Babesia by analysis of DNA, thereby demonstrating the potential for further studies of feline populations in Brazil.

Three new species of Cytauxzoon in European wild felids

Protists of the genus Cytauxzoon infect a wide variety of wild and domestic felids worldwide. While the American Cytauxzoon felis has been well described, data on the European isolates of Cytauxzoon are still scant. The aim of the current study was to determine the genetic diversity of European Cytauxzoon spp. in wild felids across Europe by analyzing one nuclear and two mitochondrial genes, along with representative complete mitochondrial genomes. Overall, 106 biological samples from wild felids (92 from Felis silvestris and 14 from Lynx lynx) from Germany, Romania, Czech Republic, and Luxembourg were collected and screened for the presence of Cytauxzoon spp. using nested PCR protocols, targeting the highly conserved 18S rDNA, mitochondrial cytochrome b (CytB) and cytochrome c oxidase subunit I (COI) genes. Furthermore, 18 previously confirmed wild felid biological samples from Europe, and comparative material from USA positive for C. felis, were included in the study. In 18S rDNA sequences analyses, Cytauxzoon spp. from felids formed two separate clades of New World and Old World isolates, with a low inner diversity of the European clade. In contrast to 18S rDNA, the phylogenetic analyses of CytB and COI genes affirmatively revealed three highly supported clades, resulting in three defined genotypes. Similar intra- and interspecific variability of CytB and COI genes was observed in the case of different Babesia spp. Considering geography, host species and analyses of three genes, we conclude that the three detected genotypes of Cytauxzoon in European wild felids represent three new species, which we herein describe.

Role of vector-borne pathogens in the development of fever in cats: 1. Flea-associated diseases

PRACTICAL RELEVANCE

There has been increasing identification of vector-borne pathogens in cats presented to veterinary clinics around the world for evaluation of fever and the associated secondary effects, such as signs of depression and loss of appetite.

AIM

The aim of this article is to summarize the clinically relevant information concerning fever in cats that is associated with pathogens known or suspected to be vectored by fleas, with an emphasis on presenting clinical abnormalities and optimal diagnostic, treatment and prevention strategies. Fever in cats that is associated with pathogens vectored by ticks or sandflies is discussed in Part 2 of this article series.

Role of vector-borne pathogens in the development of fever in cats: 2. Tick- and sandfly-associated diseases

PRACTICAL RELEVANCE

There has been increasing identification of vector-borne pathogens in cats presented to veterinary clinics around the world for evaluation of fever and the associated secondary effects, such as signs of depression and loss of appetite.

AIM

The aim of this article is to summarize the clinically relevant information concerning fever in cats that is associated with pathogens vectored by ticks or sandflies, with an emphasis on presenting clinical abnormalities and optimal diagnostic, treatment and prevention strategies. Fever in cats associated with pathogens known or suspected to be vectored by fleas was discussed within Part 1 of this two-part article series.

Serological and molecular detection of Anaplasma phagocytophilum in Thoroughbred horses from Chilean racecourses

Anaplasma phagocytophilum is the causative agent of equine granulocytic anaplasmosis (EGA). This study aimed to perform serological and molecular surveys of A. phagocytophilum in thoroughbred horses from racecourses in Chile. Additionally, hematological findings related to A. phagocytophilum molecular positivity were addressed, and phylogenetic analysis of selected positive samples was performed. Complete blood count and msp2 gene real-time PCR were performed in 457 thoroughbred horses from three racecourses located in three different cities of Chile (Santiago, Viña del Mar and Concepción). Sera from horses in two racecourses (Santiago and Vina del Mar) were tested by Indirect fluorescent antibody test (IFAT) to detect IgG antibodies against A. phagocytophilum. The occurrence of A. phagocytophilum by real-time PCR was 13.6 % (62/457, 95 % CI: 10.8-16.3 %), with the highest occurrence observed in Santiago (26.5 %), followed by Concepción (9%), and the lowest in Viña del Mar (5%). The overall frequency of IgG antibodies to A. phagocytophilum was 7.9 % (23/290, 95 % CI: 4.8-12.7 %), with 9.9 % in Santiago and 6.5 % in Viña del Mar. Only three animals from Santiago Racecourse were positive in both real-time PCR and serology. PCR-positive horses from Santiago racecourse presented significantly lower hemoglobin, mean corpuscular value (MCV), and mean corpuscular hemoglobin concentration (CHCM), and higher eosinophil counts. Phylogenetic analysis based on the msp2 gene showed that A. phagocytophilum sequences found in the present study were closely related with A. phagocytophilum sequences from the USA and Europe. Anaplasma phagocytophilum DNA is detected for the first time in Chile.

Molecular detection of vector-borne agents in cats in Southern Brazil

This study used serological and molecular methods to investigate the occurrence of vector-borne pathogens (VBP) with zoonotic potential in cats neutered at the University Veterinary Hospital in Canoinhas, Santa Catarina. The combined PCR and serological results revealed that 17 (56.6%) cats were positive for one or more pathogens. The sampled cats had antibodies to Ehrlichia spp. (7/30), Anaplasma phagocytophilum (3/30) and Leishmania infantum (2/30). The PCR assay detected DNA closely related to Ehrlichia canis in 6/30 cats, Mycoplasma haemofelis in 2/30 cats, A. phagocytophilum and Cytauxzoon sp. in one cat each. While Bartonella clarridgeiae and B. henselae were detected in two cats each, and B. koehlerae was detected in one cat.

Ehrlichia spp. infection in domestic cats from Rio de Janeiro State, southeast Brazil

Ehrlichiosis is caused by agents belonging to Ehrlichia genus. Despite the frequent reports on the serological and molecular detection of E. canis in dogs in Brazil, there is scant data on ehrlichiosis in brazilian cats. This study aimed at investigating the occurrence of Ehrlichia spp. in domestic cats from Greater Rio de Janeiro, and evaluating hematological changes associated with this rickettsial infection. We searched for IgG antibodies against E. canis on blood samples of 216 cats by Indirect Fluorescence Assay (IFA). Additionally, we performed nested PCR (nPCR) and real-time PCR (qPCR) assays targeting E. canis-16S rRNA and dsb gene, respectively. Fifty-seven (26.4%) cats were seropositive for Ehrlichia spp. by IFA. Ehrlichia spp.-16S rRNA gene fragments were detected in 3 cats (1.4%). Although the obtained 16S rRNA sequences showed 99 to 100% identity with E. canis, cats were negative in qPCR. Anemia, thrombocytopenia, leukocytosis, left shift neutrophil and hyperproteinemia were observed. Anemia was statistically associated with seropositivity to E. canis and kittens showed lower positivity rates (p<0.05). This study showed that Ehrlichia spp. occur in domestic cats from Greater Rio de Janeiro. Further studies involving culture isolation are much needed to more precisely characterize these organisms.

Molecular detection, characterization of Anaplasma spp. in domestic cats from Rio de Janeiro state

Species of the genus Anaplasma, in the family Anaplasmatacae, are responsible to vector-borne diseases that affecting animals and humans. Feline anaplasmosis is poorly reported in Brazil. This study aimed at investigating the occurrence of Anaplasma spp. in domestic cats from Greater Rio de Janeiro, and evaluating hematological changes associated with this rickettsial infection. Were sampled 216 cats, we performed nested PCR (nPCR) and real-time PCR (qPCR) assays targeting A. platys-16S-rDNA, A. platys-gltA and A. phagocytophilum-msp2 sequences. As evaluated with gltA-qPCR the frequency of cats positive for A. platys was 3.7% (n = 8/216) and by 16S-rDNA nested-PCR it was 0.9% (n = 2/216). No cats were positive to msp2-qPCR to A. phagocytophilum. The sequences of A. platys presented 100% similarity with previously described isolates around the world and Brazil. Two cats that were positive in the gltA-qPCR reactions have platelet inclusions in the microscopic examination. However, no significant (p > 0.05) hematological changes were observed, probably due to low parasite load. This study showed that A. platys occur in domestic cats from Greater Rio de Janeiro. Further studies are needed to more precisely characterize these organisms.

Diversity of Anaplasma and Ehrlichia/Neoehrlichia Agents in Terrestrial Wild Carnivores Worldwide: Implications for Human and Domestic Animal Health and Wildlife Conservation

Recently, the incidence and awareness of tick-borne diseases in humans and animals have increased due to several factors, which in association favor the chances of contact among wild animals and their ectoparasites, domestic animals and humans. Wild and domestic carnivores are considered the primary source of tick-borne zoonotic agents to humans. Among emergent tick-borne pathogens, agents belonging to family Anaplasmataceae (Order Rickettsiales) agents stand out due their worldwide distribution and zoonotic potential. In this review we aimed to review the genetic diversity of the tick-transmitted genera Ehrlichia, Anaplasma and "Candidatus Neoehrlichia sp." in wild carnivores Caniformia (Canidae, Mustelidae and Ursidae) and Feliformia (Felidae, Hyanidae, Procyonidae and Viverridae) worldwide, discussing the implications for human and domestic animal health and wildlife conservation. Red foxes (Vulpes vulpes) have been identified as hosts for Anaplasma spp. (A. phagocytophilum, Anaplasma ovis, A. platys), Ehrlichia canis and "Candidatus Neoehrlichia sp." (FU98 strain) and may contribute to the maintaenance of A. phagocytophilum in Europe. Raccoons (Procyon lotor) have been reported as hosts for E. canis, A. bovis, "Candidatus Neoehrlichia lotoris" and A. phagocytophilum, and play a role in the maintenance of A. phagocytophilum in the USA. Raccoon dogs (Nyctereutes procyonoides) may play a role as hosts for A. bovis and A. phagocytophilum. New Ehrlichia and/or Anaplasma genotypes circulate in wild canids and felids from South America and Africa. While Ehrlichia sp. closely related to E. canis has been reported in wild felids from Brazil and Japan, Anaplasma sp. closely related to A. phagocytophilum has been detected in wild felids from Brazil and Africa. Red foxes and mustelids (otters) are exposed to E. canis in countries located in the Mediaterranean basin, probably as a consequence of spillover from domestic dogs. Similarly, E. canis occurs in procyonids in North (raccoons in USA, Spain) and South (Nasua nasua in Brazil) Hemispheres, in areas where E. canis is frequent in dogs. While "Candidatus Neoehrlichia lotoris" seems to be a common and specific agent of raccoons in the USA, "Candidatus Neoehrlichia sp." (FU98 strain) seems to show a broader range of hosts, since it has been detected in red fox, golden jackal (Canis aureus) and badger (Meles meles) in Europe so far. Brown (Ursus arctos) and black (Ursus americanus) bears seem to play a role as hosts for A. phagocytophilum in the North Hemisphere. Anaplasma bovis has been detected in wild Procyonidae, Canidae and Felidae in Asia and Brazil. In order to assess the real identity of the involved agents, future works should benefit from the application of MLST (Multi Locus Sequence Typing), WGS (Whole Genome Sequencing) and NGS (Next Generation Sequencing) technologies aiming at shedding some light on the role of wild carnivores in the epidemiology of Anaplasmataceae agents.

First report of Cytauxzoon sp. infection in domestic cats in Switzerland: natural and transfusion-transmitted infections

BACKGROUND

Cytauxzoonosis is an emerging tick-borne disease of domestic and wild felids. Cytauxzoon felis induces severe and often fatal disease in domestic cats. In Europe, clinical and subclinical infections caused by Cytauxzoon sp. are described. We report the first cases of Cytauxzoon sp. infection in domestic cats in Switzerland.

METHODS

Clinical and laboratory data and results of PCR analyses were collected from Cytauxzoon sp. PCR-positive cats and the cats followed for up to 851 days.

RESULTS

The cases were three two-month old kittens from the same litter (Cases 1-3) and two adult domestic shorthair cats (Cases 4 and 5). The cats originated from the north-west and west of Switzerland. Cases 1-3 presented with moderate to severe regenerative anaemia and intraerythrocytic inclusions. Cytauxzoon sp. was confirmed by PCR and sequencing. The kittens made a clinical and haematological recovery after blood transfusion and/or treatment with azithromycin and atovaquone, but erythroparasitaemia persisted. Case 4 presented with severe non-regenerative anaemia. Case 5 was healthy and used as a blood donor for Case 4. Following blood transfusion, Case 4 showed intraerythrocytic inclusions, and Cytauxzoon sp. was confirmed in both Cases 4 and 5 using PCR and sequencing. Case 4 achieved clinical and haematological remission after treatment with azithromycin, atovaquone and immunosuppressive drugs. Eight months later, Case 4 was presented again with anaemia but tested Cytauxzoon sp. PCR-negative. Sequencing of 1637 bp of the 18S rRNA gene of Cytauxzoon sp. revealed 100% nucleotide sequence identity among isolates of Cases 1-3 and between isolates of Cases 4 and 5, and 99% sequence identity between isolates of all cases. Phylogenetic analysis revealed the closest relationship of the Swiss isolates to Cytauxzoon sp. isolates from domestic cats and wild felids from France, Spain and Romania and to Cytauxzoon manul from a Pallas's cat.

CONCLUSIONS

This is the first report of Cytauxzoon sp. infection in domestic cats in Switzerland. It is also the first report of infection in very young kittens and transmission of Cytauxzoon sp. to an adult cat by transfusion of blood from an asymptomatic cat. The cats recovered but some developed chronic asymptomatic erythroparasitaemia for up to 28 months. Domestic cats may act as reservoirs for Cytauxzoon sp. in Europe and blood donor cats should be screened for this agent by PCR.