Canine heartworm disease (Dirofilaria immitis) in Western Europe: survey of veterinary awareness and perceptions
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BACKGROUND: This survey examines the experience and opinion of veterinarians with canine heartworm (HW; Dirofilaria immitis) infection in non-endemic and endemic areas of Europe. METHODS: A questionnaire was distributed by e-mail to veterinary practitioners within non-endemic countries including UK, Germany, and Netherlands,non-endemic regions of France, Spain, Italy and endemic regions of France, Spain and Italy. The main questions were about the HW cases seen in the last 12 months, if the number of cases had changed over the last 5 years and practitioner awareness of the ESCAAP Guidelines on HW. Additional questions examined practitioner perception regarding the risk of HW for pets travelling in endemic areas and the use of preventatives including veterinary perception of pet owner compliance. RESULTS: Overall 584 responses, 389 from non-endemic countries and regions and 195 from endemic regions were obtained. Most of the cases were seen in endemic regions, although in Germany 20% of veterinarians reported cases of HW infection. Overall, 10% of practitioners in non-endemic areasand 12% in endemic areas, respectively, reported an increasing number of cases. The practitioner awareness of ESCCAP guidelines is low. Veterinarians responded that preventative drugs were prescribed to most client dogs in endemic areas and most practitioners rated owner compliance as good or excellent in following the veterinarian's guidance for HW prevention. Overall 63% of veterinarians responded that owners are more or less aware of the HW risk traveling with their dogs in endemic areas. Forty four percent of responders in non-endemic regions considered it somewhat likely to very likely that HW infection will become endemic in their regions. CONCLUSIONS: In both non-endemic and endemic countries at least 1 responding practitioner admitted seeing a case of canine HW infection and has shown awareness regarding infection. Ten percent of practitioners stated that the number of cases is increasing. Although the number of owners traveling with their dogs was low, the perception of surveyed veterinarians was that owners were quite aware of the HW risk for their dogs. Several veterinary practitioners believe that HW infection could become endemic in their non-endemic area within the next 10 years.
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In the United Kingdom and the Netherlands, Genchi et al. showed existence of D. immitis as isolated cases based on veterinarian questionnaire answers.
“In the United Kingdom and the Netherlands, Genchi et al. [56], based on the answers from veterinarians to a questionnaire in some European countries, have shown the existence of the disease in those non-endemic countries, considering the presence of D. immitis as isolated cases.”
From What has happened to heartworm disease in Europe in the last 10 years? (2022) · cites this paper as [56]
The increase in publications reporting Dirofilaria spp. infections is most likely driven by both increased research and awareness, but also the spread of the parasites.
“This is most likely driven by both increased research and awareness, but also the spread of the parasites [25, 39].”
From Vectors, host range, and spatial distribution of Dirofilaria immitis and D. repens in Europe: a systematic review (2025) · cites this paper as [39]
The spread of Dirofilaria in Europe is in part a diagnostic artefact, i.e. imported and travelling dogs are more routinely tested, leading to more detection.
“In part this might be also a diagnostic artefact, i.e. imported and travelling dogs are more routinely tested, which leads to more detection [39].”
From Vectors, host range, and spatial distribution of Dirofilaria immitis and D. repens in Europe: a systematic review (2025) · cites this paper as [39]
A questionnaire survey by Genchi et al. detected an increasing number of positive cases of D. immitis in non-endemic areas (10%) and endemic areas (12%) of Europe.
“as demonstrated also in a questionnaire survey by Genchi et al., [31] where an increasing number of positive cases to D. immitis was detected in non- endemic area (10 %) and in endemic- area (12 %) of Europe.”
From Dirofilaria immitis and Angiostrongylus vasorum: the contemporaneous detection in kennels (2015) · cites this paper as [31]
Awareness among veterinarians of Dirofilaria-related infections is significantly lower in non-endemic countries than in endemic regions.
“This could be due to a significantly lower awareness among veterinarians of Dirofilaria-related infections in non-endemic countries compared with their colleagues in endemic regions (Genchi et al. 2014).”
From Current trends in canine dirofilariosis in Austria-do we face a pre-endemic status? (2020) · cites this paper as Genchi et al. 2014
The increase in reported cases might be due to the increasing number of dogs with a travel history to endemic regions and dogs imported from endemic countries, but also due to rising awareness of travel infections affecting dogs and, therefore, an increased and more adequate screening for associated diseases.
“This might be due to the increasing number of dogs with a travel history to endemic regions and dogs imported from endemic countries, but also due to rising awareness of travel infections affecting dogs and, therefore, an increased and more adequate screening for associated diseases (Leschnik et al. 2008; Genchi et al. 2014).”
From Current trends in canine dirofilariosis in Austria-do we face a pre-endemic status? (2020) · cites this paper as Genchi et al. 2014
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- Genchi C Solari Basano F Marone RV Petruschke G Seward RLS, Batavia IL Canine and Feline Heartworm in Europe with special emphasis to Italy Proceedings of the heartworm symposium '98, Tampa, Florida, USA, 1-3 May, 1998 1998 75 82
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MATFEI, A., Ivanescu, L. M., ANDRONIC, L., MÎNDRU, R., MARTINESCU, G.-V., Acatrinei, D. M., Iacob, O. C., & Miron, L. D. (2023) · Lucrări Ştiinţifice - Medicină Veterinară, Universitatea de Ştiinţe Agricole şi Medicină Veterinară "Ion Ionescu de la Brad" Iaşi · doi:10.61900/spjvs.2023.04.07
Ciuca, L., Vismarra, A., Constanza, D., Di Loria, A., Meomartino, L., Ciaramella, P., Cringoli, G., Genchi, M., Rinaldi, L., & Kramer, L. (2024) · Figshare · doi:10.6084/m9.figshare.26566520
Evans, C. C., Normile, D. M., Gamble, S., Guerino, F., Dzimianski, M. T., & Moorhead, A. R. (2024) · Figshare · doi:10.6084/m9.figshare.26585286
Evans, C. C., Normile, D. M., Gamble, S., Guerino, F., Dzimianski, M. T., & Moorhead, A. R. (2024) · Figshare · doi:10.6084/m9.figshare.26585283
Evans, C. C., Normile, D. M., Gamble, S., Guerino, F., Dzimianski, M. T., & Moorhead, A. R. (2024) · Figshare · doi:10.6084/m9.figshare.26585274
Evans, C. C., Normile, D. M., Gamble, S., Guerino, F., Dzimianski, M. T., & Moorhead, A. R. (2024) · Figshare · doi:10.6084/m9.figshare.26585280
Evans, C. C., Normile, D. M., Gamble, S., Guerino, F., Dzimianski, M. T., & Moorhead, A. R. (2024) · Figshare · doi:10.6084/m9.figshare.26585277
Wyler, M. K. E. (2026) · Frontiers in Veterinary Science · doi:10.3389/fvets.2025.1603592
Young, L., Reinemeyer, C. R., Mansour, A., & Wiseman, S. (2026) · Parasites & Vectors · doi:10.1186/s13071-026-07379-0
- Authors
- Genchi, C., Bowman, D., & Drake, J.
- Affiliations
- University of Milan (IT)
- Cornell University (US)
- Corresponding author
- Genchi, Claudio
- Venue
- Parasites & Vectors
- Published
- 2014
- Volume
- 7
- Issue
- 1
- Pages
- 206
- ISSN
- 1756-3305 (ISSN-L)
- PMC
- PMC4013803
- OpenAlex
- W2123548668
- Cited by
- 67
- References
- 15
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 5 · 2023: 8 · 2022: 4 · 2021: 10 · 2020: 6 · 2019: 10 · 2018: 4 · 2017: 3 · 2016: 2 · 2015: 9 · 2014: 1
- FWCI
- 3.52
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Parasites & Vectors (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Parasitic Diseases Research and Treatment
- Health Sciences › Veterinary › Small Animals › Helminth infection and control
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Research on Leishmaniasis Studies
- Keywords
- canine heartworm disease, Dirofilaria immitis, heartworm prevention, owner compliance, imported dogs, travel risk, non-endemic region, Western Europe, incidence trends
- MeSH terms
- Animals, Data Collection, Dirofilaria immitis, Dirofilariasis, Dog Diseases, Dogs, Europe, Humans, Ownership, Surveys and Questionnaires, Practice Guidelines as Topic, Veterinarians, Endemic Diseases
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