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UNTIL relatively recently in the UK, Angiostrongylus vasorum appeared to be restricted to patches or hotspots in Cornwall (Martin and Neal 1992) and south Wales (Trees 1987), each just a few miles in diameter, within which the parasite was common in foxes and a frequent cause of disease in dogs. Elsewhere, infection was unknown. As the parasite spread to the southeast of England (Chapman and others 2004) and beyond, it took some time for it to appear on the radar of practitioners, and many dogs undoubtedly suffered because unusual presentations were not easily recognised in hitherto uncolonised areas. A vasorum was dubbed a ‘real heartbreaker’ (Morgan and others 2005), to emphasise the potentially tragic outcome when acutely presenting cases of dyspnoea, neurological disease or bleeding disorders went undiagnosed until it was too late. Just two years after that paper was published, a follow-up review reflected an alternative view; that the parasite had become a ‘bleeding nuisance’ (McEniry and others, 2007). Many vets in general practice were by then all too aware of the disease, but doubted that it was present or particularly frequent in their area, and questioned whether apparent spread was in fact driven by a cycle of increasing awareness. Most inconveniently, well-established worming regimes were challenged by the apparent emergence of a deadly infection, one of very few …
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