Eosinophilic meningitis in New Caledonia: The role of Angiostrongylus cantonensis?

Abstract

Introduction Eosinophilic meningitis is a rare form of meningitis with sequelae or death occurring in approximately 2–3% of cases. The most frequent etiological agent is the parasite Angiostrongylus cantonensis. The aim of this study was to characterize New Caledonian cases and to assess the extent to which of A. cantonensis was involved. Material and methods We performed a retrospective study of all cases of eosinophilic meningitis (EM) admitted to the Territorial Hospital of New Caledonia, from 2004 to 2019. We performed a descriptive and a multivariate analysis to identify association of variables with severe and fatal cases (or cases with sequelae). Conclusion Angiostrongyliasis was confirmed as being responsible for 17 of the 92 reported EM cases in New Caledonia from 2004 to 2019 with most being young adults and non-walking infants, and with two peaks of incidence one during the dry season and one during the rainy season. Considering the high incidence and regularity of cases, the potential reservoirs should be identified to target prevention campaigns.

Paratenic hosts of Angiostrongylus cantonensis and their relation to human neuroangiostrongyliasis globally

“… USA Experimentally Primary: [ 76 ] Secondary: [ 105 , 106 ] Crabs Birgus latro (coconut crab) Saipan Experimentally Primary: [ 67 ] Secondary: [ 3 , 4 , 7 , 17 , 47 , 51 , 75 , 77 , 102 , 103 , 107 , 108 ] Tuerkayana hirtipes (as “ Cardisoma ” hirtipes or Ocypode spp.) (land crab) Saipan Naturally Primary: [ 67 , 69 ] Secondary: [ [3] , [6] , [7] , [17] , [19] , [23] , [51] , [53] , [59] , [61] , [62] , [63] , [71] , [74] , [75] , [76] , [77] , [92] , [103] , [108] , [109] ] Scylla serrata (mangrove crab) Pohnpei Assumed Primary: [ 67 ] Secondary: [ 3 , 7 ...…”

“…(land crab) Saipan Naturally Primary: [ 67 , 69 ] Secondary: [ [3] , [6] , [7] , [17] , [19] , [23] , [51] , [53] , [59] , [61] , [62] , [63] , [71] , [74] , [75] , [76] , [77] , [92] , [103] , [108] , [109] ] Scylla serrata (mangrove crab) Pohnpei Assumed Primary: [ 67 ] Secondary: [ 3 , 7 , 17 , 19 , 47 , 51 , 71 , 77 , 103 ] Land planarians (flatworms) Kontikia forsterorum (as “ Geoplana ” forsterorum ) New Caledonia Naturally Primary: [ 110 ] Secondary: [ 6 , 17 , 20 , 23 , 61 , 62 , 103 , 107 , 108 ] Endeavouria septemlineata (as “ Geoplana ” septemlineata ) …”

Re-Emerging, Under-Recognized Zoonotic, and Neglected Tropical Diseases in Hawaiʻi

“…evidence-based guidelines for managing NAS (87, 88). After the guidelines were published, it was then disseminated to different public health sectors in Hawaiʻi where researchers, clinicians, veterinarians, and public health officials spearheaded a workshop in Hilo, Hawaiʻi for the management and treatment of NAS, which is not only a serious public health concern in Hawaiʻi, but also in other countries such as Tahiti, New Caledonia, Australia, and Japan (132)(133)(134).…”

Emerging and Re-Emerging Parasitic Infections of the Central Nervous System (CNS) in Europe

“…Diagnosing angiostrongyliasis often involves a combination of clinical evaluation, examination of cerebrospinal fluid, and imaging studies such as MRI. The presence of eosinophilia and evidence of inflammation in the CNS can support the diagnosis [65]. Treatment may include supportive care to manage symptoms and reduce inflammation [63].…”

“…The epidemiology of Angiostrongylosis in Europe has been demonstrated through reported cases in various countries including France, Germany, the Netherlands, Switzerland, Belgium, Croatia, Italy, Spain, and the United Kingdom [59] (Table 2). In New Caledonia, a retrospective study of eosinophilic meningitis cases revealed that 17 out of 92 cases were confirmed as angiostrongyliasis between 2004 and 2019, predominantly affecting young adults and non-walking infants [65].…”