Skip to main content

Advertisement

SpringerLink
Log in

Some aspects of the epidemiology, clinical manifestations, and diagnosis of human dirofilariasis caused by Dirofilaria repens

  • Original Paper
  • Published:
Parasitology Research Aims and scope Submit manuscript

Abstract

In recent years, zoonotic filariae Dirofilaria immitis and Dirofilaria (Nochtiella) repens are gaining popularity as incidental human parasitic pathogens. The usual hosts for these nematodes are domestic and wild carnivorous animals. The medical significance of human dirofilariasis is due to frequent misdiagnosis as malignancy and in many cases diagnosis is made after invasive surgical procedures. The aim of this study was to ascertain the geographical distribution and clinical manifestations of a relatively rare among people zoonotic disease such as dirofilariasis, whose epidemiological features depends on prevalence of the parasite among usual hosts, presence of suitable vector, and human activities favoring exposure. Data for a 39-year period were analyzed, during which, in Bulgaria, were recorded 47 cases of human dirofilariasis with various organ localizations. Morphological methods were also used for species identification of Dirofilaria (N.) repens and serological diagnostic tests for filariasis. Some epidemiological parameters such as annual incidence, prevalence for different geographic areas in Bulgaria, distribution by gender (28 females and 19 males) and age (from 19 to 77 years of age) of the diseased were identified, and aspects of the clinical manifestations, diagnosis, and treatment of the disease were discussed. Comparison was made between the number of cases in Bulgaria and those in other European countries. Although the climatic and faunal conditions in Bulgaria are favorable for disease transmission between animal reservoir hosts and humans, the diagnosis of dirofilariasis is often omitted.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  • Alexandrov V (2006) Climate of Bulgaria In: On spatial distribution of soil drought in Bulgaria. http://meteorology.meteo.bg/soil_drought_2.pdf. Accessed 17 Oct 2013

  • Angelov I, Vuchev D (2010) Dirofilariasis caused by Dirofilaria repens in humans. Infectology 1:36–39 (in Bulgarian)

    Google Scholar 

  • Arakeljan RS, Kovtunov AI, Bikov VP, Shatalin VA, Arakeljan EM (2008) Epidemiologic-epizootologic features of three-member system of dirofilariosis (dog – mosquito – man) on the territory of Astrakhan region. Siberian Med J 7:13–18 (in Russian)

    Google Scholar 

  • Ashrafi K, Golchai J, Geranmayeh S (2010) Human subcutaneous dirofilariasis due to Dirofilaria (Nochtiella) repens: clinically suspected as cutaneous fascioliasis. Iranian J Publ Health 39(1):105–109

    CAS  Google Scholar 

  • Avduhina TI (2002) Dirofilariasis. In: Lysenko AY (ed) Clinical parasitology. WHO, Geneva, pp 521–526 (in Russian)

    Google Scholar 

  • Bocková E, Rudolf I, Kočišová A, Betášová L, Venclíková K, Mendel J, Hubálek Z (2013) Dirofilaria repens microfilariae in Aedes vexans mosquitoes in Slovakia. Parasitol Res 112(10):3465–3470. doi:10.1007/s00436-013-3526-9

    Article  PubMed Central  PubMed  Google Scholar 

  • Cancrini G, Gabrielli S (2007) Vectors of Dirofilaria nematodes: biology, behaviour and host/parasite relationships. In: Genchi C, Rinaldi L, Cringoli G (eds) Dirofilaria immitis and D. repens in dog and cat and human infections. Mappe Parassitologiche 8:49–58

    Google Scholar 

  • Digital library of the National Statistical Institute. Population of Bulgaria by years. http://statlib.nsi.bg:8181/isisbgstat/SSP/isisframes-basic.html. Accessed 30 Jul 2013

  • Dissanaike AS, Abeyewickreme W, Wijesundera MD, Weerasooriya MV, Ismail MM (1997) Human dirofilariasis caused by Dirofilaria (Nochtiella) repens in Sri Lanka. Parasitologia 39(4):375–382

    CAS  Google Scholar 

  • Drandarska I, Vuchev D, Chergova M (2002) Case of dirofilariasis with male breast localization caused by Dirofilaria repens. Probl Inf Parasit Dis 30(2):17

    Google Scholar 

  • Genchi C, Rinaldi L, Cascone C, Mortarino M, Cringoli G (2005) Is heartworm disease really spreading in Europe. Vet Parasitol 133(2–3):137–148

    Article  PubMed  Google Scholar 

  • Genchi C, Kramer LH, Rivasi F (2011a) Dirofilarial infection in Europe. Vector Borne Zoonotic Dis 11(10):1307–1317. doi:10.1089/vbz.2010.0247. Epub 2011 Mar 21

    Article  PubMed  Google Scholar 

  • Genchi C, Mortarino M, Rinaldi L, Cringoli G, Traldi G, Genchi M (2011b) Changing climate and changing vector-borne disease distribution: the example of Dirofilaria in Europe. Vet Parasitol 176(4):295–299. doi:10.1016/j.vetpar.2011.01.012

    Article  PubMed  Google Scholar 

  • Harizanov R (2012) Natural focality, epidemiology, clinical, diagnostic and therapeutic characteristics of visceral leishmaniasis in Bulgaria. Dissertation, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria (in Bulgarian)

  • Harizanov R, Jordanova D, Bikov I, Kaftandjiev I (2010) Cases of human dirofilariasis in Bulgaria 2009. In: Abstracts of the VIII National congress of clinical microbiology and infections of Bulgarian association of microbiologists. Plovdiv, April, pp. 35

  • Kanev I, Kamenov I, Ganchev I et al (1996) Dirofilaria repens and Dirofilaria immitis in animals and humans in Bulgaria. Parassitologia 38:358

    Google Scholar 

  • Klotchko A, Wallace M (2010) Dirofilariasis. Medscape reference, Drugs, Diseases & Procedures. http://emedicine.medscape.com/article/236698-overview. Accessed 27 Jun 2012

  • Knudsen AB (1995) Geographic spread of Aedes albopictus in Europe and the concern among public health authorities. Eur J Epidemiol 11:345–348

    Article  CAS  PubMed  Google Scholar 

  • Maltezos ES, Sivridis EL, Giatromanolaki AN, Simopoulos CE (2002) Human subcutaneous dirofilariasis: a report of three cases manifesting as breast or axillary nodules. Scott Med J 47(4):86–88

    CAS  PubMed  Google Scholar 

  • Manfredi MT, Di Cerbo A, Genchi M (2007) Biology of filarial worms parasitizing dogs and cats. In: Genchi C, Rinaldi L, Cringoli G (eds) Dirofilaria immitis and D. repens in dog and cat and human infections. Mappe Parassitologiche 8:39–47

    Google Scholar 

  • Mikov O, Vuchev D, Lalkovski N (2011) Distribution of mosquito species as potential vectors of dirofilariases in humans and animals in Bulgaria. In: Abstracts of the “Anniversary Scientific Session 110 years from foundation of the NDSRVMI”. November 9, 2011. Sofia, Bulgaria: National Diagnostic Science-and-Research Veterinary Medical Institute (NDSRVMI), Sofia, Bulgaria, pp. 152-156 (in Bulgarian)

  • Muro A, Genchi C, Cordero M, Simon F (1999) Human dirofilariasis in the European Union. Parasitol Today 15:386–389

    Article  CAS  PubMed  Google Scholar 

  • National Statistical Institute (2013) Statistical Reference Book 2013 http://statlib.nsi.bg:8181/FullT/FulltOpen/SRB_BG_7_2012_2013.pdf. Accessed 3 Jan 2014

  • Otleanu G (1996) Dirofilariasis in men and animals in Romania. Parasitologia 38:360

    Google Scholar 

  • Pampiglione S, Rivasi F (2000) Human dirofilariasis due to Dirofilaria (Nochtiella) repens: an update of world literature from 1995 to 2000. Parasitologia 42(3–4):231–254

    CAS  Google Scholar 

  • Pampiglione S, Canestri TG, Rivasi F (1995) Human dirofilariasis due to Dirofilaria (Nochtiella) repens: a review of world literature. Parasitologia 37(2–3):149–193

    CAS  Google Scholar 

  • Rusev I, Lalkovski N (2007) Distribution of dirofilaria infection in dogs. In: Abstracts of the conference “Traditions and contemporary trends in the veterinary medicine”. November 23, 2007. Sofia, Bulgaria. University of forestry, Sofia, Bulgaria, 2007, pp. 313-316 (in Bulgarian)

  • Sassnau R, Genchi C (2013) Qualitative risk assessment for the endemisation of Dirofilaria repens in the state of Brandenburg (Germany) based on temperature-dependent vector competence. Parasitol Res 112(7):2647–2652. doi:10.1007/s00436-013-3431-2

    Article  CAS  PubMed  Google Scholar 

  • Sergiev VP, Suprjaga VG, Morozov EN, Jukova LA (2009a) Human dirofilariasis: diagnosis and character of the relationship between causative agent and host. Med Parasitol and Parasit Dis 3:3–6 (in Russian)

    Google Scholar 

  • Sergiev VP, Suprjaga VG, Darchenkova NN et al (2009b) Distribution of human dirofilariasis in Russia. Med Parasitol and Parasit Dis 2:3–7 (in Russian)

    Google Scholar 

  • Service MW, Ashford RW (2001) Dirofilariasis. In: Service MW (ed) Encyclopedia of artropod-transmitted infections of man and domesticated animals. CABI. pp. 145-148

  • Simon F, Lopez-Belmonte J, Marcos-Atxutegi C, Morchon R, Martın-Pacho JR (2005) What is happening outside North America regarding human dirofilariasis? Vet Parasitol 133:181–189

    Article  CAS  PubMed  Google Scholar 

  • Tasić A, Rossi L, Tasić S, Miladinović-Tasić N, Ilić T, Dimitrijević S (2008) Survey of canine dirofilariasis in Vojvodina, Serbia. Parasitol Res 103(6):1297–1302. doi:10.1007/s00436-008-1132-z

    Article  PubMed  Google Scholar 

  • Vodovosov AM, Jarulin GR, Djakonowa SV (1973) Dirofilaria in human vitreous body. Ophthalmologica 162(2):88–93

    Article  Google Scholar 

  • Vuchev D, Coruev A (2001) Cases of dirofilariasis with ocular localization caused by Dirofilaria repens. Probl Inf Parasit Dis 29(2):39–40

    Google Scholar 

  • Vuchev D, Mikov O (2004) Dirofilariasis—vector born human zoonotic helminthoses. Disinfection Disinsection Deratization 1(4):106–110 (in Bulgarian)

    Google Scholar 

  • Vuchev D, Dimitrov H, Drandarska I et al (2003) Dirofilariatosis caused by Dirofilaria repens—clinical observations. Probl Inf Parasit Dis 31(2):36

    Google Scholar 

Download references

Financial support

This research received no specific grant from any funding agency, commercial, or not-for-profit sectors.

Conflict of interest

None

Author information

Authors and Affiliations

  1. Department of Parasitology and Tropical Medicine, National Center of Infectious and Parasitic Diseases, 26, Yanko Sakazov Blvd, 1504, Sofia, Bulgaria

    Rumen N. Harizanov, Diana P. Jordanova & Ivailo S. Bikov

Authors
  1. Rumen N. Harizanov
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Diana P. Jordanova
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ivailo S. Bikov
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rumen N. Harizanov.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Harizanov, R.N., Jordanova, D.P. & Bikov, I.S. Some aspects of the epidemiology, clinical manifestations, and diagnosis of human dirofilariasis caused by Dirofilaria repens . Parasitol Res 113, 1571–1579 (2014). https://doi.org/10.1007/s00436-014-3802-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00436-014-3802-3

Keywords

Search

Navigation