Molecular identification of new cases of human Dirofilariosis (Dirofilaria repens) in Italy

1) Dirofilariosis is a vector‐borne parasitic disease mainly in domestic and wild carnivores caused by Dirofilaria (Noctiella) repens, which is endemic in many countries of the Old World, and D. immitis, which has a worldwide distribution. In recent years, an increase in the number of human cases has been reported, suggesting that dirofilariosis is an emergent zoonosis. Here, we describe further cases (N = 8), observed in Central Italy during the years 2018–2019. 2) Molecular diagnosis was performed on: i) live worms extracted from ocular conjunctiva, cheek, and calf muscle; ii) histological sections of surgically removed nodules from parenchymal lung, coccyx, and breast. 3) Sequence analysis (650‐bp) of the mitochondrial cytochrome oxidase subunit I gene (mtDNA cox1) showed a match of 100% with the sequences of D. repens previously deposited in GenBank. ELISA test to detect IgG against filarial antigens was performed on four patients’ sera and resulted positive in two patients who showed ocular and subcutaneous dirofilariosis, respectively. Microfilariae have been never detected in the peripheral blood of the patients. 4) The occurrence of N = 8 new cases of human D. repens‐infections observed in a two‐year period suggests an increased circulation of the parasite in Italy. Therefore, dirofilariosis should be included in differential diagnosis in patients presenting subcutaneous and/or pulmonary nodules. Molecular diagnosis of the etiological agents is fundamental. Specific serological diagnosis needs to be improved in future research work.