title: The Emergence of Zoonotic Onchocerca lupi Infection in the United States--A Case-Series.
abstract: This case-series describes the 6 human infections with Onchocerca lupi, a parasite known to infect cats and dogs, that have been identified in the United States since 2013. Unlike cases reported outside the country, the American patients have not had subconjunctival nodules but have manifested more invasive disease (eg, spinal, orbital, and subdermal nodules). Diagnosis remains challenging in the absence of a serologic test. Treatment should be guided by what is done for Onchocerca volvulus as there are no data for O. lupi. Available evidence suggests that there may be transmission in southwestern United States, but the risk of transmission to humans is not known. Research is needed to better define the burden of disease in the United States and develop appropriately-targeted prevention strategies.
authors.affiliation: Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Paul T
authors.initials: PT
authors.lastname: Cantey
authors.affiliation: Indian Health Service - Navajo Area, Window Rock, Arizona.
authors.forename: Jessica
authors.initials: J
authors.lastname: Weeks
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Morven
authors.initials: M
authors.lastname: Edwards
authors.affiliation: Children's Hospital Colorado, University of Colorado School of Medicine, Aurora.
authors.forename: Suchitra
authors.initials: S
authors.lastname: Rao
authors.affiliation: Maricopa Medical Center, District Medical Group, University of Arizona, Phoenix.
authors.forename: G Amin
authors.initials: GA
authors.lastname: Ostovar
authors.affiliation: University of New Mexico Health Sciences Center, Albuquerque.
authors.forename: Walter
authors.initials: W
authors.lastname: Dehority
authors.affiliation: Clin-Path Associates, Tempe, and.
authors.forename: Maria
authors.initials: M
authors.lastname: Alzona
authors.affiliation: Indian Health Service - Navajo Area, Window Rock, Arizona.
authors.forename: Sara
authors.initials: S
authors.lastname: Swoboda
authors.affiliation: Phoenix Children's Hospital, Arizona.
authors.forename: Brooke
authors.initials: B
authors.lastname: Christiaens
authors.affiliation: Phoenix Children's Hospital, Arizona.
authors.forename: Wassim
authors.initials: W
authors.lastname: Ballan
authors.affiliation: Phoenix Children's Hospital, Arizona.
authors.forename: John
authors.initials: J
authors.lastname: Hartley
authors.affiliation: Indian Health Service - Navajo Area, Window Rock, Arizona.
authors.forename: Andrew
authors.initials: A
authors.lastname: Terranella
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Jill
authors.initials: J
authors.lastname: Weatherhead
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: James J
authors.initials: JJ
authors.lastname: Dunn
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Douglas P
authors.initials: DP
authors.lastname: Marx
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: M John
authors.initials: MJ
authors.lastname: Hicks
authors.affiliation: Baylor College of Medicine, Houston, Texas.
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Rauch
authors.affiliation: Children's Hospital Colorado, University of Colorado School of Medicine, Aurora.
authors.forename: Christiana
authors.initials: C
authors.lastname: Smith
authors.affiliation: Children's Hospitals and Clinics of Minnesota, Minneapolis.
authors.forename: Megan K
authors.initials: MK
authors.lastname: Dishop
authors.affiliation: Children's Hospital Colorado, University of Colorado School of Medicine, Aurora.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Handler
authors.affiliation: Montreal Children's Hospital, McGill University, Montreal, Canada.
authors.forename: Roy W R
authors.initials: RW
authors.lastname: Dudley
authors.affiliation: Maricopa Medical Center, District Medical Group, University of Arizona, Phoenix.
authors.forename: Kote
authors.initials: K
authors.lastname: Chundu
authors.affiliation: Maricopa Medical Center, District Medical Group, University of Arizona, Phoenix.
authors.forename: Dan
authors.initials: D
authors.lastname: Hobohm
authors.affiliation: Maricopa Medical Center, District Medical Group, University of Arizona, Phoenix.
authors.forename: Iman
authors.initials: I
authors.lastname: Feiz-Erfan
authors.affiliation: San Juan Regional Medical Group, Farmington, New Mexico.
authors.forename: Joseph
authors.initials: J
authors.lastname: Hakes
authors.affiliation: University of New Mexico Health Sciences Center, Albuquerque.
authors.forename: Ryan S
authors.initials: RS
authors.lastname: Berry
authors.affiliation: Division of Dermatopathology, Pathology Associates of Albuquerque, New Mexico.
authors.forename: Shelly
authors.initials: S
authors.lastname: Stepensaski
authors.affiliation: University of New Mexico Health Sciences Center, Albuquerque.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Greenfield
authors.affiliation: North Phoenix Infectious Diseases, Arizona.
authors.forename: Laura
authors.initials: L
authors.lastname: Shroeder
authors.affiliation: Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Henry
authors.initials: H
authors.lastname: Bishop
authors.affiliation: Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Marcos
authors.initials: M
authors.lastname: de Almeida
authors.affiliation: Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Blaine
authors.initials: B
authors.lastname: Mathison
authors.affiliation: Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Mark
authors.initials: M
authors.lastname: Eberhard
mesh_terms: D000293:Adolescent; D000818:Animals; D002415:Cats; D002648:Child; D002675:Child, Preschool; D021821:Communicable Diseases, Emerging / Q000175:diagnosis / Q000453:epidemiology / Q000469:parasitology / Q000635:transmission; D017281:Cost of Illness; D004283:Dog Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000469:parasitology; D004285:Dogs; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009854:Onchocerca / Q000235:genetics / Q000302:isolation & purification*; D009855:Onchocerciasis / Q000175:diagnosis / Q000469:parasitology / Q000635:transmission / Q000662:veterinary; D015206:Southwestern United States / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D015047:Zoonoses / Q000175:diagnosis / Q000453:epidemiology / Q000469:parasitology / Q000635:transmission
keywords: Onchocerca lupi; emerging infectious diseases; zoonotic infection