Threat of cercarial dermatitis in Hungary: A first report of Trichobilharzia franki from the mallard (Anas platyrhynchos) and European ear snail (Radix auricularia) using molecular methods

Cercarial dermatitis in humans is a re-emerging zoonotic disease caused by infectious larvae of avian blood flukes within the Schistosomatidae family. Upon water contact, these avian schistosome larvae directly penetrate human skin and cause irritation. Between September 2018 and September 2020, carcasses of 94 mallards (Anas platyrhynchos), two green-winged teals (Anas crecca) along with one ferruginous duck (Aythya nyroca) were examined. Birds were collected within 12 regions of Hungary, representative of 9 different counties. Inspecting both morphological characters and molecular data, the cytochrome oxidase subunit I (COI) and large subunit ribosomal DNA (LSU rDNA) sequences, Bilharziella polonica and Dendritobilharzia pulverulenta were each identified. Most importantly, Trichobilharzia franki was found for the first time in Hungary and in 5 dispersed counties in conjunction with of 3 counties where other avian schistosomes were found. Of note, these avian blood flukes were predominately encountered in wild mallards (∼50%) and not in birds reared for hunting (∼1%). In total, 245 European ear snails (Radix auricularia), a known intermediate host of Trichobilharzia spp., were collected from an urban pond in Eger, Hungary. Five snails (∼2%) consistently shed numerous furcocercariae of T. franki that were confirmed by molecular methods. Our findings help to pinpoint a contemporary life cycle of this avian schistosome within an urban environment, a location regularly visited by various wild waterfowl and the possible species of avian schistosomes responsible for cercarial dermatitis in Hungary. Taken as a whole, we demonstrate the actual and potential risk zone for cercarial dermatitis, particularly with reference to R. auricularia distributions, within Hungary and across Central Europe

Investigations on the distribution of Schistosoma turkestanicum Skrjabin, 1913 (Trematoda: Schistosomatidae) infection of red deer in Hungary and a combined method for the detection of S. turkestanicum eggs in droppings

Additional geographical distribution of the Central European populations of Schistosoma turkestanicum and the detectability of their eggs in droppings were investigated in red deer samples, because this rare species had previously been shown only in a single Hungarian habitat. Samples from visceral organs, intestinal contents, and droppings on the ground from 11 hunting areas of Hungary were investigated to find a new presence of this fluke. Close to the first site of detection in the Gemenc forest another habitat along the southern border of the country was found where the parasite lives in red deer. Therefore, it is possible that the worm also occurs in neighbouring Serbia or Croatia. Schistosoma turkestanicum causes a low-intensity infection in red deer and this host sheds low amounts of eggs, therefore the eggs are difficult to detect. Droppings were cleared by sedimentation, filtered by sieve screening and then the eggs were flotated using solutions with an increasing density of 1200 g/L, 1300 g/L, 1350 g/L, and 1400 g/L while they were being stained red with acid fuchsin. Eggs in fresh faeces can be most efficiently separated from plant fibres using a flotation solution of 1350 g/L density, but in some cases eggs in old dung can be detected using a solution of a specific gravity lower or higher than that. By combining the advantages of the three concentration processes, eggs of S. turkestanicum, which are more recognisable by the red stain, can be found in samples in which they are present at a density lower than 1/g

Eco-epidemiology of Borrelia miyamotoi and Lyme borreliosis spirochetes in a popular hunting and recreational forest area in Hungary

BACKGROUND: Borrelia miyamotoi, the newly discovered human pathogenic relapsing fever spirochete, and Borrelia burgdorferi sensu lato are maintained in natural rodent populations. The aim of this study was to investigate the natural cycle of B. miyamotoi and B. burgdorferi s.l. in a forest habitat with intensive hunting, forestry work and recreational activity in Southern Hungary. METHODS: We collected rodents with modified Sherman-traps during 2010–2013 and questing ticks with flagging in 2012. Small mammals were euthanized, tissue samples were collected and all ectoparasites were removed and stored. Samples were screened for pathogens with multiplex quantitative real-time polymerase chain reaction (qPCR) targeting a part of flagellin gene, then analysed with conventional PCRs and sequencing. RESULTS: 177 spleen and 348 skin samples of six rodent species were individually analysed. Prevalence in rodent tissue samples was 0.2 % (skin) and 0.5 % (spleen) for B. miyamotoi and 6.6 % (skin) and 2.2 % (spleen) for B. burgdorferi s.l. Relapsing fever spirochetes were detected in Apodemus flavicollis males, B. burgdorferi s.l. in Apodemus spp. and Myodes glareolus samples. Borrelia miyamotoi was detected in one questing Ixodes ricinus nymph and B. burgdorferi s.l in nymphs and adults. In the ticks removed from rodents DNA amplification of both pathogens was successful from I. ricinus larvae (B. miyamotoi 5.6 %, B. burgdorferi s.l. 11.1 %) and one out of five nymphs while from Ixodes acuminatus larvae, and nymph only B. burgdorferi s.l. DNA was amplified. Sequencing revealed B. lusitaniae in a questing I. ricinus nymph and altogether 17 B. afzelii were identified in other samples. Two Dermacentor marginatus engorged larva pools originating from uninfected hosts were also infected with B. afzelii. CONCLUSIONS: This is the first report of B. miyamotoi occurrence in a natural population of A. flavicollis as well as in Hungary. We provide new data about circulation of B. burgdorferi s.l. in rodent and tick communities including the role of I. acuminatus ticks in the endophilic pathogen cycle. Our results highlight the possible risk of infection with relapsing fever and Lyme borreliosis spirochetes in forest habitats especially in the high-risk groups of hunters, forestry workers and hikers

Egy ritka zoonosis: a Schistosoma turkestanicum vérmétely által okozott cercaria dermatitis Magyarországon | A rare zoonosis in Hungary: cercarial dermatitis caused by Schistosoma turkestanicum blood-fluke

Absztrakt Az állatokban sok mételyfaj él, amelyek lárvája a gazda bőrén keresztül fertőzi azt. Ezek közül az ember szempontjából a legfontosabbak az emlősök vérmételyei, mert belőlük kerülnek ki az embert fertőzni képes vérmételyek is. Több fajuk a trópusi országok lakóinak rettegett schistosomosisát okozza, míg más fajok behatolnak ugyan az ember bőrébe, de adulttá nem válnak a testében. A mérsékelt égövben főleg az utóbbi, bőrgyulladás formájában jelentkező infekció fordul elő. A mételylárvák eredete legtöbbször nem tisztázható, ezért általában sem orvosok, sem állatorvosok nem foglalkoznak a fertőzés forrásával. Szarvasokban élő mételyfajról bizonyítottuk be, hogy a régen „vízi rühösség”-nek nevezett bőrbántalmat csigákból kirajzó cercariák okozzák. A Duna egyik árterén endemikus Schistosoma turkestanicum okozta dermatitis ritkán kerül orvos szeme elé, pedig informális közlések alapján úgy tűnik, hogy rendszeresen előforduló tünet a métely élőhelyén lévő vizekben halászó vagy fürdőző embereken. Ráutaló kórelőzmény esetén indokolt a humán vérmétely-fertőzöttséghez hasonló szerológiai reakciót adó cercaria dermatitis eredetét kivizsgáltatni. Orv. Hetil., 2016, 157(40), 1579–1586. | Abstract Several trematodes that parasitize vertebrate animals utilize swimming aquatic larvae to infect the host percutaneously. The most important ones among these parasites are the blood-flukes of birds and mammals comprising species that are also zoonotic. Within this latter group are species that cause the bilharziasis or schistosomiasis of inhabitants of the tropical countries, and other trematode species that are able to penetrate human skin, but do not develop to an adult form of the worm in the body. In temperate climates this latter type of infection occurs mainly in the form of an unpleasant inflammation of the skin and is often called “swimmer’s itch”. In most of these cases, the origin of the larvae remains unexplored, the source of the infection is neglected by the medical or veterinarian practitioners. Herein we report for the first time in Hungary that the cause of such dermatitis was the cercariae of Schistosoma turkestanicum, which infected red deer (Cervus elaphus) in this country. The local name of this pristine disease is “water mange” and it occurs only in one of the floodplains of the Danube. On the basis of informal communication this symptom seems to be rather regular among people who do fishing or have a bath in the habitat of the blood-fluke. In the case of adequate anamnesis it is worth examining the origin of the cercarial dermatitis which may give cross-reactions with human schistosomiasis during serological tests. Orv. Hetil., 2016, 157(40), 1579–1586

Asymptomatic faecal carriage of ESBL producing Enterobacteriaceae in Hungarian healthy individuals and in long-term care applicants: a shift towards CTX-M producers in the community

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