Canine infection with Dirofilaria immitis, Borrelia burgdorferi, Anaplasma spp., and Ehrlichia spp. in the United States, 2013-2019

BACKGROUND

Dogs in the US are commonly infected with vector-borne pathogens, including heartworm and tick-borne disease agents. The geographic distribution of both arthropod vectors and the pathogens they transmit continues to expand.

METHODS

To describe the current geographic distribution and prevalence of antigen of Dirofilaria immitis and antibody to Borrelia burgdorferi, Ehrlichia spp., and Anaplasma spp. in dogs, we summarized over 144 million test results from 2013 to 2019, inclusive, by county, state, and region. Canine seroprevalence by state was compared to population-adjusted human reports of tick-borne diseases.

RESULTS

Results varied regionally, with D. immitis antigen and Ehrlichia spp. antibodies more frequently detected in the Southeast (2.6% and 5.2%, respectively) and antibody to B. burgdorferi and Anaplasma spp. most common in the Northeast (12.1% and 7.3%, respectively). Overall, percent positive test results to D. immitis decreased in the Southeast by 33.3% when compared to earlier summaries using the same strategy (from 3.9 to 2.6%). Geographic expansion of areas where dogs commonly test positive for Ehrlichia spp. was evident, likely because of a change in the test made in 2012 to allow detection of antibodies to E. ewingii concomitant with expansion of vector tick populations. Percent positive test results to Ehrlichia spp. increased in every region; this shift was particularly pronounced in the Southeast, where percent positive test results increased fourfold (from 1.3 to 5.2%). Continued geographic expansion of B. burgdorferi and A. phagocytophilum was apparent in the Northeast, Midwest, and Upper South, although canine seroprevalence of antibody to B. burgdorferi was much lower than prior surveys in many Lyme-endemic areas. Annual reports of human cases of Lyme disease, ehrlichiosis, and anaplasmosis were associated with percent positive canine results by state for the three tick-borne disease agents (R2 = 0.812, 0.521, and 0.546, respectively). Within endemic areas, percent positive test results for all three tick-borne agents demonstrated evidence of geographic expansion.

CONCLUSIONS

Large scale analysis of results from screening dogs in practice for evidence of vector-borne infections, including those with zoonotic importance, continues to be a valuable strategy for understanding geographic trends in infection risk over time.

Comparative evaluation of field samples using 2 in-clinic assays for heartworm antigen detection in dogs

Dirofilaria immitis (heartworm) antigen testing is routinely performed in veterinary practices to detect canine heartworm infections. The purpose of this study was to evaluate the performance of two in-clinic assays to detect heartworm antigen on field samples from practices in heartworm endemic regions. Veterinary staff in 3 practices located in the Southern United States performed a side by side comparison of the SNAP® 4Dx® Plus Test (IDEXX) and the VETSCAN FLEX4® Test (Zoetis) on samples from canine patients presented for vector-borne disease screening. Assays were performed according to the manufacturer's instructions. The remaining plasma sample was submitted for confirmatory testing using the PetChek® Heartworm Test (IDEXX) including immune complex dissociation (ICD) by heat treatment. A total of 232 samples were evaluated by the two in-clinic assays and PetChek Test. SNAP 4Dx Plus was significantly more sensitive for the detection of heartworm antigen in this study; sensitivity was 97.4 % for the SNAP 4Dx Plus test and 76.9 % for VETSCAN FLEX4 test (p < 0.01). The specificity of both tests was 99.5 %. This study reveals significant difference in detecting canine heartworm antigen in field samples.

Associations between clinical canine leishmaniosis and multiple vector-borne co-infections: a case-control serological study

BACKGROUND

Dogs that have clinical leishmaniosis (ClinL), caused by the parasite Leishmania infantum, are commonly co-infected with other pathogens, especially vector-borne pathogens (VBP). A recent PCR-based study found that ClinL dogs are more likely to be additionally infected with the rickettsial bacteria Ehrlichia canis. Further information on co-infections in ClinL cases with VBP, as assessed by serology, is required. The research described in this report determined if dogs with ClinL are at higher risk of exposure to VBP than healthy control dogs using a case-control serology study.

RESULTS

Of the 47 dogs with ClinL, anti-E. canis/ Ehrlichia ewingii antibodies were detected in 17 (36.2%), anti-Anaplasma phagocytophilum/Anaplasma platys antibodies in 5 (10.6%) and antigen for Dirofilaria immitis in 2 (4.3%). Of the 87 control dogs, anti-E. canis/E. ewingii antibodies were detected in 14 (16.1%) and anti-A. phagocytophilum/A. platys antibodies in 2 (2.3%). No anti-Borrelia burgdorferi antibody tests were positive. No statistical differences between the ClinL dogs and control dogs regarding lifestyle or use of ectoparasitic prevention, were identified. The ClinL was significantly associated with anti-E. canis/E. ewingii antibodies (odds ratio = 2.9, 95% confidence interval: 1.3-6.7, P = 0.010) compared to controls by both multivariable logistic regression and structural equation modelling.

CONCLUSIONS

It was demonstrated that an increased risk for E. canis/E. ewingii seropositivity is present in dogs with ClinL compared to clinically healthy control dogs, despite similar ectoparasitic prevention use and lifestyle. Based on these findings it is suggested that dogs with ClinL should not only be tested for E. canis co-infection using PCR but also serologically for E. canis/E. ewingii.

Countrywide serological evaluation of canine prevalence for Anaplasma spp., Borrelia burgdorferi (sensu lato), Dirofilaria immitis and Ehrlichia canis in Mexico

BACKGROUND

Canine vector-borne diseases (CVBD) have become a major concern for canine and human public health. The aim of the study described here is to add epidemiological data regarding four pathogens responsible for CVBD, namely anaplasmosis, borreliosis, dirofilariosis and ehrlichiosis in a national survey conducted in Mexico.

METHODS

Seventy-four veterinary centres located in 21 federal Mexican states were asked to test dogs with clinical signs suspect for CVBD and healthy dogs, for detection of Dirofilaria immitis antigen and antibodies against Anaplasma spp., Borrelia burgdorferi (sensu lato) and Ehrlichia canis using the SNAP® 4DX® from IDEXX® Laboratories.

RESULTS

A total of 1706 dogs were tested, including 943 apparently healthy and 722 CVBD-suspect dogs. Infected dogs were 36.7 %. The highest percentages of infection with E. canis (51.0 %) and Anaplasma spp. (16.4 %) were obtained in the northwestern region, while D. immitis was most frequently found in the northeastern region of the country (8.9 %). Four dogs from the northwestern, northeastern, eastern and southeastern regions, respectively, were positive for B. burgdorferi (sensu lato). Northcentral regions showed lowest overall prevalence of infection (2.4 %). Co-infections were detected in 8.8 % of the dogs tested. Statistically significant lower positivity was found among dogs aged less than one year (23.2 %) and small-sized dogs (27.6 %), while higher prevalence of infection was found in dogs living outdoors (42.0 %), dogs with detectable tick infestation (43.3 %) and dogs that received treatment for tick-transmitted infections (58.8 %). Seropositivity was a risk factor for the presence of clinical signs as follows: Anaplasma spp. (OR = 2.63; 95 % CI: 1.88-3.67; P < 0.0001), D. immitis (OR = 2.52; 95 % CI: 1.61-3.95; P < 0.0001), E. canis (OR = 3.58; 95 % CI: 2.88-4.45; P < 0.0001), mixed infections (OR = 4.08; 95 % CI: 2.79-5.96; P < 0.0001), one or more agents (OR = 3.58; 95 % CI: 2.91-4.42; P < 0.0001).

CONCLUSIONS

Canine serological evidence supports that dogs from Mexico are at risk of acquiring Anaplasma spp., D. immitis and/or E. canis, while B. burgdorferi (sensu lato) transmission is minimal in the country. Practitioners play a fundamental role in the detection and control of these diseases to protect dogs and humans.

Recent study on canine vector-borne zoonoses in southern Slovakia - serologic survey

Over the last decade a significant spread of Canine Vector Borne Diseases has been recorded in Central Europe. The aim of the study described here, was to collect current data on the occurrence and distribution of three major canine vector-borne pathogens in the veterinary clinical practice by a newly-developed commercial ELISA test for the detection of Dirofilaria immitis antigen as well as specific circulating antibodies to Anaplasma phagocytophilum and Borrelia burgdorferi sensu lato. Circulating D. immitis antigen was detected in five of 180 investigated sera samples. Two of D. immitis seropositive dogs revealed also microfilariae of D. repens in the blood and three of them were negative for the presence of microfilariae in the Knott's test. From the practical point of view, the finding of D. immitis occult infections might influence existing knowledge about distribution of this species among dogs in Central European countries. In 11.7% of the tested dogs the presence of specific antibodies against A. phagocytophilum was confirmed. Antibodies against B. burgdorferi s.l. were detected in 2.8% of tested sera samples. Coinfection with A. phagocytophilum and B. burgdorferi s.l. was observed in two dogs from Košice district in south-eastern Slovakia. Our data point toward the presence of Canine Vector Borne Diseases in the studied area. Therefore, veterinarians should include these diseases in their differential diagnosis and higher awareness should be focused also on prophylactic measures to prevent the pathogens transmission by arthropod vectors.

Toxoplasma gondii, Dirofilaria immitis, feline immunodeficiency virus (FIV), and feline leukemia virus (FeLV) infections in stray and pet cats (Felis catus) in northwest China: co-infections and risk factors

This study was conducted to estimate the prevalence of Toxoplasma gondii, Dirofilaria immitis, feline immunodeficiency virus (FIV), and feline leukemia virus (FeLV) infections among stray and pet cats in Lanzhou, northwest China, and to identify the influence of age, gender, and regions on seropositivity. T. gondii antibodies were examined in cat sera by the modified agglutination test (MAT). The circulating antigens of D. immitis and FeLV and specific antibodies to FIV were examined using kits commercially available. The overall prevalence of T. gondii, FIV, FeLV, and D. immitis was 19.34, 9.12, 11.33, and 3.04 %, respectively. For the genetic characterization of T. gondii genotypes in cats, genomic DNA was extracted from the seropositive cats and the T. gondii B1 gene was amplified using a semi-nested PCR. DNA samples giving positive B1 amplification were then genotyped using multilocus PCR-RFLP. Two T. gondii genotypes (ToxoDB#9 and ToxoDB#1) were identified. Results of the multivariate logistic regression analysis showed that older cats are more likely to be seropositive than juveniles for T. gondii, FIV, FeLV, and D. immitis. This is the first report of T. gondii genotypes in cats in northwest China. Moreover, the present study is the first study of retrovirus and D. immitis seroprevalence in cats in China. The results revealed that T. gondii, FIV, and FeLV infections are common in stray and pet cats in northwest China.

[Asymptomatic human infection from contact with dogs: a case of human ehrlichiosis]

INTRODUCTION

Living with dogs leads one to consider the necessity of identifying canine infections found in the people with whom the dogs live.

OBJECTIVE

Dogs which were clinically and serologically positive with the infections Ehirlichia canis, Anaplasma phagocytophilum, Borrelia burgdorferi, and Dirofilaria Immitis were sought. People with the same infections were also identified.

MATERIAL AND METHODS

From a population of 80 dogs identified in the villages of San Bartolo Coyotepec and San Agustín Etla (suburbs peripheral to the city of Oaxaca, Mexico), 27 dogs were selected for study, all of which had adenomegaly, hepatomegaly, splenomegaly, and fevers of at least 43° C. Using enzyme immunoassay in this population of dogs and their closest human contacts, antibodies for Ehirlichia canis, Anaplasma phagocytophilum, Borrelia burgdorferi, and the antigen for Dirofilaria immitis were sought. Positive results in humans were confirmed by polymerase chain reaction (PCR).

RESULTS

Ten dogs with the clinical signs mentioned above tested positive for antibodies to Ehrlichia canis; two cases tested positive for Anaplasma phagocytophilum; one case tested positive for Dirofilaria Immitis. From human contact, one person tested positive for Ehirlichia canis; this case was confirmed by DNA amplification by means of PCR.

CONCLUSION

It is necessary to identify the population of sick dogs in order to reduce related infections in people.

Human and animal dirofilariasis: the emergence of a zoonotic mosaic

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.

Seroprevalence of Borrelia burgdorferi, Anaplasma phagocytophilum, Ehrlichia canis, and Dirofilaria immitis among dogs in Canada

The seropositivity of dogs to Borrelia burgdorferi, Anaplasma phagocytophilum, and Ehrlichia canis antibodies, and Dirofilaria immitis antigen was assessed in Canada. Borrelia burgdorferi had the highest seroprevalence, while that of Dirofilaria immitis has not changed significantly in the past 20 y. The risk for these vector-borne infectious agents in Canadian dogs is low but widespread with foci of higher prevalence.

Size and charge antigens of Dirofilaria immitis adult worm for IgG-ELISA diagnosis of bancroftian filariasis

We used Dirofilaria immitis adult worm antigens to develop an IgG-ELISA, then used this to evaluate 30 serum samples of patients with proven Wuchereria bancrofti infection, 131 samples of patients with other parasitic diseases and 30 serum samples of healthy controls. The D. immitis antigen was prepared using two methods: Sephacryl S-200 chromatography and iso-electric focusing with a Rotofor cell. This was done to determine the best method for diagnosing W. bancrofti filariasis. Before fractionation, crude male D. immitis antigen yielded 100% sensitivity and 60.8% specificity, and crude female antigen yielded 80% sensitivity and 52.8% specificity, respectively, to detect W. bancrofti infection. After gel filtration chromatography, the male D. immitis antigen, called MP1, yielded 100% sensitivity and 95% specificity, and female D. immitis antigen, called FmP1, gave 100% sensitivity and 59.6% specificity, to detect W. bancrofti infection. Using iso-electric-focusing, both male and female crude D. immitis antigens (Iso-MF and Iso-FmF, respectively) were separated mechanically into 20 iso-fractions (F1-F20) each. By preliminary screening with ELISA, using pooled positive and negative sera, Iso-MF10, pH 7.5, and Iso-FmF14, pH 7.6, were selected. Iso-MF10 gave 100% sensitivity and 96.9% specificity, and Iso-FmF14 gave 100% sensitivity and 64% specificity. In the study, Og4C3-ELISA, for the detection of circulating filarial antigen, was also used to analyze these serum samples, it gave 87.6% sensitivity and 99.4% specificity to detect W. bancrofti infection. Male D. immitis antigens, MP1 and Iso-MF10, gave high sensitivity and specificity, and appear to be the best choices for use in an ELISA to diagnose bancroftian filariasis.

Activation in vitro of some biological systems by extracts of adult worms and microfilariae of Dirofilaria immitis

Extracts of Dirofilaria immitis adults and microfilariae cause the dcgranulation of mast cells in rat mesentery when applied in vitro and also cause increased vascular permeability in guinea-pigs and rabbits. Adult worms DUt not microfilariac are able to activate complement in vitro and both stages contain a plasminogen activator. No protcolytic activity or hacmolysins could be detected in cither stage. The possibility that these factors may be important in the pathogencsis of dirofilariasis and in the adverse drug reactions that may follow treatment of microfilaraemic animals with dicthylcarbamazine is discussed.

Dirofilaria immitis in cats: diagnosis and management

Imaging and laboratory studies can help with the diagnosis of heartworm disease in cats, but no test is definitive. Furthermore, even when the diagnosis can be reliably established, therapy directed at the heartworms does little to help the cat. Rather, management is directed at alleviating clinical signs, with an emphasis on prevention for all.

A survey for infection with Dirofilaria immitis, Ehrlichia canis, Borrelia burgdorferi, and Babesia canis in feral and client-owned dogs in the Turks and Caicos Islands, British West Indies

The frequency of infection with Dirofilaria immitis and Babesia canis and seropositivity to Ehrlichia canis and Borrelia burgdorferi in feral and client-owned dogs was determined. Feral dogs were 14.8 and 11.2 times more likely to be seropositive to D. immitis and E. canis, respectively, than were client-owned dogs. None of the dogs tested positive for B. burgdorferi or B. canis.

Vascular endothelial cell activation by adult Dirofilaria immitis antigens

Dirofilaria immitis is the causal agent of cardiopulmonary dirofilariosis (heartworm disease). Adult worms lodge in the pulmonary arteries and right ventricle, thus vascular endothelium is exposed to high concentrations of Dirofilaria antigenic products. Heartworm disease habitually develops as a chronic foreseeable pathology. Moreover, the simultaneous death of many adult worms, naturally or induced by a filaricide treatment, can cause acute thromboembolisms and endarteritis. To better understand the effects of the massive death of D. immitis adult worms on the blood vessel endothelium, we cultured vascular endothelial cells in the presence or absence of an antigenic extract of D. immitis adult worms (DiSA). The parasite products increased the expression of enzymes and the synthesis of eicosanoids related to inflammation, such as COX-2, 5-LO, PGE(2) and LTB(4). The expression of ICAM-1 and PECAM-1 adhesion molecules and endothelial and inducible Nitric Oxide Synthases (eNOS and iNOS) was also increased in cultures treated with DiSA. Nevertheless, DiSA decreased endothelial permeability and does not alter both proliferation and apoptosis. These results suggest that the somatic extract of D. immitis adult worms stimulate inflammatory mechanisms in endothelial cells, without altering their basic physiologic processes.

The prevalence of Dirofilaria immitis in dogs in Kirikkale

Heartworm infection is one of the most important parasitic diseases in dogs. The aim of the present study was to determine the prevalence of heartworm in dogs in Kirikkale. Blood samples of 172 dogs were collected. Microfilariae were detected in 10 (5.8%). dogs with the Knott technique. The anal and excretory pores stained with acid phosphates showed that the microfilariae belonged to Dirofilaria immitis. Microfilariae were found in dogs aged between 2-10 years, and especially in Siberian huskies, setters, pointers and crossbred sheepdogs. The serum samples of 142 dogs were analyzed using the commercial ELISA test kit for detection of anti-D. immitis antibody. The occult infection rate was found to be 27.46% in dogs. According to these results, Kirikkale region has a high risk for heartworm infection.

Cell adherence to microfilariae of Onchocerca volvulus: a comparative study

The conditions were examined for in vitro antibody-mediated adherence of granulocytes to microfilariae of Onchocera volvulus and Dirofilaria immitis. Reactivity in human sera from patients in endemic foci in Sudan was specific for O. volvulus and no reactions were observed with heterologous Onchocerca species or with Mansonella perstans. Microfilariae from skin, nodules or adult female worms were satisfactory targets for cell adherence, and the cells involved were almost exclusively eosinophils. The reaction was inhibited by indomethacin but not by nordihydroguaiaretic acid, an inhibitor of leukotriene production. Agents that slowed or stopped microfilarial motility (e.g. nifedipine, lidocaine, chloroquine) inhibited the reaction, probably by reducing target/cell contact. Ivermectin did not enhance the reaction, and in the absence of cells exerted only slight effects on the movement of microfilariae at higher concentrations (greater than 10 micrograms/ml). Antibody activity was labile, and did not persist well through freeze-thaw cycles. Some differences between homologous and heterologous mixtures (microfilariae/cells/serum) were seen but they could not be resolved satisfactorily. There were no apparent geographical differences between microfilariae from different foci in Sudan. In the D. immitis system neutrophils were the dominant cell type adhering to microfilariae, and the activity was stable to storage and freeze-thaw. No enhancement was detectable with diethylcarbamazine. Antibody activity was absorbable with microfilarial antigens and was reduced by agents that inhibited microfilarial motility. In dogs, adherence-mediating antibody was seen only in amicrofilaraemic animals with occult infection, and in only a minority of these sera. In humans the relationship to clinical findings was less clear, but patients with punctate keratitis were the most likely to have positive serum and were the most reactive in the assay. This system may therefore offer some insights into disease mechanisms in vivo, and its molecular mechanisms deserve further characterization.

Seroprevalence ofDirofilaria immitis, feline leukemia virus, and feline immunodeficiency virus infection among dogs and cats exported from the 2005 Gulf Coast hurricane disaster area

OBJECTIVE

To determine seroprevalence of dirofilariasis in dogs and seroprevalences of dirofilariasis, FeLV infection, and FIV infection in cats exported from the Gulf Coast region following the 2005 hurricanes.

DESIGN

Seroprevalence survey.

ANIMALS

1,958 dogs and 1,289 cats exported from Louisiana, Mississippi, and Texas between August 20 and December 31, 2005.

PROCEDURES

141 animal welfare groups in 37 states and Alberta, Canada, reported results of serologic testing. Risk factors for infection, including age, sex, neuter status, breed, and state of rescue, were examined by means of univariate and multivariate logistic regression.

RESULTS

Seroprevalence of dirofilariasis in dogs was 48.8%. Sexually intact dogs were 1.6 times as likely to have dirofilariasis as were neutered dogs, dogs in the ancient breed group were 2.2 times as likely and dogs in the guarding breed group were 1.7 times as likely to have dirofilariasis as were dogs in the herding breed group, and dogs from Mississippi were significantly less likely to have dirofilariasis than were dogs from Texas. Seroprevalences of dirofilariasis, FeLV infection, and FIV infection in cats were 4.0%, 2.6%, and 3.6%, respectively. Seroprevalence of FIV infection was significantly higher in adult cats than in juveniles and in males than in females.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggest that dogs and cats exported from the 2005 Gulf Coast hurricane disaster area had disease rates similar to those for animals in the region prior to the hurricanes.

Gray foxes (Urocyon cinereoargenteus) as a potential reservoir of a Bartonella clarridgeiae-like bacterium and domestic dogs as part of a sentinel system for surveillance of zoonotic arthropod-borne pathogens in northern California

Two species of Bartonella, a novel Bartonella clarridgeiae-like bacterium and B. vinsonii subsp. berkhoffii, were isolated from rural dogs and gray foxes in northern California. A novel B. clarridgeiae-like species was isolated from 3 (1.7%) of 182 dogs and 22 (42%) of 53 gray foxes, while B. vinsonii subsp. berkhoffii was isolated from 1 dog (0.5%) and 5 gray foxes (9.4%). PCR and DNA sequence analyses of the citrate synthase (gltA) gene and the 16S-23S intergenic spacer region suggested that strains infecting dogs and gray foxes were identical. Fifty-four dogs (29%) and 48 gray foxes (89%) had reciprocal titers of antibodies against Bartonella spp. of > or =64. The high prevalence of bacteremia and seroreactivity to Bartonella spp. in gray foxes suggests that they may act as a reservoir species for the B. clarridgeiae-like species in this region. Domestic dogs were also tested for other arthropod-borne infectious agents. Fifty-one dogs (28%) were positive for Dirofilaria immitis antigen, seventy-four (40%) were seroreactive to Anaplasma phagocytophilum, and five (2.7%) were seropositive for Yersinia pestis. Fourteen dogs (7.6%) were PCR positive for A. phagocytophilum. Polytomous logistic regression models were used to assess the association of Bartonella antibody titer categories with potential risk factors and the presence of other vector-borne agents in domestic dogs. Older dogs were more likely to be seroreactive to Bartonella spp. There was no association between the exposure of dogs to Bartonella and the exposure of dogs to A. phagocytophilum in this study.

Experimental Infection of Dirofilaria immitis in Raccoon Dogs

Canine heartworm (Dirofilaria immitis) is a nematode that naturally parasitizes in the pulmonary arteries and the right ventricle of domestic dogs (Canis familiaris) as final hosts. Japanese raccoon dogs (Nyctereutes procyonoides viverrinus) also are known to be susceptible to infection by the parasite. However, prevalence of this infection among free-ranging raccoon dogs is low and so is the worm burden. To examine the susceptibility of the raccoon dog to D. immitis infection, 3 raccoon dogs and 2 beagles were inoculated 4 times with 25 third-stage larvae (L3s) of D. immitis at 3-wk intervals. Worms were recovered from 2 raccoon dogs and both domestic dogs. The average percentage of recovery (2.3%) of the raccoon dogs was almost 10 times lower (24.5%) than that of the domestic dogs, but there was no significant difference in the body length of worms recovered from 2 types of hosts. To examine microfilaremia, 2 raccoon dogs were infected with 100 L3s. Microfilaremia was observed for 180 days postinoculation (PI) but disappeared at about 300 days PI. The raccoon dog was mildly susceptible to infection with D. immitis, but surviving worms developed and matured normally.

Immunopathology of Dirofilaria immitis infection

Heartworm disease caused by Dirofilaria immitis affects canine and feline hosts, with infections occasionally being reported in humans. Studies have shown that both dirofilarial antigens and those derived from its bacterial endosymbiont Wolbachia, interact with the host organism during canine, feline and human infections and participate in the development of the pathology and in the regulation of the host's immune response. Both innate and acquired immune responses are observed and the development of the acquired response may depend on the host and, or on its parasitological status. This review aims at illustrating current research on the role of both D. immitis and Wolbachia, in the immunology and immunopathology of dirofilariosis.

Evaluation of a covered-rod silicone implant containing ivermectin for long-term prevention of heartworm infection in dogs

OBJECTIVE

To evaluate use of covered-rod (CR) silicone implants containing ivermectin for long-term prevention of infection with Dirofilaria immitisin dogs.

ANIMALS

145 adult male and female dogs.

PROCEDURES

Dogs received implants of different sizes, and ivermectin concentrations and serum ivermectin concentrations were monitored for 16, 57, and 56 weeks, respectively, in 3 preclinical dose selection studies. Ability of implants to prevent infection with D immitis was evaluated in 2 further studies; dogs were challenged with 50 infective third-stage larvae 52 weeks after implant administration and necropsied 145 days after challenge, and the total number of adult heartworms was counted. A field study was then undertaken in which client-owned dogs received an implant and plasma samples were collected at intervals until week 52 for ivermectin analysis and heartworm antigen determination.

RESULTS

Use of the implants resulted in maintenance of an ivermectin concentration > or = 0.2 ng/mL for 12 months. In challenge studies, no treated dogs had adult heartworms, in contrast to untreated dogs, which all had adult heartworms at necropsy. In the field study, dogs treated with an implant had negative results of heartworm antigen testing for 12 months.

CONCLUSIONS AND CLINICAL RELEVANCE

The CR silicone implant containing 7.3 mg of ivermectin was 100% effective in preventing experimental infection with D immitislarvae and resulted in negative results for heartworm antigen in a field trial. This product has the potential to alleviate poor owner compliance with monthly prevention regimens.

Focos de dirofilariose canina na Ilha do Marajó: um fator de risco para a saúde humana

A ocorrência de dirofilariose pulmonar humana relaciona-se com a prevalência de infecção por Dirofilaria immitis na população canina. Várias espécies de mosquitos são vetores desse nematóide. Analisaram-se amostras de sangue canino coletados nas vilas Pingo d'Água e União, município de Salvaterra (Ilha do Marajó, PA), em junho, 2004 (n=34) e abril, 2005 (N=90). Os diagnósticos parasitológico e imunológico (ELISA - kit SNAP® 3DX™, Biobrasil) foram comparados (chi2, alfa=0,05) no exame de 34 amostras. A prevalência na população (N=90) foi avaliada pelo ELISA. O ELISA revelou mais positivos (25/34; 73,5%) que a gota espessa (23/34, 67,6%) e o Knott (21/34, 61,8%), mas a diferença não foi significativa (p>0,05). A freqüência de infecção por D. immitis na faixa de 0 a 2 anos foi 58%, enquanto em cães mais velhos foi 100%. A prevalência da dirofilariose canina em Pingo d'Água e Vila União foi alta (53,5%), indicando risco de transmissão do parasito às pessoas nessa área.

Pulmonary arterial disease in cats seropositive for Dirofilaria immitis but lacking adult heartworms in the heart and lungs

OBJECTIVE

To determine the prevalence and severity of pulmonary arterial lesions in cats seropositive for heartworms (Dirofilaria immitis) but lacking adult heartworms in the heart and lungs during necropsy.

ANIMALS

630 adult cats from an animal control shelter in Florida.

PROCEDURE

Cats were tested for adult heartworms in the heart and pulmonary arteries and antibody against heartworms in the serum. Histologic examination was conducted on the right caudal lung lobe of 24 heartworm- and antibody-positive cats; 24 heartworm-negative and antibody-positive cats; and 24 heartworm-, antibody-, and antigen-negative cats. Wall areas of 10 small to medium-sized pulmonary arteries of each cat were measured and expressed as a proportion of total cross-sectional area.

RESULTS

Heartworm infection or seropositive status was significantly and strongly associated with seventy of medial hypertrophy of pulmonary arterial walls. Heartworm- and antibody-positive cats and heartworm-negative and antibody-positive cats had a significant increase in wall thickness, compared with wall thickness for heartworm- and antibody-negative cats. Heartworm- and antibody-positive cats had the most severe hypertrophy. The proportion with occlusive medial hypertrophy was significantly higher in heartworm- and antibody-positive cats (19/24 [79%]) and heartworm-negative and antibody-positive cats (12/24 [50%]), compared with heartworm- and antibody-negative cats (3/24 [13%]).

CONCLUSIONS AND CLINICAL RELEVANCE

Cats with serologic evidence of exposure to heartworms, including those without adult heartworms in the lungs and heart, have a greater prevalence of pulmonary arterial lesions than heartworm-negative cats without serologic evidence of exposure. Additional studies are needed to define the pathogenesis, specificity, and clinical importance of these lesions.

Physiological and haematological findings and clinical observations in a model of acute systemic anaphylaxis in Dirofilaria immitis-sensitised cats

OBJECTIVE

This study aims to understand the pathophysiology of anaphylaxis in Dirofilaria immitis-sensitised cats by analysing objective physiological and haematological measurements after challenge.

DESIGN

Nineteen healthy D immitis-naive cats were sensitised using weekly injections of aluminium hydroxide-adjuvanted D immitis antigen, administered subcutaneously over 6 weeks. After sensitisation, cats (n = 16) were anaesthetised and challenged with intravenous D immitis antigen. A control group (n = 3) was sham-challenged using intravenous sterile 0.9% saline. Systolic blood pressure (measured non-invasively/indirectly), respiratory rate, degree of dyspnoea, blood O2 saturation, expired CO2, and heart rate and were measured immediately before and at 10 to 15 min intervals after challenge until terminal apnoea occurred or euthanasia at 140 mins post-challenge. Blood was collected for complete blood count immediately before and at 10, 20 and 35 mins after challenge. Clinical observations were recorded as they occurred.

RESULTS

Antigen-challenged cats were divided into two groups: acute (apnoea occurred within 25 mins of challenge) and subacute (breathing at 25 mins after challenge). In both groups, the degree of dyspnoea increased and blood O2 saturation and blood pressure decreased. Respiratory rate increased in the subacute group. Expired CO2 decreased in both Ag-challenged and control groups. Haematocrit increased in the subacute group. Neutrophil count decreased in the acute group and platelet count decreased in the subacute group. Eosinophil count decreased in the subacute and control groups. Sustained dyspnoea and gastrointestinal signs were the most common clinical manifestations of anaphylaxis in the antigen-challenged cats.

CONCLUSIONS

Intravenous challenge with D immitis antigen in sensitised cats results in dyspnoea, hypoxaemia and systemic hypotension accompanied by haemoconcentration.

Increase in cellular immune responses in Onchocerca-infected cattle after treatment with the microfilaricide, milbemycin

Lymphocytes from Onchocerca-infected steers treated with the microfilaricide, milbemycin showed increased proliferation when challenged with antigen from Dirofilaria immitis, concanavalin A, tuberculin and tetanus toxoid, compared with untreated animals. This paper confirms that Onchocerca infection induces immunosuppression to filarial and non-filarial antigens. It raises the possibility that filarial-induced immunosuppression may increase the susceptibility to mycobacterial infections and reduce the efficacy of vaccinations and strongly indicates that further research is required.

Environmental factors associated with Bartonella vinsonii subsp. berkhoffii seropositivity in free-ranging coyotes from northern California

Bartonella vinsonii subsp. berkhoffii is a newly recognized pathogen of domestic dogs and humans. Coyotes (Canis latrans) are considered an important reservoir of this bacterium in the western United States, but its vectors are still unknown. Our objective was to identify environmental factors associated with Bartonella antibody prevalence in 239 coyotes from northern California, using an enzyme-linked immunosorbent assay. In addition, associations were evaluated between B. v. berkhoffii and two pathogens with known vectors and habitat requirements, Dirofilaria immitis and Anaplasma phagocytophilum. Overall, B. v. berkhoffii seroprevalence was 28% (95% confidence interval [CI], 22.3%, 33.7%) and Bartonella seropositive coyotes were more likely than seronegative coyotes to be positive for Anaplasma phagocytophilum (Odds ratio = 3.3; 95% CI = 1.8, 5.9) and Dirofilaria immitis (Odds ratio = 2.1; 95% CI = 1.2, 3.8). The most likely geographic clusters of Bartonella and Dirofilaria overlapped. Bartonella seropositivity was associated with higher precipitation (p = 0.003) and proximity to the coast (p = 0.007) in univariate analysis. The association with precipitation varied with season, based on a logistic regression model.

Increased rat alveolar macrophage expression of functional iNOS induced by a Dirofilaria immitis immunoglobulin superfamily protein

Dirofilaria immitis is a worldwide filarial nematode causing heartworm disease in dogs and cats. Several mosquito species, which are able to feed both on humans and animals, can transmit this parasite. Inflammatory progression of host tissues induced by parasites are mediated by several molecules, including nitric oxide (NO), which usually exerts deleterious effects on parasites and occasionally on the host. We analyze the in vitro effect of total D. immitis adult worm somatic antigens on naïve rat alveolar macrophage NO production and further separation of parasite proteins to define specific D. immitis somatic molecules influencing host cell NO secretion. Additionally, we address the possible influence of Wolbachia spp. on the in vitro production of NO by macrophages. Our results demonstrate that D. immitis adult worm soluble antigens are able to specifically induce NO production from host macrophages. Furthermore, we demonstrated that this effect is due to nematode antigens rather than to defined components (LPS and metabolic molecules) derived from its endosymbiont, Wolbachia spp. In addition, we were able to isolate and identify one of the parasite specific components from the DiSo extract, denominated DiID35.3 and putatively belonging to the Immunoglobulin Superfamily Protein (ISP) group, triggering NO release from macrophages in a dose-dependent and specific manner.

Mosquito innate immunity: involvement of beta 1,3-glucan recognition protein in melanotic encapsulation immune responses in Armigeres subalbatus

Beta 1,3-glucan recognition proteins (GRP) have specific affinity for beta 1,3-glucan, a component on the surface of fungi and bacteria. By interacting with beta 1,3-glucan, GRP initiates activation of prophenoloxidase, a key enzyme in the signaling pathway leading to melanotic encapsulation in invertebrates. In this study, we characterize a novel hemocyte-specific GRP from the mosquito, Armigeres subalbatus (AsGRP). The 1.57 kb cDNA clone encodes a 499 deduced amino acid sequence, which contains a region that displays significant similarity to the glucanase-like regions of other GRPs and Gram-negative bacteria binding proteins found in other organisms. AsGRP is constitutively expressed in the hemolymph of adult female mosquitoes, and is upregulated following challenge with Escherichia coli, Micrococcus luteus, and the filarial worm Dirofilaria immitis. AsGRP specifically recognizes curdlan (insoluble beta 1,3-glucan), but not mannose or N-acetyl-D-glucosamine. AsGRP binds a low percentage of E. coli, most M. luteus and D. immitis microfilariae. AsGRP double-stranded RNA interference strongly inhibits melanotic encapsulation of D. immitis in Ar. subalbatus. These results suggest that AsGRP has the capacity to bind to a variety of pathogens, functions as a pattern recognition receptor, and is required for effective melanotic encapsulation immune responses in Ar. subalbatus.

Prevalence of naturally occurring Dirofilaria immitis infection among nondomestic cats housed in an area in which heartworms are endemic

OBJECTIVE

To determine prevalences of heartworm exposure (ie, positive heartworm antibody test results) and heartworm infection (ie, positive heartworm antigen test results or identification of mature heartworms at necropsy) among nondomestic cats housed in an area in rural North Carolina where Dirofilaria immitis is known to be endemic and among nondomestic cats housed in areas with a low prevalence of dirofilariasis or in an area considered to be free from heartworms.

DESIGN

Cross-sectional prevalence survey.

ANIMALS

97 nondomestic cats in North Carolina (study population) and 29 nondomestic cats in Colorado; Queensland, Australia; or Auckland, New Zealand (control population).

PROCEDURE

Results of serologic tests and postmortem examinations were reviewed.

RESULTS

Results of heartworm antibody tests were positive for 57 of 75 (76%) study cats and 1 of 29 (3%) control cats. Male study cats had a significantly higher risk of heartworm exposure than did female study cats (relative risk, 1.3). Results of heartworm antigen tests were negative for all 47 study cats and 16 control cats that were tested. Postmortem examinations were performed on 21 study cats, and 1 (5%) was found to be infected with heartworms.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that nondomestic cats housed outdoors in the southeastern United States are at risk for heartworm exposure and infection, with male cats having a greater risk of exposure than female cats.

Immunoblotting analysis of somatic components ofDirofilaria immitis

SDS-PAGE analysis of Dirofilaria immitis extracts demonstrated the complexity of somatic protein component of adult male similar to that of adult female worm. Western blot analysis showed six major peptide bands of 85, 66, 42, 20, 16.2 and 14.5 kDa recognized in the sera of infected dogs. Western blotting sera from dogs with Dirofilaria immitis infection suggest that antigenic components in the low molecular weight region may be related to the anti-parasitic mechanism of the host.

The use of gene silencing to study the role of dopa decarboxylase in mosquito melanization reactions

Mosquito melanization involves hydroxylation of tyrosine to dopa, which then is oxidized to dopaquinone by phenoloxidase, or decarboxylated to dopamine by dopa decarboxlase (DDC). An Armigeres subalbatus cDNA encoding DDC was cloned and real-time PCR analysis revealed increased transcripts in blood-fed and microfilariae (mf)-inoculated mosquitoes. A double subgenomic Sindbis virus was used to silence DDC and assess its role in melanization of mf. DDC transcription and activity were significantly decreased in silenced mosquitoes, as was the degree of mf melanization 48 h postinoculation; however, melanization increased after 72 and 96 h, demonstrating that DDC influences the rate of melanization. DDC-silenced mosquitoes also exhibit high mortality, over-feeding and abnormal movement, consistent with an involvement of DDC in neurotransmission.

Detection of IgG antibodies of Brugian filariasis with crude male and female antigens of Dirofilaria immitis

Crude antigens from male and female Dirofilaria immitis were used to detect antibody to Brugian filariasis in humans by indirect ELISA. Both antigens were tested with 42 cases of Brugian filariasis, 131 cases of 20 heterologous infections and 35 healthy controls. The results--using male and female antigens--showed sensitivity of 88.1% and 88.1%, and specificities of 64.1% and 51.8%, respectively. Cross-reaction from other helminthic infections using crude male antigen gave false-positives with 48 sera from 13 heterologous diseases at the threshold value of 0.180, while the female antigen gave 63 sera from 15 diseases, at 0.309. Serum antibodies from patients with other helminthic infections--gnathostomiasis, strongyloidiasis, hookworm infections, trichinellosis, capillariasis, angiostrongyliasis, ascariasis, trichuriasis, toxocariasis, neurocysticercosis, cystic echinococcosis, taeniasis and opisthorchiasis--resulted in false-positives with both male and female antigens. One each of sparganosis and paragonimiasis heterotremus sera cross-reacted with only crude female antigen and their OD values were close to the threshold value. Although crude male antigen showed better specificity than crude female antigen, both female and male worms are sources of antigens needed for further purification. This study provides baseline data for further serodiagnosis of Brugian filariasis using dirofilaria antigen.

The role of phenylalanine hydroxylase in melanotic encapsulation of filarial worms in two species of mosquitoes

Melanin formation has a significant influence on mosquito vector competence by limiting the development of metazoan parasites. Tyrosine, the rate-limiting substrate of melanin production, can be obtained exogenously or derived from phenylalanine by phenylalanine hydroxylase (PAH). The characteristics of this defense mechanism, such as temporal expression of constituent enzymes involved in the biosynthetic pathway, can vary considerably between mosquito species. We investigated the functional role of PAH in the melanotic encapsulation response in Aedes aegypti and Armigeres subalbatus, two mosquito species with markedly different melanization responses. We used double-stranded RNA (dsRNA) to knock down PAH and observed the phenotypic effects on melanin formation. PAH transcripts were dramatically reduced in both mosquito species after gene knock down. The abundance of PAH proteins was decreased in gene knockdown mosquitoes that were inoculated with Dirofilaria immitis microfilariae (mf) as compared to inoculation controls. A significant reduction of mf melanization also was observed in these knockdown mosquitoes as compared to inoculation controls. Our data suggest that PAH is required for a fully functional melanotic encapsulation response in both mosquito vectors.

Specific IgG antibody response against antigens of Dirofilaria immitis and its Wolbachia endosymbiont bacterium in cats with natural and experimental infections

Sera from three groups of cats under different experimental conditions were studied by ELISA to assess the host's immune response against synthetic peptides derived from Dirofilaria immitis (Dipp) and against the surface protein of its endosymbiont, Wolbachia (WSPr). In experimentally infected cats (Group 1), an increase of IgG antibody against both Dipp and WSPr was observed from 2 months post-infection until the end of the study, 6 months post-infection. In experimentally infected cats, treated against infective larvae (Group 2), anti-Dipp IgG decreased dramatically from 4 months post-infection (3 months post treatment), showing very low values till the end of the study (6.5 months from infection, 5.5 months from treatment), while anti-WSP IgG increased constantly till the end of the study. Of 49 outdoor, asymptomatic cats exposed to a high risk of natural infection (Group 3), 9 were positive for anti-Dipp IgG and for a validated, in-clinic commercial antibody diagnostic kit for cats. Two cats were also found positive for circulating antigens of adult female worm. Anti-WSPr IgG were found in five of nine anti-Dipp IgG-positive sera and from eight ELISADipp-negative sera. Our results confirm the strong IgG response in heartworm infected cats and demonstrate the involvement of the Wolbachia endosymbiont in the immune reaction to the parasite both in experimentally infected cats and in cats exposed to a high risk of natural infection.

Epidemiological aspects of filariosis in dogs on the coast of Paraná state, Brazil: with emphasis on Dirofilaria immitis

The present study determined the prevalence and geographical distribution of Dirofilaria immitis and other filariae, from dogs in littoral areas of Paraná state, in Brazil. This survey spanned eight months, between 1998 and 1999, and was also designed to compare the efficacy of different tests for diagnosis of heartworm infection in that area. Blood samples were collected from 256 native-owned dogs distributed along the Paraná coastal area. Five diagnostic procedures were used: direct smear examination, the Knott's modified test, filtration assay, and two heartworm antigen detection kits. A follow-up imaging exam was performed to support the heartworm diagnosis. The imaging diagnosis included radiographic and ultrasonographic exams of six dogs that had positive results for the heartworm antigen detection kits, but showed different microfilarial burdens. The presence and severity of radiographic and ultrasonographic signs were compared with the results obtained in microfilariae detection and antigen tests. Diagnostic parasitology results indicated that 31.25% of the dogs were microfilaremic. Three different microfilariae were recovered: D. immitis, Dipetalonema reconditum, and the third (mf3) was not identified. D. reconditum was the species with the highest prevalence: 22.6%. In general, D. immitis prevalence was 5.47% (28.57% occult infections), but it varied along the coast and the range was from 0 to 20%. No correlation could be established between the overall scores for microfilarial counts (small or large numbers) and the severity of radiographic results or the likelihood of detecting filariae in the pulmonary artery using echocardiography. The finding of a different type of microfilaria (mf) suggested the existence of a third species in Paraná state, whose prevalence was 4.68%. These results show that to obtain a reliable diagnosis of heartworm infection, antigen detection kits are indicated. Knott's test or filtration should be performed to confirm microfilaremia and not for diagnosis of heartworm infection. Imaging tests support parasitology exams and add more about severity of infection. The northern areas, specially Guaraqueçaba and Ilha das Peças, presented the highest number of heartworm-infected dogs.

Prevalence of Dirofilaria immitis and gastrointestinal helminths in cats euthanized at animal control agencies in northwest Georgia

Cats euthanized at six northwest Georgia animal control agencies were examined for adult Dirofilaria immitis in heart and lung tissue and presence of gastrointestinal helminth ova by fecal flotation. D. immitis were found in 4 of 184 cats (2.1%). The prevalence of feline dirofilariasis in northwest Georgia was lower than that found in other studies conducted in the southeastern United States, but closer to the prevalences occurring in areas of similar topography. Heartworm antigen and antibody tests performed on batched serum samples resulted in low sensitivity and high specificity. Gastrointestinal helminth ova were found in 39.6% of the fecal samples examined and 6.1% of the samples contained two or more species.

Prevalence and Risk Factors for Heartworm Infection in Cats From Northern Florida

Necropsies were performed on 630 adult cats in northern Florida to determine the prevalence and risk factors for heartworm infection in cats of this region. Heartworms were identified in 4.9% of cats, and serological evidence of heartworm exposure was present in 17% of cats. Not all cats from which heartworms were recovered were seropositive for heartworm antigen or antibody. There was no association between heartworm infection and co-infection with feline leukemia virus (FeLV) or feline immunodeficiency virus (FIV). Male cats were at higher risk of infection with heartworm, FeLV, or FIV than were females. Because even a single heartworm can cause clinical disease or death in cats, the authors conclude that cats in this region should receive heartworm prophylaxis to prevent heartworm infection.

Various types of Dirofilaria immitis polyproteins selectively induce a Th2-Type immune response

Dirofilaria immitis polyproteins (DiAgs) are found as 15-kDa monomeric and 30-kDa dimeric forms in excretory-secretory products of the adult worm. We evaluated the ability of various types of recombinant DiAg (rDiAg; V1 and V2 as monomers and V1V2, V2V1, V1V1, and V2V2 as dimers) to influence Th1/Th2 immune responses. V1-, V1Vx- and V2-, V2Vx-driven nonspecific immunoglobulin E (IgE) production peaked at 21 and 14 days after administration, respectively. Dimer-induced IgE response was an interesting biphasic pattern with the second peaks on days 35 (V2Vx) or 42 (V1Vx). Absolute amounts of nonspecific IgE production induced with monomers were larger than those observed with dimers at the first peak. The magnitude of cell expansion and interleukin-10 (IL-10) production in mesenteric lymph node (MLN) B-cell induced with rDiAgs was linked to the levels of the first IgE peak in vivo and IgE produced by rDiAg plus IL-4-stimulated B cells in vitro. All rDiAgs failed to augment IgG2c production. V2 and V2Vx elicited IL-4 production by MLN cells more rapidly than V1 and V1Vx. The inhibitory effect of rDiAg on gamma interferon (IFN-gamma) production was stronger in monomers than in dimers. Neutralization of IL-10 restored IFN-gamma production, whereas the expression of IL-4 and IgE was partly prevented by depletion of IL-10. These results indicate that monomer rather than dimer is an efficient form of DiAg and suggest that the difference of IgE-inducing capacity among these DiAgs is closely associated with the pattern of both B-cell activation and IL-4 production.

Serologic prevalence of Dirofilaria immitis, Ehrlichia canis, and Borrelia burgdorferi infections in Brazil

Dogs infected with Dirofilaria immitis, Ehrlichia canis, or Borrelia burgdorferi may show nonspecific clinical signs or may be asymptomatic. In Brazil, E. canis and D. immitis infections are frequently diagnosed based on the presence of classical signs; however, serologic tests are seldom performed to confirm the presence of infection. To estimate the seroprevalence of these three canine diseases in Brazil, 2,553 dogs presented at veterinary practices for various tests, routine treatments, or examinations were evaluated by an in-office commercial ELISA test kit (SNAP 3Dx, IDEXX Laboratories). Each dog was examined by the veterinarian, and a whole-blood sample was collected and immediately tested for the simultaneous detection of B. burgdorferi and E. canis antibodies and D. immitis antigen. D. immitis infection was detected in 51 dogs (2.0%) and E. canis antibodies were present in 505 dogs 19.8%). Only one dog tested positive for B. burgdorferi antibodies.

Seroprevalence of canine dirofilariosis in South Korea

Eight-hundred and forty eight dogs (480 females and 368 males) not on chemoprophylaxis were examined for Dirofilaria immitis infection from 2001 to 2002. Three-hundred and thirty nine (40.0%) of 848 samples tested with antigen detecting ELISA kits showed positive reaction for D. immitis antigen. More male (43.5%) than female (37.3%) dogs were affected in this study, although there was no significant difference between both groups. Chi2 analysis showed that female and male dogs of shoreline areas had higher significant prevalence than other areas (P<0.001), respectively. The mean overall positive rates of heartworm infection were 10.4% in dogs <2-year-old group, 46.5% in 2-4-year-old group, 48.4% in 4-6-year-old group and 50.3% in >6-year-old group. The older the age, the higher the prevalence of D. immitis infection in this study. Chi2 analysis revealed a significant higher prevalence in 4-6-year-old group (100%) of shoreline areas and in 2-4-old-year group (51.2%) of urban areas (Chungnam province), respectively (P<0.001), and also revealed that the over 6-year-old group (50.3%) in mean overall prevalence had the significant higher prevalence than other age group (P<0.001). In climate comparison, our data showed that shoreline areas (69.5%) had the significant higher prevalence than urban areas and mountain areas (P<0.001). This survey confirms that the prevalence of canine heartworm infection increases, and also that the prevalence in shoreline areas is higher than in other areas in South Korea.

[Eosinophilic pleural effusion by dirofilariasis]

A 44-year-old man visited our hospital because of right chest pain. Pleural effusion in the right lung was detected on a chest radiograph. A chest CT scan demonstrated no abnormal lesions in either lung field, but passive atelectasis due to the pleural effusion was present. Since many eosinophils were found in the exudative pleural effusion, a parasitic infection was suspected. An enzyme-linked immunosorbent assay test led to a diagnosis of eosinophilic pleural effusion by dirofilariasis. Pleural effusion disappeared spontaneously and the level of anti-Dirofilaria immitis antibody decreased. Continued careful observation is necessary in such cases.

Comparison of results of three commercial heartworm antigen test kits in dogs with low heartworm burdens

OBJECTIVE

To compare results of 3 commercial heartworm antigen test kits performed on serum samples from dogs infected with low numbers of adult female heartworms.

DESIGN

Blinded laboratory evaluation. Sample Population-Serum samples from dogs (n = 208) proven at necropsy to be infected with 1 to 4 adult female heartworms and from dogs (32) without heartworms.

PROCEDURE

Samples were sequentially tested with each test kit, following the manufacturers' instructions, by licensed veterinary technicians in private practice who were not aware of infection status of the dogs. The order of test kit evaluations was randomly chosen. For each test kit, sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were evaluated.

RESULTS

All tests yielded some false-negative results, and there were significant differences among tests in regard to ability to detect low heartworm burdens. Sensitivity of the test kits ranged from 78 to 84%. For all test kits, sensitivity increased as number of female heartworms increased. All 3 test kits had high specificity (97%).

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that sensitivity of the 3 commercially available heartworm antigen test kits ranged from 78 to 84% when used to test serum samples from dogs with low heartworm burdens, and that sensitivity varied among test kits. For all 3 test kits, specificity was 97%. All 3 test kits yielded false-positive and false-negative results for some dogs with low heartworm burdens.

Human pulmonary dirofilariasis in a patient whose clinical condition altered during follow-up

Pulmonary dirofilariasis is a rare disease. We have experienced a case which developed pleural effusion while being followed, rendering it difficult to establish the diagnosis. The patient, a 53-year-old woman, had previously undergone two operations; one for uterine cancer and another for breast cancer. She developed a cough in February 2002, and chest computed tomography (CT) scans disclosed a nodular mass in the right lung. A biopsy revealed a fibrous nodule with macrophage aggregation. Pleural effusion was demonstrated on chest CT scans performed in May. As the possibility of malignant tumor could not be ruled out, an operation was undertaken. The nodular lesion showed marked coagulation necrosis, and dead parasites were noted in the vascular lumen. The parasites had the characteristic morphological features of Dirofilaria immitis. Immunological studies produced a positive test result for the anti-dirofilaria immitis antibody; hence a diagnosis of pulmonary dirofilariasis was made.

Th1 response in BALB/c mice immunized with Dirofilaria immitis soluble antigens: a possible role for Wolbachia?

The immune response to filarial infection has been shown to be of both the Th1 and Th2 types. Studies aimed at developing immunization strategies against Dirofilaria immitis infection in dogs have shown that protection against larval challenge is of the Th2 type and that several proteins are recognized by immunized or infected animals. The bacterial endosymbiont Wolbachia, harbored by many filarial species including D. immitis, has recently been shown to interact with the host immune system. Specific antibodies to the Wolbachia recombinant surface protein (WSPr) have been observed in cats infected with D. immitis. In this work the authors have determined cytokine production and antibody response in BALB/c mice inoculated with soluble antigens from third stage larvae or from adult worms of D. immitis. Inoculated mice first produced IFN-gamma followed by a peak in IL-4. Specific antibodies to the Wolbachia protein WSPr were exclusively IgG2a, while antibodies against peptides derived from antigens of D. immitis were in the IgG1 and IgE subclasses. The cytokine response is thus similar to that reported for other filarial infection, where Th1 response shifts towards Th2. Antibody response indicates that Wolbachia may induce preferentially a Th1 response during filarial infection, while nematode antigens may be involved in Th2 response. There is thus an overall agreement with current opinions on the role of bacterial versus nematode molecules in driving the response towards the different directions.

Evaluation of crude antigen of Dirofilaria immitis third-stage larva for detection of antibody against Wuchereria bancrofti infection by indirect ELISA

Dirofilaria immitis is an important heart worm in dogs. An immunodiagnostic test is frequently applied to use an alternative antigen from other parasites. A crude antigen from infective third stage larva (L3) of D. immitis was employed in detecting the antibody to Bancroftian filariasis in humans by indirect ELISA. It was shown that 25 cases of Bancroftian filariasis (76%) at a cut-off value of 0.230, were positive. Cross-reactivity was tested using available sera of other helminthic infections. These sera were 47% (23/49) positive. They comprised a major intestinal helminthic infection, 7 from 15 (46%) strongyloidiasis sera, none from 5 (0%) hookworm infection sera, 6 from 10 (60%) trichinosis sera, 2 from 10 (20%) cysticercosis sera and 8 from 9 (88%) gnathostomiasis sera. The mean OD of sera from Bancroftian filariasis patients was not significantly different from that of the other helminthic infections (p>0.05). In this study, crude antigen may be valuable for the serodiagnosis of Wuchereria bancrofti when subjects do not have tissue helminth infections. However, the crude antigen should be purified to obtain a better sensitivity and specificity of the test.

Cross-reactivity between sera from dogs experimentally infected with Dirofilaria immitis and crude extract of Toxocara canis

This study was performed to investigate whethere there is cross-reactivity between Dirofilaria immitis and three intestinal nematodes of dogs. In ELISA, D. immitis-infected dog sera obtained at the 4th molting stage (9-11 weeks) and microfilaremic stage (25-30 weeks) were shown to be highly reactive with crude extract of T. canis. In immunoblotting, some antigenic fractions, 44, 57, 88, 100 kDa of crude extract of T. canis, were found to be positive reaction with sera of dogs infected with D. immitis. However, little or no cross-reaction were observed between sera of D. immitis-infected dogs and crude extract antigen of T. vulpis or A. caninum. These result suggest that there are partial cross reaction between sera of D. immitis-infected dogs and the antigen of T. canis.