Dirofilarial Infections in Europe
Open accessAbstract
Nematodes of the genus Dirofilaria are currently considered emerging agents of parasitic zoonoses in Europe. Climatic changes and an increase in the movement of reservoirs (mostly infected dogs) have caused an increase in the geographical range of these parasites from the traditionally endemic/hyperendemic southern regions, and the risk for human infection has increased. In the last several years, forecast models have predicted that current summer temperatures are sufficient to facilitate extrinsic incubation of Dirofilaria in many areas of Europe. The global warming projected by the Intergovernmental Panel on Climate Change suggests that warm summers suitable for Dirofilaria transmission in Europe will be the rule in the future decades, and if the actual trend of temperature increase continues, filarial infection should spread into previously infection-free areas. Dirofilaria repens is currently the filarial species that is most commonly reported as spreading from southern to northern areas. This article reviews the zoonotic aspects, effects of climate, and other global drivers on Dirofilaria infections in Europe and the possible implications on the transmission and control of these mosquito-borne nematodes.
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Dirofilaria repens might be underreported and its actual prevalence among dogs is probably higher due to lack of rapid diagnostic tests.
“Therefore, D. repens might be underreported and its actual prevalence among dogs is probably higher [11].”
From Vectors, host range, and spatial distribution of Dirofilaria immitis and D. repens in Europe: a systematic review (2025) · cites this paper as [11]
Prolonged warm periods extend the transmission season.
“Prolonged warm periods extend the transmission season [11].”
From Vectors, host range, and spatial distribution of Dirofilaria immitis and D. repens in Europe: a systematic review (2025) · cites this paper as [11]
By now (with the exception of Liechtenstein), both D. repens and D. immitis have been reported in all countries neighboring Austria (Germany, the Czech Republic, Slovakia, Hungary, Slovenia, Italy, and Switzerland).
“By now (with the exception of Liechtenstein), both parasites have been reported in all countries neighboring Austria (Germany, the Czech Republic, Slovakia, Hungary, Slovenia, Italy, and Switzerland) [3,7,11–17]”
From Dirofilaria in Humans, Dogs, and Vectors in Austria (1978–2014)—From Imported Pathogens to the Endemicity of Dirofilaria repens (2016) · cites this paper as [11]
D. repens was documented in most central European areas prior to D. immitis.
“and it is obvious that D. repens was documented in most central European areas prior to D. immitis.”
From Dirofilaria in Humans, Dogs, and Vectors in Austria (1978–2014)—From Imported Pathogens to the Endemicity of Dirofilaria repens (2016) · cites this paper as [11]
D. repens and D. immitis have been documented more frequently in recent years, and autochthonous findings in dogs as well as mosquitoes are reported in new areas where both filarioid species were not known as endemic before.
“D. repens and D. immitis have been documented more frequently in recent years, and autochthonous findings in dogs as well as mosquitoes are reported in new areas where both filarioid species were not known as endemic before [3,7,11].”
From Dirofilaria in Humans, Dogs, and Vectors in Austria (1978–2014)—From Imported Pathogens to the Endemicity of Dirofilaria repens (2016) · cites this paper as [11]
Dirofilaria repens has been the primary pathogen reported in Central and Eastern Europe, and it is currently considered an emerging zoonotic agent in all of Europe.
“Dirofilaria repens [26–28] has been the primary pathogen reported in Central and Eastern Europe, and it is currently considered an emerging zoonotic agent in all of Europe [29].”
From Retrospective evaluation of vector-borne pathogens in cats living in Germany (2012–2020) (2021) · cites this paper as [27]
According to predictive models developed for dirofilariasis, temperatures during the summer may be suitable for the life-cycle of larvae in mosquitoes even in colder regions like the UK, provided that reservoirs are present.
“According to predictive models developed for dirofilariasis, temperatures during the summer may be suitable for the life-cycle of larvae in mosquitoes even in colder regions like the UK, provided that reservoirs are present [10, 27, 41, 42].”
From Retrospective evaluation of vector-borne pathogens in cats living in Germany (2012–2020) (2021) · cites this paper as [27]
Canine dirofilarioses by Dirofilaria immitis and Dirofilaria repens are key examples of the success of vector-borne helminths spreading into non-endemic areas.
“Although canine dirofilarioses by Dirofilaria immitis and Dirofilaria repens are key examples of the success of VBH spreading into non-endemic areas, another example is represented by Thelazia callipaeda eyeworm, an emergent pathogen of dogs, cats and humans in several regions of Europe.”
From Vector-borne helminths of dogs and humans in Europe (2013) · cites this paper as [2]
A large number of vector-borne helminths are prevalent in Europe, and some are of growing importance due to the significant level of disease they cause in dogs and humans.
“A large number of vector-borne helminths (VBH) are prevalent in Europe, and some of them are of growing importance due to the significant level of disease they cause in dogs and humans [1-3].”
From Vector-borne helminths of dogs and humans in Europe (2013) · cites this paper as [2]
Dirofilaria spp. have been recognised as emerging zoonotic agents currently spreading throughout Europe.
“Among vector-borne helminths, Dirofilaria spp. have been recognised as emerging zoonotic agents, currently spreading throughout Europe [5,6].”
From Risk of canine and human exposure to Dirofilaria immitis infected mosquitoes in endemic areas of Italy (2013) · cites this paper as [5]
Genchi and colleagues considered both Baden-Wurttemberg and Brandenburg as climatically suitable for dirofilarial development in mosquitoes and assigned to these regions a risk of stable endemicity.
“Genchi and colleagues [5,44] considered both Baden-Wurttemberg and Brandenburg as climatically suitable for dirofilarial development in mosquitoes and assigned to these regions a risk of stable endemicity.”
From Molecular detection of Dirofilaria immitis, Dirofilaria repens and Setaria tundra in mosquitoes from Germany (2014) · cites this paper as [5]
Human infestations by Dirofilaria spp. often induce nodular lesions, which may be erroneously diagnosed as cancers.
“In addition, human infestations by Dirofilaria spp. often induce nodular lesions, which may be erroneously diagnosed as cancers, hence representing a further challenge to physicians [2].”
From Vector-borne helminths of dogs and humans in Europe (2013) · cites this paper as [2]
Dirofilaria immitis and Dirofilaria repens probably represent the species more frequently reported in humans, where they are detected predominantly in subcutaneous tissues, pulmonary vessels, testicles and also in the central nervous system, causing a range of clinical manifestations from asymptomatic to, more rarely, fatal syndromes.
“Among the zoonotic filarioids, D. immitis and D. repens probably represent the species more frequently reported in humans where they are detected predominantly in the subcutaneous tissues, pulmonary vessels, testicles and also in the central nervous system, causing a range of clinical manifestations from asymptomatic to, more rarely, fatal syndromes [1,2,66].”
From Vector-borne helminths of dogs and humans in Europe (2013) · cites this paper as [2]
The occurrence of autochthonous infections in domestic animals and the numbers of notified human cases of dirofilariosis, mainly attributed to D. repens, have increased substantially in several European countries in recent years.
“the occurrence of autochthonous infections in domestic animals and the numbers of notified human cases of dirofilariosis, mainly attributed to D. repens, have increased substantially in several European countries in recent years [5, 27, 28]”
From Molecular characterization of Dirofilaria spp. circulating in Portugal (2017) · cites this paper as [28]
Dirofilaria repens has been implicated in the increasing number of reports of human dirofilariosis in Europe.
“this species has been implicated in the increasing number of reports of human dirofilariosis in Europe [28]”
From Molecular characterization of Dirofilaria spp. circulating in Portugal (2017) · cites this paper as [28]
Adult D. repens worms generally reside in the subcutaneous tissues of definitive hosts, although they can also be found in the abdominal cavity and within connective muscular fasciae.
“Adult D. repens worms generally take residence in the subcutaneous tissues of definitive hosts, although they can also be found in the abdominal cavity and within connective muscular fasciae (148), where they achieve sexual maturity at 6 to 9 m.p.i.(252).”
From Human and animal dirofilariasis: The emergence of a zoonotic mosaic (2012) · cites this paper as [148]
Studies in Europe have allowed determination of the number of annual D. immitis generations and the length of periods of high infection risk throughout several regions of the continent.
“Studies in Europe have allowed the determination of the number of annual D. immitis generations and the length of periods of high infection risk throughout several regions of the continent (Fig. 7) (148, 149, 150).”
From Human and animal dirofilariasis: The emergence of a zoonotic mosaic (2012) · cites this paper as [148]
D. repens infection in dogs usually progresses asymptomatically.
“The infection usually progresses asymptomatically.”
From Human and animal dirofilariasis: The emergence of a zoonotic mosaic (2012) · cites this paper as [148]
D. repens worms have been found in the lungs, scrotum, penis, spermatic cord, epididymis, and female mammary glands.
“and D. repens worms have been found in the lungs, scrotum, penis, spermatic cord, epididymis, and female mammary glands (148, 328).”
From Human and animal dirofilariasis: The emergence of a zoonotic mosaic (2012) · cites this paper as [148]
The frequently asymptomatic character of D. repens in dogs and lack of clinical diagnosis could contribute to its silent spread through canine reservoirs, increasing risk of human infection in the same areas.
“The frequently asymptomatic character of D. repens in dogs and, thus, the lack of its clinical diagnosis could contribute to its silent spread through canine reservoirs, increasing the risk of infection in humans residing in the same areas (148).”
From Human and animal dirofilariasis: The emergence of a zoonotic mosaic (2012) · cites this paper as [148]
Between 30% and 35% of D. repens-related infections occur in ocular regions (orbital zone, eyelids, subconjunctival and intravitreous tissues).
“Between 30% and 35% of D. repens-related infections occur in ocular regions (orbital zone, eyelids, and subconjunctival and intravitreous tissues) (Fig. 14C) (148, 328).”
From Human and animal dirofilariasis: The emergence of a zoonotic mosaic (2012) · cites this paper as [148]
Some ocular dirofilariasis cases have serious consequences, with symptoms including damaged vision, floaters, or loss of sight.
“Some of these cases have serious consequences, with symptoms including damaged vision, floaters, or loss of sight (148).”
From Human and animal dirofilariasis: The emergence of a zoonotic mosaic (2012) · cites this paper as [148]
It is not infrequent to find worms of both D. immitis and D. repens in anatomical locations distinct from those commonly associated with each species.
“It is not infrequent to find worms of both species in anatomical locations distinct from those commonly associated with each species.”
From Human and animal dirofilariasis: The emergence of a zoonotic mosaic (2012) · cites this paper as [148]
Heartworm disease is more commonly diagnosed in the Balkans, South of Hungary and also South of Russia.
“In fact, heartworm disease is more commonly diagnosed in the Balkans, South of Hungary and also South of Russia.”
From Impact of climate change in the epidemiology of vector-borne diseases in domestic carnivores (2013) · cites this paper as [25]
Heartworm disease can now be maintained beyond the Mediterranean region, based only on the biology of vectors and parasites and the evolution of temperatures.
“Thus, it seems that heartworm disease can now be maintained beyond the Mediterranean region, based only on the biology of vectors and parasites and the evolution of temperatures (Fig. 5).”
From Impact of climate change in the epidemiology of vector-borne diseases in domestic carnivores (2013) · cites this paper as [25]
These studies predict the beginning and end of seasonal transmission, and some consider the impact of climate change.
“These studies predict the beginning and end of seasonal transmission, and some consider the impact of climate change [ 56 ].”
From Key factors influencing canine heartworm, Dirofilaria immitis, in the United States (2012) · cites this paper as [56]
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Human and animal dirofilariasis: The emergence of a zoonotic mosaic
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“Several studies have described the effects of the climate change in the spreading of other vectorborne diseases in Europe (Semenza and Menne, 2009; Genchi et al., 2011a,b).”
BackgroundSubcutaneous dirofilariosis (Dirofilaria repens): an infection spreading throughout the old world
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Impact of climate change in the epidemiology of vector-borne diseases in domestic carnivores
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The Complexity of Zoonotic Filariasis Episystem and Its Consequences: A Multidisciplinary View
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Key factors influencing canine heartworm, Dirofilaria immitis, in the United States
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A multiplex PCR for the simultaneous detection of species of filarioids infesting dogs
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Evidences of increasing risk of dirofilarioses in southern Italy
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Dirofilarioses in cats: European guidelines from the ABCD on prevention and management
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Capelli, G., Frangipane di Regalbono, A., Simonato, G., Cassini, R., Cazzin, S., Cancrini, G., Otranto, D., & Pietrobelli, M. (2013) · Parasites & Vectors · doi:10.1186/1756-3305-6-60 · Cited by 50 · see citing works
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Screening blood-fed mosquitoes for the diagnosis of filarioid helminths and avian malaria
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Dirofilaria immitis and D. repens in dog and cat: A questionnaire study in Italy
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Simón, L., Afonin, A., López-Díez, L. I., González-Miguel, J., Morchón, R., Carretón, E., Montoya-Alonso, J. A., Kartashev, V., & Simón, F. (2014) · Veterinary Parasitology · doi:10.1016/j.vetpar.2013.12.027 · Cited by 41 · see citing works
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Circulation of Dirofilaria repens and Dirofilaria immitis in Moldova
Șuleșco, T., von Thien, H., Toderaș, L., Toderaș, I., Lühken, R., & Tannich, E. (2016) · Parasites & Vectors · doi:10.1186/s13071-016-1916-4 · Cited by 40 · see citing works
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Self-citationSeroepidemiological survey of human exposure to Dirofilaria spp. in Romania and Moldova
Ciuca, L., Simòn, F., Rinaldi, L., Kramer, L., Genchi, M., Cringoli, G., Acatrinei, D., Miron, L., & Morchon, R. (2018) · Acta Tropica · doi:10.1016/j.actatropica.2018.07.012 · Cited by 37 · see citing works
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Prevalence of heartworm in dogs and cats of Madrid, Spain
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“Ethical approval was not provided for this study on human participants because people data do not require permission; everyone provided verbal consent.”
BackgroundMethodDini, F. M., Musto, C., Brogi, R., Moroni, B., Fiorentini, L., Bassi, P., Bianchi, A., Pupillo, G., Tedesco, P., Donato, A. D., et al. (2026) · International Journal for Parasitology · doi:10.1016/j.ijpara.2025.06.005 · Cited by 2 · see citing works
- Authors
- Genchi, C., Kramer, L. H., & Rivasi, F.
- Affiliations
- University of Milan (IT)
- University of Parma (IT)
- University of Modena and Reggio Emilia (IT)
- Corresponding author
- Genchi, Claudio
- ORCID
- Kramer, Laura H.
- Venue
- Vector-Borne and Zoonotic Diseases
- Publisher
- SAGE Publications
- Published
- 2011-10
- Volume
- 11
- Issue
- 10
- Pages
- 1307-1317
- ISSN
- 1530-3667 (ISSN-L)
- 1557-7759
- OpenAlex
- W2095082194
- Cited by
- 214
- References
- 127
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 8 · 2023: 10 · 2022: 13 · 2021: 11 · 2020: 13 · 2019: 18 · 2018: 13 · 2017: 19 · 2016: 17 · 2015: 25 · 2014: 20 · 2013: 16 · 2012: 17
- FWCI
- 2.19
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Vector-Borne and Zoonotic Diseases (publishedVersion)
- PubMed (publishedVersion)
- IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
- 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
- Dirofilaria, Dirofilaria repens, zoonotic filariasis, climate change, global warming, extrinsic incubation, geographical range expansion, dogs as reservoir, filarial transmission, disease control, Europe
- MeSH terms
- Animals, Dirofilaria, Dirofilariasis, Europe, Forecasting, Humans, Temperature, Zoonoses, Climate Change
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