Mosquito Borne Research Articles

Pharmacophore modeling, molecular docking and molecular dynamics simulation for screening and identifying anti-dengue phytocompounds

Dengue is a fast spreading mosquito borne viral disease that poses a serious threat to human health. Lack of therapeutic drugs and vaccines signify that more resources need to be explored. Accumulated evidence has suggested that plants offer a vast reservoir for antiviral drug discovery which are safe for human consumption. Plant-based drug discovery is a complex and time-consuming process as plants possess rich repository of chemically diverse compounds. Various in silico methods can make this process simple and economic. We, therefore, performed pharmacophore mapping, molecular docking, molecular dynamics (MD) simulations and ADME (absorption, distribution, metabolism, excretion) prediction to screen potential candidates against dengue. In particular, combined pharmacophore mapping and molecular docking were used to prioritize the potentially active ligands from a ligand library. Biological activities of plant based ligands were predicted using 3D-QSAR pharmacophore modeling. Interaction between proteins, namely, envelope G protein, NS2B/NS3 protease, NS5 methyltransferase, NS1, NS5 polymerase and active plant-based ligands (pIC50 > 5.1) were analyzed using molecular docking. Best docked complex, namely, envelope G protein–mulberroside C, NS2B-NS3 protease–curcumin, NS5 methyltransferase–chebulic acid, NS1–mulberroside A, NS5 methyltransferase–punigluconin and NS5 methyltransferase–chebulic acid were further subjected to MD simulations study to assess the fluctuation and conformational changes during protein–ligand interaction. ADME studies were performed to assess their drug-likeness properties. Collectively, these in silico results helped to identify the potential plant-based hits against the various receptors of dengue virus which can be further validated by bioactivity-based experiments.Communicated by Ramaswamy H. Sarma

Flaviviruses and Kidney Diseases.

The genus Flavivirus comprises approximately 73 viruses, which share several common aspects, such as dimension, structure, nucleic acid properties, and shape in electronic microscopy. Global incidence of flavivirus infection increased dramatically over the last decades, causing large outbreaks in several areas of the world. These viruses are expanding from endemic tropical and subtropical areas to previously nonendemic areas, affecting and causing diseases in millions of individuals worldwide and posing a formidable challenge to public health in several countries. The majority of clinically significant flavivirus-associated infections are mosquito borne (arboviruses-acronym for ARthropod-BOrne VIRUSES), such as dengue, yellow fever, Japanese encephalitis, Zika, and West Nile fever. Most diseases caused by flaviviruses are asymptomatic or manifest as self-limited, mild, undifferentiated febrile diseases. In a limited number of cases, these diseases may evolve to severe inflammatory, multisystem diseases, causing high morbidity and mortality. Some flaviviruses have been consistently identified in kidney tissue and urine and have been clinically associated with kidney diseases. In this review, we will provide an overview of the epidemiology, risk factors, kidney pathology, etiopathogenesis, and outcomes of acute and chronic kidney syndromes associated with dengue, yellow fever, Zika, and West Nile virus disease.

Review on Malaria and Antimalarial Activity of Vernonia Amygdalina in Ethiopia: A Review Article

Malaria is a mosquito borne infectious disease caused by a protozoan of the genus Plasmodium. Humans are mainly infected by P. falciparum , P. vivax , P. ovale and P. malariae . Around 44% of world’s population is at risk from malaria. Malaria is one of the leading causes of morbidity and mortality in Ethiopia. The clinical features of malaria vary. The most characteristic symptom are fever, headache, lassitude, loss of appetite, muscle pain and chills, resulting in uncontrollable shivering with teeth chattering. Diagnosis of malaria is achieved by light microscopy, rapid diagnostic tests, polymerase chain reaction. Management of malaria includes general measures to be taken to save life of the person and prevention of recrudescence using drugs and other supportive measures. Parasite resistance to antimalarial medicines is a major threat to achieving malaria control and eventual elimination. The most important problem associated with the management of malaria are resistant to or is developing resistance to the most widely available, affordable and safest first line treatments. Prevention of malaria includes vector control to disrupt transmission from mosquito to human, prevention of infection and treatment after infection. V. amygdalina commonly called bitter leaf in English and ‘Girawa’ in Amharic. V. amygdalina has antimalarial properties and the aqueous extract of Vernonia amygdalina leaves exhibit antimalarial activity on P.falcifarum, P.vivax, P. ovale and P. malariae . Malaria is one of the life-threatening diseases. Moreover, Vernonia amygdalina can be used for the treatment of malaria in rural communities. Keywords: Antimalarial activity, Ethiopia, Malaria, V. amygdalina . DOI : 10.7176/JHMN/60-01 Publication date :March 31 st 2019

Knowledge and Practices regarding commonly occurring mosquito borne diseases among people of urban and rural areas of Rajkot District, Gujarat

Background: People’s knowledge and awareness towards the disease can help in the formation of the design of Behaviour Change Communication campaigns to influence acceptance and use of any control measures. Aims: To study the knowledge and practices regarding commonly occurring mosquito borne diseases among people of urban and rural areas of Rajkot District. Material and Methods: Multistage sampling method was used. Total 432 households, 216 each from urban and rural areas, were studied. Selection of areas was based on Annual Parasite Incidence. Six areas from urban and six talukas form rural areas were studied. Data were collected using a pretested semi structured questionnaire during the high transmission season (July 2011 to October 2011) of mosquito borne diseases. Data were entered in Microsoft Excel and analysis was done using Epi Info 6. Results: 87.96%respondents knew that mosquito transmits malaria.75.93% respondents did not know how dengue is transmitted. Fever (95.60%) and chills (71.06%) were the most common malaria symptoms told by respondents. 85.65%respondents were not knowing about dengue symptoms. 48.84% told joint pain as chikunguniya symptom. 90.05% respondents associated water collection to mosquito breeding place. 90.51% respondents knew that mosquito borne diseases can be prevented by using personal protective measures. 23.84% of the respondents did not use anything for prevention against mosquito bites. Conclusion: Knowledge regarding malaria was found satisfactory but knowledge regarding other mosquito borne diseases was unsatisfactory. Knowledge regarding prevention of mosquito borne disease was good and majority of the households were using preventive measures against mosquito bites.

Knowledge And Preventive Practices On Mosquito Borne Diseases In Relation To Japanese Encephalitis Outbreak In Imphal East District Manipur- A Cross Sectional Study

Knowledge And Preventive Practices On Mosquito Borne Diseases In Relation To Japanese Encephalitis Outbreak In Imphal East District Manipur- A Cross Sectional Study

Larval breeding habitats and ecological factors influence the species composition of mosquito (Diptera : Culicidae) in the parks of Dhaka city, Bangladesh

Mosquito larval ecology is prerequisite for determining the larval abundance and species assemblage in mosquito control program. The study explored the association of five mosquito species with their breeding habitat diversity and species distribution in three selected parks from May to October, 2015. A total of 3217 mosquito larvae were reported from six breeding habitats, namely tree hole, leaf axils, water bottle, tire, drain and coconut shell. The frequency of the three species (Ae. aegypti, Ae. albopictus and Ar. subalbatus) coexistence was higher in tree holes (82.4%) than that of the other coexisting species. Pearson Chi-square result revealed that the association of species was significantly dependent on the breeding habitats. ANOVA further suggested that mosquito density varied across habitats where among the highest density of Cx. quinquefasciatus (3.87 ± 0.22) found in drain, followed by both Ae. albopictus (2.02 ± 0.17) and Ar. subalbatus (0.50 ± 0.09) in tree holes and Ae. aegypti (1.25 ± 0.23) in coconut shell. Cx. tritaeniorhynchus occurred in drain with the least observed density (0.03 ± 0.01). CCA results suggested that Aedes species were likely preferred to oviposit in shaded habitats where pH was associated with Ae. albopictus and dissolved oxygen was with Ae. aegypti and Ar. subalbatus. Culex species were positively associated with the habitats characterizing muddy bottom and emerging vegetation but not with any of the physico-chemical parameters. These findings concluded that ecological factors influence mosquito species to favor their breeding habitats can be helpful in controlling targeted vector species as well as the mosquito borne diseases.Bangladesh J. Zool. 45(2): 111-122, 2017

A Comparative study on normal symptomatic medication with Andrographis Paniculata (nila-Vembu) extract on platelets count in thrombocytopenia patient affected from dengue fever

Dengue virus is a mosquito borne belongs to the Flaviviridae family, are the causative agents of dengue fever. Globally about 50 million cases of dengue fever reported in which 500000 cases of dengue haemorrhagic fever (DHF) each year which require hospitalization. The present study was aimed to explore the potential of Andrographis paniculata extracts against the Dengue fever. Totally 86 patients who infected with dengue virus were enrolled for this study and divided into two groups. In which one group 43 were administered with Andrographis paniculata extract as complementary drug along with normal symptomatic medication. About 25ml of nila vembu extract juice was administered orally twice a day (morning and evening) for 7 consecutive days (1 week). Result showed average platelet count at the time of hospitalization was 83575/μL of blood and it was significantly raised to 151539/μL and 182182/μL of blood in the patient with normal medication and normal medication with Andrographis paniculata extract respectively. Administration of Andrographis paniculata extract showed significant rise in the platelet count when compared with normal medication subjects in the present study. Still, this is a preliminary study and required large clinical trials, identification and isolation of the active compounds and mechanism of action from this valuable Andrographis paniculata extract are warranted which may help in control/treat against the Dengue fever.

Evolution and Current Scenario of Zika Virus Infection: A Review

Zika virus is a mosquito borne Flavivirus (genus), which belongs to the family Flaviviridae, a member of arbovirus. This genus includes several viruses such as Yellow fever virus, Japanese encephalitis virus, Dengue virus and West Nile virus. In 1947, Zika virus was first isolated in Zika forest, near the Lake Victoria in Uganda from a febrile sentinel Rhesus monkey. In 1948, it was also isolated from a pool of Aedes africanus mosquitoes during a Yellow fever study. In 1952, the virus was first investigated and isolated from humans in East Africa and Uganda respectively. Zika virus was active in several countries in Africa and Asia before spreading to Pacific regions and America. In between 2007-2013, sporadic cases were reported in travelers (Thailand, Cambodia and Indonesia). From April 2007-August 2007, the health care authorities reported 185 cases of Zika virus infection, including 108 confirmed cases on the Island of Yap belongs to the Federal states of Micronesia, in Pacific Ocean. According to WHO, 3 cases were reported in Ahmadabad in India. Currently, the infection is treated only for symptomatic relief such as: Fever is generally managed with damp clothes, light clothing, baths or showers (physical cooling measures). If fever persists paracetamol is recommended. For itchy rash antihistamines like chlorpheneramine is recommended. In case of pregnancy (1st trimester) loratadine and citrizine (H1 antagonists) are usually advised because they do not show any adverse fetal outcome during pregnancy especially regarding teratogenicity. Recently, sofosbuvir an antiviral is clinically approved for treating Zika infection. Other broad spectrum antivirals like ribavarin, interferons and favipiravir are not usually prescribed as they show toxic effects in pregnant women. Novobiocin previously an antibiotic is now used as a potent anti Zika drug. As it is a rare infection which lacks availability of drugs and vaccines due to limited research. To combat complication of Zika virus infection symptomatic treatment is recommended. For implementation of the effective vaccine further research is needed to prevent the morbidity and complications.

Study of Acid Phosphatase and Heamoglobin Level in Malarial and Non Malarial Fever Patients

Background: Malaria is a mosquito borne disease. It is a major health hazard in India and other tropical countries. An estimated 198 million cases of malaria and 584 000 malaria deaths occurred in 2013. Acid phosphatase (ec 3.1.3.2, ACP) includes all the phosphatases with optimal activity below the pH of 7.0. ACP is present in lysosomes in all cells and exist extra-lysosomally in erythrocytes. Little is known about the levels of ACP in infectious diseases like malaria. So we undertook this study to know the Hb and ACP level in malarial patients. Methods: 60 subjects in the age group of 20 to 50 years were included in this study. These subjects were divided into 2 groups. Group 1 included 30 confirmed malaria fever patients. Group 2 included 30 non-malarial fever patients of same age & sex group. These selected subjects had no prostate problems, previous anaemia, or any other kind of bone disorder. Serum ACP was estimated using kit method Result: The serum ACP levels were significantly increased in malarial fever patients when compared with the non malaria fever patients (P=0.032). There is also statistical significant difference in the Hb levels between malarial and non-malarial fever patients Conclusion: Our results of increased levels of serum ACP and decreased Hb in malarial fever patients could be used as a marker for haemolysis & anemia. ACP may be used as an additional investigation in the diagnosis of malaria. DOI:10.21276/APALM.1515

Seroprevalence of Dengue from a Tertiary Care Hospital in South India

Dengue is a mosquito borne viral fever transmitted by Aedes aegypti and albopictus mosquito. The globally estimated burden of symptomatic cases ranges to 96 million and 58.4 million cases/year). The estimated mortality amounts 2.5% and the endemicity is spread around 128 countries of the world. The aim of our study is to identify the prevalence of dengue to the patients reporting to our tertiary care hospital in Puducherry. A prospective crosssectional study was conducted at our tertiary care hospital in Puducherry. The study was conducted over a period of 4 years from January 2013 to December 2016. The serum samples were tested by Rapid immunochromatography test. Around 272 (12.3%) cases of both primary and secondary dengue were identified. The age wise distribution of cases showed more cases in 21 to 30 age group (38.6%). The seasonal distribution shows more cases were present from September to January. There was a gradual increase in the positive cases from 2013 onwards with a peak during 2016. Being a persistent viral infection a proper vector control measure, concomitant monitoring on the Seroprevalence of dengue among the population is needed.

Sheehan’s syndrome in a dengue parturient

Dengue fever is a mosquito borne arboviral infection which is a major health problem worldwide. Complications vary widely and become critical mostly during defervescence period. Dengue fever in pregnant women can cause variety of obstetric and neonatal complications. Sheehan’s syndrome (SS) is a parturition-related pituitary disease resulting from severe postpartum haemorrhage and can present with varying degrees of pituitary insufficiency. Emergency anaesthetic management of a dengue parturient and SS which developed subsequently, secondary to profuse intrapartum bleeding is discussed.

A Survey of the Relative Abundance of Mosquitoes in Their Preferred Breeding Micro-habitats in Refuse Dumps in Owerri, Imo State, Nigeria

Studies on the abundance and preferred breeding sites of mosquitoes in different larval micro-habitats of refuse disposal dumps in Owerri were carried out between April and December 2016. Mosquito larvae were collected twice a week using standard dipping method and reared to adult stage. Two thousand, nine hundred and eighty seven adult mosquitoes were harvested. They were identified morpho-metrically into different species using binocular stereomicroscopes and taxonomic identification keys. Eight species of mosquitoes were identified: Aedes aegypti (28%), Aedes albopictus (18.1%), Anopheles species (4.0%), Culex trigripes (16.0%), Culex quinquefasciatus (19.9%), Culex vittatus (5.3%), Eretampodite spp (4.8%) and Toxorhynchites spp (3.7%). The findings showed that blocked gutters, empty cans and ground pools favoured the breeding of mosquitoes. Highest abundance of mosquitoes in the study sites were recorded in Relief Market and Concord Area. The presence of mosquitoes in the refuse dump sites was observed throughout the year. This suggests why mosquito borne diseases like malaria are prevalent in the study area throughout the year. The implication of the findings and recommendations for implementation of proper and regular disposal of refuse are discussed.

Biochemical and histological alterations induced by the smoke of allethrin based mosquito coil on mice model

BackgroundMosquito coil (MC) emits insecticide upon burning which provides limited protection against lethal mosquito borne diseases. However, apart from killing the insect, toxicities associated with the inhalation of these insecticides poses severe health hazards. However, the use of MC is increasing day by day in third world countries in particular but, yet to receive enough attention of both policy maker and general public. The current study was aimed to assess the MC smoke induced damage of pulmonary and hepatic tissues along with observing the alterations of several blood biochemical parameters in mice model.MethodsA total of twenty four Swiss albino mice were allowed to inhale the smoke of allethrin based MC at different duration per day for 120 days. By the end of treatment period, blood sample was drawn from each mouse and blood biochemical parameters including alanine transaminase (ALT), aspartate transaminase (AST), blood urea nitrogen(BUN), serum total protein, cholesterol, low density lipoprotein (LDL) and triglyceride (TG) were analyzed. Intact lung and liver were collected for histological analysis using standard protocol.ResultsBiochemical study indicates elevated activity of two hepatic enzymes: ALT (89%), AST (85%), in comparison with the respective control. Increased level of some parameters of lipid profile including cholesterol (36%), LDL (48%) and triglyceride (30%) in smoke inhaled mice is the new finding of this study. On the contrary, the activity of serum total protein and BUN was decreased by 20% and 24%, respectively in inhaled mice. Pulmonary tissue of treated mice shows severe forms of emphysema and hyperplasia, especially in the peripheral region of lung, which is the hallmark of chronic obstructive pulmonary disease (COPD). Histological study of hepatic tissue shows apoptosis mediated damage of hepatocytes along with severe form of necrosis. Infiltration of Inflammatory cells was also observed in both of the organs.ConclusionResults from the present studies suggest that chronic exposure of allethrin based MC is responsible factor for severe health complications such as COPD due to the alterations of the key biochemical parameters of blood and histo-organization of lung and liver.

Dengue Research: Three Dimensional Bibliometric Study of the Global Research Output During 1989-2015

Dengue fever is undoubtedly one of the most rapidly spread mosquito borne re-emerging infection that poses significant threat to about half of the world’s population. People working in this field have taken dengue seriously it is reflected from the continuous increasing number of publications during 1989-2015. This study is an attempt to make a 3D bibliometric portfolio of research on dengue. This 3D bibliometric analysis portray the dengue research through various measures quality, quantity, consistency and two secondary indicators h index and z index. The data retrieved from the Web of Science. Number of publications increases 70 folds in given time span during 1989-2015. Vietnam has the highest impact (quality) while India has the lowest impact among the leading countries. Taiwan has a higher variability 0.41 (consistency ƞ), whereas Germany has a lower consistency. Walter Reed Army Institute of Research WRAIR of USA has the highest impact (quality) while Universidade DE Sao Paulo of Brazil has the lowest impact among the organisations in the list. University of Texas Medical Branch Galveston (USA) has a highest consistency 0.33, whereas University of Massachusetts System (USA) has a lowest consistency (0.03).

A thirty one year old man with co-infection of malaria and dengue

Malaria and dengue are two important mosquito borne diseases. Only imported malaria cases are currently seen in Sri Lanka, mostly from India and Africa. Co-infections with malaria and dengue have not been reported previously in Sri Lanka. A 31-year-old male who had returned from Mozambique 4 weeks before was admitted with a low grade fever for 4 days and diagnosed as dengue fever. After 5 days the fever became high grade and intermittent with chills and rigors. His blood film and antigen test were positive for P. falciparum. Antimalarial treatment was started with intravenous artesunate, followed by artemisinin based combination therapy. The patient’s fever improved with 24 hours of treatment and thereafter he recovered completely. Although co-infections are uncommon, malaria should be considered in any febrile patient with a travel history up to 1 year to a malaria endemic country, even if chemoprophylaxis is taken. Diagnosis of one infection should not exclude the possibility of a coexisting malarial infection in patients with an appropriate travel history, since missing the diagnosis can lead to severe consequences.

Modelling Wolbachia infection in a sex-structured mosquito population carrying West Nile virus

Wolbachia is possibly the most studied reproductive parasite of arthropod species. It appears to be a promising candidate for biocontrol of some mosquito borne diseases. We begin by developing a sex-structured model for a Wolbachia infected mosquito population. Our model incorporates the key effects of Wolbachia infection including cytoplasmic incompatibility and male killing. We also allow the possibility of reduced reproductive output, incomplete maternal transmission, and different mortality rates for uninfected/infected male/female individuals. We study the existence and local stability of equilibria, including the biologically relevant and interesting boundary equilibria. For some biologically relevant parameter regimes there may be multiple coexistence steady states including, very importantly, a coexistence steady state in which Wolbachia infected individuals dominate. We also extend the model to incorporate West Nile virus (WNv) dynamics, using an SEI modelling approach. Recent evidence suggests that a particular strain of Wolbachia infection significantly reduces WNv replication in Aedes aegypti. We model this via increased time spent in the WNv-exposed compartment for Wolbachia infected female mosquitoes. A basic reproduction number R_0 is computed for the WNv infection. Our results suggest that, if the mosquito population consists mainly of Wolbachia infected individuals, WNv eradication is likely if WNv replication in Wolbachia infected individuals is sufficiently reduced.

Host Range Restriction of Insect-Specific Flaviviruses Occurs at Several Levels of the Viral Life Cycle.

The genus Flavivirus contains emerging arthropod-borne viruses (arboviruses) infecting vertebrates, as well as insect-specific viruses (ISVs) (i.e., viruses whose host range is restricted to insects). ISVs are evolutionary precursors to arboviruses. Knowledge of the nature of the ISV infection block in vertebrates could identify functions necessary for the expansion of the host range toward vertebrates. Mapping of host restrictions by complementation of ISV and arbovirus genome functions could generate knowledge critical to predicting arbovirus emergence. Here we isolated a novel flavivirus, termed Niénokoué virus (NIEV), from mosquitoes sampled in Côte d'Ivoire. NIEV groups with insect-specific flaviviruses (ISFs) in phylogeny and grows in insect cells but not in vertebrate cells. We generated an infectious NIEV cDNA clone and a NIEV reporter replicon to study growth restrictions of NIEV in comparison to yellow fever virus (YFV), for which the same tools are available. Efficient RNA replication of the NIEV reporter replicon was observed in insect cells but not in vertebrate cells. Initial translation of the input replicon RNA in vertebrate cells was functional, but RNA replication did not occur. Chimeric YFV carrying the envelope proteins of NIEV was recovered via electroporation in C6/36 insect cells but did not infect vertebrate cells, indicating a block at the level of entry. Since the YF/NIEV chimera readily produced infectious particles in insect cells but not in vertebrate cells despite efficient RNA replication, restriction is also determined at the level of assembly/release. Taking the results together, the ability of ISF to infect vertebrates is blocked at several levels, including attachment/entry and RNA replication as well as assembly/release. IMPORTANCE Most viruses of the genus Flavivirus, e.g., YFV and dengue virus, are mosquito borne and transmitted to vertebrates during blood feeding of mosquitoes. Within the last decade, an increasing number of viruses with a host range exclusively restricted to insects in close relationship to the vertebrate-pathogenic flaviviruses were discovered in mosquitoes. To identify barriers that could block the arboviral vertebrate tropism, we set out to identify the steps at which the ISF replication cycle fails in vertebrates. Our studies revealed blocks at several levels, suggesting that flavivirus host range expansion from insects to vertebrates was a complex process that involved overcoming multiple barriers.

Larvicidal Efficacy of Cleistanthus patulus Muell. Arg. (Euphorbiaceae) Leaf Extract against Filarial Vector Culex quinquefasciatus (Say 1823)

As resistance against synthetic insecticides has been increasing day by day, mosquito control becomes a great problem around the world. So it is crucial to manage the vector population to overcome the mosquito borne diseases. The present study was executed to assess the larvicidal activities of Cleistanthus patulus leaf extract against filarial vector Culex quinquefasciatus. Method: Crude extracts of C. patulus mature leaf with different concentration gradients ranging from 0.1% - 0.5% were applied against all the larval instars of Cx. quinquefasciatus. Three solvent extractives namely petroleum ether, ethyl acetate and acetone were applied in different graded concentrations against all the larval instars. Through log-probit analysis LC50 and LC90 values were determined. Regression and ANOVA analyses were done for further statistical justification. Activities of bioactive fraction against the non-target organism were carried out in laboratory condition. In addition to these, a qualitative phytochemical analysis of leaf extract was also done. Result: The highest mortality was observed at 0.5 concentration of crude extract against all the larval instars after 72 hours of exposure. Among three used solvent extracts ethyl acetate exhibited the best larvicidal potentiality against target mosquito. 1st instar larvae showed 100% mortality at 250 ppm concentration after 48 hours of exposure. Preliminary qualitative phytochemicals analyses of leaf extract revealed the presence of tannin, steroid and flavonoid as secondary metabolites. Non-target organism was found non-responsive to both extracts. Conclusion: Above experiment indicates that the leaf of C. patulus has the prospective to be used as larvicidal agent against Cx. quinquefasciatus.

Travel during pregnancy

The pregnant woman can be given a clean bill of health to travel if certain rules are followed. Catherine Brewer runs through what the practice nurse needs to know, and what to ask Pregnancy should not preclude most women from travelling. However, careful planning and consideration with regards to certain health risks is vital. Ideally this should be assessed prior to even booking the trip to avoid disappointment or putting themselves in grave danger. This article will examine general considerations with regards to pregnancy and travel, as well as looking at specific risks related to the journey, food and water, mosquito borne diseases and the vaccinations themselves.

Clinical management of a Labrador retriever dog concurrently infected with Leptospira interrogans, Babesia gibsoni and Dirofilaria repens

Concurrent infection of Leptospira interrogans, Babesia gibsoni, and Dirofilaria repens in a properly vaccinated and dewormed Labrador retriever dog and its successful clinical management are described. The dog was presented with a history of anorexia, vomiting, lethargy, brownish yellow urine, frequent shivering, and weakness. Clinical and laboratory investigations revealed pyrexia, spleenomegaly, icterus, lymphadenopathy, dehydration, hemoglobinuria, anemia, neutrophilia, thrombocytopenia, and hyperbilirubinemia. Concurrent infection of Leptospira interrogans var pyrogenes and autumnalis, Babesia gibsoni and Dirofilaria repens, was confirmed by dark field microscopy of urine sample and blood smear examination, respectively. The animal was stabilized and undergone a combination therapy using Metronidazole (20 mg/kg bid i/v) and Clindamycin (12 mg/kg bid i/v) for 7 days, Doxycycline (5 mg/kg bid po) for 21 days, single dose of Ivermectin was given at 100 μg/kg orally on day 7. Supportive therapy using plasma volume expander, polyionic electrolytes, antiemetics, hepatotonics, vitamin supplements, and hematinics was provided during the course of treatment. The animal made a dramatic recovery by 3 months of care. The case point towards the need of selection of appropriate clinical materials for differential diagnosis, the control of mosquito borne diseases based on ecological characteristics of vector, and the need of incorporating emerging virulent serovars of leptospira in vaccines.