Immitis Infection Research Articles

A nationwide serological survey for Dirofilaria immitis in companion cats in the United States of America: 3.5% antibody and 0.3% antigen positivity

BackgroundFeline heartworm disease (HWD) is a complex and often misdiagnosed disease in cats, caused by the filarial nematode Dirofilaria immitis. Despite its significant impact, studies reporting the prevalence of D. immitis in apparently healthy pet cats in the USA are lacking.MethodsTo investigate feline heartworm seroprevalence in apparently healthy pet cats in the USA, serum samples (n = 2165) collected from cats across 47 states and Washington District of Columbia were analyzed for D. immitis antibody (Heska Corp.) and antigen (DiroCHEK®; Zoetis Inc.) with and without acid treatment of the samples.ResultsAntibodies to D. immitis antibodies were identified in 3.5% (76/2165) of cats from 26 states, with a significantly higher prevalence in cats from the westernmost US states (West region; 5.4%, 23/429) compared to those from the South (3.8%, 32/847), Midwest (2.7%, 9/338) and Northeast regions (2.2%, 12/551) (P < 0.04). Antigen from D. immitis was detected in 0.3% (6/2165) of cats, which was significantly lower than the antibody detection (P < 10–4), and no samples were positive for both antibody and antigen.ConclusionsThis is the largest antibody-based, nationwide serosurvey of feline heartworm in an apparently healthy cat population, and the results suggest that cats in the USA have a high risk of exposure to D. immitis-infected mosquitoes. The high nationwide prevalence (3.5%) indicates that the true prevalence of cats infected with D. immitis in the USA may be significantly underestimated. Our findings emphasize the need for increased awareness and routine testing of cats for heartworm infection, especially in non-endemic areas of the USA. Clinicians should consider appropriate use of broad-spectrum veterinary-approved parasiticides and lifestyle management in feline patients to reduce the risk of infection. Future studies should focus on evaluating the D. immitis infection status in healthy cats and developing better diagnostic assays to detect this complex infection.Graphical

Elimination of Dirofilaria immitis Infection in Dogs, Linosa Island, Italy, 2020-2022.

On Linosa Island, Italy, Dirofilaria immitis infection has been hyperendemic in dogs and seroprevalent among islanders. In 2020, we implemented a heartworm disease elimination program on Linosa Island. Of 54 dogs tested for D. immitis antigen and microfilariae, 28 had positive results and received treatment with oral doxycycline twice daily for 4 weeks plus topical imidacloprid/moxidectin monthly for 12 months. The 26 dogs with negative results received monthly topical imidacloprid/moxidectin as preventive. During month 1, the number of microfilaremic dogs was reduced by 76.5%. From month 2 on, all animals were microfilariae negative, and during months 3 to 9, the number of antigen-positive dogs decreased progressively. Treatment of positive dogs coupled with chemoprophylaxis for noninfected dogs was effective, protecting them from new infections. The elimination program reduced the risk for human infection, representing a One Health paradigm. Monitoring and chemoprophylaxis are advocated to maintain the status of heartworm disease-free area.

Relative diagnostic accuracy of point-of-care tests to rule-in Dirofilaria immitis infection in clinically suspect dogs: A systematic review and meta-analysis.

Canine heartworm, Dirofilaria immitis, can cause severe disease and sometimes death of the host. Associated clinical signs, lack of preventative usage and regional endemicity are unlikely sufficient by themselves to reach a definitive diagnosis. Several point-of-care (POC) diagnostic tests are commercially available to aid in-clinic diagnosis, however, there is variable diagnostic accuracy reported and no synthesis of published evidence. This systematic review aims at meta-analysing the likelihood ratio of a positive result (LR+) to inform the selection and interpretation of POC tests in practice to rule-in heartworm infection when there is clinical suspicion. Three literature index interfaces (Web of Science, PubMed, Scopus) were searched on November 11th, 2022, for diagnostic test evaluation (DTE) articles assessing at least one currently commercialised POC test. Risk of bias was assessed adapting the QUADAS-2 protocol and articles with no evidence of high risk of bias were meta-analysed if deemed applicable to our review objective. Substantial between DTE heterogeneity was investigated including potential threshold or covariate effects. A total of 324 primary articles were sourced and 18 were retained for full text review of which only three had low risk of bias in all four QUADAS-2 domains. Of the nine heartworm POC tests evaluated, only three, IDEXX SNAP (n DTEs = 6), Zoetis WITNESS (n DTEs = 3) and Zoetis VETSCAN (n DTEs = 5) could be analysed. Both WITNESS and VETSCAN DTEs showed substantial heterogeneity due to a putative threshold effect and no summary point estimates could be reported. SNAP DTEs showed acceptable heterogeneity, and a summary LR+ was estimated at 559.0 (95%CI: 24.3-12,847.4). The quality and heterogeneity of heartworm POC test DTEs was highly variable which restricted our summary of the diagnostic accuracy to only the SNAP test. A positive result from the SNAP test provides strong evidence of the presence of an infection with adult heartworm(s) in a dog patient and this test is warranted to rule-in clinical suspicion(s) in clinics. However, our review did not appraise the literature to assess the fitness of SNAP test, or any other POC tests, to rule-out heartworm infection in dogs without clinical suspicion or following heartworm therapy.

Dirofilaria immitis Identified in Galapagos Sea Lions (Zalophus wollebaeki): A Wildlife Health and Conservation Concern.

The Galapagos sea lion (Zalophus wollebaeki), an endemic and endangered pinniped, faces an increasing threat due to infectious diseases related to domestic animals. Dirofilaria immitis, the parasite responsible for canine heartworm disease, is one such threat, as canine infections on the archipelago have been documented. We used a canine heartworm antigen test kit to analyze the blood from 25 juvenile Galapagos sea lions for D. immitis. Two (8%) sea lions tested positive for D. immitis antigen. Using morphologic and genetic assessments, we evaluated 20 filarial-like worms collected from within the heart of an adult male Galapagos sea lion during a previous routine postmortem examination. The intracardiac worms were morphologically consistent with adult D. immitis, and sequence analysis of targeted PCR amplicons confirmed their identity. This is the first report of D. immitis infection in Galapagos sea lions, which could become a major health problem for these pinnipeds. Further studies are necessary to confirm the level of threat from this parasite; however, widespread adoption of routine heartworm testing, prevention, and treatment in the canine population, and the control of mosquitos, could potentially reduce the disease impact on this endangered pinniped species.

The seroprevalence of canine dirofilariosis in dogs in the eastern coastal areas of China

Background and objectivesThe present study was carried out to assess the presence of canine Dirofilaria immitis infection in pet dogs in China. Materials and methodsFrom October 2018 to November 2019, a total of 216 sera were collected from pet hospitals in Shandong, Jiangsu, Shanghai, Zhejiang, and Fujian regions of Eastern China. The sera were tested by using a commercial canine heartworm antibody ELISA test kit. Results70.8% of the pets had significant clinical symptoms resembled to heartworm infection; the overall dirofilariosis positivity found was 12.5% (27/216); Significant positive rates differences were observed between symptomatic and asymptomatic dogs (P < 0.05) (i.e. 15.7% and 4.7% respectively).The prevalence of infection in Shandong Province (15.5%) was the highest among the surveyed areas, but the difference among the geographic regions was not statistically significant (P > 0.05). Furthermore, the prevalence detected in summer (28.2%) was significantly higher than in other seasons (P < 0.05). In addition, no significant difference was observed between male and female sex (P > 0.05). ConclusionsAltogether, these results suggest that an epidemic of dirofilariosis exists in eastern coastal China, as such preventive measures should be taken to control the spread of dirofilariosis to reduce the risk of human and pet infection with heartworm.

Safety of Simparica Trio® (sarolaner, pyrantel, moxidectin) in heartworm-infected dogs

BackgroundAssessment of the safety of heartworm preventatives in dogs with pre-existing patent heartworm (Dirofilaria immitis) infections is necessary because rapid adult worm and microfilarial death can lead to severe clinical complications, including thromboembolism and anaphylactic shock in dogs. The aim of this study was to determine the clinical safety of Simparica Trio® (sarolaner, pyrantel, moxidectin) in heartworm-infected dogs and the degree of microfilaricidal and adulticidal activity of three consecutive monthly treatments of Simparica Trio.MethodsTwenty-four laboratory Beagle dogs were implanted with 10 male and 10 female D. immitis (ZoeKY isolate), and once infection was patent, they were randomized equally among three groups to receive no treatment, 1× or 3× the maximum recommended label dose of Simparica Trio. Dogs in the treated groups received Simparica Trio on days 0, 28 and 56. In-life assessments included body weight, physical examinations, clinical observations, daily general health observations, a quantitative estimate of food consumption and blood collections for pharmacokinetic (PK) analysis, microfilariae (MF) counts and D. immitis antigen testing. At the end of the study the heart, lungs and pleural and peritoneal cavities were examined for adult D. immitis worms.ResultsSimparica Trio was generally well tolerated. Emesis occurred at low frequency in all groups including control. Abnormal stool occurred occasionally in the 1× and 3× groups throughout the 3-month study. Fever (> 104 °F/40 °C) was recorded in one 1× and one 3× dog 1 day after the first dose and resolved by the following day. No severe hypersensitivity reactions occurred. The mean number of circulating microfilariae (MF) counts in the control group increased from 12,000/ml at study start (Day 0) to > 20,000/ml at Day 28 and remained > 20,000/ml for the duration of the study. The least squares means of circulating MF were reduced by 69.8% on Day 1 and 97.4% on Day 7 for the 1× group and remained at > 99% lower than the control group for the remainder of the study. Similarly, least squares means of circulating MF were reduced by 85.3% on Day 1 and 93.9% on Day 7 for the 3× group and remained > 98% lower than the control group for the remainder of the study. At the end of the study, the mean number of implanted adult worms recovered was < 10 per sex in all groups with 90%, 85% and 75% of live adult heartworms recovered in control, 1× and 3× treatment groups, respectively. Low numbers of dead adult worms were recovered in 1× and 3×, with none in control. Following each dose, the moxidectin and sarolaner AUC and Cmax had close to dose proportional increases.ConclusionsThis study demonstrated that Simparica Trio (sarolaner, pyrantel, moxidectin) was well tolerated when administered to heartworm-positive dogs at 1× and 3× the maximum recommended dose at 28-day intervals for 3 consecutive months. Simparica Trio significantly reduced microfilaria counts in both treatment groups, without significant clinical consequences. At the doses administered, Simparica Trio had minor adulticidal activity but resulted in no clinical sequelae.Graphical

Improved Antigen Detection of Male-Only Dirofilaria immitis Infections in Canine Serum after Heat Treatment for Immune Complex Dissociation

Since the mid-1990s, male-only heartworm infections have been considered undetectable using antigen tests based on experimental studies. Results from those studies are in contrast to reports in the decade prior showing variable male heartworm antigen detection using naturally infected animals and antigen tests using chemical and/or heat immune complex dissociating steps. Several recent studies utilizing heat treatment for immune complex dissociation (Heat ICD) demonstrated increased antigen sensitivity for necropsy verified male-only infections and a higher-than-expected frequency of this type of infection. This study utilized archived canine serum with verified male-only heartworm infections to evaluate detection of the heartworm antigen using the DiroCHEK® (Zoetis LLC, Parsippany, NJ, USA), Witness® (Zoetis LLC, Parsippany, NJ, USA), and SNAP® Heartworm RT (IDEXX Laboratories, Inc., Westbrook, ME, USA) antigen tests. Results showed significant increases in sensitivity for the heartworm antigen following heat treatment for DiroCHEK® (+42.1%, p &lt; 0.0001) and Witness® (+26.3%, p = 0.0020), but not the SNAP® Heartworm RT (+10.5%, p = 0.1250). Prior to heat treatment, false negative results were obtained in 76.3–83.0% of mature infections. Infections with only immature male worms were never detected using any heartworm test used. Heat treatment of serum allows improved detection of mature male-only heartworm infections, which may occur more frequently than previously recognized, and like all heartworm infections pose a risk of chronic and cumulative pathology as well as thromboembolic disease regardless of infection intensity.

Prevalence of canine heartworm infection in Queensland, Australia: comparison of diagnostic methods and investigation of factors associated with reduction in antigen detection

BackgroundThe prevalence of Dirofilaria immitis infection in dogs is increasing globally and spreading into new areas. Prevalence of dirofilariosis in the state of Queensland, Australia, was as high as 90% before the introduction of macrocyclic lactones. Limited research on prevalence of D. immitis infection in dogs in Queensland has been reported in the last 30 years. Antigen testing is the most common method for detection of dirofilariosis but its accuracy is reduced by antigen getting trapped (blocked antigen) in immune complexes (ICs). The objectives of this research were to determine the prevalence of D. immitis infection in dogs from two geographical areas (Brisbane and Townsville) in Queensland, to determine the extent to which blocked antigen affects the validity of antigen testing, and to explore whether this was associated with microfilaraemia, location, age or sex.MethodsBlood samples from Brisbane (sub-tropical climate) and Townsville (tropical climate) shelter dogs were evaluated for the presence of D. immitis antigen before (conventional antigen testing, CAT) and after dissociation of ICs by heat treatment (antigen testing after heat treatment, ATHT), using a commercially available test. Microfilariae were detected using modified Knott’s test (MKT). Test proportions were compared with McNemar’s test and the association between antigen test-discordant results (positive for antigen after dissociation of ICs) and microfilaraemia, location, sex and age was modelled using logistic regression.ResultsDirofilaria immitis prevalence in dogs from Townsville (22% by CAT, 32.1% by ATHT and 16.7% by MKT) was significantly higher than in dogs from Brisbane (1.1% by CAT and MKT and 1.7% by ATHT) (P< 0.001). Dissociation of ICs allowed detection of significantly more D. immitis infected dogs than either conventional antigen testing or microfilariae detection, or the combined antigen and microfilariae detection (P< 0.001). The odds of dogs being positive for antigen after dissociation of ICs were significantly higher for microfilaraemic, 3–4-year-old female dogs from Townsville.ConclusionsThe high prevalence of infection with D. immitis in dogs from Townsville poses a health risk for local susceptible host species, including humans. Dissociation of ICs increases antigen detection and should be considered in dogs suspected of D. immitis infection but negative on routine testing.Graphical

Efficacy of oral, topical and extended-release injectable formulations of moxidectin combined with doxycycline in Dirofilaria immitis naturally infected dogs

BackgroundSeveral studies in both experimentally and naturally infected dogs have reported the adulticide effect of a combination of macrocyclic lactones and doxycycline against Dirofilaria immitis, showing that these protocols can be used as an alternative to melarsomine. The present study evaluated the efficacy of oral, topical and extended-release injectable formulations of moxidectin when combined with doxycycline in dogs naturally infected with D. immitis from a shelter located in southern Italy.MethodsThirty dogs with naturally acquired D. immitis infection were divided in three groups (G) and treated with oral moxidectin (G1) once a month for 9 consecutive months, topical moxidectin (G2) once a month for 9 consecutive months or extended release moxidectin injectable (G3) at enrolment and again at 6 months (Day 180). All treatment groups received doxycycline for the first 30 days. Microfilarial concentrations in 1 ml (mff/ml) blood were determined monthly for 9 months with the modified Knott’s test. A clinical scoring system was employed for each dog enrolled in the study based on thoracic radiography and cardiac ultrasound (CU) examinations performed at Day − 15 (before treatment) and at Day 180.ResultsResults from the present study suggest that the majority of dogs from all treatment groups became antigen negative, as evaluated at Day 270: 9/10 dogs (90.0%) from G1, 6/10 dogs (60.0%) from G2 and 8/10 dogs (80.0%) from G3. Improvement of radiographic alterations was observed in all treatment groups, and almost all dogs were cleared of pulmonary abnormalities by 6 months from the beginning of treatment (P = 0.000). Cardiac ultrasound examination showed a progressive improvement of cardiac function in a limited number of animals (4/30).ConclusionsThe combination of doxycycline and three different formulations of moxidectin leads to antigen-negative status in naturally infected dogs.

Frequency of Dirofilaria immitis infection in blood donor dogs of the Rio de Janeiro state.

Dirofilariasis, a parasitic disease caused by the nematode Dirofilaria immitis, commonly known as heartworm, primarily inhabits the pulmonary artery and right heart of dogs and other animals. The disease is transmitted through diptera, predominantly from the Culex, Aedes, and Anopheles genera. Dirofilariasis is cosmopolitan in nature, endemic in coastal regions and tropical climates. Factors such as temperature, humidity, vector density, and the presence of definitive hosts significantly contribute to the spread of this parasitic disease. In the state of Rio de Janeiro, a prevalence of 58.6% of D. immitis infected animals has been recorded in municipalities like Niterói. Given that blood transfusions are routine clinical procedures and blood bags are not always accurately evaluated, an investigation into D. immitis infection in blood donor dogs from the metropolitan region of Rio de Janeiro was conducted. A total of 1044 blood donor dog files from a blood bank in Niterói, RJ, collected from January 2019 to December 2022, were analyzed. These samples, originating from kennels in various municipalities in the Metropolitan Region, were tested for the presence of microfilariae through direct examination using tubes and microhematocrit evaluated in optical microscopy. Additionally, the search for antigens was conducted using the enzyme-linked immunosorbent assay technique. Out of the 1044 records evaluated, 17.8% (186/1044) were positive for heartworm infection, with 2% (21/1044) samples positive for microfilariae and 14.8% (154/1044) positive for D. immitis antigens. The high prevalence rate indicates that canine D. immitis infection remains prevalent in the state of Rio de Janeiro, necessitating effective guidelines for prescribing preventive medications by veterinarians and an increase in epidemiological surveillance in the region.

Dirofilaria immitis is endemic in rural areas of the Brazilian Amazonas state capital, Manaus.

The canine filarial parasite Dirofilaria immitis has not been reported in Brazil´s Amazonas state capital, Manaus, for over a century. Here, we report one imported and 27 autochthonous D. immitis infections from a microfilarial survey of 766 domestic dog blood samples collected between 2017 and 2021 in Manaus. An Overall prevalence estimate of 15.44% (23/149) was calculated from our two rural collection sites; a prevalence of 1.22% (4/328) was estimated at our periurban collection site, and an overall prevalence of 0.35% (1/289) was calculated from our two urban clinic collections. Our data suggest that in the urban areas of Manaus, where the parasites are very likely vectored by the same species of mosquito that historically vectored Wuchereria bancrofti (Culex quinquefasciatus), prevalence levels are very low and possibly maintained by an influx from rural areas where sylvatic reservoirs and/or more favorable vector transmission dynamics maintain high prevalences.

Dogs infected by Dirofilaria immitis: a threat to the health of human and non-human animals in Rio de Janeiro, Brazil.

This study aimed to investigate the presence of Dirofilaria immitis microfilaremia in dogs from two regions of the state of Rio de Janeiro, Brazil, where heartworm infections are highly prevalent. Blood samples were collected from dogs aged > 12 months, independent of the use of preventatives. All samples obtained and analyzed using Knott's modified test by the investigators. A total of 133 blood samples were tested, and D. immitis microfilariae were detected in 29 of them, resulting in an occurrence of 21.8%. The percentage of dogs with microfilaremia detected raises concerns for pet families, one health professionals, and small animal practitioners. Microfilaremic dogs are the richest source of infection for the mosquitoes, increasing the risk of transmission. Therefore, the stakeholders in One Health must raise concerns regarding the health of wild animals, as wild canids and other species of wild animals are exposed to the risk of D. immitis infection. In addition, humans can get infected and develop human pulmonary dirofilariasis. In conclusion, the presence of dogs with microfilaremia potentiates opportunities for D. immitis transmission, exposing all animals, wild or domestic, human or non-human to the disease.

Molecular detection of Dirofilaria immitis and its Wolbachia endosymbionts in dogs from Myanmar

Heartworm disease in dogs and cats caused by Dirofilaria immitis continues to be a major clinical issue globally. This study focused on dogs suspicious of having tick-borne diseases (TBD) brought to a clinic and a veterinary teaching hospital in Myanmar. Blood samples were collected and initially screened using SNAP® 4Dx® Plus test kit. All dog blood samples were subjected to conventional PCR to detect both Dirofilaria spp. (cox1 gene) and Wolbachia spp. (16S rDNA) infections. Infection with D. immitis was detected in 14 (28.0%) of 50 examined samples, while the detection rate of TBD causative agents, including Anaplasma phagocytophilum and Ehrlichia canis, was 26.0% (13/50) and 26.0% (13/50), respectively, as determined by ELISA rapid test. In this study, D. immitis infection was moderately but significantly correlated with TBD infections (Pearson’s r = 0.397, P = 0.008). Comparative sequence and phylogenetic analyses provided molecular identification of D. immitis in Myanmar and confirmed the identity of its Wolbachia endosymbiont with Wolbachia endosymbionts isolated from D. immitis, Rhipicephalus sanguineus and Aedes aegypti. The present study contributes to our understanding of the coexistence of D. immitis and Wolbachia endosymbiosis in dogs, and the findings may benefit the future prevention and control of dirofilariasis in dogs.

Prevalence of Dirofilaria immitis Infection in Dogs in Maiduguri, Borno State

Dirofilaria immitis infection is a major potential life threatening disease of dogs with worldwide distribution and of zoonotic importance. This study was carried out to investigate the prevalence of D. immitis. A total of 250 blood samples were randomly collected from dogs in the study area. The examination for D. immitis infection was carried out based on the conventional and immunological procedures using wet mount and Buffy coat methods. The total prevalence of D. immitis was 100 (40.00%). The prevalence of D. immitis in the adult dogs was 62 (24.80%) while, in the young dogs was 38 (15.20%). The prevalence of D. immitis in the male dogs was 54 (21.60%) while, 46 (18.40%) was the prevalence of the female dogs. The prevalence of outdoor dogs was 64 (25.60%) while, that of the indoor dogs was 36 (14.40%). The dogs with thin body condition scores had a prevalence of 80 (32.00%) while, the overweight (obesed) dogs were 20 (8.00%). However, the prevalence of D. immitis is higher in the adult, male and outdoor dogs compared to the young, female and indoor dogs. Therefore, the present study revealed a high prevalence of D. immitis infection in the study area.

Geographical analysis of seroprevalence of Ehrlichia spp., Anaplasma spp., Borrelia burgdorferi and Dirofilaria immitis, in clinics and dog shelters in different Mexican states

This study aimed to determine the seroprevalence and geographical distribution of Ehrlichia spp., Anaplasma spp., Borrelia burgdorferi and Dirofilaria immitis in dogs in Mexico, including owned dogs from veterinary clinics with regular medical care and shelter dogs. The Mexican territory was divided into eight geographical regions; 22 out of 32 states were included; 110 veterinary clinics and 53 dog shelters participated. SNAP® 4Dx Plus® (IDEXX® Laboratories) was used to detect antibodies against Ehrlichia spp., Anaplasma spp., Borrelia burgdorferi and Dirofilaria immitis antigens. A total of 3522 apparently healthy dogs were tested, 1648 from clinics and 1874 from shelters. The highest seroprevalence of infection/exposure was found for Ehrlichia spp. (30.9%), followed by Anaplasma spp. (14.6%), D. immitis (5.3%) and B. burgdorferi (0.1%). Significantly more positive dogs were older than 3 years. Regarding differences between facility types, there were only differences for D. immitis which was more prevalent in clinics than in shelters (OR ​= ​1.97; 95% CI: 1.45–2.69; P ​< ​0.0001). Co-infections were detected in 38.4% of the positive samples. Dogs from Mexican states located on the Atlantic and the Pacific coast were significantly more at risk for Ehrlichia spp. and Anaplasma spp. infections than dogs from interior states. Dogs in Atlantic coastal states were more at risk for Dirofilaria immitis infection.

First serological study of Dirofilaria immitis antibodies in household domestic ferrets (Mustela putorius furo) in southern Spain - Short communication.

Dirofilaria immitis is an endemic mosquito-borne pathogen widely spread throughout Europe as well as North and South America. Infection by D. immitis has been reported in domestic ferrets, although little is known about the occurrence and the epidemiological features of this nematode in this species. Theaim of the present retrospective study was to assess the prevalence of D. immitis antibodies using an in-house enzyme-linked immunosorbent assay specifically developed for use in ferrets. One hundred and eighty-six serum samples were obtained from the Province of Valencia (Spain), an area endemic for dirofilariosis. Of the 186 serum samples included in the study, 27 (14.51%) were classified as D. immitis seropositive and 159 samples as D. immitis seronegative. The results provide valuable information on the seroprevalence of D. immitis infection in domestic ferrets in an area endemic for this vector-borne pathogen. The presence of seropositive ferrets should be taken into account and preventive measures should be implemented, including the possibility of serological screening for the early detection of Dirofilaria antibodies as a serological marker of exposure. This is the first study that demonstrates thepresence of D. immitis exposure in ferrets in Spain. Veterinarians working in endemic areas should be aware of this infection in ferrets and their susceptibility.

Exploration of the sensitivity to macrocyclic lactones in the canine heartworm (Dirofilaria immitis) in Australia using phenotypic and genotypic approaches

Canine heartworm disease is a potentially deadly cardiopulmonary disease caused by the mosquito-borne filarial nematode Dirofilaria immitis. In Australia, the administration of macrocyclic lactone (ML) drugs has successfully reduced the prevalence of D. immitis infection. However, the recent re-emergence of D. immitis in dogs in Queensland, Australia and the identification of ML-resistant isolates in the USA poses an important question of whether ML-resistance has emerged in this parasite in Australia. The aim of this study was to utilise phenotypic and genotypic approaches to examine the sensitivity to ML drugs in D. immitis in Australia. To do this, we surveyed 45 dogs from Queensland and New South Wales across 3 years (2019–2022) for the presence of D. immitis infection using an antigen test, quantitative Modified Knott's test, and qPCR targeting both D. immitis and the D. immitis symbiont Wolbachia. A phenotype observed by utilising sequential quantification of microfilariae for 23/45 dogs was coupled with genetic testing of filtered microfilariae for SNPs previously associated with ML-resistance in isolates from the USA. Sixteen (16/45) dogs tested positive for D. immitis infection despite reportedly receiving ‘rigorous’ heartworm prevention for 12 months prior to the study, according to the owners' assessment. The phenotype and genotypic assays in this study did not unequivocally demonstrate the presence of ML-resistant D. immitis in Australia. Although the failure of 16 dogs to reduce microfilaremia by >90% after ML treatment was considered a suspect phenotype of ML-resistance, no genotypic evidence was discovered using the genetic SNP analysis. The traditional quantitative Modified Knott's test can be substituted by qPCR targeting D. immitis or associated Wolbachia endosymbiont DNA for a more rapid measurement of microfilariae levels. More definitive phenotypic evidence of resistance is critically needed before the usefulness of SNPs for the detection of ML-resistance in Australia can be properly assessed.

Probe-based qPCR as an alternative to modified Knott’s test when screening dogs for heartworm (Dirofilaria immitis) infection in combination with antigen detection tests

BackgroundCurrent recommendations for diagnosis of Dirofilaria immitis infection in dogs rely on the detection of antigen produced largely by adult females coupled with the visualization of microfilariae (mf) in the circulation via a microfilaria detection test (MFDT). It is hypothesized that qPCR assays used in parallel with antigen detection tests will perform better in detecting mf than modified Knott’s test (MK), when combined with antigen detection. This study compares probe-based qPCR and MK techniques for mf detection used in parallel with the DiroCHEK® antigen test to screen for heartworm infection in shelter dogs.MethodsMatching blood and serum samples were collected from 300 shelter dogs in Brazos and Harris counties, Texas, USA. Blood was assessed for the presence of mf via MK and the presence of D. immitis DNA by a species-specific probe-based qPCR assay. Serum samples were tested for the presence of heartworm antigen using DiroCHEK® before and after immune complex dissociation (ICD) via heat treatment. In addition, the performance of each diagnostic test was evaluated via Chi-square test, Cochran’s Q test, and post hoc analysis.ResultsQualitatively, MK detected mf in 22.0% (66/300) of samples, 55 of which were morphologically identified as D. immitis and 11 as Acanthocheilonema reconditum. The range of heartworm mf was 28 to 88,803 mf/ml (median: 6627.5). Real-time PCR detected D. immitis DNA in 20.7% (62/300) of samples. Heartworm antigen was detected in 24.7% (74/300) of samples pre-ICD, and in 29.3% (88/300) post-ICD. When comparing tests, the Chi-square and McNemar’s tests showed that the difference between positive and negative proportions was statistically significant. The Cochran test showed the difference in the distributions of cases and non-cases was significant when individual tests were combined (χ2 = 62.3, df = 3, P < 0.0001) and when parallel methods were combined (χ2 = 43.1, df = 4, P < 0.0001).ConclusionConsidering individual and combined test performances, practicality, and efficient use of bench time, this heartworm-specific probe-based qPCR method is a viable option as a mf detection test to be used in parallel with antigen tests for canine heartworm infection in diagnostic and research settings.Graphical

Evaluation of Side Effects and Long-Term Protection of a Sustained-Release Injectable Moxidectin Formulation against Dirofilaria immitis Infection in Dogs: An Observational-In Field Multicentric Study.

Simple SummaryThe sustained-release moxidectin formulation of Afilaria SR is labelled to prevent Dirofilaria immitis infection in dogs for a period of six months. An observational—in field multicentric study was design to evaluate the tolerability and the long-term prevention of Afilaria SR in Italy. A total of 583 dogs were recruited from 2018 to 2021, receiving the drug annually and monitored by veterinary practitioners after each administration. Antigenic tests were performed 210, 365, 730, and 1095 days after the administration of the drug. None of the enrolled dogs was detected as positive, since it was possible to establish that 100% of protection was achieved. Afilaria SR was well tolerated since only the 13% of dogs demonstrated mild reaction in the injection site and only two dogs out of 583 demonstrated anaphylactoid or angioneurotic reactions. These data support the high prevention rate against Dirofilaria immitis disease in all enrolled dogs and indicate the high safety profile of the product, considering the low number and the low grade of side effects.The sustained-release moxidectin formulation Afilaria SR is a relatively new product and has been labelled to prevent Dirofilaria immitis infection in dogs for a six months-period. An observational, in field multicentric study was performed, aiming to evaluate the tolerability and the long-term prevention of Afilaria SR in Italy, a country where filariasis is endemic. The study was designed to include not less than 300 dogs, older than 6 months, of any breed. Side effects were recorded by veterinarians and antigenic tests were performed after 210, 365, 730, and 1095 days after the administration of the drug. A total of 583 dogs were recruited from 2018 to 2021 and all of them were negative with respect to antigenic tests at all time points, indicating that 100% of protection was achieved. Ranking of adverse reactions and correlation to patient features were analyzed using descriptive statistics and χ2 square test, respectively. Afilaria SR was well tolerated: 13% of dogs experienced mild reactions and only two dogs out of 583 (0.3%) demonstrated anaphylactoid/angioneurotic reactions, resolved administering corticosteroids. These data support that Afilaria SR prevented Dirofilaria immitis disease in all enrolled dogs and the low number and the low grade of side effects indicate the high safety profile of the product.

Subclinical dirofilariosis in dogs in Croatia – results of retrospective research based on archived blood samples

Dirofilariosis is an emerging vector-borne disease of dogs and other canids transmitted by female mosquitoes of the Culicidae family, and caused by filarial nematodes of the genus Dirofilaria. Dirofilaria immitis mainly infects the pulmonary arteries and right heart chambers, and it can cause heartworm disease in dogs, while D. repens is found mainly in subcutaneous tissue and causes subclinical infection. Both have zoonotic potential. Human infections caused by D. repens are increasing in Europe, and it is emerging as a serious public health threat. Scientific interest has tended to focus mostly on D. immitis because of its pathogenicity and veterinary importance. This study aimed to update the information about dirofilariosis in the canine population in Croatia. Therefore, 531 blood samples were tested for the presence of microfilariae using a modified Knott’s test and a commercial test for detection of D. immitis circulating antigens. Microfilaremia was detected in 8.1% of the tested dogs, of which 7.9% were caused by D. repens and 0.4% by D. immitis. A single sample (0.2%) showed a mixed infection with both D. repens and D. immitis. The seroprevalence for D. immitis was 0.4%. No occult D. immitis infection was detected, and microfilariae were detected in all antigen-positive samples.