4.2. Within-rat parasite community/coinfections
The studied rats presented a rich and varied within-host parasite community, most remarkably being that 19 infrapopulations were found in only 14 rats, 14 of these parasite species being potentially zoonotic parasites, posing a possible risk of transmission to the human population with which the rats coexist.
The
A. cantonensis-infected rats captured in the sewers presented the greatest parasite species richness, as only the stomach nematode
Mastophorus muris and the microsporidian
E. bieneusi were not found (
Table 2 and
Table 3).
All components of the parasite community were found in rats trapped in spring (10/14). Only two rats captured in autumn and two in winter were found to be infected by A. cantonensis, so the absence of certain parasites in these individuals cannot be discussed.
Except for the microsporidian
Encephalitozoon hellem, all other parasite species, 18, were found in the 10
R. norvegicus infected by
A. cantonensis and 12 different infrapopulations were found in only four individuals of
R. rattus (
Table 1).
Only the 10
A. c
antonenesis-infected
R. norvegicus analyzed in this study presented a richer parasite community than the 100 Norway rat individuals we previously studied in Barcelona [
6,
7,
10], without even considering the microsporidians and
T. gondii, which were not investigated in the Barcelona rats.
Concerning coinfections, there was no case of monoparasitism among the studied rats. Adult
A. cantonensis-infected
R. norvegicus harbored from 6 to 12 different infrapopulations in the same individual. The case of one adult
R. norvegicus that harbored representatives of protists, trematodes, cestodes, nematodes as well as acanthocephalans in the intestine, most of the helminths with high parasite loads (
Table 2,
Rn IX), is remarkable. Also noteworthy is the case of one juvenile Norway rat harboring 57 individuals of
A. cantonensis (26 males and 31 females) in the pulmonary arteries as well as high burdens of
C. hepaticum infecting the liver (
Table 2,
Rn X). Both rats were trapped in the sewer system.
When analyzing the parasite community/coinfections found and the transmission routes, in the case of the monoxenous protists and microsporidia, rats become infected by the fecal/oral transmission route directly throughout the ingestion of cysts/oocysts/spores contaminating the environment, in particular the sewer system, and orchards which are not normally irrigated with safe or potable water.
The presence of T. gondii in the rats may also be related to contamination by oocysts from cat feces or by cannibalism, a common occurrence in cases of limited food supply. The absence of the usual amount of food on the streets, due to the lockdown and the closure of restaurants during the pandemic, could have led to an increase in cannibalism that favored the T. gondii life cycle.
Considering the helminth parasites, 7 worms presented an indirect or heteroxenous life cycle and 5 had a monoxenous or direct cycle (
Table 1). In the case of
H. nana, the parasite is able to complete its life cycle either with the intervention of an arthropod intermediate host harboring the larval stage (cysticercoid) (heteroxenous life cycle) or without the intervention of any intermediate host but directly inside the intestine of the definitive host (monoxenous life cycle). Only one
R. norvegicus presented a high
H. nana load (
R.n. IX in
Table 2), suggestive of the monoxenous-type cycle.
Among the monoxenous helminths, eggs shed in feces (or urine in the case of
Trichosomoides crassicauda) are infective for the rats once the eggs embryonate in the soil. To become infected by
C. hepaticum, a nematode that lives in the liver parenchyma, rats must also ingest the eggs that contaminate the environment. However, in this case, as the eggs are trapped in the liver, the rat must die in order to release the eggs which mature in the soil. It is noteworthy that all the 10
R. norvegicus were infected by
C. hepaticum (
Table 2). This could indicate an increase in rat mortality during the pandemic period that ultimately favored cannibalism, leading to the release of eggs into the environment enhancing the life cycle of
C. hepaticum, as in the case of
T. gondii.
In the case of
Nippostrongylus brasiliensis (a murine model of
Necator americanus), the larvae penetrate the skin of rats, or may also be ingested from the soil, and after molting and maturing in the lungs, reach the small intestine. The eggs are released in feces and hatch in the soil releasing the L1 larvae which become infective after molting. The nematode was found in almost all Norway rats at high burdens (
Table 2). Exceptionally, two of them (VIII and IX) harbored hundreds and hundreds of
N. brasiliensis. It is hard to believe that this life cycle does not include processes of autoinfection and that the extraordinary number of adults in the intestine is due to repeated infections.
For heteroxenous life cycles, rats must ingest the eggs of Hydatigera taeniaeformis shed in cat (definitive host) feces. Rats act as intermediate hosts harboring the metacestode (strobylocercus) in the liver parenchyma. Cats are the only predator that rats have in cities, completing the biological cycle. Several rats harbored both H. taeniaeformis and T. gondii, parasites that share a common infection route, i.e., cat feces.
To become infected by Brachylaima spp. and A. cantonensis, rats must ingest infected snails (also slugs or paratenic hosts in the case of the rat lungworms). Two Norway rats were coinfected by both helminths, leading to the hypothesis that these two parasites could have shared a snail as intermediate host.
For the rest of the heteroxenous helminths, intermediate hosts involve arthropods, mainly beetles for H. diminuta and cockroaches for Mastophorus muris, G. neoplasticum and M. moniliformis, with arthropods being an important element of the rat diet.
In terms of the host microhabitats for which the worms might compete,
A. cantonenesis (adults, eggs and L1 larvae) and
N. brasiliensis larvae (L3 and L4) share the same microhabitat, i.e., the lungs. In this regard, 8 of the 10
R. norvegicus and one
R. rattus harbored both species (
Table 2 and 3), so they do not appear to be competitors, at least in the studied rats. Likewise, 6 rats harbored
A. cantonensis and
T. gondii, parasites that share the brain as microhabitat at a particular time of their life cycles.
The liver was also coinfected by the tapeworm larvae of
H. taeniaeformis and
C. hepaticum in 3
R. norvegicus, while the small intestine presented the greatest species richness, namely up to 5 different ones (
Table 1).
N. brasiliensis always occupies the first part of the small intestine, the duodenum, while the remaining helminths (
Hymenolepis spp.,
Brachylaima and
M. moniliformis) are usually located in the jejunum and ileum.
As far as we are aware, only one case of coinfection has been published so far between a species of
Angiostrongylus (
A. chabaudii) and another parasite, specifically
Dirofilaria immitis, in the definitive host
, in this case in a wildcat [
15]. Therefore, this study exposes, for the first time, the range of macro-, as well as micro-parasites (excluding bacteria and viruses), with which
A. cantonensis can coexist in its definitive hosts in urban/periurban environments.
4.3. Host resistance or tolerance?
Hosts which are ubiquitous, like rats, are more likely to become coinfected, as are hosts that occupy different ecological niches in which several parasites are present [
16]. Consequently, rats which flourish in a wide range of environmental conditions, like sewers, parks and gardens and orchards in this particular case, are exposed to a greater diversity of parasites. Once infected, hosts use two strategies to cope with their parasites: resistance or tolerance [
17]. Hosts can, by different mechanisms, reduce parasite burdens (resistance) or they can minimize the damage caused by the parasite load (tolerance).
Angiostrongylus cantonensis was experimentally shown to cause a 10-20% mortality in R. norvegicus [
18]. Also, an experimental study on parasite tolerance showed that mortality is related to the number of larvae of the rat lungworm used to infect rats [
19]. However, it is difficult to know how to extrapolate these findings based on laboratory rats - not infected by any other parasite - to understand the consequences of coinfection in nature. Although we are aware of the limited number of rats studied, the total predominance of coinfected rats as well as their high parasite loads, seem to indicate a clear trend towards parasite tolerance.
In addition, coinfections can have negative effects on the host accelerating its mortality or, otherwise, coinfections can have positive effects on the host reducing its mortality [
20]. In this context, it seems clear that if at some point coinfections led to an increase in the mortality rate of the urban rat populations in Valencia, those populations that survived, considering their high reproductive capacity, may have given rise to tolerant populations that justify these high prevalences, parasite loads, and coinfections found in this study.