Autochthonous Human Dirofilaria repens Infection in Austria

PURPOSE

This report describes a rare autochthonous case of human D. repens infection in Austria. Dirofilariosis is a mosquito-borne parasitic infection that predominantly affects dogs. Human D. repens infections have primarily been reported in Mediterranean countries, but are emerging throughout Central and Northern Europe.

METHODS

The worm was removed surgically and identified using PCR and DNA sequencing. The consensus sequences were compared against reference sequences of Dirofilaria repens from GenBank.

RESULTS

The 56-year-old woman acquired the infection, which presented as a subcutaneous nodule, in Vienna, Austria. This is the second autochthonous case of human D. repens infection in Austria.

CONCLUSION

The reasons for the emergence of D. repens and other parasitic infections in Central and Northern Europe are manifold, including climate change and globalization. This case demonstrates that with the growing number of D. repens infections, health care professionals must place further emphasis on emerging infectious diseases to ensure appropriate diagnostics and treatment in the future.

A systematic review and meta-analysis on the prevalence, distribution and nematode species diversity in small ruminants: a Nigerian perspective

Despite the global projections that agriculture will have to feed an additional 3 billion of the world's population in the nearest future, the global trends and negative impacts of nematodes on livestock productivity are still on the increase. Here, we reported the burden of gastrointestinal nematodes in small ruminants in Nigeria. Six thousand, five hundred and eighty one of the 13,259 small ruminants reported in 40 eligible studies across 18 Nigerian States were infected with at least one nematode species, yielding an overall pooled prevalence (PP) of 58.3% (95% CI 48.8, 67.2). Regional PP varied significantly (P < 0.001) and ranged between 19.5 (95% CI 5.8, 48.7) and 83.7% (95% CI 68.5, 92.3). Seasonal PP was higher in the dry (Prev: 56.5%, 95% CI 34.2, 76.4) than the rainy (Prev: 43.2%, 95% CI 26.7, 61.3) season. Haemonchus species were the most prevalent 21.3% while, Trichuris ovis and Strongyloides species had the widest geographic distribution. Several species of nematodes of small ruminants are highly prevalent in Nigeria. An all-inclusive approach involving public education and standardised management practices that involve adequate hygiene and sanitation, strategic and prophylactic use of anthelmintics, rotational grazing and the control of arthropod intermediate hosts will reduce the economic losses due to these parasites and curtail possible transmission to humans.

Gene expression profiles of the small intestine of village chickens from an Ascaridia galli infested environment

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The transcriptome of chickens from parasite infested environment was sequenced.

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Different genes were reported between A. galli infected and non-infected chickens.

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Upregulated immune and inflammatory response genes are associated with fighting parasites.

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T cell receptor signalling and arachidonic acid metabolism pathways were impacted.

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Different segments of the intestines differed in gene expression and associated pathways.

Nematodes of the genus Ascaridia are known to infect many species of birds and result in fatal diseases. A. galli damages the intestinal mucosa of chickens leading to blood loss, secondary infection and occasionally the obstruction of small intestines due to high worm burden. This study investigated the gene expression profiles in chickens from two different provinces of South Africa naturally exposed to A. galli infestations and tested either positive or negative for the parasite. The study further investigated gene expression profiles of the A. galli infected duodenum, jejunum and ileum tissues of the small intestines. The A. galli positive intestines displayed hypertrophy of the intestinal villi with accumulation of inflammatory cells and necrosis of the crypts of Lieberkühn glands, lesions that were absent in the uninfected intestines. Total RNA isolated from small intestines of infected and non-infected intestines was sequenced using Illumina HiSeq technology to generate up to 23,856,130 reads. Between any two-way comparisons of the intestines, 277 and 190 transcripts were significantly expressed in Limpopo and KwaZulu-Natal (KZN) chickens, respectively. Gene ontology analysis of the differentially expressed genes (DEGs) revealed an enrichment of genes reported to function in the immune response, defense response, inflammatory response and cell signalling genes. T cell receptor signalling pathways and arachidonic acid metabolism pathways were among the most significantly impacted pathways. Overall, the study provided insights into adaptative mechanisms for chickens extensively raised in parasite infected environments.

Worm Infestation: Diagnosis, Treatment and Prevention

Worm infections continue to be among the most common diseases affecting children from low and middle income countries. Major worm infections of public health importance include Ascariasis, Trichuriasis, Hookworm, and Enterobiasis, which are transmitted through contaminated soil. In India, combined prevalence rates of worm infestation as per pooled data of 127 surveys is over 20%. Although most helminthic infections are mild and are often asymptomatic, but moderate to heavy worm infestations are generally associated with growth faltering, nutritional compromise, anemia and suboptimal academic performance among children from endemic regions. Migration of larval or adult worms also underpins pulmonary and gastrointestinal morbidity in affected children. Some of the distinctive life cycle and clinical features of various worms are discussed in the review. The gold standard diagnostic technique for evaluation of worm infestation includes stool microscopy for direct egg detection and species identification. Most of the community based surveys for detecting soil transmitted helminths (STH) use Kato-Katz technique. The drug armamentarium against worm infestation has evolved tremendously in last three to four decades with the availability of more efficacious and broad spectrum anthelminthics. The key strategies of a multi-component integrated management of worm infestation include individualized treatment, community management (mass drug administration) as well as preventive measures. Finally, barriers to diagnosis, treatment and prevention of worm infestations need to be identified and aggressively managed at individual, family and societal levels so that WHO's 75% coverage target can be achieved to eliminate soil transmitted helminthiasis in children by 2020.

Evolutionary expansion of nematode-specific glycine-rich secreted peptides

Genome-wide comparisons across 10 species from algae Guillardia theta to mammal human indicated that Caenorhabditis elegans and Caenorhabditis briggsae were highly enriched for glycine-rich secreted peptides (GRSPs) (110 GRSPs in C. elegans and 93 in C. briggsae) in this study. Chromosomal mapping showed that most GRSPs were clustered on the two nematode genomes [103 (93.64%) in C. elegans and 82 (88.17%) in C. briggsae], which could be divided into 18 cluster units in C. elegans and 13 in C. briggsae, respectively. Except for four C. elegans GRSPs clusters without matching clusters in C. briggsae, all other GRSPs clusters had paired synteny block between the two nematode genomes. Analyzing transcriptome datasets quantified by microarray indicated extensive genome-wide co-expression of GRSPs clusters after C. elegans infections. Highly homologous coding sequences and conserved exon-intron structures indicated that GRSPs tight clusters were likely derived from local DNA duplications. Phylogenetic conservation of synteny blocks between their genomes, co-expression of GRSPs clusters after C. elegans infections, and strong purifying selections of coding sequences may indicate evolutionary constraints acting on C. elegans to guarantee that C. elegans could mount rapid systematic responses to infections by co-expression, co-regulation, and co-functionality of GRSPs clusters.

Comparison between PCR and larvae visualization methods for diagnosis of Strongyloides stercoralis out of endemic area: A proposed algorithm

Underdiagnosis of chronic infection with the nematode Strongyloides stercoralis may lead to severe disease in the immunosuppressed. Thus, we have set-up a specific and highly sensitive molecular diagnosis in stool samples. Here, we compared the accuracy of our polymerase chain reaction (PCR)-based method with that of conventional diagnostic methods for chronic infection. We also analyzed clinical and epidemiological predictors of infection to propose an algorithm for the diagnosis of strongyloidiasis useful for the clinician. Molecular and gold standard methods were performed to evaluate a cohort of 237 individuals recruited in Buenos Aires, Argentina. Subjects were assigned according to their immunological status, eosinophilia and/or history of residence in endemic areas. Diagnosis of strongyloidiasis by PCR on the first stool sample was achieved in 71/237 (29.9%) individuals whereas only 35/237(27.4%) were positive by conventional methods, requiring up to four serial stool samples at weekly intervals. Eosinophilia and history of residence in endemic areas have been revealed as independent factors as they increase the likelihood of detecting the parasite according to our study population. Our results underscore the usefulness of robust molecular tools aimed to diagnose chronic S. stercoralis infection. Evidence also highlights the need to survey patients with eosinophilia even when history of an endemic area is absent.

Anti-Ascaris immunoglobulin E associated with bronchial hyper-reactivity in 9-year-old rural Bangladeshi children

BACKGROUND

Studies have addressed the immunomodulatory effects of helminths and their protective effects upon asthma. However, anti-Ascaris IgE has been reported to be associated with an increased risk of asthma symptoms. We examined the association between serum levels of anti-Ascaris IgE and bronchial hyper-responsiveness (BHR) in children living in rural Bangladesh.

METHODS

Serum anti-Ascaris IgE level was measured and the BHR test done in 158 children aged 9 years selected randomly from a general population of 1705 in the Matlab Health and Demographic Surveillance Area of the International Centre for Diarrhoeal Disease Research, Bangladesh. We investigated wheezing symptoms using a questionnaire from the International Study of Asthma and Allergies in Childhood. BHR tests were successfully done on 152 children (108 'current wheezers'; 44 'never-wheezers'). We examined the association between anti-Ascaris IgE level and wheezing and BHR using multiple logistic regression analyses.

RESULTS

Of 108 current-wheezers, 59 were BHR-positive; of 44 never-wheezers, 32 were BHR-negative. Mean anti-Ascaris IgE levels were significantly higher (12.51 UA/ml; 95% confidence interval (CI), 9.21-17.00) in children with current wheezing with BHR-positive than in those of never-wheezers with BHR-negative (3.89; 2.65-5.70; t test, p < 0.001). A BHR-positive test was independently associated with anti-Ascaris IgE levels with an odds ratio (OR) = 7.30 [95% CI, 2.28-23.33], p = 0.001 when adjusted for total IgE, anti-Dermatophagoides pteronyssinus IgE, pneumonia history, parental asthma, Trichuris infection, forced expiratory volume in one second, eosinophilic leukocyte count, and sex.

CONCLUSIONS

Anti-Ascaris IgE level is associated with an increased risk of BHR among 9-year-old rural Bangladeshi children.

IgE Content and IgE Receptor Expression of Mast Cells in Normal and Nematode-Infected Rats

A cytofluorometric method was used to measure the native IgE content, the number of IgE receptors available for binding, and the degree of saturation of the receptors on microscopically identified mast cells. The peritoneal mast cells of normal, naive, murine pathogen-free Sprague-Dawley rats as well as of Wistar and Hooded-Lister rats raised under controlled conditions and without signs of infection, were found to carry a significant number of IgE molecules with unknown specificity. The IgE content varied greatly among the individual mast cells within a given population, but, on average, 60-70% of the receptors available for binding were occupied. During an infection with the nematode worm, Nippostrongylus brasiliensis which is associated with an elevated serum IgE level, an increased number of IgE receptors on the peritoneal mast cells was already found on days 2-3 of the infection, preceding a reduction of mast cell numbers and an inflammatory response in the peritoneal cavity. This up-regulation of IgE receptors occurred much earlier than a previously observed increase in serum IgE.