Abstract
BackgroundDirofilariosis is a vector-borne parasitosis caused by filarial nematodes of the genus Dirofilaria. In humans, who represent accidental hosts, dirofilariosis is mostly caused by Dirofilaria repens and Dirofilaria immitis. In Austria, the first reported case occurred in 1978. Since then, several (case) reports have been published.MethodsA systematic and retrospective review of collected published cases and new, unpublished confirmed cases of human dirofilariosis occurring in Austria was performed. A nematode was extracted from the eyelid of a previously unreported case and subsequently characterized histologically and using molecular biology techniques.ResultsData on a total of 39 cases of human dirofilariosis in Austria occurring between 1978 and 2020 are summarized. Over the past four decades the incidence has markedly increased, in particular after 1998. Of the 39 patients, men and women were equally affected, and the mean age was 47.1 years. The area most frequently affected was the head (38.5% of cases). Confined ocular involvement was observed in 23.1% of cases, and nematodes were isolated from the neck/trunk, extremities and the genito-inguinal area in 25.6, 15.4 and 15.4% of patients, respectively. Microfilariae were detected in two cases. Of the 39 patients, only 73.9% tested positive for anti-filarial antibodies and 56.3% for eosinophilia, despite successful isolation of a nematode; consequently, these measures did not represent reliable markers for dirofilariosis. Most patients had a travel history to countries endemic for Dirofilaria species. One patient who had not traveled abroad represented the only autochthonous case recorded to date. Dirofilaria repens was the predominant species, identified in 89.7% of cases. In the newly reported case of subcutaneous dirofilariosis, a live non-gravid Dirofilaria repens adult female of 12 cm length was isolated from the eyelid of the patient, and a video of the extraction is provided.ConclusionsThe incidence of human dirofilariosis cases has increased strikingly over the last four decades in Austria. More cases can be expected in the foreseeable future due to changes in human behavior and (travel) activities as well as climate changes and the associated alterations in the availability of the natural reservoir, the vectors and the intrinsic characteristics of the parasite.Graphical
Highlights
Dirofilariosis is a vector-borne parasitosis caused by filarial nematodes of the genus Dirofilaria
We report here our review of dirofilariosis in Austria in which we have collected and summarized data reported in all published and unpublished cases of human dirofilariosis in Austria from 1978 to 2020; report new, unpublished cases, including that of a patient with subcutaneous dirofilariosis from whom a live, adult D. repens was extracted from the eyelid and the procedure recorded; and provide a perspective on the potential drivers of this emerging disease
A total of 39 published and unpublished cases of human dirofilariosis occurring in Austria over the period January 1978 to July 2020 were collected; the results are summarized in Additional file 1: Table S1
Summary
Dirofilariosis is a vector-borne parasitosis caused by filarial nematodes of the genus Dirofilaria. Dirofilariosis is a vector-borne zoonosis caused by various species of filarial nematodes belonging to the genus Dirofilaria. After copulation the female nematodes release microfilariae, which are taken up from the infected host’s peripheral bloodstream by blood-sucking arthropods, primarily mosquitoes of the genera Aedes, Culex, Anopheles and Mansonia [2,3,4]. These serve as intermediate hosts, in which development from microfilariae to the infective filariform larvae occurs, which are subsequently transmitted to a new host
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