martes, 19 de julio de 2016

Increase in Eyeworm Infections in Eastern Europe - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC

Increase in Eyeworm Infections in Eastern Europe - Volume 22, Number 8—August 2016 - Emerging Infectious Disease journal - CDC





Volume 22, Number 8—August 2016

Letter

Increase in Eyeworm Infections in Eastern Europe

To the Editor: In the past 30 years, war in the Balkans, the fall of Communist regimes, and economic recession in Europe have undermined the economic stability of countries in eastern Europe and eventually favored occurrence of so-called neglected infections of poverty (1). Parasitic infections causing eye disease in persons living in areas with low socioeconomic standards might be caused by parasites not well known by healthcare providers.
A good example is Thelazia callipaeda (Spirurida, Thelaziidae) nematode infections in children and elderly persons living in rural and poor communities in countries in Europe and Asia (2). In Europe, vectors for this nematode are male Phortica variegata drosophilids, which feed on ocular secretions of hosts and transmit infective stage larvae to domestic and wild carnivores, lagomorphs, and humans (3). Possible outcomes of this infection include conjunctivitis, lacrimation, corneal ulcers, perforation, and blindness (3), but differentiating T. callipaeda infection from other ocular conditions, such as conjunctivitis-causing pathogens and allergies, can be difficult because signs and symptoms might be similar.
T. callipaeda was previously known as the oriental eyeworm because of its original description in countries in eastern Asia (e.g., China, Japan, and Thailand), where it has caused >1,000 cases of human infections in the past 2 decades (2). Since 1989, this nematode has also been detected in many countries in Europe, including Italy, France, Spain, Portugal, Switzerland, Germany, and Greece, as an agent of animal and human ocular infection (3). However, data on the occurrence of this parasite in countries in eastern Europe were not available until 2014.
Over the past 2 years, several autochthonous cases of ocular thelaziosis in dogs and cats (Romania, Croatia, Serbia, Bosnia and Herzegovina, Bulgaria) and foxes (Bosnia and Herzegovina) were reported (47) (Table). In 2016, the zoonotic potential of this parasite in those regions was further confirmed by 2 human cases of thelaziosis, one in a 36-year-old man living in Serbia (7) and one in an 82-year-old man living in Croatia (8) (Table).
We report 10 new cases of ocular infection by T. callipaeda in dogs living in Bulgaria (n = 9) and Hungary (n = 1). All animals had no history of travel outside their native countries and were brought to the Department of Parasitology (Stara Zagora, Bulgaria) and to a veterinary practitioner (Pécs, Hungary) with various ocular disorders (i.e., epiphora, conjunctivitis). Nematodes detected in the conjunctival sac were collected by flushing the sac with saline solution. These nematodes were then stored in 70% ethanol and morphologically identified according to the procedure of Otranto et al. (9).
Molecular characterization by using PCR amplification and sequencing of a partial region of the cytochrome oxidase subunit 1 gene were performed as described (10). Nucleotide sequences were identical to those of T. callipaeda nematode haplotype-1 (GenBank accession no. AM042549), which is the only haplotype circulating in animals and humans in Europe.
Our confirmed autochthonous cases of thelaziosis in Hungary and Bulgaria have extended the geographic distribution of T. callipaeda nematodes from neighboring countries (e.g., Bosnia and Herzegovina, Croatia, Romania and, Greece), where occurrence of the parasite in humans and animals was already documented. Cases of human thelaziosis are reported in areas where the infection is highly prevalent in animals (3). Although no large-scale prevalence study has been conducted in countries in eastern Europe, 51 (27.7%) of 184 foxes in Bosnia and Herzegovina were infected with T. callipaeda nematodes (5). Isolation of T. callipaeda eyeworms from dogs in Bulgaria and Hungary should increases awareness of medical and veterinary communities in countries in eastern Europe for this zoonotic parasitosis. Use of a One Health approach is imperative for preventing additional eyeworm infections in persons living in eastern Europe.
Vito Colella, Zvezdelina Kirkova, Éva Fok, Andrei D. Mihalca, Suzana Tasić-Otašević, Adnan Hodžić, Filipe Dantas-Torres, and Domenico OtrantoComments to Author 
Author affiliations: Università Degli Studi di Bari, Bari, Italy (V. Colella, F. Dantas-Torres, D. Otranto)Trakia University, Stara Zagora, Bulgaria (Z. Kirkova);Szent István University, Budapest, Hungary (É. Fok)University of Agricultural Sciences and Veterinary Medicine, Cluj Napoca, Romania (A.D. Mihalca);University of Niš, Niš, Serbia (S. Tasić-Otašević)University of Veterinary Medicine Vienna, Vienna, Austria (A. Hodžić)Centro de Pesquisas Aggeu Magalhães, Recife, Brazil (F. Dantas-Torres)

References

  1. Hotez PJGurwith MEurope’s neglected infections of poverty. Int J Infect Dis2011;15:e6119DOIPubMed
  2. Máca JOtranto DDrosophilidae feeding on animals and the inherent mystery of their parasitism. Parasit Vectors2014;7:516DOIPubMed
  3. Otranto DCantacessi CDantas-Torres FBrianti EPfeffer MGenchi CThe role of wild canids and felids in spreading parasites to dogs and cats in Europe. Part II: helminths and arthropods. Vet Parasitol2015;213:2437DOIPubMed
  4. Gajić BBogunović DStevanović JKulišić ZSimeunović PStanimirović ZCanine and feline thelaziosis caused by Thelazia callipaeda in Serbia. Acta Vet (Beogr)2014;64:44755.
  5. Hodžić ALatrofa MSAnnoscia GAlić ABeck RLia RPThe spread of zoonotic Thelazia callipaeda in the Balkan area. Parasit Vectors2014;7:352.DOIPubMed
  6. Mihalca ADD’Amico GScurtu IChirilă RMatei IAIonică AMFurther spreading of canine oriental eyeworm in Europe: first report of Thelazia callipaeda in Romania. Parasit Vectors2015;8:48DOIPubMed
  7. Tasić-Otašević SGabrielli STrenkić-Božinović MPetrović AGajić BColella VEyeworm infections in dogs and in a human patient in Serbia: a One Health approach is needed. Comp Immunol Microbiol Infect Dis2016;45:202DOIPubMed
  8. Paradžik MTSamardžić KŽivičnjak TMartinković FJanjetović ŽMiletić-Medved MThelazia callipaeda: first human case of thelaziosis in Croatia.Wien Klin Wochenschr2016;128:2213DOIPubMed
  9. Otranto DLia RPTraversa DGiannetto SThelazia callipaeda (Spirurida, Thelaziidae) of carnivores and humans: morphological study by light and scanning electron microscopy. Parassitologia2003;45:12533.PubMed
  10. Otranto DTestini GDeluca FHu MShamsi SGasser RBAnalysis of genetic variability within Thelazia callipaeda (Nematoda: Thelazioidea) from Europe and Asia by sequencing and mutation scanning of mitochondrial cytochrome c oxidase subunit 1. Mol Cell Probes2005;19:30613DOIPubMed

Table

Suggested citation for this article: Colella V, Kirkova Z, Fok É, Mihalca AD, Tasić-Otašević S, Hodžić A, et al. Increase in eyeworm infections in eastern Europe [letter]. Emerg Infect Dis. 2106 Aug [date cited]. http://dx.doi.org/10.3201/eid2208.160792


DOI: 10.3201/eid2208.160792

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