Dirofilaria repens: emergence of autochthonous human infections in the Czech Republic (case reports).
BACKGROUND
Human dirofilariasis is a zoonotic infection that continues to spread to previously unaffected areas of Europe. In the South Moravian Region of the Czech Republic (CR), imported as well as autochthonous canine infections were recorded in the last decade, and parasite DNA was detected in mosquitoes of Aedes vexans. In the present paper, human Dirofilaria infections are reported from the country for the first time.


METHODS
The samples from five patients with suspected tissue helminthiases were investigated. In particular cases, nematodes were isolated from various tissues including skin of lower leg, soft tissues of finger, subcutaneous tissue of hypogastrium, lymph node and peritoneum. The diagnosis was based on light microscopic morphology and/or DNA analysis of the worms. In addition, ELISA examination of patients' sera for anti-filaria IgG antibodies was performed.


CONCLUSIONS
In the CR, five cases of human dirofilariasis caused by Dirofilaria repens were recorded during 2010-2014 (species determination for three of them was confirmed besides morphological also by DNA analysis). At least, three of the cases were of autochthonous origin (the patients are Czech citizens residing in South Moravian Region who have never travelled abroad). The findings confirm the natural setting of D. repens in South Moravian Region of the CR. Dirofilariasis should be therefore considered as endemic in this area where it may represent a significant risk factor for public health.
Institute of Immunology and Microbiology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.|National Reference Laboratory for Tissue Helminthoses, General University Hospital in Prague, Prague, Czech Republic.
Jana
J
Matějů
Institute of Immunology and Microbiology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
Marta
M
Chanová
Department of Pathology and Parasitology, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic.|Central European Institute for Technology, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic.|Biology Centre, Institute of Parasitology, Czech Academy of Sciences, České Budějovice, Czech Republic.
David
D
Modrý
Department of Pathology and Parasitology, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic.|Central European Institute for Technology, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic.
Barbora
B
Mitková
Central European Institute for Technology, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic.|Department of Virology, Veterinary Research Institute, Brno, Czech Republic.
Kristýna
K
Hrazdilová
First Department of Pathological Anatomy, Faculty of Medicine, Masaryk University - St. Anne's University Hospital Brno, Brno, Czech Republic.
Víta
V
Žampachová
Institute of Immunology and Microbiology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic. Libuse.Kolarova@lf1.cuni.cz.|National Reference Laboratory for Tissue Helminthoses, General University Hospital in Prague, Prague, Czech Republic. Libuse.Kolarova@lf1.cuni.cz.
Libuše
L
Kolářová
D000293:Adolescent; D000328:Adult; D000818:Animals; D000909:Antibodies, Helminth / Q000097:blood; D018153:Czech Republic; D018509:DNA, Helminth / Q000235:genetics / Q000378:metabolism; D060348:Dirofilaria repens / Q000235:genetics* / Q000302:isolation & purification / Q000378:metabolism; D004184:Dirofilariasis / Q000175:diagnosis* / Q000469:parasitology / Q000473:pathology; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012341:RNA, Ribosomal, 5S / Q000235:genetics / Q000378:metabolism; D012867:Skin / Q000469:parasitology / Q000473:pathology; D040521:Subcutaneous Tissue / Q000469:parasitology / Q000473:pathology; D055815:Young Adult
D000909:Antibodies, Helminth; D018509:DNA, Helminth; D007074:Immunoglobulin G; D012341:RNA, Ribosomal, 5S
Autochthonous diseases in Czech Republic; Dirofilaria repens; Emerging disease; Human dirofilariasis