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Canine Vector-Borne Diseases in Brazil Filipe Dantas-Torres

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Canine Vector-Borne Diseases in Brazil Filipe Dantas-Torres Parasites & Vectors BioMed Central Review Open Access Canine vector-borne diseases in Brazil Filipe Dantas-Torres Address: Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, PO Box 7472, Recife, 50670420, Pernambuco, Brazil Email: Filipe Dantas-Torres - [email protected] Published: 8 August 2008 Received: 2 July 2008 Accepted: 8 August 2008 Parasites & Vectors 2008, 1:25 doi:10.1186/1756-3305-1-25 This article is available from: http://www.parasitesandvectors.com/content/1/1/25 © 2008 Dantas-Torres; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Canine vector-borne diseases (CVBDs) are highly prevalent in Brazil and represent a challenge to veterinarians and public health workers, since some diseases are of great zoonotic potential. Dogs are affected by many protozoa (e.g., Babesia vogeli, Leishmania infantum, and Trypanosoma cruzi), bacteria (e.g., Anaplasma platys and Ehrlichia canis), and helminths (e.g., Dirofilaria immitis and Dipylidium caninum) that are transmitted by a diverse range of arthropod vectors, including ticks, fleas, lice, triatomines, mosquitoes, tabanids, and phlebotomine sand flies. This article focuses on several aspects (etiology, transmission, distribution, prevalence, risk factors, diagnosis, control, prevention, and public health significance) of CVBDs in Brazil and discusses research gaps to be addressed in future studies. Background been recognized in previously free areas, as it is the case of Canine vector-borne diseases (CVBDs) constitute an canine leishmaniasis in São Paulo, Southeast Brazil [4- important group of illnesses affecting dogs around the 11]. Despite their recognized importance, many aspects world. These diseases are caused by a diverse range of concerning epidemiology and public health significance pathogens, which are transmitted to dogs by different of CVBDs in Brazil are still poorly known and data have arthropod vectors, including ticks, fleas, lice, triatomines, not been comprehensively discussed. mosquitoes, tabanids, and phlebotomine sand flies. This article summarizes several aspects (etiology, trans- CVBDs are historically endemic in tropical and subtropi- mission, distribution, prevalence, risk factors, diagnosis, cal regions and have increasingly been recognized, not control, prevention, and public health significance) of only in traditionally endemic areas, but also in temperate CVBDs in Brazil and discusses research gaps to be regions [1]. This may be attributed to several factors, addressed in future studies. including the availability of improved diagnostic tools, higher public awareness about CVBDs, dog population Protozoal diseases dynamics, and environmental and climate changes [2], Canine babesiosis which directly influences the distribution of arthropod Canine babesiosis has been recognized in Brazil since the vectors and the diseases they transmit. beginning of the 20th century [12]. This disease is caused by Babesia vogeli (= Babesia canis vogeli) (Piroplasmida: CVBDs have long been recognized in Brazil [3]. At the Babesiidae) (Fig. 1), which has recently been molecularly beginning of the 21st century, CVBDs are prevalent in all characterized in Brazil [13]. Cases of Babesia gibsoni infec- regions of the country and some of them have increasingly tion in Brazilian dogs have also been reported [14]. The Page 1 of 17 (page number not for citation purposes) Parasites & Vectors 2008, 1:25 http://www.parasitesandvectors.com/content/1/1/25 BabesiaFigure vogeli1 Babesia vogeli. Two Babesia sp. trophozoites in a blood smear from a naturally infected dog. only proven vector of B. vogeli in Brazil is Rhipicephalus sanguineus (Fig. 2), which is also the suspected vector of B. gibsoni [15]. Canine babesiosis is prevalent in virtually all Brazilian RhipicephalusFigure 2 sanguineus regions [12,16-24]. The prevalence of infection ranges Rhipicephalus sanguineus. A dog heavily infested by Rhipi- from 35.7 [24] to 66.9% [16] in serological surveys and cephalus sanguineus ticks. from 1.9 [23] to 42% [21] by cytology on blood smears. The incidence of disease seems to be higher among adult dogs [24], although young dogs are also highly suscepti- (e.g., L. infantum and Leishmania braziliensis) as well [29]. ble to infection [22]. Apparently, there are no breed or sex The main vector of L. infantum in Brazil is Lutzomyia longi- predilections [16,21,24-26]. palpis (Diptera: Psychodidae). Other modes of transmis- sion, including by Rh. sanguineus ticks, are suspected to The diagnosis of canine babesiosis is usually based on the occur [30,31], particularly in foci where suitable phlebot- presence of suggestive clinical signs (e.g., apathy, fever, omine sand fly vectors are absent (e.g., Recife, Northeast anorexia, weigh loss, pale mucous membranes, and jaun- Brazil) [32]. The vectors of L. amazonensis and L. brazilien- dice) and patient history. The infection by Babesia spp. is sis vary from region to region and several species may confirmed by the examination of Giemsa-stained periph- eventually be involved, including Lutzomyia whitmani (Fig. eral blood smears. A detailed review of all aspects, includ- 4) and Lutzomyia intermedia (reviewed in [33]). ing diagnosis and treatment, of canine babesiosis in Brazil can be found elsewhere [22]. Canine visceral leishmaniasis by L. infantum is endemic in all Brazilian regions [34-47], except in South where the Canine leishmaniasis disease is seldom recognized [44,48,49]. Canine cutane- Canine leishmaniasis was firstly recognized in Brazil dur- ous leishmaniasis by L. braziliensis is also prevalent in all ing the 1930s [27]. This disease is mainly caused by Leish- regions [7,10,38,50-58], except in Center-West. The only mania infantum (Kinetoplastida: Trypanosomatidae) (Fig. two cases of L. amazonensis infection in dogs reported so 3), sometimes referred to as Leishmania chagasi or Leishma- far were diagnosed in Southeast Brazil [10]. The preva- nia infantum chagasi [28]. Infection by other Leishmania lence of Leishmania spp. infection in dogs varies widely species (e.g., Leishmania amazonensis) have also been [38,47,59,60] and may be as high as 67% in highly reported [7,10] and cases of co-infection by two species endemic foci [61]. Risk factors associated with canine Page 2 of 17 (page number not for citation purposes) Parasites & Vectors 2008, 1:25 http://www.parasitesandvectors.com/content/1/1/25 infection [60]. Short-furred dogs are at a higher risk of infection [60] and this has been attributed to the fact that their short-hair makes them more exposed to phlebotom- ine sand fly bites. The diagnosis of canine leishmaniasis is based on the presence of suggestive clinical signs (e.g., weight loss, der- matitis, hair loss, mouth and skin ulcers, enlarged lymph nodes, onychogryphosis, and conjunctivitis) (Fig. 5) and on a positive serological response to Leishmania antigens [47,62]. Detailed information on several aspects of canine leishmaniasis, including diagnosis and treatment, can be found elsewhere [31,63,64]. The treatment of canine leishmaniasis is not routinely practiced in Brazil. Until the middle of the 1980s, most attempts to treat Brazilian dogs affected by leishmaniasis were unsuccessful [65]. Nowadays, there is scientific evi- dence supporting the treatment of canine leishmaniasis in Brazil [66-69]. However, although the available protocols LeishmaniaFigure 3 infantum are effective in promoting clinical improvement, a parasi- Leishmania infantum. Several Leishmania infantum amastig- tological cure is seldom achieved [66-71]. Hence, consid- otes in a bone marrow smear from a naturally infected dog. ering the importance of dogs in the epidemiology of zoonotic visceral leishmaniasis, the Ministry of Health and the Ministry of Agriculture, Livestock and Food Sup- leishmaniasis have extensively been studied in Brazil. ply have recently prohibited the treatment of canine vis- There appears to be no sex predilection [35,60]. Although ceral leishmaniasis in Brazil [see Addendum]. the prevalence of infection is often higher among males [47], this seems to be a matter of exposition rather than sex-related susceptibility. The prevalence is also higher in young dogs [47]. Some breeds (e.g., boxer and cocker spaniel) are apparently more susceptible to L. infantum LutzomyiaFigure 4 whitmani Lutzomyia whitmani. External genitalia of a male of Lutzo- CanineFigure visceral5 leishmaniasis myia whitmani, which contains structures of major taxonomic Canine visceral leishmaniasis. A dog displaying a typical importance. clinical picture of visceral leishmaniasis. Page 3 of 17 (page number not for citation purposes) Parasites & Vectors 2008, 1:25 http://www.parasitesandvectors.com/content/1/1/25 Canine hepatozoonosis Canine hepatozoonosis was firstly diagnosed in Brazil during the 1970s [72]. This disease is caused by Hepato- zoon canis (Apicomplexa: Hepatozoidae) (Fig. 6), which has recently been molecularly characterized in Brazil [73- 75]. Dogs become infected by ingestion of a tick contain- ing mature H. canis oocysts. Ticks involved in the trans- mission of H. canis in Brazil include some Amblyomma species, particularly Amblyomma aureolatum, Amblyomma ovale (Fig. 7), and Amblyomma cajennense [76-78]. Rhipi- cephalus sanguineus, which is a known
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