<i>Dirofilaria repens</i> Nematode Infection with Microfilaremia in Traveler Returning to Belgium from Senegal

Potters, Idzi; Vanfraechem, Gaëlle; Bottieau, Emmanuel

doi:10.3201/eid2409.180462

Cited by 18 publications

(13 citation statements)

References 10 publications

(11 reference statements)

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“…In most of the cases a single worm develops, probably because the stimulation of the immune system prevents the development of others [1, 8]. In rare cases the worm may develop to a mature adult [1, 207, 208] and even fertilized worms releasing microfilariae have been described, especially in immunosuppressed patients [1, 8, 42, 146, 209–212], which in very rare cases may even reach the bloodstream [213].…”

Section: Human Infectionsmentioning

confidence: 99%

Recent advances on Dirofilaria repens in dogs and humans in Europe

et al. 2018

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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.Electronic supplementary materialThe online version of this article (10.1186/s13071-018-3205-x) contains supplementary material, which is available to authorized users.

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Section: Human Infectionsmentioning

confidence: 99%

Recent advances on Dirofilaria repens in dogs and humans in Europe

et al. 2018

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“…To the best of our knowledge, microfilaremia due to Dirofilaria spp. has been published only four times, [1][2][3][4] and in these cases, definitive species identification could not be performed. In another case of infection due to D. repens with concomitant meningoencephalitis, microfilaremia must be proposed, as crossing the blood-brain barrier by microfilariae is the only mechanism to involve the central nervous system.…”

Section: Introductionmentioning

confidence: 99%

Case Report: Successful Treatment of a Patient with Microfilaremic Dirofilariasis Using Doxycycline

Lechner

Gastager²,

Kern

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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We report the case of a 56-year-old woman with microfilaremic dirofilariasis due to Dirofilaria repens, which is a very rare condition in humans. Of note, just one of six large-volume blood samples of this patient was positive for microfilariae. Polymerase chain reaction (PCR) and sequencing of the parasite gene determined the geographic origin of the causative helminth. The patient was treated successfully with doxycycline. This drug was chosen because of the patient's reluctance to the use of ivermectin and to provide an anthelmintic effect by targeting the bacterial endosymbiont Wolbachia present in most filarial species.

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“…Most cases of human dirofilariasis are diagnosed after surgical removal of the adult nematode and subsequent histologic workup (3). D. repens microfilaremia in humans has been only rarely described (4,5). Several filarial species result in periodic microfilaremia (11), and these fluctuations can be substantial and relevant for diagnosis.…”

Section: Discussionmentioning

confidence: 99%