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Capelli G, Genchi C, Baneth G, Bourdeau P, Brianti E, Cardoso L, Danesi P, Fuehrer HP, Giannelli A, Ionică AM, Maia C, Modrý D, Montarsi F, Krücken J, Papadopoulos E, Petrić D, Pfeffer M, Savić S, Otranto D, Poppert S, Silaghi C. Recent advances on Dirofilaria repens in dogs and humans in Europe. Parasit Vectors 2018; 11:663. [PMID: 30567586 PMCID: PMC6299983 DOI: 10.1186/s13071-018-3205-x] [Citation(s) in RCA: 130] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 11/19/2018] [Indexed: 02/03/2023] Open
Abstract
Dirofilaria repens is a nematode affecting domestic and wild canids, transmitted by several species of mosquitoes. It usually causes a non-pathogenic subcutaneous infection in dogs and is the principal agent of human dirofilariosis in the Old World. In the last decades, D. repens has increased in prevalence in areas where it has already been reported and its distribution range has expanded into new areas of Europe, representing a paradigmatic example of an emergent pathogen. Despite its emergence and zoonotic impact, D. repens has received less attention by scientists compared to Dirofilaria immitis. In this review we report the recent advances of D. repens infection in dogs and humans, and transmission by vectors, and discuss possible factors that influence the spread and increase of this zoonotic parasite in Europe. There is evidence that D. repens has spread faster than D. immitis from the endemic areas of southern Europe to northern Europe. Climate change affecting mosquito vectors and the facilitation of pet travel seem to have contributed to this expansion; however, in the authors' opinion, the major factor is likely the rate of undiagnosed dogs continuing to perpetuate the life-cycle of D. repens. Many infected dogs remain undetected due to the subclinical nature of the disease, the lack of rapid and reliable diagnostic tools and the poor knowledge and still low awareness of D. repens in non-endemic areas. Improved diagnostic tools are warranted to bring D. repens diagnosis to the state of D. immitis diagnosis, as well as improved screening of imported dogs and promotion of preventative measures among veterinarians and dog owners. For vector-borne diseases involving pets, veterinarians play a significant role in prevention and should be more aware of their responsibility in reducing the impact of the zoonotic agents. In addition, they should enhance multisectorial collaboration with medical entomologists and the public health experts, under the concept and the actions of One Health-One Medicine.
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Affiliation(s)
- Gioia Capelli
- Laboratory of Parasitology, National reference centre/OIE collaborating centre for diseases at the animal-human interface, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Claudio Genchi
- Department of Veterinary Medicine, Università degli Studi di Milano, Milan, Italy
| | - Gad Baneth
- Koret School of Veterinary Medicine, The Hebrew University, Rehovot, Israel
| | - Patrick Bourdeau
- Veterinary School of Nantes ONIRIS, University of Nantes, LUNAM, Nantes, France
| | - Emanuele Brianti
- Department of Veterinary Science, Università degli Studi di Messina, Messina, Italy
| | - Luís Cardoso
- Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Patrizia Danesi
- Laboratory of Parasitology, National reference centre/OIE collaborating centre for diseases at the animal-human interface, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Hans-Peter Fuehrer
- Institute of Parasitology, University of Veterinary Medicine, Vienna, Austria
| | - Alessio Giannelli
- Department of Veterinary Medicine, University of Bari, Valenzano, Italy
| | - Angela Monica Ionică
- Department of Parasitology and Parasitic Diseases, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Cluj-Napoca, Romania
| | - Carla Maia
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisboa, Portugal
| | - David Modrý
- Department of Pathology and Parasitology, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
- Biology Centre, Institute of Parasitology, Czech Academy of Sciences, České Budějovice, Czech Republic
| | - Fabrizio Montarsi
- Laboratory of Parasitology, National reference centre/OIE collaborating centre for diseases at the animal-human interface, Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Italy
| | - Jürgen Krücken
- Institute for Parasitology and Tropical Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Elias Papadopoulos
- Laboratory of Parasitology and Parasitic Diseases, Faculty of Veterinary Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dušan Petrić
- Laboratory for medical and veterinary entomology, Faculty of Agriculture, University of Novi Sad, Novi Sad, Serbia
| | - Martin Pfeffer
- Institute of Animal Hygiene and Veterinary Public Health, Veterinary Faculty, University of Leipzig, Leipzig, Germany
| | - Sara Savić
- Scientific Veterinary Institute “Novi Sad”, Novi Sad, Serbia
| | - Domenico Otranto
- Department of Veterinary Medicine, University of Bari, Valenzano, Italy
| | - Sven Poppert
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University Basel, Basel, Switzerland
| | - Cornelia Silaghi
- National Centre of Vector Entomology, University of Zurich, Zurich, Switzerland
- Institute of Infectology, Friedrich-Loeffler-Institute, Isle of Riems, Greifswald, Germany
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Abstract
Zusammenfassung:
Gegenstand und Ziel: Der Fallbericht erörtert das diagnostische Vorgehen und differenzialdiagnostische Überlegungen bei Patienten mit Mikrofilarämie und negativem Dirofilaria-immitis-Antigentest und diskutiert die Infektion mit Dirofilaria repens und deren Therapie. Material und Methode: Bei einem Hund aus Ungarn wurden im Blutausstrich Mikrofilarien gefunden. Die weitere Diagnostik zur Differenzierung der Mikrofilarien umfasste einen Dirofilaria-immitis-Antigentest, eine Polymerasekettenreaktion zum Nachweis von Dirofilaria immitis und Dipetalonema reconditum sowie eine Saure-Phosphatase-Reaktion zur Diagnose einer Infektion mit Dirofilaria repens. Ergebnisse: Mittels der Saure-Phosphatase-Reaktion konnte eine Infektion mit Dirofilaria repens diagnostiziert werden. Die Therapie gegen die Mikrofilarien erfolgte mit Selamectin. Schlussfolgerung und klinische Relevanz: Bei mikrofilarämischen Patienten muss differenzialdiagnostisch neben einer Infektion mit Dirofilaria immitis eine Infektion mit anderen, weniger pathogenen Parasiten in Betracht gezogen werden, da sich die Notwendigkeit einer Therapie und das Therapieregime je nach Infektion deutlich unterscheiden.
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Simón F, Siles-Lucas M, Morchón R, González-Miguel J, Mellado I, Carretón E, Montoya-Alonso JA. Human and animal dirofilariasis: the emergence of a zoonotic mosaic. Clin Microbiol Rev 2012; 25:507-44. [PMID: 22763636 PMCID: PMC3416488 DOI: 10.1128/cmr.00012-12] [Citation(s) in RCA: 480] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Dirofilariasis represents a zoonotic mosaic, which includes two main filarial species (Dirofilaria immitis and D. repens) that have adapted to canine, feline, and human hosts with distinct biological and clinical implications. At the same time, both D. immitis and D. repens are themselves hosts to symbiotic bacteria of the genus Wolbachia, the study of which has resulted in a profound shift in the understanding of filarial biology, the mechanisms of the pathologies that they produce in their hosts, and issues related to dirofilariasis treatment. Moreover, because dirofilariasis is a vector-borne transmitted disease, their distribution and infection rates have undergone significant modifications influenced by global climate change. Despite advances in our knowledge of D. immitis and D. repens and the pathologies that they inflict on different hosts, there are still many unknown aspects of dirofilariasis. This review is focused on human and animal dirofilariasis, including the basic morphology, biology, protein composition, and metabolism of Dirofilaria species; the climate and human behavioral factors that influence distribution dynamics; the disease pathology; the host-parasite relationship; the mechanisms involved in parasite survival; the immune response and pathogenesis; and the clinical management of human and animal infections.
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Affiliation(s)
- Fernando Simón
- Laboratory of Parasitology, Faculty of Pharmacy and IBSAL, University of Salamanca, Spain.
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Affiliation(s)
- Claudio Genchi
- Department of Animal Pathology, Università degli Studi di Milano, Milano, Italy
| | - Laura H. Kramer
- Department of Animal Health, University of Parma, Parma, Italy
| | - Francesco Rivasi
- Institute of Human Pathology, University of Modena, Modena, Italy
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Jaksic V, Mitic N, Pavlovic I, Vitosevic Z, Mirkovic M, Zoric L, Stamenkovic D, Vuksa D, Đokić O. Discrete eyelid swelling caused by live subconjunctival Dirofilaria repens. Open Med (Wars) 2011; 6:177-80. [DOI: 10.2478/s11536-010-0070-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AbstractWe present a case concerning a 48 year-old man, who had complaints about ocular pains and an unpleasant feeling, which had started two days before admission. It was as if there was “something moving in his left eye.” The examination showed an extremely motile white worm, which was wrapped in concentric circles around the limb in the subconjunctival space of the patient’s left eye. It was identified as the adult female form of Dirofilaria repens. The patient had a normal clinical finding, except eosinophilia. Ocular filariasis is as a possibility to think about, even when the cases are not in a typically endemic area and with no specific subjective complains.
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Abstract
Dirofilaria repens, a common parasite of carnivore mammals, is transmitted by mosquitos and may also infect humans accidentally causing a subcutaneous dirofilariosis. Autochthonous infections of dogs, foxes or cats with D. repens has not been found in Austria so far; however, 12 cases of imported subcutaneous dirofilariosis in man were noticed between 1981 and 2005. The recent case report deals with the 13(th) human case, which has to be considered as the first autochthonously acquired in Austria.
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Affiliation(s)
- Herbert Auer
- Abteilung für Medizinische Parasitologie, Klinisches Institut für Hygiene und Medizinische Mikrobiologie, MUW, Wien, Osterreich.
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Dzamić AM, Colović IV, Arsić-Arsenijević VS, Stepanović S, Boricić I, Dzamić Z, Mitrović SM, Rasić DM, Stefanović I, Latković Z, Kranjcić-Zec IF. Human Dirofilaria repens infection in Serbia. J Helminthol 2009; 83:129-37. [PMID: 19379543 DOI: 10.1017/S0022149X09341346] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Human infection by Dirofilaria repens in Serbia has been increasing steadily. The first case was reported in 1971, presented in the form of a single subcutaneous nodule on the back of a young boy. As established by a literature search, eight additional cases were reported until mid-2001. The most frequent site of infection was subcutaneous tissue, with the exception of two cases, in which parasites were found in subconjunctiva and epididymis. Our study, conducted from 2001 to 2008, encompasses 19 new cases. Most of them (63.1%) presented as ocular or periocular infections, in which the parasite was typically found under the conjunctiva. In other cases a parasitic nodule was localized in the temporal region of the head, epididymis, testicle, abdomen, breast or arm. The diagnosis was made by morphological and histological analysis of the extracted intact worms and parasite sections from the tissue. Morphology of the filarial worms was well preserved in more than half of the cases (12/19) and there was never more than one parasite found inside the lesions. Adult worms and immature nematodes were observed in nine and seven cases, respectively. Furthermore, in two cases microfilariae were discovered inside the pseudocoelom, sections of the female reproductive tubes filled with clearly visible larval stages. Dirofilaria repens infection was diagnosed by its morphological features (17/19) or by performing polymerase chain reactions (PCR) using paraffin-embedded tissues (2/19) in the cases where the morphology was insufficient for identification and the parasites had been determined initially as Dirofilaria spp. The amplified 246 bp PCR product showed that the worms were D. repens.
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Abstract
A patient with a diagnosis of chronic and idiopathic unilateral dacryoadenitis was submitted to our clinic for diagnostic reasons from a regional hospital. Within a period of 1 year, this was the second onset of a swelling in the region of the lacrimal gland which - unlike the first time - showed resistance to antibiotic treatment. The patient's general and ophthalmic condition was good, and his only complaint was of cosmetic nature because of the disfiguring swelling in the lateral part of the left upper eyelid. Basic laboratory findings showed no abnormalities and radiographic imaging showed enlargement of the left lacrimal gland without bony destruction. Guided by epidemiological data for noninfectious dacryoadenitis we decided to perform excisional biopsy of the left lacrimal gland. To our surprise, the pathologist verified the presence of a worm of the genus Dirofilaria, which is, to the best of our knowledge, the second reported case of lacrimal gland dirofilariasis in the literature and the second reported case of such a disease in Croatia.
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Affiliation(s)
- Jelena Juri
- Department of Ophthalmology, Medical School, University of Zagreb, Clinical Hospital Center Zagreb, Zagreb, Croatia.
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