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Dirofilarial human cases in the Old World, attributed to Dirofilaria immitis: a critical analysis

Silvio Pampiglione1, Francesco Rivasi, Andrea Gustinelli

  • 1Department of Veterinary Public Health and Animal Pathology, University of Bologna, Ozzano Emilia, Bologna, Italy.

Histopathology
|February 12, 2009
PubMed
Abstract

Insights

Current evidence does not confirm Dirofilaria immitis as a cause of human dirofilariasis in the Old World. Further research is needed to understand geographic variations in its pathogenicity.

Area of Science:

  • Veterinary parasitology
  • Zoonotic diseases
  • Medical entomology

Background:

  • Human dirofilariasis is a zoonotic parasitic infection.
  • Dirofilaria immitis, the canine heartworm, is a known cause of dirofilariasis.
  • Geographic variations in Dirofilaria species pathogenicity are observed.

Purpose of the Study:

  • To review cases of human dirofilariasis in the Old World attributed to Dirofilaria immitis.
  • To investigate the pathogenic role of Old World Dirofilaria immitis in humans.
  • To explore reasons for differing pathogenicity of Dirofilaria immitis between the Americas and the Old World.

Main Methods:

  • Systematic review of 28 reported human dirofilariasis cases from the Old World.
  • Analysis of published case reports.
  • Interviews with case authors when possible.

Main Results:

  • No definitive proof confirms Dirofilaria immitis as pathogenic in humans in the Old World.
  • Pulmonary dirofilariasis in the Americas is linked to D. immitis.
  • In the Old World, pulmonary dirofilariasis is associated with Dirofilaria repens.

Conclusions:

  • The pathogenic role of Old World Dirofilaria immitis in humans remains unproven.
  • Hypotheses for differing pathogenicity include distinct genotypes or environmental factors affecting vector-parasite interactions.
  • Further investigation is required to elucidate the vector-parasite relationship and geographic variations in Dirofilaria pathogenicity.

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