![]() Infections in Serbia and Croatia have increased from sporadic to occurring. ![]() But cases have also been reported from Hungary, Slovakia and Czech Republic. In Europe, heartworm still appears to be more confined, for the most part, to southern European countries like Portugal, Spain, France, Italy, Slovenia, Bulgaria, Romania, Greece and Turkey. Once a reservoir of microfilaraemic domestic and feral canids is established beyond the reach of veterinary care, eradication becomes much more difficult. Major reasons for this dramatic development have been attributed to the increased transport of dogs from southern areas for hunting and breeding, the movement of dogs belonging to army personnel and to normal citizens and the burgeoning wild canids population, like the Californian coyote. In a matter of 50 years, the disease spread from a well restricted south-eastern coastal area of the United States to the point where it is considered now that heartworm is at least regionally endemic in each of the contiguous 48 states, Hawaii, Puerto Rico, US Virgin Islands, and Guam, as well as in most of the Canadian provinces. In the USA, the spread of the heartworm disease was monitored extensively over the last years. Dirofilaria immitis and its clinical aspect, heartworm disease, can be found in tropical and temperate regions of the world, with the highest known prevalence in the USA, South America, Japan, Australia and Italy.
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