title: Description of five dirofilariasis cases in South Hungary and review epidemiology of this disease for the country.
abstract: BACKGROUND
  Dirofilariasis is an emerging zoonosis (supported by climate change) in Central Europe. Human infections are usually caused by Dirofilaria repens and Dirofilaria immitis with mediation of mosquito vectors. Aims of this publication were to report our dirofilariasis cases, and to summarize Hungarian epidemiological data by reviewing literature.
  
  
  RESULTS
  We present five (four ophthalomological, one subcutaneous) cases observed within a 2-year period in Southern Hungary. Ages of infected patients were between 31 and 74 years. First case during pregnancy is also reported. There was no travel history in the anamnesis of patients which could explain acquisition of the infection. Moving, intact worms eliminated by surgical interventions were identified on the basis of morphological features as D. repens. Since the first report of human case, 115 further episodes (in addition to ours) were diagnosed in Hungary. Mean age of the patients was 47 years. Reviewing national reports, the ratio of subcutaneous infections was higher than that of the ocular ones (66 and 45, respectively). Evaluation of the territorial distribution of human episodes revealed that most infections occurred in patients living in the Danube-Tisza interfluvial region and eastern part of the country. However, sporadic cases were also found in western counties during 2014.
  
  
  CONCLUSIONS
  Most of the Hungarian dirofilariasis cases were autochthonous infections. Occurrence in the western counties may suggest the spreading of this emerging zoonosis to these areas. Comprehensive monitoring and data analysis are desirable, therefore reporting the epidemiologic data in the case of human infections should be made mandatory.
authors.affiliation: Faculty of Medicine, Department of Clinical Microbiology, Albert Szent-Györgyi Clinical Center, University of Szeged, 6 Semmelweis str, 6725, Szeged, Hungary. ilonadoczi@yahoo.com.
authors.forename: Ilona
authors.initials: I
authors.lastname: Dóczi
authors.affiliation: Faculty of Medicine, Department of Clinical Microbiology, Albert Szent-Györgyi Clinical Center, University of Szeged, 6 Semmelweis str, 6725, Szeged, Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Bereczki
authors.affiliation: Faculty of Medicine, Department of Ophthalmology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
authors.forename: Tamás
authors.initials: T
authors.lastname: Gyetvai
authors.affiliation: Faculty of Medicine, Department of Ophthalmology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
authors.forename: Imre
authors.initials: I
authors.lastname: Fejes
authors.affiliation: Faculty of Medicine, Department of Ophthalmology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
authors.forename: Ákos
authors.initials: Á
authors.lastname: Skribek
authors.affiliation: Faculty of Medicine, Department of Ophthalmology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
authors.forename: Áron
authors.initials: Á
authors.lastname: Szabó
authors.affiliation: Faculty of Medicine, Department of Ophthalmology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
authors.forename: Szilvia
authors.initials: S
authors.lastname: Berkes
authors.affiliation: Faculty of Medicine, Department of Pathology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
authors.forename: László
authors.initials: L
authors.lastname: Tiszlavicz
authors.affiliation: Faculty of Medicine, Department of Clinical Microbiology, Albert Szent-Györgyi Clinical Center, University of Szeged, 6 Semmelweis str, 6725, Szeged, Hungary.
authors.forename: Noémi
authors.initials: N
authors.lastname: Bartha
authors.affiliation: Faculty of Medicine, Department of Dermatology and Allergology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
authors.forename: Balázs
authors.initials: B
authors.lastname: Bende
authors.affiliation: Faculty of Medicine, Department of Dermatology and Allergology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
authors.forename: Erika
authors.initials: E
authors.lastname: Kis
authors.affiliation: National Center for Epidemiology, Budapest, Hungary.
authors.forename: István
authors.initials: I
authors.lastname: Kucsera
mesh_terms: D000328:Adult; D000368:Aged; D004184:Dirofilariasis / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D015995:Prevalence; D012307:Risk Factors
keywords: Case report; Dirofilaria repens; Epidemiology; Hungary; Pregnancy