[Dirofilariasis, an emerging and underestimated zoonoses in France]

A total of 71 cases of dirofilariasis due to Dirofilaria repens and two cases of pulmonary dirofilariasis due to Dirofilaria have been reported in France. As a result France ranks second after Italy in the incidence of this emerging zoonoses that has been given little attention (48 p. 100 of cases in the last ten years). Most human infections (80 p. 100) have occurred in Mediterranean areas but in the last ten years a few cases have been reported in Southwestern France and at least one case was documented in a northern area (Alsace). The epidemiological profile of human dirofilariasis in France is consistent with usual data showing highest incidence in adults and no gender preference. More than 50 p. 100 of superficial nodules are located on the head with the most common site being the conjuctiva and orbit (29.4 p. 100). Nodules on the breast and male genitals as well as pulmonary nodules require differential diagnosis to rule out neoplasm. Intra-abdominal forms are usually discovered incidentally. Identification is rarely based on detection of a whole adult worm but rather on observation of a nematode segment on histological sections. In most cases it is an unexpected finding. Data concerning canine heartworm in France is available but the extent of infestation is probably underestimated and will require further study. In addition, data on other animal reservoirs should be updated.