Emerging Angiostrongyliasis in Mainland China

Abstract

Our review of angiostrongyliasis in China found that the disease is emerging as a result of changes in food consumption habits and long-distance transportation of food. Enhanced understanding of angiostrongyliasis epidemiology, increased public awareness about the risks associated with eating raw food, and enhanced food safety measures are needed.

Eosinophilic Meningitis Attributable to Angiostrongylus cantonensis Infection in Hawaii: Clinical Characteristics and Potential Exposures

“…LPs were performed a median of 7 days after symptom onset. In the CSF, the median WBC was 637 cells/mm 3 , the median eosino phil percentage was 33% ( Table 1 ), and the median absolute eosinophil count was 177 cells/mm 3 . For case-patients with available data, the median glucose level was 46.5 mg/ dL, and 8 of 16 (50%) case-patients had hypoglycorrhachia; the median protein level was 110 mg/dL, and the value was elevated for 14 of 15 (93%) case-patients.…”

“…23 In brief, we carried out a retrospective review of CSF data provided by clinical laboratories in Hawaii for all lumbar punctures (LPs) performed at 22 of Hawaii's 24 acute care hospitals from January 2001 to February 2005. Eosinophilic meningitis was defined as the presence of ≥ 6 white blood cells (WBC) per mm 3 and either an eosinophil percentage of ≥ 10% or an absolute eosinophil count of ≥ 10/mm 3 in the CSF. 2 For each of six persons with multiple LPs, the LP with the highest absolute eosinophil count was included in the analyses.…”

“…1,2 Individual cases and outbreaks of infection with this nematode have been reported for years in endemic areas of Southeast Asia and the Pacific Rim (e.g., China, Taiwan, Thailand, and the Pacific Islands) and travelers returning from endemic areas. [3][4][5][6] In the United States, angiostrongyliasis is endemic in Hawaii; one human case was reported in New Orleans, LA. 7 A. cantonensis is becoming more widespread in the world, in part because of ship-borne transport of rats and introduction of non-native snails/slugs.…”

“…7 A. cantonensis is becoming more widespread in the world, in part because of ship-borne transport of rats and introduction of non-native snails/slugs. 3,4,8,9 Humans become infected by ingesting third-stage larvae in intermediate hosts (slugs and snails) or transport hosts (e.g., freshwater crustaceans). Although intentional consumption of snails/slugs is common in certain cultures, in areas like Hawaii, such practices may be less customary.…”

Prevalence and distribution of Angiostrongylus cantonensis (Nematoda, Angiostrongylidae) in Achatina fulica (Mollusca, Gastropoda) in Baixada Santista, São Paulo, Brazil

“…In Brazil, the occurrence of A. cantonensis has been reported in all states except for Acre [9][10][11][12][13][14][15][16][17] . Man, being an accidental host, acquires parasitosis when eating foods contaminated with stagethree larvae (L3), raw or undercooked mollusks, and paratenic hosts such as shrimp, frogs, fish, and flatworms 4,[18][19][20] , as well as crabs and lizards 21,22 . In humans, these parasites migrate to the central nervous system (CNS), where they die in the meninges, causing inflammatory reactions 23 24 .…”