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Cited by 38Parasitic Diseases Research and TreatmentResearch on Leishmaniasis StudiesHelminth infection and control

Description of five dirofilariasis cases in South Hungary and review epidemiology of this disease for the country

Dóczi, Ilona, Bereczki, László, Gyetvai, Tamás, Fejes, Imre, Skribek, Ákos, Szabó, Áron, Berkes, Szilvia, Tiszlavicz, László +4 more·2015·Wiener klinische Wochenschrift
DOI 10.1007/s00508-015-0825-4
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Abstract

Background Dirofilariasis is an emerging zoonosis (supported by climate change) in Central Europe. Human infections are usually caused by Dirofilaria repens and Dirofilaria immitis with mediation of mosquito vectors. Aims of this publication were to report our dirofilariasis cases, and to summarize Hungarian epidemiological data by reviewing literature.Methods and results We present five (four ophthalomological, one subcutaneous) cases observed within a 2-year period in Southern Hungary. Ages of infected patients were between 31 and 74 years. First case during pregnancy is also reported. There was no travel history in the anamnesis of patients which could explain acquisition of the infection. Moving, intact worms eliminated by surgical interventions were identified on the basis of morphological features as D. repens. Since the first report of human case, 115 further episodes (in addition to ours) were diagnosed in Hungary. Mean age of the patients was 47 years. Reviewing national reports, the ratio of subcutaneous infections was higher than that of the ocular ones (66 and 45, respectively). Evaluation of the territorial distribution of human episodes revealed that most infections occurred in patients living in the Danube-Tisza interfluvial region and eastern part of the country. However, sporadic cases were also found in western counties during 2014.Conclusion Most of the Hungarian dirofilariasis cases were autochthonous infections. Occurrence in the western counties may suggest the spreading of this emerging zoonosis to these areas. Comprehensive monitoring and data analysis are desirable, therefore reporting the epidemiologic data in the case of human infections should be made mandatory.

AI snapshot

Written from the paper’s full text.

TL;DR

This paper reports five human dirofilariasis cases from southern Hungary diagnosed between 2010 and 2012 and reviews Hungarian epidemiological data. All removed worms were identified as female *Dirofilaria repens*, and the national review found most cases were autochthonous, with subcutaneous infections outnumbering ocular ones.

Key findings

  • Among the five cases, four were ophthalmological and one subcutaneous; patient ages ranged from 31 to 74 years (mean 54 years in the authors’ institution), and the paper reports the first human dirofilariasis case during pregnancy.
  • All intact adult worms measured 7.7–13.3 cm in length and 0.37–0.47 mm in diameter and were morphologically identified as female *D. repens*.
  • The national review reports 116 dirofilariasis cases registered in Hungary since 1879 (106 published plus 10 diagnosed at the NCE in 2014); mean patient age was 47.4 years, with 66 subcutaneous, 45 ocular, and 5 other-site infections.
  • Most Hungarian infections occurred in the Danube-Tisza Interfluvial Region and eastern Hungary, while sporadic cases in western counties during 2014 may suggest spread of this emerging zoonosis.

Methods

  • Case series: five patients diagnosed at different departments of the University Hospital in Szeged, Hungary, between October 2010 and May 2012, with clinical, ophthalmological, and dermatological evaluation and surgical removal of worms.
  • Parasitological identification: intact nematodes were sent to the Parasitological Laboratory, Department of Clinical Microbiology (Szeged), and identified by size and morphological features, including cuticular ridges and striations.
  • Epidemiological review: Hungarian human dirofilariasis reports and National Center for Epidemiology data were summarized, including territorial distribution and infection site.

Limitations

  • The paper states that the exact prevalence of human and animal dirofilariasis in Hungary is not well known, that the small number of cases may not represent a true tendency, and that it is unclear whether the observed aggregation reflected real increase or greater attention.
  • The authors state they had no information about possible infections in their patients’ animals, and note that vector competence of blood-fed mosquitoes was not mentioned in the cited vector study.
  • Evident from the text: the national epidemiology relies on published and reported cases, so underreporting and inconsistent reporting may affect counts; autochthonous status is inferred from absent travel history and epidemiological data rather than confirmed vector transmission.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1007/s00508-015-0825-4

Cites

31 of 31 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 58 cited sources checked · 0 supported · 0 flagged

  • Findingown data
    § Abstract

    Five cases of dirofilariasis (4 ophthalmological, 1 subcutaneous) were observed within a two-year period in Southern Hungary.

    “We present 5 (4 ophthalomological, 1 subcutaneous) cases observed within a two-year period in Southern Hungary.”
    Quote in the paperSubstantial claim
  • Findingnone given
    § Abstract

    Since the first report of human case, 115 further episodes (in addition to ours) were diagnosed in Hungary.

    “Since the first report of human case, 115 further episodes (in addition to ours) were diagnosed in Hungary.”
    Quote in the paperNot a substantial claim
  • Findingown data
    § Abstract

    The ages of the five infected patients were between 31 and 74 years.

    “Ages of infected patients were between 31 and 74 years.”
    Quote in the paperNot a substantial claim
  • Findingown data
    § Abstract

    Moving, intact worms eliminated by surgical interventions were identified as Dirofilaria repens on the basis of morphological features.

    “Moving, intact worms eliminated by surgical interventions were identified on the basis of morphological features as Dirofilaria repens”
    • Also stated in: § Parasitological findings · plain
      “Based on the size and other morphological features, all intact, adult worms were identified as female D. repens .”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Morphological identification of worms as D. repens is sufficient for species-level diagnosis without molecular confirmation.
  • Findingown data
    § Abstract

    The first case of human dirofilariasis during pregnancy is reported.

    “First case during pregnancy is also reported.”
    • Also stated in: § Discussion · hedged
      “To the best of our knowledge, we report the first case of human dirofilariasis in a pregnant woman (Case 1).”
    Quote in the paperSubstantial claim
  • May combine two claims. 21
  • Classified as probably not a substantial claim. 24

  • May combine two claims.

    Findingcitation
    § Introduction

    Based on data from 1879-2013, the most frequent form of human dirofilariasis in Hungary is subcutaneous infection (59 out of 101 episodes), with eyes involved in 39 cases and other body sites in 3 patients.

    “Based on these data, the most frequent form of human dirofilariasis in Hungary is subcutaneous infection (59 out of 101 episodes). The eyes were involved in 39 cases, and the worms were eliminated from other body sites (ligamentum gastrosplenicum, spermatic cord and excised lymph node) in the case 3 patients [13,14].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [13] Szenasi Z, Hari Kovacs A, Pampiglione S, et al. Human dirofilariosis in Hungary: an emerging zoonosis in Central Europe. Wien Klin Wochenschr. 2008;120(3–4):96–102. source

      Not checked in the free run.

    • cites [14] Kucsera I, Danka J, Orosz E, Fok E. Human dirofilariosis in Hungary. (Humán dirofilariosis Magyarországon.). Epinfo. 2014;21(24):273–7.

      Not checked in the free run.

  • May combine two claims.

    Findingown data
    § Discussion

    None of our patients with ocular infection had complications or any functional damages.

    “None of our patients with ocular infection had complications or any functional damages.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Discussion

    In our practice we have found a single subcutaneous case only, fewer than the number of ocular episodes.

    “In our practice we have found a single case only, fewer than number of ocular episodes.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given
    § Discussion

    The light of the slit lamp has an impact on the worm: an intense moving is detectable.

    “It is a fact, that the light of slit lamp has an impact on the worm: an intense moving is detectable.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Discussion

    Three patients lived in close proximity of rivers, but the residences of all patients were situated in the watershed of the river Tisza, where a higher density of mosquitoes is persistent.

    “Three patients lived in close proximity of rivers, but the residences of all patients were situated in the watershed of the river Tisza, where a higher density of mosquitoes is persistent (Figure 7).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Discussion

    Two out of the five patients lived in rural areas, while three came from an urban environment.

    “Two out of 5 patients lived in rural areas, while 3 patients came from urban environment.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Findingnone given
    § Discussion

    In Hungary all human cases published until now were caused by D. repens.

    “In Hungary all human cases published until now were caused by D. repens .”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data
    § Discussion

    Neither atropine nor pilocarpin was effective in paralyzing the worms; they continued moving after the application of both drugs.

    “Neither atropine, nor pilocarpin was effective in paralyzing the worms, they continued the moving after the application of both drugs.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Discussion

    Four women suffered from ophthalmofilariasis, and one man had subcutaneous infection.

    “Four women suffered from ophthalmofilariasis, and one man had subcutaneous infection.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given
    § Discussion

    Seasonality cannot be seen in our episodes.

    “Seasonality cannot be seen in our episodes.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Introduction

    The main natural hosts of Dirofilaria species are dogs and wild caniforms such as foxes, wolves and raccoons.

    “The main natural hosts of Dirofilaria species are dogs and wild caniforms, such as foxes, wolves and raccoons [3].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] Ondriska F, Lengyel D, Miterpáková M, Lengyelová B, Strehárová A, Dubinský P. Human dirofilariosis in the Slovak Republic—a case report. Ann Agric Environ Med. 2010;17:169–71.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § Introduction

    Ocular and subcutaneous infections are usually caused by D. repens, while D. immitis is involved in pulmonary dirofilariasis in humans.

    “Ocular and subcutaneous infections are usually caused by D. repens , while D. immitis is involved in pulmonary dirofilariasis in humans [7,9].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [7] Jelinek T, Schulte-Hillen J, Löscher T. Human dirofilariasis. Int J Dermatol. 1996;35(12):872–5. source

      Not checked in the free run.

    • cites [9] Kim MK, Kim CH, Yeom BW, Park SH, Choi SY, Choi JS. The first human case of hepatic dirofilariasis. J Korean Med Sci. 2002;17:686–90. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § Introduction

    In humans, dirofilariasis manifests as subcutaneous nodule, ocular or pulmonary dirofilariasis, and there are reports of unusual body sites including orbital area, liver, spermatic cord and abdominal cavity.

    “In humans, the disease manifests as a subcutaneous nodule, ocular or pulmonary dirofilariasis, but there are several reports about presentation in unusual body sites as well, including orbital area, liver, spermatic cord and abdominal cavity [8-11].”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [8] Smitha M, Rajendran VR, Devarajan E, Anitha PM. Case report: Orbital dirofilariasis. Ind J Radiol Imaging. 2008;18(1):60–2. source

      Not checked in the free run.

    • cites [9] Kim MK, Kim CH, Yeom BW, Park SH, Choi SY, Choi JS. The first human case of hepatic dirofilariasis. J Korean Med Sci. 2002;17:686–90. source

      Not checked in the free run.

    • cites [10] Pampiglione S, Fioravanti ML, Piccolotti D, Pizzicannella G. Reale D. Human dirofilariasis in Italy: a new case in the spermatic cord. Parassitol. 2002;44(1–2):93–6.

      Not checked in the free run.

    • cites [11] Tada I, Sakabuchi Y, Eto K. Dirofilaria in the abdominal cavity of a man in Japan. Am J Trop Med Hyg. 1979;28:988–90. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § Introduction

    Although all reported human infections were caused by D. repens, tested mosquitoes in Southern Hungary carried D. immitis at a higher rate.

    “Although all of the reported human infections were caused by D. repens , the tested mosquitoes carried D. immitis at higher rate [6].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] Zittra C, Kocziha Z, Pinnyei S, et al. Screening blood-fed mosquitoes for the diagnosis of filarioid helminths and avian malaria. Parasit Vectors. 2015;8:16. doi:10.1186/s13071-015-0637-4. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Introduction

    Babes reported the first human case of dirofilariasis from Hungary in 1879.

    “Babes reported the first human case from Hungary in 1879 [12].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] Babes V. Über einen neuen Parasiten des Menschen. Medizinisch-chirurgisches Zentralblatt. 1879;14:554.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § Introduction

    Dirofilariasis is an endemic zoonosis in the Mediterranean area and appears to be an emerging disease in Central Europe.

    “Dirofilariasis is an endemic zoonosis in the Mediterranean area and it seems to be an emerging disease in Central Europe as well [1,2].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [1] Babal P, Kobzova D, Novak I, Dubinsky P, Jalili N. First case of cutaneous human dirofilariosis in Slovak Republic. Bratisl Lek Listy. 2008;109(11):486–8.

      Not checked in the free run.

    • cites [2] Pónyai K, Wikonkál N, Bottlik G, et al. Dirofilaria repens infection case in Hungary: a case report. J Dtsch Dermatol Ges. 2006;4(12):1051–3. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § Introduction

    People handling or owning dogs and wild caniforms are at higher risk of Dirofilaria infection, although this is not exclusive.

    “People handling or owning these animals are at higher risk of infections, although this phenomenon is not exclusive [5].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5] Sathyan P, Manikandan P, Bhaskar M, Padma S, Singh G, Appalaraju B. Subtenous infection by Dirofilaria repens. Ind J Med Microbiol. 2006;24(1):61–2. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Introduction

    Tourism and migration can contribute to increased incidence of human dirofilariasis outside endemic areas.

    “Tourism and migration can also contribute to the increase of incidence of human cases outside the endemic areas [7].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [7] Jelinek T, Schulte-Hillen J, Löscher T. Human dirofilariasis. Int J Dermatol. 1996;35(12):872–5. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Introduction

    Potential vectors of Dirofilaria in Southern Hungary may be Culex pipiens, C. modestus and Ochlerotatus caspius.

    “According to a recent study, potential vectors in Southern Hungary may be Culex pipiens , C. modestus and Ochlerotatus caspius .”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] Zittra C, Kocziha Z, Pinnyei S, et al. Screening blood-fed mosquitoes for the diagnosis of filarioid helminths and avian malaria. Parasit Vectors. 2015;8:16. doi:10.1186/s13071-015-0637-4. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationnone given
    § Discussion

    The size and quantity of wetlands are growing because of climate change (much more rain), contributing to increasing abundance of real and potential vectors.

    “Nowadays, the size and quantity of wetlands are growing because of the effects of climate change (much more rain). This fact contributes to the increasing abundance of real and potential vectors.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § Discussion

    According to the life cycle of Dirofilaria sp., humans are infected with L3 larva, which passes through the mosquito's proboscis.

    “According to the life cycle of Dirofilaria sp., humans are infected with L3 larva, which passes through the mosquito's proboscis.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [35] Kuzmin Y, Varodi E, Vasylyk N, Kononko G. Experimental infection of mosquitoes with Dirofilaria repens (Nematoda, Filarioidea) larvae. Vestnik Zoologii. 2005;39(6):19–24.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Discussion

    According to the localization of the nematode, symptoms can vary from moderate discomfort sensation in the eye, redness, pain and itching to more serious complications (damaged vision, retinal detachment, glaucoma, opacity of the vitreous humor, etc.).

    “According to the localization of the nematode, symptoms can vary from moderate discomfort sensation in the eye, redness, pain and itching to more serious complications (damaged vision, retinal detachment, glaucoma, opacity of the vitreous humor, etc.) [32].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [32] Simón F, Siles-Lucas M, Morchón R, et al. Human and animal dirofilariasis: the emergence of a zoonotic mosaic. Clin Microbiol Rev. 2012;25(3):507–44. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given
    § Conclusion

    The effects of climate change which favor reproduction of potential or real vectors are noticeable.

    “The effects of climate change which favor reproduction of potential or real vectors, are noticable.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § Discussion

    Adult female D. repens worms are 10-15 cm, while males are 5-7 cm long; their diameter is near 0.5 mm.

    “Adult female D. repens worms are 10-15 cm, while males are 5-7 cm long. Their diameter is near 0.5 mm [14,29].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [14] Kucsera I, Danka J, Orosz E, Fok E. Human dirofilariosis in Hungary. (Humán dirofilariosis Magyarországon.). Epinfo. 2014;21(24):273–7.

      Not checked in the free run.

    • cites [29] Pampiglione S, Rivasi F. Human dirofilariasis due to Dirofilaria (Nochtiella) repens: an update of world literature from 1995 to 2000. Parassitologia. 2000;42:231–54.

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning
    § Discussion

    Because of the small number of cases, the five observed cases may not be considered a tendency, but an aggregation can be seen compared to the number of previous cases.

    “Because of the small number of cases this phenomenon may not be considered as a tendency, but an aggregation can be seen compared to the number of previous cases.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Discussion

    Between 2001 and 2006, Szenasi et al. diagnosed dirofilariasis in 8 men and 8 women.

    “Between 2001 and 2006, Szenasi et al. diagnosed dirofilariasis in 8 men and 8 women [13].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Szenasi Z, Hari Kovacs A, Pampiglione S, et al. Human dirofilariosis in Hungary: an emerging zoonosis in Central Europe. Wien Klin Wochenschr. 2008;120(3–4):96–102. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § Discussion

    Mosquitoes collected in southern Hungary carried D. immitis at a higher rate, but vector competence of blood-fed ones was not mentioned in that study.

    “Mosquitoes collected in the southern part of the country carried D. immitis at a higher rate, but vector competence of blood fed ones was not mentioned in that study [6].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] Zittra C, Kocziha Z, Pinnyei S, et al. Screening blood-fed mosquitoes for the diagnosis of filarioid helminths and avian malaria. Parasit Vectors. 2015;8:16. doi:10.1186/s13071-015-0637-4. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Discussion

    The subcutaneous presence of the parasite causes local symptoms (swelling, inflammation and itching), which can intensify within weeks or months.

    “The subcutaneous presence of the parasite causes local symptoms (swelling, inflammation and itching), which can intensify within weeks or months [3].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] Ondriska F, Lengyel D, Miterpáková M, Lengyelová B, Strehárová A, Dubinský P. Human dirofilariosis in the Slovak Republic—a case report. Ann Agric Environ Med. 2010;17:169–71.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Discussion

    Pre-adult or adult worms in subcutaneous nodules are often localized on the face, neck, hands, chest, eyelids, and can also be found on the scrotum.

    “Pre-adult or adult worms in subcutaneous nodules are often localized on the face, neck, hands, chest, eyelids, and can also found on the scrotum [3,29].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [3] Ondriska F, Lengyel D, Miterpáková M, Lengyelová B, Strehárová A, Dubinský P. Human dirofilariosis in the Slovak Republic—a case report. Ann Agric Environ Med. 2010;17:169–71.

      Not checked in the free run.

    • cites [29] Pampiglione S, Rivasi F. Human dirofilariasis due to Dirofilaria (Nochtiella) repens: an update of world literature from 1995 to 2000. Parassitologia. 2000;42:231–54.

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationown data
    § Discussion

    In one of our cases (case 4) the worm migrated from the eye, possibly due to the light of the microscope (negative phototaxis).

    “In one of our cases (case 4) the worm migrated from the eye, which was possibly due to the light of the microscope (negative phototaxis).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning
    § Conclusion

    Thus the conditions are given to infect humans with dirofilariasis, and not only those who handle host animals.

    “Thus the conditions are given to infect humans, and not only those who handle host animals.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The presence of infected dogs or cats and mosquitoes carrying Dirofilaria in an area means humans can acquire dirofilariasis there.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationnone given
    § Discussion

    The morphological property of white cuticles with transverse striations and longitudinal ridges can aid the differentiation of D. repens from D. immitis.

    “This property can also aid the differentiation of D. repens from D. immitis .”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given
    § Discussion

    People usually take medical care sooner in the case of more irritating ocular symptoms than in the case of subcutaneous ones.

    “People usually take medical care sooner in the case of more irritating ocular symptoms, than in the case of subcutaneous ones.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § Discussion

    The percentage of reported cases of ocular dirofilariasis has been increasing: D. repens occurred in ocular regions in 30-35% of the cases.

    “The percentage of reported cases of ocular dirofilariasis has been increasing: D. repens occurred in ocular regions in 30-35% of the cases [32].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [32] Simón F, Siles-Lucas M, Morchón R, et al. Human and animal dirofilariasis: the emergence of a zoonotic mosaic. Clin Microbiol Rev. 2012;25(3):507–44. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationnone given
    § Conclusion

    Nowadays, dirofilariasis is an emerging zoonosis in Hungary, but the exact prevalence of this infection in humans and host animals is not well known yet.

    “Nowadays, dirofilariasis is an emerging zoonosis in Hungary, however, the exact prevalence of this infection in humans and host animals is not well known yet.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Increased diagnosis of dirofilariasis in Hungary reflects a true increase in incidence rather than only greater attention or reporting.

  • May combine two claims.

    Interpretationreasoning
    § Discussion

    These data suggest development into the adult form and fertilization of this worm in humans.

    “These data suggest development into the adult form and fertilization of this worm in humans [32].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [32] Simón F, Siles-Lucas M, Morchón R, et al. Human and animal dirofilariasis: the emergence of a zoonotic mosaic. Clin Microbiol Rev. 2012;25(3):507–44. source

      Not checked in the free run.

36 of 36

  • The paper relies on this without support.

    Human infections are caused most commonly by D. repens and D. immitis.

    “There are many species in the genus of Dirofilaria , but human infections are caused most commonly by D. repens and D. immitis .”

  • The paper relies on this without support.

    Humans become infected with D. repens and D. immitis through mosquito bites.

    “Humans become infected with these worms through mosquito bites.”

  • The paper relies on this without support.

    The reported lack of travel history in the patients is accurate and complete enough to rule out imported infection.

    “There was no travel history in the anamnesis of patients which could explain acquisition of the infection.”

  • The paper relies on this without support.

    Increased diagnosis of dirofilariasis in Hungary reflects a true increase in incidence rather than only greater attention or reporting.

    “The question is rising: was this a real aggregation, or just greater attention was given to this infection?”

  • The paper relies on this without support.

    Morphological identification of worms as D. repens is sufficient for species-level diagnosis without molecular confirmation.

    “Based on the size and other morphological features, all intact, adult worms were identified as female D. repens .”

  • The paper relies on this without support.

    The presence of infected dogs or cats and mosquitoes carrying Dirofilaria in an area means humans can acquire dirofilariasis there.

    “Mosquitoes collected in the southern part of the country carried D. immitis at a higher rate, but vector competence of blood fed ones was not mentioned in that study [6].”
6 of 6

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • D. repens presents a continuous risk of human infection.

    “Our results confirm that D. repens is widely distributed in the local dogs, presenting a continuous risk of human infection (Dóczi et al. 2015).”

    From The current situation of canine dirofilariosis in Hungary (2020) · cites this paper as Dóczi et al. 2015

Cites

Flagged first, then by citations

Research works printed but not linked: 8

  1. Babes V. Über einen neuen Parasiten des Menschen. Medizinisch-chirurgisches Zentralblatt. 1879;14:554.
  2. Kucsera I, Danka J, Orosz E, Fok E. Human dirofilariosis in Hungary. (Humán dirofilariosis Magyarországon.). Epinfo. 2014;21(24):273–7.
  3. Anda T. The first case of onchocercosis in Hungary. (Az onchocerkózis első esete Magyarországon). Orv Hetil. 1941;85:331–3.
  4. Németh B, Kugler S. Ophthalmo-filariosis. Orv Hetil. 1968;109:195–7.
  5. Parlagi G, Á S, Elek G, Varga I. Orbital dirofilariosis. (Szemüregi dirofilariosis). Szemészet. 2000;137:105–7.
  6. Hári Kovács A, Szénási Z, Tiszlavitz L, Kolozsvári L, Pampiglione S, Fioravanti ML. A new case of ocular filarioidosis in Hungary. (Ophthalmo-filarioidosis újabb esete Magyarországon.) Szemészet. 2002;139:87–90.
  7. Fok E, Kiss G, Majoros G, Jacsó O, Farkas R, Gyurkovszky M. Preliminary results of an epidemiological survey on dirofilariosis of dogs and cats in Hungary. Mappe Parassitologiche. 2007;8:195–6.
  8. Kucsera I, Szenasi Z. Danka J. Review of human dirofilariosis diagnosed at the Department of Parasitology, National Center for Epidemiology, Budapest, Hungary. Mappe Parassitologiche. 2007;8:197.

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Authors
Dóczi, I., Bereczki, L., Gyetvai, T., Fejes, I., Skribek, Á., Szabó, Á., Berkes, S., Tiszlavicz, L., Bartha, N., Bende, B., Kis, E., & Kucsera, I.
Affiliations
  • University of Szeged (HU)
  • National Center for Epidemiology (HU)
Corresponding author
Dóczi, Ilona
ORCID
Venue
Wiener klinische Wochenschrift
Publisher
Springer Science and Business Media LLC
Published
2015-07-16
Volume
127
Issue
17-18
Pages
696-702
ISSN
  • 0043-5325 (ISSN-L)
  • 1613-7671
DOI
10.1007/s00508-015-0825-4
OpenAlex
W1183607730
Semantic Scholar
633b8d4f1ca2fc8c536734a7bdfb19258bbc0615
Cited by
38
References
31
Citations by year
2026: 1 · 2025: 18 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 4 · 2020: 2 · 2019: 2 · 2018: 4 · 2017: 2 · 2016: 1
FWCI
1.82
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Wiener klinische Wochenschrift (publishedVersion)
  • PubMed (publishedVersion)
  • SZTE Publicatio Repozitórium (University of Szeged) (acceptedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Parasitic Diseases Research and Treatment
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Research on Leishmaniasis Studies
  • Health Sciences › Veterinary › Small Animals › Helminth infection and control
Keywords
dirofilariasis, Dirofilaria repens, Dirofilaria immitis, ocular dirofilariasis, subcutaneous dirofilariasis, emerging zoonoses, autochthonous infection, mosquito vectors, climate change, epidemiology
MeSH terms
Adult, Aged, Dirofilariasis, Female, Humans, Hungary, Male, Middle Aged, Pregnancy, Pregnancy Complications, Risk Factors, Prevalence

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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