Excellent. OK, so hello everyone and thank you very much for joining us today. I'm Hanni Al Shaika, the chairperson of this webinar.
I also serve as the head of SCAP UK and Ireland. And this webinar will be exploring exotic parasites, some of which might seem almost like science fiction. It's a privilege to receive firsthand insights from a clinician with such a professional expertise like Doctor Ian Wright.
We are fortunate to have him as our speaker today. I have known Ian for a longer time. He is deeply passionate about the study and management of parasites and combining animals.
Ian is a practising vet surgeon. He's a co-owner of the Mount Veterinary practise in Fleetwood. He has also a master's degree in veterinary paratology, and he is the chair of the European Scientific Council of Combinian Animal Parasites.
Vienna has published over 130 peer-reviewed articles. He is a member of the editorial board of the Companion Animal Journal. He continues to carry out research and practise, including work on intestine and nematodes and texts.
Very impressive CV for a busy clinician. Just before I hand the stage over to Ian, if anyone has any questions for our speaker, please put them in a dedicated Q&A box. For comments or other queries, please use the chat box.
Finally, I would like to thank ESCAP UK and Ireland for sponsoring this webinar. Doctor Wright, thank you very much for joining us today. We are really excited to hear your insight.
Thank you very much, Alice, thank you for that very generous introduction. Hanny, Hanny and I have known each other for a long time. The one thing that we, we really have in common is a deep love, passion, not obsession, but you know, deep passion for parasites and especially parasites that look like this, you know, very visually impressive, striking, stunning, even.
But the parasites that are in front of us, these exotic worms are, largely overlooked, I think, going under the radar at the moment, even though, cases for each one of them have been recorded in the UK and that, and despite the fact that there is a significant risk, of all three, establishing here. So just to clarify, the term exotic, when we're talking about parasites is used widely, it's used in in peer reviewed literature. I may have even used it the odd time myself, but it's fairly poorly defined.
So here, when I'm using the term exotic, I'm talking about not endemic in, in the country that we're talking about, at least we don't think so currently, and you know, in this case, that's, that's the UK. So I'm going to be talking about these worms individually, their importance and how we might watch out for them, control them in individual patients, but also in your local area and in the country as a whole. But also then talking a little bit about the exotic worm surveillance scheme that APHA are running supported by SSCAP UK and Ireland.
And how you can help, how it'd be wonderful if you were sending your worms, into that scheme. So although we can't be certain that this statement is true because surveillance currently is patchy, I think it could be described as as fairly poor, case reports, sort of queries coming in to SSCAP UK and Ireland, and sort of anecdotal reports would suggest that the numbers of exotic worms entering the UK are increasing. And if we accept that that's the case, it's going to be driven by a number of factors.
So the first of these is increased pet travel. So pet travel, since the rules sort of really relaxed, there's been a few changes over the years, but I guess that they they relax most heavily probably around 2012. And since then, since it became easier to travel year by year, the number of pets travelling went up, especially dogs.
Now that did take a couple of hits. COVID naturally dropped those numbers. For people travelling recreationally with their pets and also us leaving the EU.
So Brexit means that we now have to use animal health certificates, a one use certificates means that it's not necessarily more complex to travel, but it, it's more expensive. So that had a knock-on effect. But despite all of these things, the trend for increased pet travel is now going up again.
And the more pets that are travelling around endemic countries that have these worms with vectors or intermediate hosts that might transmit them, the more likely they're going to be brought back er to this country. So that's pet travel which is transient, but we've seen a very steady increase, even you know right through COVID, er right through importation and pet travel rules, we've seen a steady increase in the number of dogs, particularly pets as a whole, but especially dogs that are being imported into this country. And I mean these dogs typically will have lived for a long time, maybe their whole lives in endemic countries.
A lot of them will have lived out on the streets or in kennel situations where their likelihood of acquiring exotic parasites is much higher than say your well pampered, you know, well looked after domestic pet. And a lot of these pets are being rescued, then being brought into the UK, it's a very emotive topic, a lot of debates about how much control there should be surrounding that, but a lot of it happening, there's a lot of need, a lot of welfare issues in other countries, and as a result, more parasites entering the UK. And this is happening against a background of increased risk of UK establishment.
So we're seeing across Europe increased movement of vectors, things like mosquitoes, fly vectors, ticks, you know, are being moved around a lot by pets, by wildlife. Like migrating birds, in trucks, you know, large movement vehicles, by wind dispersal, all sorts of factors that are contributing to increased movement of these vectors in Europe. And that is happening against a background of changes in climate.
You know, if it's warmer, if it's, more humid, that increases the likelihood of a lot of these vectors being able to increase their range. And we're seeing changes in habitat, so whether you're a. Tick or whether you're a fruit fly or a mosquito, there's lots more forested areas, a lot more green habitats right across Europe, but especially encroaching into urban areas.
I mean that's a wonderful thing, you know, I mean we should embrace. That, enjoy the fact that we've all got more green space, that nature is, is thriving in, in many parts of Europe, but that also increases the opportunity if factors are moved around that they can establish in new areas. So specifically, relocating dogs, so relocating dogs on a, on a semi or permanent basis as a result of rescues or people just moving countries is going to have an impact on the distribution of parasites and potential establishment.
And those impacts can happen in a variety of different ways. So we might see parasites, if, say, an infected dog, enters the UK, then parasites might enter into existing vector populations. So if we take worm examples, Dirophylaria repens or Dirophylariaimatus might infect mosquitoes that are feeding upon infected pets, and then if conditions are right, it might establish in those mosquito populations.
And as we'll talk about, that's more likely to happen at the moment with Diopylaria repens than it is with imetus. We might see parasites introduced into intermediate hosts, so if you're Linguaula serrata, an infected dog decides to sneeze up some eggs, those eggs are consumed by cattle or rabbits or another suitable intermediate host, then it could very easily establish here. And then, you know, we have the introduction of parasites into completely new vector populations.
So as we'll see in a moment, the eyeworm Plaiacalipeda is extremely good at following its vector around. So the fruit fly Fortica is expanding its range. That means that just more likely that if an infected dog moves to a new area, there will be lovely new fruit flies waiting for those eyeworms.
So for all of these different methods, dogs moving with their parasites can inadvertently expand their range. And climate is having a big effect as well. So the way I like to compare the two is that climate is the fuel for fire, essentially.
So climate it creates conditions in which vectors and parasites are more likely to establish. So if we have a warmer, more humid climate, that might lead to increased vector survival time. So you know they might live for longer, they might be active for longer sort of through a season or all year round.
It might increase their activity time, so, you know, if your intermediate host is something like an arthropod, like a slug, and it's lovely, it's warm, it's humid, it might be active for longer periods of time. And I mean that's very important for a parasite like lungworm, which we're we're not going to talk about today, but is an important factor. And it also allows establishment of new vectors.
So, you know, if we have a, a tick, say like Rhiphocephalus, you know, it doesn't like chilly, dry conditions, but if it suddenly gets warmer, then, you know, that that allows it to expand its range, and that's been true for many mosquito species and for Fortica fruit flies as well. That mosquito is on the ceiling of my bathroom, which seems to happen periodically, but more and more frequent times now right throughout the year, which, you know, is, is anecdotal, but it's a sign of our changing climate that certainly in my, my neck of the woods, mosquito species seem to be doing very, very well. Sadly, that mosquito is no longer with us.
So we have significantly emerging worms of interest. So these worms, I mean there are many exotic parasitic worms that might come into the UK er and we'll talk very briefly about a couple of other potential ones in the future later. But these are the ones I think that are of greatest concern at the moment.
And they're worms that have zoonotic potential and or significant animal health impacts, and they could establish in the UK. So, you know, if we're confident that we can tick all of those boxes, then they'd be in this list. And the top two have received a lot of attention because they are very, very serious.
So Dirofilariaimatus is heartworm that I'm sure many of us will be familiar with, may even have seen cases in practise in imported or travelled pets. I mean it is a zoonosis, but only through vector exposure, through, mosquito bites, . So you know we're not too, too worried about that at the moment.
Even then it's not a serious zoonosis, but it can cause very serious disease in dogs and to a lesser extent cats, more sort of chronic or very acute disease in. In cats can can infect ferrets as well, at the moment it's unlikely to establish in the UK because the climate would need to be a little bit warmer for it to maintain its transmission in the mosquito year on year. We're very lucky though in that we have a wide range of effective licenced treatments that we can use as preventatives monthly in endemic countries for travel, you know, so that's useful, you know, we can protect pets that are travelling er abroad.
And you know, we also have a wide range of tests, so it means that we're in a position where we could use commercial PCR or antigen screening tests to look for the parasite for dogs that are coming into the country. Sorry, it keeps automatically moving on. You know, they're coming into the country, so we've got a good screen, we've got a good preventative treatment, and that is very, very useful, so we don't have to rely on, you know, gross identification of adults in the heart or the arteries alone.
Echinococcus multilocularis in comparison causes almost no pathology or no pathology in dogs, but is a very, very severe zoonosis. I mean, I say that it can in dogs if they act as an intermediate host, but carrying the adults, no problem. But very, very serious zoonosis for us and something that we really want to keep out of the UK.
It's not endemic here at the moment. We rely heavily on that, use of preventative treatments, which is a legal requirement, 1 to 5 days before you come into the UK treatment with Prasiquantal, and you can use it strategically to keep pets safe while they're abroad and after they return to the UK as we've got a very effective and preventative treatment. But we've also got tests that have been developed, so we've got commercial PCRs, that we can use for surveillance for Echinococcus multilocularis as well.
The free parasites that we're going to talk about in detail though, don't have those advantages. So yes, there is a licenced preventative treatment for diroylaria repens, but there isn't an easy commercial PCR or antigen screening test that we can use. So we're either relying on looking at microfilaria or gross morphology, morphology to detect it.
And diarrheallaria repens is a significant zoonosis and as we're going to discuss, could establish here. Very similar situation for Plaia Caipeda eyeworm and you know, we don't even have a licenced effective treatment for Linguula errata. So where I'm heading with all of this is that surveillance is incredibly important and we're relying on gross identification of these parasites, to act quickly, and put preventative measures in place.
So that's really what all of these parasites have in common. So let's start off by discussing Diroylaria repens. So Diopylaria repens is a worm, filaroid worm, very closely related to heartworm, but the adults live in the skin or nodules in the skin or in structures around the eye, so although, you know.
It can cause pathology, you'd much rather have your 14 centimetre worm in those locations than you would in the pulmonary arteries or the heart, where Diroylaria immaus resides. Microfilaria, are in the blood and lymph, so these are the larval worms. Circulating, so there's potential for detection there, and there is zoonotic potential, so if mosquitoes become infected and feed on people, then we can develop clinical signs, so we might get skin nodules, we might get migrating larvae in our skin, rarely more.
Aberrant migration to the eye or abdominal organs. We do have the mosquito vectors present in the UK able to transmit it and temperatures are adequate for its transmission as well. So if mosquitoes are exposed enough in the UK, it's very, very likely that this worm would establish.
And we're already seeing cases, so there are cases written up in the literature, free that I'm aware of. So there was a, a, this worm has come from a pre-scrotal, incision, that came from a dog. Dog from Corfu, so someone was doing a routine castrate and got a really, really exciting surprise in their day, and that dog was exhibiting no other clinical signs at all.
It was the emergence of the worm that alerted the vet to the parasite's presence. There was another, well documented case that was ocular, and again it was the, it was the appearance of the worm out of a nodule, that, you know, gave that diagnosis and alerted clinicians to the cause of the ocular signs. The distribution maps for heartworm and for dirophtheria reens show the difference and what temperature is doing.
So mosquito vectors are able to transmit both all over Europe, and we have seen heartworms spread as well. So it has moved from, you know, very much being a Southern European parasite. It's spread up through.
Through Eastern Europe, and we're starting to see untraveled cases in the Baltic states, it's endemic in parts of Russia, so, you know, very much an Eastern European parasite as well as a Southern European parasite, and it is creeping north, but it's temperature that is holding that tide back. And if we look at the stripe lines, we'll see that you know that the fact that Dirophylaria repens doesn't need those increased temperatures has allowed it to have a much wider range and it is spreading as well and you know, you look at this and think that it's probably only a matter of time before it, you know, skips over the Channel and gets into the UK. And I mean if that's the case, then you know, the, the only way that we can really delay that or try and hold that off is by trying to prevent exposure of our own mosquitoes to the parasite.
So when we look at our diagnostic tools and treatments, we can look for the microfilaria, and I'm a big fan of the Knotts test, both as part of diagnostic screening for heartworm, but for dirofilaria repens as well. So it's something that you can either do in-house, you can do in your own lab, you can have hours of fun. Spinning down some, some blood mixed with a little bit of heparin, a little bit of formalin, sorry, and then either you can examine it, stain it, examine it under the microscope, and I mean there are, there are lots of the techniques well written up in the literature.
If anybody's interested, they can contact me and I could give you a methodology, but there are a lot of external labs that will do this as well. Once they're stained, and we, you've got larvae like this one under the microscope, it is possible to differentiate them from heartworm and other microfilaria that we might find in blood, as I'm going to demonstrate in a minute, it is tricky, even for people who do this a lot, it's tricky. So you know, it does have limitations looking in terms of, you know, working out which parasite you've got, but if you find microfilaria, it suggests that you have some sort of filaroid parasite on board, and then you can always do further tests.
Another technique that is really useful is histology of nodules. So, you know, sometimes these worms will form a nodule that they're living in, those nodules sometimes have to be surgically removed or they can be removed for diagnostic purposes, sent off to the lab, and then like this wonderful image here, we can see, you can see the worms inside the nodules, and that is much diagnosis done. However, the most common way that we're probably going to diagnose this parasite is by gross demonstration of the worms.
So sooner or later, whether it's through incisions, whether it's through nodules rupturing, you know, we're going to see worms or we'll be able to extract them. And you know, once we have those worms, you know, we can get them expertly identified, and then we know that the parasite is present. Treatment is very straightforward, I mean if you've got huge nodules, it may be useful to surgically remove them, but often that isn't necessary.
I mean lots of dogs are subclinical carriers, so you know we may just be eliminating the parasite for epidemiological reasons. But you know, if there are clinical signs, often they will resolve with fairly simple treatments. So we'd be looking at using a monthly, licenced moxidectin emmiocloprid spot on, and you use that monthly, two treatments should be enough to eliminate the parasites.
So this is just a table to demonstrate that it really is possible to differentiate Dirophlarimatus versus Diroylaria repens. Could I do it with confidence? Not for money, I don't think.
I might have a go, but I wouldn't be 100% confidence in the results. I mean, you need. Someone who's very experienced, you need very careful measuring equipment.
If you've got those two things, it's possible to do, but I think in practise you would just be looking for the presence of, of microfilaria and therefore, you know, some sort of of filaroid worm. So the possibility of dirofilaria repens establishing in the UK is very, very real, and you know, there are very practical control options that we can take to try and prevent that from happening. And the biggest tool that we've got is to rapidly identify cases, and then if we treat them promptly, that is going to minimise the risk of vector exposure and all is good.
The problem that we have with this is that many dogs, and to a lesser extent cats will be subclinical carriers, so you may not have any clinical signs to recognise. However, you know, if you do find worms or you have pets with relevant clinical signs, that rapid identification is really important. And then using those positive cases, so submitting them to surveillance programmes like the one I'm going to discuss a bit later, will help to build up a picture of where cases are, whether they're occurring in untraveled pets, and therefore, you know, whether we might have endemic foci establishing.
We want that just like heartworm, we want to have preventative treatments in place for pets travelling abroad. Now, if they're travelling to a heartworm endemic country, that really takes priority in terms of compliance, feeding it into a pet travel programme in terms of the products that you might choose. But if we're going to an area that isn't endemic for heartworm, then you would use a licenced product.
For dirophylaria reapens and you would use that monthly. We do really want to be aware for relevant clinical signs for dogs entering the country, so we want to pick up and test dogs that have dermatitis, particularly skin swellings or nodules, and we want to consider this as a differential in pets, dogs, cats that have ocular signs. And you know we either, I would encourage people in imported pets to run a modified knots, you know, to see if you know, sort of dirophylaria dirophylaria repens or imetus is present, whether we've got microfilaria there, .
But essentially if we've got negative dogs for heartworm, then I don't think it would be unreasonable to give them a treatment with moxidectin and midocloprid when they arrive in the country. They're very likely that a single treatment would eliminate the parasites. Certainly if not two a month apart would be very likely to do the job.
So let's move on to Plaiacalipeda, the Oriental eye worm. What a great name. Of course originally it really wasn't a big problem in Europe.
If it was Far Eastern Europe, Asia, it's not a parasite that you would have been expecting to drop into sort of Western Central Europe and perhaps one day the UK. It's a worm that lives in and around the conjunctive sac, so in around the, in and around the eyes. So we've got, you know, larvae and adult worms there.
So you've got the, the, the parasite living almost in its entirety, in and around the eye. And it infects a wide range of suitable hosts, so a range of wildlife like foxes, rabbits, hares, dogs and cats, and crucially humans. So we have, another zoonosis.
It can cause a wide range of signs, so early on it can be subclinical, so, you know, it's easily missed, in infected cats and dogs, but as it progresses, signs can get progressively worse. So you'll very commonly see conjunctivitis, but then if the worms are left in situ, it can lead to keratitis. You can get a lot of swelling in and around the eye and then ultimately corneal ulcers and even blindness, so just for this reason alone, diagnosis, rapid recognition and treatment is very important.
It's transmitted. By the humble fruit fly, so not necessarily, a sort of vector that you would automatically assume would transmit parasites, and fruit flies aren't parasites themselves, they don't feed on blood, they don't live on us, but as well as, you know, the, Sap of trees and a variety of sort of vegetables and fruits. Fordica love eye secretions, so it's in in feeding and moving around that Fortica transmits this worm from one host to another.
And the story of Falaia is really the story of Fortica as a fruit fly having tremendous success in Europe. So as the climate has warmed, it's become more suitable for Fortica as we've got more glades and orchards and forests, you know, loves, loves that kind of environment. And as a result, climate modelling, and case reports, would suggest, that Fortica is, is, is going to continue to do well and continue to spread.
It's already present focally in, in the UK, in the south of England, and all the indications are, that the fruit fly will, will continue to spread its range throughout the UK. Now, we don't, as far as we know, Flaia isn't currently endemic in the UK but climate modelling and case reports of Falaia have also demonstrate that it likes to follow its fruit fly vector around and wherever the fruit fly vector moves to, Eventually Faria appears to become endemic and to a certain extent this can be due to wildlife movement, but a big driving factor in this is the movement of pets, particularly pet dogs around Europe. So there have been cases reported in UK dogs, with travel history from Eastern Europe, the Mediterranean, you know, France, a wide range of, of countries, and, you know, it does suggest, that probably these reported cases are probably the tip of the iceberg.
There's probably more coming into the UK than we think. So this is a distribution map, a climate modelling map showing just the the very strong likelihood that that Fortica will continue to spread and as it does, you know, we're going to see Flaia eyeworm follow it. So again, it's very, very important to diagnose the parasite early and treat it.
And in the case of Flaia, all we have is morphological identification. And just recognition, of pets with relevant clinical signs. So it's important to examine the eyes of all, or probably all pets in a standard exam, but especially carefully with dogs that have travel history and have been imported from endemic areas.
It is possible sometimes just to see the worm on a straightforward ocular exam, but sometimes. Local anaesthetic, sedation is required to really get into the sort of conjunctival sac area, get under the third eyelid, and sort of see if these worms are knocking around, and that's useful for treatment because then part of the treatment is the flushing of the eye, physical removal of worms, and that can be done in combination, with a licenced macrocyclic lactone. So that could either be moxidectin, midocloprid spot on treatment, or you can use two, milbamycin oxy oral treatments given two weeks apart.
If you choose the latter option, strictly speaking, that should be the monovalent, it shouldn't have prasequontylin cos we're not treating any tapeworm here. Unless you're using it as part of an imported dog programme or a travel pet, you're you're treating, you're you're using it for Echinococcus multilocularis. But if we're treating a clinical case, then strictly speaking, it should be the monoalent.
In reality, prasequantal is incredibly short acting. You know, it's not going to build up in the body. You could use the bilbamycinin prasequontal treatment, off licence, you know, two weeks apart, and, you know, it's going to do the job.
So, you know, it's really a question of compliance and personal choice. So in terms of control options, if we're going to look at trying to prevent phasia establishing in the UK, then it's a very similar story in that it is absolutely crucial that we rapidly identify cases. So we find those worms in the eye and we sort them out.
Before any fruit flies can be exposed, but it is also tremendously important in the case of phasia for individual prognosis as well. The quicker we find those worms, the quicker we treat them, the better the outcome for that patient's eye or eyes is going to be. And just like Diroylaria reens, having got positive cases, we want to log them, surveillance is really important to know if we're getting local transmission occurring in these small, you know, endemic foci of fruit flies that we have in the UK that are likely to spread.
There isn't, a treatment as far as I'm aware, which is licenced specifically for preventative use, in endemic countries or for pets travelling abroad. However, it's likely that monthly treatment with a macrocyclic lactone is going to be beneficial, and almost every country currently that we know Faria is endemic in, heartworm is also endemic in. So it's very likely that you're going to be using a licenced macrocyclic lactone for that purpose anyway.
And finally we move on to Linguula serrata, the tongue worm, and well, this is a beautiful parasite. I've got an image in a moment that will probably stay with you for at least the rest of the day, you know, they're like, they're like an alien, they're like an extra off a horror movie, but they do have a certain beauty to them as well, but they look like a serrated tongue. And they look a bit like a worm, and hence their common and Latin name, but they are actually nasal pentastomids that live in the nasopharynx of the definitive host that they're infecting, which is most commonly, canids, most commonly dogs, but a range of other carnivore hosts can be infected, I mean, including cats and including people.
But fortunately for us, you get the adult parasite by eating infected intermediate hosts. And currently the sort of range of this parasite is more out in, Eastern Europe, the Middle East, you know, sort of in, in sort of Europe. European and adjacent areas.
So, I mean, unless you're going to go to the Middle East or an Eastern European country and just live that dream and eat a load of raw offal that's infected, it's very unlikely you're going to end up with your own 2 to 3 centimetre shrimp-like organism stuck up your nose. However, we do also act as intermediate hosts as well, and that's the primary zoonotic concern. So if we have a pet that's infected, they will shed eggs in their nasal excretion secretions, possibly pass some eggs in the faeces.
So if we do a nice bit of facial snuggling, you know, or if our hand hygiene isn't very good, then. Potentially we might end up with nymphs insisting in our abdominal organs. There's a wonderful video we've associated with one paper online that's got a little shrimp-like organism swimming around in someone's eye, successfully removed, all ended well, but you know, there's a variety of outcomes that can happen if we're exposed to the eggs.
It's a low risk, but it's there. And a wide range of other animals act as very viable intermediate hosts, so, rabbits, livestock, so you can see they'd be very easy for it to establish in, in new countries or new geographic areas if, infected pets, infected animals remain undetected. Most infections in dogs and cats are subclinical, which again is, is tricky in finding the parasite quickly, but it is very obliging in that periodically it does like to get sneezed up.
So, you know, the first encounter you're likely to have with these parasites is one of your clients getting on the big red phone and saying some horrific organism has been sneezed up onto the carpet and they don't know what it is, and that's. Most common way it's probably diagnosed, however, sometimes you do get clinical signs, you can get some epistaxis, some reverse sneezing, coughing, you can get some discharge as well, so if you get those signs in an imported dog, actually this should absolutely be on your differential list. There have been imported cases in the UK from Eastern Europe.
There was an imported case that was written up from Turkey. There has been one untraveled case which is interesting, which has raised the question of whether there may be endemic foci in the UK, and this has been postulated with cases in wildlife in the past as well. I mean the short answer is that we don't know, but to date there's only been one untraveled case, so if it is present, it's unlikely that it's widespread.
This particular particular case was being fed on imported food with a raw component if I remember correctly as well. So it may be that the organism was imported, it's not actually truly an endemic case. So Linguula Sarada diagnosis and treatment, again, we're really mostly relying on the fact that, you know, your day is going to be made, you're gonna have a 5 star day because somebody is going to bring in one of these parasites and you're just gonna wonder at what it is.
But you know, once you've got a sample, it can be sent away, morphologically identified. So you know that's, that's the main route of diagnosis. You can look for the eggs, they're pretty sparse in faeces, that, that can be a, a bit tricky to find them there.
You'll find more of them in nasal secretions, but it can just be difficult to get enough nasal secretion to float. So you know, all of these techniques worth doing, they're relatively insensitive. If we do, you know, go looking, then you rhinoscopy, of the nasopharynx, you know, can be, can identify adults as well, and in part forms part of the treatment in that they can be physically removed.
There's no licenced treatments and there's actually very, very few cases in the literature to tell us what's most likely to work, but macrocyclic lactones as a whole appear to have some efficacy, if used to treat. Control options, again, it's rapid identification of these cases, so lots of eggs aren't sneezed up, and intermediate hosts don't get exposed, so they need to be identified quickly and treated quickly. So yes, but also, you know, if these cases become more chronic, they may cause more inflammation and issues, so potentially you're going to improve individual prognosis, and you know, you're absolutely going to minimise the risk of zoonotic exposure, and in terms of reducing zoonotic exposure as a whole, good hand hygiene, no facial smuggling, snuggling, all a really good plan.
And having found these cases, we want to log them, surveillance again, really important to see, you know, having already found one untraveled case, if others might be occurring, if this is. Actually an endemic issue or becomes one in the future, there's absolutely no evidence that preventative use of macrocyclic lactones is beneficial er while in endemic countries, it may be but we simply, we, we don't know. There are potentially going to be other future invaders, so there has been a reported case of Onca circa lopi, which is another sort of parasite, Filaroid parasite that lives.
In and around the eye and can form nodules. We're not quite sure. We think that simulum, the elephant gnat or black fly, which, you know, is, is present in the UK, may be a vector.
But we don't know for certain, we don't know if it's temperature dependent, you know, there's a lot of knowledge gaps, you know, with Onca circa loopi, but, you know, wants to be on your differential list as well if you've got these ocular nodules or if you've got ocular signs. The worm can be trickier to find because often it's in the retrobulbar space, but you know, just something for the future that may become more common. And the other one is Spiro circa lopi, which is an esophageal worm, that can lead to oesophageal cancer, obstructive issues, spondylosis, spondylosis bizarrely, you know, in dogs, so a significant pathogen from the Middle East, Africa, currently no confirmed cases have been detected in the UK.
I mention it here because eggs were found that were thought to belong to Spirocirca lupi in a prevalent study of worms in the UK in 2016. One of those cases was a dog and it was being fed on imported food. I mean, transmission is through beetle, to paratenic type hosts, so it's possible that a, a poor beetle might have stumbled onto the food supply chain.
We, we don't know. The other one was in cats and, and we do see artefacts in cats because. Birds have lots of spiroid, have lots of spirocirca type parasites, they, you know, they, they have those in their body, they get eaten by cats and then eggs get passed in their faeces without them actually being infected.
So again, it's one to watch out for for the future, but one that isn't currently thought to be of major concern in the UK. So where this has all been leading, what I would really encourage you all to do is to support this APHA scheme supported by SAP UK and Ireland. So hopefully I've convinced you that surveillance is essential for limiting the spread of exotic worms.
In the UK and what we need is a hub. We need somewhere where they can be identified, but then logged, and we can start to build up a surveillance picture with enough cases even start to generate maps as to where these parasites are in the UK. So if you find one of these worms and you think, oh, you know, this could be one of the worms that I've talked about today, please don't throw it away, which is what a lot of people are doing at the moment, that's, you know, I, I can understand you might want to keep it as a.
Lovely souvenir on your, you know, shelf or, you know, by your computer, please don't throw it away. Why not send it in to this scheme, so if you send it in, it's free, all the details for what to do are on these website links here, and they will identify it for you free of charge, but you'll also be contributing to this nationwide surveillance. The submissions do need to be accompanied by a full clinical history to qualify for the free testing, but it really isn't too arduous, it's a very simple form, and you know you've got the, the web address there if you would like more.
Information, but these parasites are going under the radar, I think that they're significantly underdiagnosed, and there is a real risk of them establishing, so I would really encourage everyone who's listening, if you do find these worms to send them in to the APHA. And don't forget the four pillars as well. So this was developed by ESCAP UK and Ireland as a systematic way for dealing with imported dogs that are coming in and arriving on your consulting room table, but.
Work for cats as well, but you know, you just want to check them for ticks, get them identified because of the risk of riphocephalus establishment in people's homes, but also it helps to inform what pathogens they might have been exposed to. You want to treat with prasiquantal, although the compulsory treatment is in place, which is hugely important for Echinococcus multilocularis, there is a window, a 1 to 5 day window, and Prasequantantal is short acting. So we would recommend another treatment after they arrive in the UK within 30 days of arrival.
It's important to recognise clinical signs like some of the ones that we've talked about today, you know, that then we can see how they might marry up, with pathogens and parasites that these pets might be carrying, and screening is absolutely essential for leishmania, heartworm, Brucella canis, and a range of exotic tick-borne pathogens. So thank you very much, don't forget that there's more information on both the SSCAP UK and Ireland and the European SSCAP website. Er there's more information on these worms, petra.
Travel, importation, but also as free query service, so you know you can email us, you know, put in a request on the website and you know, one of us will attempt to answer your questions and and enjoy doing it, it livens up a Monday morning. So you know, please feel free to get in touch and I mean that service is also free of charge. So thank you very much.
Thanks Ian so much. It's as anticipated, always very informative and very exciting presentation. We've got only 3 simple questions, I think.
The first one is, need a good microscope tool. It's just a comment, not a question, and I think this comment was provided around the time you were talking about diary flurry, perhaps identification of microflurry and how difficult this could be. So I think Herneeta said that this could be, you need a good, really microscope to be able to differentiate.
Yes, and I mean, crucially, you need a microscope that can measure the, the microfilaria as well. So, it, it isn't going to be for every practise. I mean, I, I would argue, and I know there's lots of demands on practise funds that a good functioning microscope with an oil immersion lens is, is well worth the investment and a good quality one.
You can use for all sorts of stuff, so for blood smears, you know, for a whole range of things, for haematology, for looking for bloodborne parasites, for urinalysis, so, so many different ways you can enjoy using your your microscope in practise. So, but yes, if you have got one that's got measurement facilities on it, that, that is also very useful. Yes, indeed.
The second question is, is there a platform to report cases or suspected cases? I think you mentioned this already. Yes.
So, so for these worms, it would be the APHA so you can go back, this will be recorded, it'll be available later, so if you haven't taken photos, you can go back and have a look at those links, so they are very useful for recording those worms, so they will identify them for you, but they will then also record them as well, so they're contributing to surveillance. Unfortunately, you know, there are other parasites like leishmania and heartworm that don't have a central surveillance, site. Used to, used to have Daktari, but it wasn't really used, so it was stopped.
It was perhaps a little bit before its time, unfortunately. So it'd be wonderful, you know, if, the government, you know, would, would set something like. That up again so we could record these cases, but it is an example of use it or lose it, I'm afraid.
So I think when we have the opportunity to submit and record these cases, you know, we, we all have a responsibility to do that. Excellent, thanks for. So next question is, what preservative, what do you choose or prefer, formal saline or booze.
So it depends what you're looking to do and it depends where you're sending it. So if you're sending them to the APHA, then follow their instructions. Basically, they've got very specific instructions as to what they'd like.
So if you go onto the website, it's very simple, very well laid out, and they'll do that for you. In general, if we're looking for PCR analysis, we don't want to put them in formalin, because that will destroy the DNA, we won't be able to identify them genetically. If you're looking for histology, you want to store them for a very long time, then you would use formalin.
So, it really depends as to what you're, what you're seeking to achieve really. Yeah. And the next question is, is AAPHA interested in suspected worms from other pet species?
Well, so this scheme is, is specifically for cats and dogs, but I mean, so, these parasites you're going to see in cats and dogs, that, that, that's where, you know, 99.9%, you're going to see them. Exotic.
It worms or worms from other species, that is an excellent question. I'm not aware that they have a scheme for other companion animals. Sure they would, you know, appreciate an email if you want to ask them, you know, I, I imagine that there are similar schemes for livestock, horses maybe, but that's, you know, outside of my scope.
I'm, I'm predominantly a cat and dog man. Yeah, so we got a question on the microscope again, and Heatta said, I can get a reasonable microscope for under 1000 pounds for, but for something like morphological identification. It's better to get size specification microscope, maybe a refurbished one.
And they train everyone in the, in the practise to just like, yeah, do a good job in identification. So it's a matter of investment, I think, how much the practise is willing to go. Yeah.
And it depends how much microscope you want to do in practise. I mean it, it does take time and not everyone, you know, wants. To dedicate those sorts of finances and time and facilities.
So, I mean, in which case, a lot of this stuff you can send off to external labs, but if you've got people who are interested, there is just tremendous satisfaction and joy in keeping it in-house, you know, have. Having people who are trained, you know, having a, a good functional, but, you know, reasonably affordable microscope. I mean, in terms of microscopes, the sky's the limit.
I mean you can spend thousands of pounds on a microscope, but you really don't need to, to get a good functioning one. I mean if people are interested, if they drop me a line, I'd be happy to give them some examples. Yes, indeed.
Can I ask you a question again? Yeah, sure. Excellent.
How effective are our current surveillance efforts in detecting emerging parasite infections? Well, they're quite poor at the moment is, is the answer, and that's no one's fault. It's the fact that we, we don't have central recording for a lot of them and there is lack of awareness.
So, you know, projects like these, I, I just can't emphasise enough how important they are, you know, that we have a sort of central place that we can submit samples, but then also that people do it, you know, and that they support them. So, you know, it would be very useful if we had more, Central European record or you know, Central UK, sorry, systems for recording these exotic parasites, you know, and that's certainly something to lobby for, you know, to talk to, DEFRA APHA about. I mean this, this scheme came out of a, out of a sort of conversation that we had, we thought it would be a really, really beneficial thing to do.
But you know, if we look at things like heartworm, leishmania, we don't know, we really don't know how many cases there are in the UK, how much. Say for Leishmania, how much non-vectorial transmission might be going on, so yes, there's a lot of work to be done in increasing surveillance, and I, I would encourage anybody who has an interesting leishmania case, heartworm case, or any other exotic pathogen, maybe just a, To pop a letter into the vet record, vet times to let us know at SAP so you know we can continue to try and build up a picture and just keep track of them. We've got really one quick, really important question.
Would you suggest sending a pooled faecal sample from all imported animals within one month in the UK? Yes, so actually, imported dogs, faecal, faecal analysis is really useful. So, you know, it wasn't, wasn't included in our original sort of plan for, for the four pillars, but it is part of, so I should also point people towards SSCAP guideline 9, which is pet importation and travel guideline.
And that in it has a more expansive list of things that would be good to test imported dogs for, and that includes their faeces, for potential, say, hookworms that may be drug resistant, tapeworms like Echinococcus, you know, hugely important to know if they're present, so yeah. Excellent. And I think we got all the questions answered.
We've got only 2 minutes to wrap up. So thanks so much for all the viewers for attending and for SCB UK and Ireland for sponsoring the webinar, for the webinar for hosting us. A special thanks to Dr.
Wright for sharing his expertise and this emerging process, which apparently compromised the health and welfare of pet animals. I hope the session has been informative. I believe so.
The recording of the webinar and the CBD certificates will be available in 24 hours' time. If you have any additional questions, please feel free to reach out to us. We look forward to welcoming you for future webinars and continuing these important discussions.
Thanks so much. I wish you a good afternoon. Thank you very much.
Thank you.
