Clinical Characteristics of Human Pulmonary Dirofilariasis in Japan: An Uncommon Differential Diagnosis of a Solitary Pulmonary Nodule.

Human pulmonary dirofilariasis (HPD) is a zoonotic disease caused by Dirofilaria immitis. Most HPD cases are asymptomatic and are either detected during annual health checkups or incidentally identified during the investigation of other diseases, particularly primary or metastatic pulmonary lung cancers. However, the frequency and clinical features of Japanese patients with HPD remain unclear. We analyzed data from the Japanese Medical Abstract Society database and identified 69 cases between 1978 and 2022. The incidence of HPD increased until the 2000s but declined markedly in the 2010s. The incidence is higher in the southwestern region and lower in the northeastern region of Japan. Health checkups are the primary diagnostic opportunities. The Chugoku and Shikoku regions have had high incidence rates per population. The diagnosis of HPD using a noninvasive procedure is typically difficult because of the absence of specific clinical symptoms, and approximately 70% of the cases are detected using video-assisted thoracoscopic surgery. Climate change may increase the incidence of HPD in the northeastern region of Japan, and travel to countries with poor vector control may be a risk factor for HPD transmission. Physicians should consider this parasitic infectious disease when examining patients presenting with solitary lung nodules.

Human Pulmonary Dirofilariasis: A Review for the Clinicians.

Human pulmonary dirofilariasis (HPD) is a rare zoonotic disease caused by Dirofilaria immitis, the nematode responsible for canine cardiopulmonary dirofilariasis (dog heartworm). The incidence of HPD is on the rise throughout the world due to increased awareness and factors affecting the vector (mosquito). Humans are accidental hosts for D. immitis. Most patients are asymptomatic and present with an incidental pulmonary nodule that mimics primary or metastatic pulmonary malignancy. Some patients suffer from pulmonary and systemic symptoms in the acute phase of pneumonitis caused by pulmonary arterial occlusion by the preadult worms resulting in pulmonary infarction and intense inflammation. These patients may have ill-defined pulmonary infiltrate on chest radiology. Pulmonary nodules represent the end result of initial pneumonitis. There are no specific clinical, laboratory, or radiologic findings that differentiate HPD from other causes of a pulmonary nodule. Although serologic tests exist, they are usually not commercially available. The majority of patients are diagnosed by histopathologic identification of the decomposing worm following surgical resection of the lesion.

Lungworms in ruminants from Brazil: A retrospective epidemiological study over four decades.

Lungworms such as Dictyocaulus spp. in cattle and small ruminants, and Muellerius capillaris and Protostrongylus rufescens in small ruminants are important pathogens, causing respiratory disease in these livestock species. Despite their veterinary importance, lungworms of livestock have been poorly studied in certain regions of the world, including Brazil. Therefore, much of their epidemiology and economic impacts on production remain unknown. This article aims to provide a comprehensive overview of the historical and current data published on lungworm infection of domestic ruminants in Brazil. This review consisted of a comprehensive search of technical and scientific publications between January 1980 to December 2020, using online sources such as PubMed, Google Scholar and Scielo. Twenty-four articles published over the last 40 years reporting lungworms exclusively in cattle (n = 16), goats (n = 6) and sheep (n = 1) in Brazil were included. In addition, a study (n = 1) with both goats and sheep were also utilized. Overall, 12 studies were based only on post-mortem examination, five in the detection of specimens in fecal samples, and seven were based on fecal analysis followed by post-mortem examination. Out of all studies, 66.7% (n = 16) articles registered D. viviparus, 4.2% (n = 1) D. filaria, 8.3% (n = 2) P. rufescens, 16.7% (n = 4) M. capillaris, and 4.2% (n = 1) co-infection by D. filaria and M. capillaris. The existence of suitable environmental conditions, as well as intermediate and definitive hosts in Brazil contribute for the survival and development of these nematode species. The majority of the reports of lungworms originate from the Southern and Southeastern regions of the country, whose mild temperatures likely contribute to their occurrence. Finally, lungworms of ruminants have been reported over the past four decades in Brazil, but most of the information was obtained at post-mortem examination. Therefore, further studies to investigate epidemiological aspects in different hosts and regions of the country are needed.

Analysis of the misdiagnosis of 8 adult cases of paragonimiasis with lung masses as the main manifestation in Xishuangbanna, Yunnan.

OBJECTIVE: To summarize the clinical characteristics of adult cases of paragonimiasis with lung masses as the main manifestation in Xishuangbanna, Yunnan Province, analyze the causes of misdiagnosis, and improve the levels of clinical diagnosis and treatment. METHOD: We conducted a retrospective analysis of the clinical data and diagnosis and treatment of 8 adult cases of paragonimiasis with lung masses as the main manifestation that were diagnosed in the Oncology Department of People's hospital of Xishuangbanna Dai Autonomous Prefecture from July 2014 to July 2019. RESULT: All 8 patients were from epidemic paragonimiasis areas and had a confirmed history of consuming uncooked freshwater crabs. The clinical manifestations were mainly fever, dry cough, and chest pain. The disease durations were long, and peripheral blood eosinophil counts were elevated. The cases had been misdiagnosed as pneumonia or pulmonary tuberculosis. After years of anti-inflammatory or anti-tuberculosis treatment, the symptoms had not improved significantly. Patients eventually sought treatment from the oncology department for hemoptysis. Chest computed tomography showed patchy consolidation in the lungs, with nodules, lung masses, and enlarged mediastinal lymph nodes. CONCLUSION: Paragonimiasis is a food-borne parasitic disease. Early clinical manifestations and auxiliary examination results are nonspecific. The parasite most often invades the lungs, and the resulting disease is often misdiagnosed as pneumonia, pulmonary tuberculosis, or lung cancer (Acta Trop 199: 05074, 2019). To avoid misdiagnosis, clinicians should inquire, in detail, about residence history and history of unclean food and exposure to infected water and make an early diagnosis based on the inquired information and imaging examination results. For patients who have been diagnosed with pneumonia or pulmonary tuberculosis and whose symptoms do not improve significantly after anti-inflammatory or anti-tuberculosis treatments, their epidemiological history should be traced to further conduct differential diagnosis and avoid misdiagnosis.

A retrospective clinical analysis of pediatric paragonimiasis in a Chinese children's hospital from 2011 to 2019.

Diagnosis of pediatric paragonimiasis is difficult because of its non-specific clinical manifestations. We retrospectively reviewed the records of pediatric paragonimiasis in Children's Hospital of Fudan University from January 2011 to May 2019. The confirmed diagnosis of paragonimiasis was based on positive anti-parasite serological tests from the local Center for Disease Control (CDC). A total of 11 patients (mean age: 7.7 ± 3.1, male-female ratio: 7:4) diagnosed as paragonimiasis were included. 81.8% were from endemic areas such as Sichuan and Yunnan, and 36% had a clear history of raw crab or crayfish consumption. The characteristic clinical features of pediatric paragonimiasis were eosinophilia (100%), pleural effusion (81.8%), hepatomegaly (54.5%), ascites (54.5%), and subcutaneous nodules (45.5%). Misdiagnosed with other diseases including tuberculosis (18.2%), pneumonia (9.1%), intracranial space-occupying lesions (9.1%) and brain abcess (9.1%) led to rehospitalization and prolonged hospitalization. For treatment, a 3-day course of 150 mg/kg praziquantel (PZQ) didn't show ideal treatment effectivity and 63.6% needed more than one course of PZQ, while triclabendazole in a total dose of 10 mg/kg had a better efficacy to stubborn manifestations. This study indicated that pediatric paragonimiasis was often misdiagnosed, and the treatment with a 3-day course of 150 mg/kg PZQ had a high rate of failure.

An outbreak of Paragonimus westermani infection among Cambodian technical intern trainees in Japan, exhibiting various extrapulmonary lesions.

We encountered an outbreak of paragonimiasis among Cambodian technical intern trainees (TITs) at a food-processing factory in Fukuoka, Japan. The patients were 20-28 years old, seven females and two males, who had been in Japan for one to four years. All of them had consumed raw or undercooked Japanese mitten crab they purchased at a local grocery store near their training place. CT images showed multiple lesions not only in the lungs but in the extrapulmonary organs as well, such as subcutaneous tissues, abdominal muscles, and mesentery, in most of the patients. Their medical records indicated that all of them acquired infection in Japan, not in Cambodia. Diagnosis was made serologically and the patients were treated with praziquantel successfully. Foreign workers and TITs are increasing in Japan so rapidly, that food borne-infections, including paragonimiasis, should be considered in people from developing countries who have exotic dietary habits.

Lungworm (Crenosoma goblei) Infection in Unweaned Free-Ranging Raccoons (Procyon lotor) in Washington State, USA.

Larval parasites morphologically identified as Crenosoma goblei were found in orphaned raccoons (Procyon lotor) admitted to a wildlife rehabilitation center in Washington State, US. Partial 18S rRNA and cytochrome oxidase I gene sequences were most similar to other Crenosoma spp. Although commonly reported in free-ranging raccoons throughout much of the central and eastern US, this finding extends the range of C. goblei into the Pacific Northwest of North America. Fecal samples taken within 48 h of admission were positive for larvae in 70% (21/30) of individuals and in all five group samples taken from an additional 14 raccoons. Typically, Crenosoma spp. use an intermediate host, but the unweaned status of all the raccoons in this report suggests a potential direct, possibly vertical, route of transmission. Serial fecal analysis of pooled samples collected over several subsequent months demonstrated spontaneous resolution of larval shedding. Adult worms and gross evidence of pneumonia were detected in the lungs of several juvenile raccoons at necropsy, and verminous pneumonia was confirmed histologically in the single case submitted. Clinical signs directly attributable to verminous pneumonia were not seen in most actively shedding raccoons, suggesting that subclinical disease among juveniles may be common.

Cardiopulmonary nematode infections in wild canids: Does the key lie on host-prey-parasite evolution?

Cardiopulmonary nematodes are among the most pathogenic parasites of domestic and wild canids. The aim of this study was to describe the species diversity, prevalence and infection intensity of these parasites in the Iberian wolf (Canis lupus signatus) and the red fox (Vulpes vulpes) in the northwest of the Iberian Peninsula. 257 foxes and 74 wolves were necropsied between 2008 and 2014. Four nematode species were identified: Angiostrongylus vasorum, Eucoleus aerophilus, Crenosoma vulpis and Filaroides hirthi. This last species was only found in wolves, being the first time that is cited worldwide in this wild canid. The overall parasite prevalence was significantly higher in foxes (70%) than in wolves (28%). Specifically, prevalences in foxes and wolves were, respectively, 43% and 22% for A. vasorum, 33% and 5% for E. aerophilus, and 30% and 9% for C. vulpis. The prevalence of F. hirthi was 16%. The A. vasorum intensity was significantly higher in foxes than in wolves. Differences between host species in the risk of infection would be associated to diverging feeding behavior, and possibly reflects a parasite-host adaptation related to host's hunting strategies and cardiorespiratory requirements. This study revealed an association between infection and environmental factors, and highlighted a wide variation in the spatial distribution of A. vasorum. Our results indicate that cardiopulmonary parasites are widespread in wild canids in northwest Spain, and further agrees with other studies indicating the expansion of A. vasorum in Europe and, therefore, the urgent need to investigate infection in dogs in sympatric areas.

Gastrointestinal and pulmonary parasites of working horses from Colombia.

Working equids are used in different countries for numerous purposes and regularly are crucial for multiple communities' income and profit. Historically, in Bogotá D.C. they were used as animal-powered vehicles but in 2013 it was initiated a substitution and adoption program as a result of society pressure and lawful processes. Infectious diseases and mainly parasitic diseases, poses a threat in the health and productivity of these animals. Our aim was to identify, by coproparasitological methods, the gastrointestinal and pulmonary parasite species infecting working horses submitted to the mentioned substitution and adoption program. Between May and December 2013 and February and July 2014, fresh faecal samples were obtained from 1004 and 648 horses from Bogotá D.C. and other Colombian municipalities, respectively. They were processed by flotation and Baermann tests in order to visualize faecal parasitic forms (eggs, oocysts, and larvae). Prevalences were calculated for each gastrointestinal parasite at origin and one year after, at destination, and analysed by age group and coinfection. At origin (Bogotá D.C.), prevalence for at least one parasite species was 87.5% and one year later, at destination (other municipalities), was 89.5%. The most prevalent species were strongyles (86.4-89.4%) followed by Parascaris spp. (0.7-6.2%), cestodes (Anoplocephalidae) (3.7-4.9%) and Oxyuris sp. (2.8-4.3%). Other species detected were Eimeria sp., Strongyloides sp. and Dictyocaulus sp. Coinfection by two or more species ranged between 14.4 and 38.3% being strongyle, Parascaris spp., Oxyuris sp. and cestodes (Anoplocephalidae) the most common species involved. Some parasitic infections commonly associated with younger animals (e.g. Parascaris spp.) were detected in all age groups. Flow patterns of parasites linking Bogotá D.C. and other municipalities are presented. Finally, these results support the widespread distribution of most of species and the plausible health and welfare impact of this infections in working equids submitted to particular epidemiological risks.

PREVALENCE AND INTENSITY OF DIGESTIVE AND PULMONARY PARASITES IN WILD BOARS IN ROMANIA.

The prevalence and intensity of infection with digestive, liver, and pulmonary parasites in wild boars in Romania was determined by examination of 280 cadavers from 26 hunting grounds during the period 2012-2016. Eleven genera of parasites were recovered: nine within the digestive system (Eimeria, Ascaris, Globocephalus, Gongylonema, Hyostrongylus, Oesophagostomum, Physocephalus, Trichuris, and Macracanthorinchus); and two (Dicrocoelium, Metastrongylus ) located in the hepatic and pulmonary systems. The overall prevalence of infection was 80.7% (n = 280). Polyparasitism was found in 82.8% of positive cases. The mean intensity of parasitism was highest for pulmonary parasites (Metastrongylus salmi, 25.95). Regarding gastrointestinal parasites, the highest mean intensity occurred in the case of Oesophagastomum dentatum infections (22.14), whilst the lowest was that of Macracanthorhynchus hirudinaceus (1.66). Wild boars are an important source of infection for domestic pigs in Romania and neighboring countries where extensive breeding systems occur.

Prevalence survey of gastrointestinal and respiratory parasites of shelter cats in northeastern Georgia, USA.

The goal of this study was to assess the prevalence of gastrointestinal and respiratory parasites of shelter cats from northeast Georgia, thus promoting a more targeted approach in parasite diagnosis and treatment. Fecal samples of cats kept in a shelter located in Lavonia, northeastern Georgia, USA, were processed for the presence of parasites using double centrifugation sugar flotation (n = 103) and Baermann techniques (n = 98). Flotation revealed eggs of Toxocara cati (17.5%), Ancylostoma sp. (11.7%), Taeniidae (3.9%), Spirometra mansonoides (2.9%), Mesocestoides sp. (1%), Dipylidium caninum (1%), and Eucoleus aerophilus (1%), and oocysts of Cystoisospora felis (16.5%), and Cystoisospora rivolta (8.7%). Baermann diagnosed Aelurostrongylus abstrusus larvae in 5 cats (5.1%), while fecal flotation alone identified only 2 of these infections. Taeniidae eggs were identified to species-level by PCR and sequencing targeting the cytochrome oxidase c subunit 1 (cox1) of the mitochondrial DNA. All isolates belong to Hydatigera taeniaeformis sensu stricto, which is the first unequivocal report of the species in North America. Overall, 45.6% of the cats were infected with at least one parasite. This prevalence of infection is much higher than what is generally reported in client owned animals, highlighting the importance of using appropriate fecal diagnostic techniques to detect gastrointestinal and respiratory parasites on newly adopted cats. Correct diagnosis may direct appropriate treatment and control strategies, which would mitigate the risk of infection of other animals in household, and human exposure to zoonotic parasites.

Cardiopulmonary parasitic nematodes of the red fox (Vulpes vulpes) in Serbia.

Among the wild canids, the red fox (Vulpes vulpes) is recognised as an important reservoir species for a range of parasites, including cardiopulmonary nematodes of public health and veterinary importance. As cross-host transmission between the red fox and domestic carnivores can play an important role in the epizootiology of cardiopulmonary parasitic diseases, the aim of the present investigations was to obtain data on the geographical distribution of cardiopulmonary nematodes of the red fox. The material for examination consisted of 83 foxes which were legally hunted at different locations during a three-month period from December 2017 to February 2018. The presence of four emerging species in Europe (Angiostrongylus vasorum, Crenosoma vulpis, Dirofilaria immitis and Eucoleus aerophilus) was revealed in red foxes of Serbia. Crenosoma vulpis and E. aerophilus were detected in foxes in both the plain and the mountainous areas across the country. Dirofilaria immitis is distributed in red foxes near alluvial rivers in Vojvodina province (northern Serbia). Angiostrongylosis caused by A. vasorum was demonstrated to exist in two enzootic foci with a high percentage of infected foxes in a plain area of northern Serbia. To the best of our knowledge, C. vulpis and A. vasorum were discovered for the first time in red foxes in central Serbia. The results provide strong evidence for veterinarians to take into consideration the parasitic nematodes discovered in red foxes in the differential diagnosis of diseases of companion animals. In the context of the 'One Health' approach the results related to the distribution of the zoonotic species E. aerophilus and D. immitis can be useful for medical epidemiology.

Raillietiella mottae (Pentastomida: Raillietiellidae) infecting Ameiva ameiva (Squamata: Teiidae) in Araripe Plateau, Northeast Brazil / Raillietiella mottae (Pentastomida: Raillietiellidae) infectando Ameiva ameiva (Squamata: Teiidae) na Chapada do Araripe, Nordeste, Brasil

Abstract We investigated the infection by pulmonary parasites in the lizard Ameiva ameiva (Teiidae) inhabiting the Environmental Protection Area of Araripe (APA-Araripe). A total of 45 specimens were collected in three areas between the cities of Várzea Alegre and Barbalha. A Pentastomid species (Raillietiella mottae) was parasitizing (nine specimens) a male of A. ameiva with a prevalence of 2.22% considering all lizards collected in the region and prevalence of 50% considering only rainforest environment. The Pentastomids infection rates shown in this study are similar to data found for infections of other insectivorous lizards. Raillietiella mottae is considered a generalist parasite, which uses insects as intermediate hosts. The results of this study represent the first record of a Pentastomid infecting this species of lizard in South America.

Resumo Neste estudo investigamos a infecção por parasitas pulmonares no lagarto teiídeo Ameiva ameiva (Teiidae) habitando a Área de Proteção Ambiental do Araripe - APA Araripe. Um total de 45 espécimes foram coletados em três áreas entre os municípios de Várzea Alegre e Barbalha. Uma espécie de pentastomida (Raillietiella mottae) estava parasitando (nove espécimes) um macho de A. ameiva com uma prevalência de 2,22%, considerando todos os lagartos da região, e uma prevalência de 50% considerando apenas a floresta úmida. A taxa de infecção por pentastomídeos demonstrado no presente estudo é semelhante aos dados de infecção encontrados para outros lagartos insetívoros. Raillietiella mottae é considerado um parasita generalista, que usa insetos como hospedeiros intermediários. O resultado do presente estudo representa o primeiro registro de um pentastomídeo infectando lagartos do gênero Ameiva na América do Sul.

Intestinal parasites and lungworms in stray, shelter and privately owned cats of Switzerland.

Endoparasitic infections represent relevant causes of respiratory and gastrointestinal diseases in cats. The aim of the study was to investigate the occurrence of endoparasites in Swiss cats in order to evaluate the risk of onset of parasitic diseases and potential correlated zoonoses. Therefore 664 faecal samples from privately owned (n = 299), shelter (n = 197) and stray (n = 168) cats were investigated by sedimentation-flotation and 468 samples additionally by the Baermann technique. Overall, 77.4% (n = 130), 21.8% (n = 43) and 11.7% (n = 35) of stray, shelter and privately owned cats, respectively, were positive, with significant differences between the groups. Among infected cats, 58.7% (n = 122) harboured a single, 30.8% (n = 64) two and 10.6% (n = 22) more than two parasite species. Toxocara cati, with an infection rate of 18.5% (n = 123), was the most frequently detected parasite. The rates for other intestinal parasites were: Taenia sp. 11.1% (n = 74), Isospora sp. 8.1% (n = 54), Capillaria sp. 4.7% (n = 31), hookworms 1.1% (n = 7), Giardia duodenalis 0.8% (n = 5), Dipylidium caninum 0.6% (n = 4), Toxoplasma gondii 0.6% (n = 4), Hammondia hammondi 0.5% (n = 3), Sarcocystis sp. 0.2% (n = 1) and Diphyllobothrium latum 0.2% (n = 1). First-stage larvae of the lungworm Aelurostrongylus abstrusus were found in 2.3% (n = 15) of all samples. The morphological identification of Taenia sp., T. gondii, H. hammondi and A. abstrusus was confirmed by molecular techniques. Overall, cats younger than one year and intact animals were more frequently infected with parasites than older and neutered animals. The observed infection rates were comparable to those from other European studies, except for Taenia sp. showing a significantly higher occurrence. This implicates that there is a persistent risk of environmental contamination with parasitic stages especially by stray cats, and a risk of infection for cat owners with potential zoonotic pathogens, emphasizing the need for appropriate parasite control measures.

Raillietiella mottae (Pentastomida: Raillietiellidae) infecting Ameiva ameiva (Squamata: Teiidae) in Araripe Plateau, Northeast Brazil.

We investigated the infection by pulmonary parasites in the lizard Ameiva ameiva (Teiidae) inhabiting the Environmental Protection Area of Araripe (APA-Araripe). A total of 45 specimens were collected in three areas between the cities of Várzea Alegre and Barbalha. A Pentastomid species (Raillietiella mottae) was parasitizing (nine specimens) a male of A. ameiva with a prevalence of 2.22% considering all lizards collected in the region and prevalence of 50% considering only rainforest environment. The Pentastomids infection rates shown in this study are similar to data found for infections of other insectivorous lizards. Raillietiella mottae is considered a generalist parasite, which uses insects as intermediate hosts. The results of this study represent the first record of a Pentastomid infecting this species of lizard in South America.

Retrospective pathological survey of pulmonary disease in free-ranging Amazon river dolphin Inia geoffrensis and tucuxi Sotalia fluviatilis.

The Amazon river dolphin Inia geoffrensis and tucuxi Sotalia fluviatilis are classified as Data Deficient species. Despite very limited knowledge on health and disease aspects of these species, the main threats to their conservation include incidental mortality in fishing gear, population fragmentation, habitat loss and environmental pollution. It is also suggested that underlying diseases may contribute to their mortality rates. Herein, we retrospectively describe gross and microscopic pulmonary lesions in free-ranging I. geoffrensis (n = 24) and S. fluviatilis (n = 28) found dead. Nearly 85% of the examined animals presented some kind of primary lung disease, wherein the main etiological diagnoses were verminous pneumonia by Halocercus brasiliensis (25%), bacterial pneumonia (25%) and a single case of meconium aspiration syndrome (1.9%). An etiology was not determined in 36.5% (19/52) of animals. These results indicate a high incidence of pulmonary pathology in these species, raising concerns about population impacts and potential zoonotic implications in some instances. These data may provide a scientific basis for future medical and conservation efforts focused on Amazonian dolphins.

The Canary Islands as a model of risk of pulmonary dirofilariasis in a hyperendemic area.

We assessed the risk of human pulmonary dirofilariasis in the Canary Islands, hyperendemic for canine heartworm (Dirofilaria immitis), a zoonotic vector-borne infection. For this purpose, 1479 inhabitants were tested for anti-D. immitis antibodies. Four of the 7 islands presented high seroprevalences (from 6.2 to 12.7%), therefore high exposure to the parasite and risk of zoonotic infection. These corresponded to those islands with high canine prevalences of dirofilariasis and favourable climatic conditions for the development of mosquito vectors. The lowest prevalences (from 0 to 1.6%) were found in the desert islands and those with low canine prevalences of heartworm. Seroprevalences were very variable inside each island as well, being related to the climate and demographic factors. Human pulmonary dirofilariasis is an emerging zoonosis worldwide which frequently goes undiagnosed. Serological studies could be useful for the correct evaluation of the risk of infection among the human population, and study of the health implications of the continuous contact with the parasite in endemic areas. Sanitary authorities should be aware of the current epidemiological data, and physicians should include human dirofilariasis in the differential diagnosis of pulmonary nodules.

Prevalence survey on lungworm (Angiostrongylus vasorum, Crenosoma vulpis, Eucoleus aerophilus) infections of wild red foxes (Vulpes vulpes) in central Germany.

BACKGROUND: Angiostrongylus vasorum, Crenosoma vulpis and Eucoleus aerophilus are a source of increasing concern, potentially causing significant pulmonary and severe cardiac/systemic diseases in domestic dogs and wild canids, especially red foxes (Vulpes vulpes). To investigate the prevalence and geographical distribution of these parasites in central Germany, a total of 569 foxes were examined by dissection. METHODS: Pluck (heart and lung) and faecal samples of red foxes were collected from three regions of Germany. Lungs, hearts and adjacent vessels were processed for adult nematode detection. Parasitological diagnoses of faecal samples were performed by SAF technique, Giardia- and Cryptosporidium-Coproantigen-ELISAs and by a duplex copro-PCR for the detection of A. vasorum and C. vulpis DNA. RESULTS: Foxes originated from three Federal States of central Germany: Thuringia (n = 359); Rhineland-Palatinate (n = 121) and Hesse (n = 89). High prevalences for all three nematodes were detected, with E. aerophilus (69.4%; 395/569), followed by C. vulpis (32.3%; 184/569) and A. vasorum (14.1%; 80/569). In case of A. vasorum, prevalences varied significantly between Federal States, with the highest prevalence of 27.3% in Rhineland-Palatinate, followed by 19.1% and 8.4% in Hesse and Thuringia, respectively. The presence of A. vasorum in fox populations showed a rather patchy distribution, increasing from north-eastern to south-western regions. Analyses on C. vulpis revealed prevalences of 35.1%, 30.3% and 25.6% (Thuringia, Hesse and Rhineland-Palatinate, respectively). The most prevalent lungworm nematode was E. aerophilus, with a prevalence of 75.2%, 71.9% and 66.9% (Rhineland-Palatinate, Hesse and Thuringia, respectively) and an almost area-wide equal distribution. Significant differences for single parasite prevalences within geographical regions of the Federal States could be detected whilst no correlation between age or gender and parasite occurrence was estimated. Weak seasonality for the winter months for A. vasorum, stronger correlation to spring and late summer for C. vulpis and no correlation to any season for E. aerophilus were detected. The method of dissection revealed a significantly higher sensitivity for C. vulpis when compared with the results of the duplex copro-PCR. CONCLUSIONS: A sylvatic cycle was confirmed for all three lungworm nematodes in the examined area. The prevalences for all three lungworm nematodes are some of the highest recorded so far in German foxes. The data suggest that A. vasorum might be spreading from south-western to north-eastern parts of Germany.

Lungworm infection in small ruminants in Ethiopia: Systematic review and meta-analysis.

Lungworms are important parasitic nematodes of small ruminants that colonize the lower respiratory tract and cause high morbidity and economic loss throughout the world. This systematic review was conducted with the aim of estimating the pooled prevalence of lungworm infection in small ruminants in Ethiopia. Besides, it examines the predictors thought to be responsible for heterogeneity noted between the reports. The search databases used were PubMed, CAB direct, AJOL and Web of science. Eligible studies were selected based on predefined inclusion and exclusion criteria. Thirty two studies published between 2000 and 2016 were found eligible and data were generated on 14,257 small ruminants (12,310 sheep and 1947 goats). Predictors including the study area, type of small ruminants affected, parasitic species involved, a diagnostic test used, study design, management systems, breed, agroecology, and year article published were used as milestone of data extraction. The statistical tool employed were meta-analysis, univariable and multivariable meta-regression and Egger's and begg's statistics for sensitivity analysis. Accordingly, the estimated pooled prevalence of lung worm infection in small ruminants was 40.8% (95% CI: 36.1, 45.6) with a very high heterogeneity between the study reports (I2 = 96.5%). However, diagnostic test used and administrative States were the only two predictors identified to explain 15.5% of the explainable heterogeneity (R2 = 0.1545, tau2 unexplained = 0.6032, tau2 total = 0.7135) noted between studies. The reviewed studies showed that three genera of lungworms, namely Dictyocaulus filaria, Mullerius capillaris and Protostrogylus rufescens were prevalent both in sheep and goats in Ethiopia. Mixed infection with two or three species was reported in 4.4 to 48.6% of the total infected animals. Indeed this review is informative and provides a better picture on lungworm infection in Ethiopia; however, it is not exhaustively detailed as there was lack of clear data on the role of some important factors like age, flock size, management system and seasonal variation on lungworm infection. Thus, thorough epidemiological studies including all seasons are required for formulation of meaning full control strategies.