Ascaris lumbricoides eggs or artefacts? A diagnostic conundrum.

Due to the presence of artefacts in stool samples, the copromicroscopic diagnosis of Ascaris lumbricoides is not always straightforward, particularly in the case of fertilized decorticated eggs. A total of 286 stool samples from 115 schoolchildren in India and 171 adult immigrants in Italy were screened for the presence of A. lumbricoides eggs by both Kato-Katz thick smear and Mini-FLOTAC. If the outer layer of A. lumbricoides eggs was absent, two aliquots of each stool sample were preserved: one for coproculture to identify larvae after development and one to compose a pool of stool for molecular analysis. A total of 64 stool samples (22.4%) were positive for A. lumbricoides using the Kato-Katz thick smear; 36 (56.3%) of these showed mammillated A. lumbricoides eggs, 25 (39.1%) showed elements resembling fertilized decorticated eggs, while three samples (4.7%) showed both mammillated and decorticated eggs. By Mini-FLOTAC, 39 stool samples (13.6%) were positive, while decorticated A. lumbricoides-like eggs were identified as artefacts. These results were confirmed by negative coprocultures and quantitative polymerase chain reaction. Mini-FLOTAC can be used for a reliable diagnosis of A. lumbricoides, thanks to the flotation and translation features which allow a clearer view, resulting in the correct identification of A. lumbricoides eggs.

An integrated approach to control Cystic Echinococcosis in southern Italy.

Cystic echinococcosis (CE) is a severe zoonosis, caused by the larval stage of the tapeworm Echinococcus granulosus. This helminth infection is of increasing public health and socio-economic concern due to the considerable morbidity rates that cause economic losses both in the public health sector and in the livestock industry. Control programmes against E. granulosus are considered long-term actions which require an integrated approach and high expenditure of time and financial resources. Since 2010, an integrated approach to control CE has been implemented in a highly endemic area of continental southern Italy (Campania region). Innovative procedures and tools have been developed and exploited during the control programme based on the following strategies: i) active and passive surveillance in livestock (using geospatial tools for georeferencing), ii) diagnosis in dogs (using the FLOTAC techniques and molecular analysis), iii) targeted treatment of farm dogs (using purpose-built confinement cages), iv) early diagnosis in livestock (by ultrasonography), v) surveillance in humans (through hospital discharge records analysis), vi) monitoring the food chain (analysing raw vegetables), vii) outreach activities to the general public (through dissemination material, e.g. brochures, gadgets, videos, virtual reality). Over eight years, the integrated approach and the new strategies developed have resulted in a noteworthy reduction of the parasite infection rates in livestock (e.g. up to 30 % in sheep). The results obtained so far highlight that using a one health multidisciplinary and multi-institution effort is of pivotal importance in preparing CE control programmes at regional level and could be extended to other endemic Mediterranean areas.

First survey of endoparasites in pet ferrets in Italy.

Endoparasites are infrequently reported in ferrets. A cross-sectional survey was conducted to determine the prevalence of intestinal parasites in pet ferrets in southern Italy. Fresh fecal samples were randomly collected from 50 ferrets housed in pet shops or privately owned. All fecal samples were processed using the FLOTAC pellet technique to identify and count helminthic eggs/larvae and protozoan cysts/oocysts. In addition, the samples were analyzed also by the Remel XpectGiardia/Cryptosporidium immunoassay. Intestinal parasites were detected in 15 out of 50 ferrets (30%). Eggs of ancylostomids were found in 28.0% (14/50) of the animals and oocysts of Sarcocystis were detected in one ferret (2.0%). None of the samples was positive for Cryptosporidium or Giardia. To the authors' knowledge, this is the first report of sarcosporidiosis in a pet ferret in Italy.

FLOTAC for diagnosis of endo-parasites in pet squirrels in southern Italy.

The present study investigated the occurrence of endoparasites in pet squirrels in southern Italy. Fresh fecal samples were collected from 50 asymptomatic pet squirrels belonging to five different species (Callosciurus finlaysonii, n=6, C. prevosti, n=6; Tamias striatus, n=26, T. sibiricus, n=10; Sciurus carolinensis, n=2) housed both in pet shops and/or in private residences. All fecal samples were processed using the FLOTAC pellet technique to identify and count helminth eggs/larvae and protozoan cysts/oocysts. In addition, to detect Cryptosporidium spp. and Giardia spp. the samples were analyzed by the Remel Xpect(®) immunoassay. Helminth eggs were detected in 9 out of 50 squirrels. Specifically, eggs of Dicrocoelium dendriticum were found in 5 squirrels (C. finlaysonii, n=2; C. prevosti, n=2; T. striatus, n=1); eggs of the pinworm Syphacia spp. in 3 squirrels (C. prevosti, n=2; T. striatus, n=1); and eggs of gastrointestinal nematoda (Nippostrongylus-like) were found in 1 subject (C. prevosti). Finally, two squirrels (C. prevosti) had multiple parasitic infections with D. dendriticum and Capillaria hepatica, and with D. dendriticum and Strongyloides spp., respectively. None of the samples were positive for Cryptosporidium spp. or Giardia spp. or any other protozoa (e.g. Eimeria). To the authors' knowledge, this is the first report of a D. dendriticum natural infection in pet rodents.