Two trichinellosis outbreaks in Serbia - challenging diagnosis due to a potential co-infection with Toxocara spp.

In Serbia, in most cases, small family outbreaks of trichinellosis occur due to the consumption of untested infected meat from domestic pigs that are raised and slaughtered in the backyards of small individual farms. The aim of this study is to present data regarding 24 patients involved in two outbreaks that occurred in two neighbouring districts in Serbia during a closely related period of time in August 2014. The source of infection in the first outbreak was undercooked pork, while raw pork sausages caused the second outbreak. Meat samples and sausages were Trichinella spp. positive by artificial digestion. With the aim to obtain a second opinion and validate the serological findings discovered at the Public Health Institute Nis, all samples were sent to the National Reference Laboratory for Trichinellosis, INEP. Serodiagnosis showed that 21 persons were positive (87.5%) and three (12.5%) were negative for anti-Trichinella antibodies, while 15 patients fulfilled the trichinellosis case definition. Western blot analysis (using an epitope unique for the muscle larvae stage of the Trichinella genus) confirmed the diagnosis of trichinellosis in five patients. Six patients also had specific antibodies against Toxocara canis (T. canis). Due to the fact that in endemic foci in Serbia there is the presence of Trichinella spiralis and T. canis and that these two infections could be asymptomatic, we consider that trichinellosis cases were irrefutably proven. The dilemma about the existence of co-infection with T. canis remained open due to the lack of clinical findings.

Human Encounter with a Horsehair Worm (Nematomorpha): Is There a Reason To Worry?

We report here a specimen of the horsehair worm (Gordiida, Nematomorpha) Spinochordodes bacescui (Capuse, 1965) found in a patient´s urine. This is the first record of this species from Serbia and the sixth gordiid species known in Serbia. It is discussed that there is no evidence that gordiids are parasites of humans. Instead, gordiids parasitize terrestrial insects, which release their mature gordiid parasite into water and may thereby also use containers in human surroundings. Pseudoparasites, such as Spinochordodes bacescui, do not pose a threat to human health nor are they a serious public health issue.

Soil and Sand Contamination with Canine Intestinal Parasite Eggs as a Risk Factor for Human Health in Public Parks in Nis (Serbia).

Regarding geographical distribution and clinical relevance, the most common canine geohelminths are Toxocara canis, ancylostomatids, and Trichuris vulpis. Canine intestinal parasites from the soil and sand present an important potential serious human health hazard, especially for the children preschool and school - age. This paper aimed to establish the degree of contamination of soil and sand with zoonotic parasites from the canine feces and the degree of risk they could pose for human health in public places and playgrounds in the city of Nis. Our parasitological study involved 200 soil samples and 50 sand samples from the public parks in the city of Nis in southeastern Serbia (43°19'15″N, 21°53'45″ E). From several locations, about 100 g of soil and sand was collected based on the bioclimatic indices. Parasitological diagnosis was performed using conventional qualitative and quantitative coprological methods, abiding by the recommendations about the diagnosis of parasitic diseases. In 38 - 46 % of soil samples and 40 % of sand samples seven species of endoparasites were diagnosed. In the samples of soil, a medium and high degree of contamination with the ascarid T. canis (14 - 22 %) was detected, as well as a low and medium degree of contamination with ancylostomatids (4 - 12 %), and in the samples of sand, a variable degree of contamination with the helminths T. canis (26 %) and A. alata (16 %) was found. A statistically significant difference was found in the contamination with A. alata eggs between the samples of sand and samples of soil. The studied public surfaces represent the reservoir of zoonotic parasites, which is a public health problem requiring a synergistic action of several factors to be successfully resolved, i.e. the implementation of prevention, surveillance, and control measures.

A competitive enzyme-linked immunosorbent assay for rapid detection of antibodies against Trichinella spiralis and T. britovi - one test for humans and swine.

Infection with parasites from the Trichinella genus occurs in many vertebrates but disease only occurs in humans (trichinellosis). Humans are infected after the consumption of raw or undercooked meat from infected wild or domestic animals (usually swine or horses). Using the monoclonal antibody (mAb) 7C2C5, specific for an epitope unique to the muscle larvae of the genus Trichinella, we have developed a competitive enzyme-linked immunosorbent assay (c-ELISA) that enables the rapid detection of Trichinella-specific antibodies in sera originating from two different host species (human, swine) infected with either Trichinella spiralis or Trichinella britovi. This novel c-ELISA exhibited 100% specificity and sensitivity, as confirmed by a Western blot test. The assay is easy to use (one incubation step), and the time required for the procedure (45 min) is shorter than in any other ELISA format. This test could be useful for both the detection and surveillance of Trichinella infections.

Subcutaneous dirofilariosis in South-East Serbia--case report.

Human dirofilariosis is a relatively rare infection caused by filarial worms of the genus Dirofilaria. We herein report the first case of human subcutaneous dirofilariosis in the southeastern part of Serbia. A complete alive nematode was removed from a nodule in the periorbital region of a 50-year-old woman. The nematode was morphologically identified as a D. repens-like immature female. The diagnosis was confirmed with molecular methods. The patient was probably infected in the South-East Serbia as she had not travelled abroad, nor in other parts of Serbia such as Vojvodina, recently identified as a hyperendemic area for D. repens infection of dogs.