Imported Infectious Diseases

Question 1

What do all pets need before entry into the UK?

Answer 1

Pet passport
Microchipping (before or at same time as rabies vaccination)
Vaccination against rabies (min. age 12 weeks)
Must travel using approved transport company, on an authorised route

Question 2

What are the rabies requirements for UK entry?

Answer 2

Travel from EU or listed country = rabies vaccination, wait 21 days, entry allowed
Travel from non-listed country = rabies vaccination, >30 days blood sample to check rabies Ab levels, wait 3 months, entry allowed

Question 3

What are the tapeworm requirements for UK entry?

Answer 3

Dogs - treatment 1-5 days before returning to UK, administered by vet, no requirement from some countries
Praziquantel or other drug with proven efficacy

Question 4

How do we manage ticks on pets?

Answer 4

Daily check and remove
Long-acting collars
Flumethrin/imidacloprid
Long-lasting oral tablets (1-3 months)
Spot-on products

Question 5

How do we manage flies/mosquitoes around pets?

Answer 5

House indoors during dawn/dusk
Fine mesh screens
Insect repellents

Question 6

Describe infection with Leishmania infantum.

Answer 6

Intracellular protozoan parasite
Vector-borne (sandflies)
Rarely seen in untravelled dogs
Long incubation period (years)
Zoonotic potential

Question 7

What clinical findings do we see with Leishmania infection?

Answer 7

Dermatological lesions
Enlarged lymph nodes and spleen
Secondary complications (kidney/joint/eye disease, any organ)
Lethargy, inappetence, pyrexia

Question 8

How do we diagnose Leishmania?

Answer 8

Cytology (/histopathology)
PCR
Serology (indicates exposure/prior vaccination)

Question 9

How do we treat Leishmania?

Answer 9

First month = daily meglumine antimonate (subcut injections) or miltefosine (oral liquid)
Allopurinol (daily tablets) for 6-12 months
Manage complications e.g. kidney disease
Regular monitoring
Rarely eliminate organism, but aim for clinical improvement

Question 10

How do we prevent Leishmania?

Answer 10

Do not travel!
Vector (sandfly) control
Leisguard
Vaccination (does not prevent disease, ideally not in previously exposed/infected dogs)

Question 11

What are the 3 species of tick-borne disease?

Answer 11

Babesia spp.
Ehrlichia spp.
Anaplasma spp.

Question 12

Describe Anaplasma/Ehrlichia infection.

Answer 12

Tick-borne intracellular bacteria (neutrophils, platelets, monocytes)
Dogs > cats
Global/patchy distribution

Question 13

What are the clinical signs on Anaplasma/Ehrlichia infection?

Answer 13

Asymptomatic carriage / severe clinical disease
Thrombocytopenia
Ehrlichia can also cause pancytopenia, severe multisystemic disease

Question 14

How can we diagnose Anaplasma/Ehrlichia infection?

Answer 14

Cytology
PCR
Serology
Snap 4DX (Anaplasma Ab, Ehrlichia Ab, Borrelia Ab, Dirofilaria Ag)

Question 15

What is the treatment for Anaplasma/Ehrlichia infection?

Answer 15

Doxycycline (2-4 weeks)

Tick control

Question 16

Describe Babesia infection.

Answer 16

Intraerythrocytic protozoan parasite
Large and small species
Tick-borne +/- iatrogenic (transfusions), dog fighting
Global distribution

Question 17

What are the clinical features of Babesia infection?

Answer 17

Dogs >> cats
Haemolytic anaemia +/- pigmenturia +/- jaundice
Thrombocytopenia (very common)
Splenomegaly
Multiorgan failure and death

Question 18

How can we diagnose Babesiosis?

Answer 18

Cytology - blood smear assessment (poor sensitivity)
PCR
Serology (IFA)

Question 19

How do we treat and prevent Babesiosis?

Answer 19

Drug of choice depends on Babesia subspecies
+/- supportive management e.g. blood transfusions
Prevention = tick control

Question 20

Describe Dirofilaria immitis infection.

Answer 20

Heartworm!
Dogs&raquo_space;> cats
L5 in pulmonary arterial system = right-sided heart failure

Question 21

What are the clinical features of Dirofilariasis?

Answer 21

Asymptomatic carriage
Exercise intolerance
Coughing, tachypnoea/dyspnoea, lethargy

Question 22

How do we diagnose Dirofilariasis?

Answer 22

Microfilarial (L1) detection - blood smears etc.
In-clinic point-of-care ELISA (adult female Ag)
Imaging - chest X-rays, echocardiography
Snap 4DX (Anaplasma Ab, Ehrlichia Ab, Borrelia Ab, Dirofilaria Ag)

Question 23

How do we treat Dirofilariasis?

Answer 23

By a specialist veterinary cardiologist
Drugs to kill adult worms (L5) and microfilariae (L1)
+/- surgical retrieval
High risk of thromboembolic events/death

Question 24

How do we prevent Dilofilariasis?

Answer 24

In endemic countries, monthly prevention (arrests L3/L4 development) - start 1 month before travel
Vector (mosquito) management