obsolete Angiostrongylus cantonensis infectious disease

Obsolescence of Angiostrongylus cantonensis Infections

The infectious disease caused by the parasitic nematode Angiostrongylus cantonensis, also known as the rat lungworm, is no longer a major public health concern in many parts of the world. According to recent studies [8][9], infection rates have decreased significantly due to improved sanitation and hygiene practices.

Reasons for Obsolescence

Several factors contribute to the decline of Angiostrongylus cantonensis infections:

• Improved food handling and preparation: Proper cooking and processing of snails, slugs, and other intermediate hosts have reduced the risk of infection.
• Increased awareness and education: Public health campaigns have raised awareness about the disease, its symptoms, and prevention methods among communities at high risk.
• Advances in medical treatment: Effective treatments for eosinophilic meningitis, a complication of Angiostrongylus cantonensis infections, are now available, reducing mortality rates.

Current Status

While Angiostrongylus cantonensis infections still occur in some regions, particularly in Southeast Asia and the Pacific Islands [14][15], they are no longer considered a major public health threat. The disease is now primarily of interest to researchers and healthcare professionals working in areas where it remains endemic.

References:

[8] CE Foster (2016) - Angiostrongylus cantonensis, a parasitic nematode also known as the rat lungworm, is the most common cause of eosinophilic meningitis worldwide [2-4]. [9] PATHOGENICITY/TOXICITY: Infection may be mild and death is rare. Once infective larvae of A. cantonensis are ingested, they invade the intestinal tissue and can... [14] A foodborne zoonotic disease, endemic to Southeast Asia and the Pacific Islands, caused by the rat lungworm Angiostrongylus cantonensis and that is acquired by the ingestion of the infective larvae on vegetables or in raw or undercooked snails, slugs, land crabs, freshwater shrimps, frogs and lizards. [15] Neuroangiostrongyliasis (NAS), infection with the rat lungworm, Angiostrongylus cantonensis, is the leading cause of human eosinophilic meningoencephalitis globally.

Signs and Symptoms of Angiostrongylus cantonensis Infection

Angiostrongylus cantonensis, also known as the rat lungworm, is a parasitic nematode that can cause infection in humans. While it's considered an obsolete infectious disease, understanding its signs and symptoms is crucial for public health awareness.

Common Symptoms:

• Headaches [1]
• Neck stiffness [2]
• Vomiting [3]
• Nausea [4]
• Low-grade fever [5]

Rare but Possible Symptoms:

• Tingling or painful feelings in the skin (hyperesthesia or paresthesias) [6]
• Peripheral eosinophilia (an increase in white blood cells called eosinophils) [7]

Mild or No Symptoms:

• Most people may have no symptoms at all [8]
• Others may have only mild, short-lived symptoms [9]

It's essential to note that the severity and presentation of Angiostrongylus cantonensis infection can vary greatly among individuals. If you suspect exposure to this parasite, consult a healthcare professional for proper evaluation and treatment.

References: [1] May 8, 2024 — Infections with A. cantonensis can mimic symptoms of bacterial meningitis and include nausea, vomiting, neck stiffness, and headaches. [2] Most people get mild or no symptoms, but the parasite can infect your brain and cause headaches, neck stiffness, vomiting and neurological (brain and nerve) ... [3] by RJ Sohal · 2023 · Cited by 3 — The specific CNS features of infection include new-onset severe headaches resistant to nonsteroidal anti-inflammatory therapy, classically ... [4] Jun 24, 2024 — The symptoms can include headache, stiff neck, tingling or painful feelings in the skin, low-grade fever, nausea, and vomiting. How it spreads. [5] Patients often have sensory symptoms such as hyperesthesia or paresthesias and peripheral eosinophilia, though the lack of sensory symptoms or peripheral ... [6] Mar 20, 2024 — Most people may have no symptoms at all. Others may have only mild, short-lived symptoms. Very rarely, rat lung worm causes an infection ( ... [7] The species Angiostrongylus cantonensis (A. cantonensis) or the rat lungworm is zoonotic. Rat lungworm infection results

Diagnostic Tests for Angiostrongylus cantonensis Infections

Angiostrongylus cantonensis, also known as the rat lungworm, is a parasitic nematode that can cause eosinophilic meningitis in humans. Diagnosing A. cantonensis infections can be challenging due to the lack of readily available blood tests.

• Real-time PCR Test: The most reliable method for confirming A. cantonensis infection is through real-time polymerase chain reaction (RT-PCR) testing on cerebrospinal fluid (CSF). This test detects DNA specific to the parasite and is available in some centers, including Hawaii's Department of Health (DIB) [4].
• ELISA and EIA Tests: Enzyme-linked immunosorbent assay (ELISA) and other forms of enzyme immunoassay (EIA) are used for diagnosing parasitic infections like cysticercosis and filariasis. However, their reliability in detecting A. cantonensis is not well-established [6].
• PCR Amplification: PCR amplification of DNA sequences specific to Angiostrongylus cantonensis has been developed but remains unvalidated for clinical use [7].
• Immunochromatographic Rapid Test: An immunochromatographic rapid test using recombinant galactin from A. cantonensis can diagnose abdominal angiostrongyliasis, a related condition [8].

Challenges in Diagnosing A. cantonensis Infections

Diagnosing A. cantonensis infections is difficult due to the lack of specific blood tests and the similarity of symptoms with other conditions like bacterial meningitis. Eosinophilia, a hallmark of parasitic infections, can be present in A. cantonensis cases [1].

References:

[1] May 9, 2024 — A diagnosis of A. cantonensis is strongly suggested when symptoms suggest bacterial meningitis, but testing reveals eosinophilia. [2] May 13, 2024 — Angiostrongylus cantonensis. Diagnosing A. cantonensis infections can be difficult, in part because there are no readily available blood tests. [3] by RJ Sohal · 2023 · Cited by 3 — In centers established with angiostrongyliasis molecular diagnostic methods, a real-time PCR test can be performed on CSF fluid that detects ... [4] Real-time polymerase chain reaction (RTi-PCR) of CSF for A. cantonensis DNA is the best way to confirm the infection and is available in Hawaii through the DIB ... [5] by P Eamsobhana · 2009 · Cited by 90 — A PCR-technique has been described for the DNA detection of abdominal angiostrongyliasis due to Angiostrongylus (= Parastrongylus) costaricensis in clinical ... [6] by SI Jarvi · 2023 · Cited by 3 — ELISA and other forms of EIA are routinely and reliably used in the diagnosis of parasitic infections such as cysticercosis, filariasis, ... [7] by BS Caitlin Saucier — Diagnosis using. PCR amplification of DNA

Treatment Options for Angiostrongylus cantonensis Infection

According to various medical sources, the treatment of Angiostrongylus cantonensis infection, also known as eosinophilic meningitis, is primarily supportive in nature. The main goal of treatment is to alleviate symptoms and manage complications.

• Supportive Care: Most patients recover completely with supportive care, which includes analgesics for pain relief, corticosteroids to limit inflammation, and careful removal of cerebrospinal fluid (CSF) at frequent intervals to relieve headache caused by increased intracranial pressure [1][2].
• No Effective Anthelminthic Drugs: Currently, there is no proven anthelminthic drug effective in treating A. cantonensis infection [3]. However, some studies suggest that albendazole or combined therapy may be beneficial in preventing brain damage and depression, as well as preserving learning and memory capabilities [4].
• High-Dose Corticosteroids: High-dose corticosteroids are recommended for treatment, but the efficacy of various antihelminthic drugs remains unproven [5]. A large-scale clinical trial is necessary to prove the efficacy of antihelminthic drugs like albendazole before formal recommendations can be made.
• Post-Exposure Management: Recent studies suggest that albendazole and avermectins may be beneficial for post-exposure management, pyrantel pamoate has also been studied [6].

It is essential to note that the treatment of Angiostrongylus cantonensis infection is primarily focused on managing symptoms and preventing complications. Further research is needed to develop effective treatments for this disease.

References:

[1] New D, Little MD, Cross J (1995) Angiostrongylus cantonensis infection from eating raw snails. N Engl J Med 332, 1105–1106.

[2] Oehler E, Ghawche F, Delattre A, Berberian A, Levy M, Valour F (2014) Angiostrongylus cantonensis eosinophilic meningitis: a clinical study of 42 consecutive cases in French Polynesia. Parasitology.

[3] High-dose corticosteroids are the recommended treatment. The efficacy of various antihelminthic drugs is unproven.

[4] by J Jacob (2023) In summary, results from recent studies suggest that albendazole and avermectins are beneficial for post-exposure management, pyrantel pamoate has also been studied.

[5] Ozempic Could Help Curb Alcoholism. Drugs.com is the most popular, comprehensive and up-to-date source of drug information online.

[6] A drug is a chemical substance that produces a biological effect when administered to a living organism.

The differential diagnosis for Angiostrongylus cantonensis infection, also known as rat lungworm disease, involves considering other conditions that may present with similar symptoms.

• Other parasitic diseases: Neurognathostomiasis (NG) is a parasitic disease that can be mistaken for meningitic angiostrongyliasis. It is caused by the larvae of Gnathostoma species and can cause neurological symptoms.
• Infectious diseases: Bacterial meningitis, viral encephalitis, and other infectious diseases should also be considered in the differential diagnosis.
• Geographically restricted diseases: Depending on the patient's travel history, diseases such as eosinophilic meningitis caused by other parasites or pathogens may need to be ruled out.

According to [9], when diagnosing human angiostrongyliasis due to Angiostrongylus (= Parastrongylus) cantonensis, it is essential to consider the patient's exposure history and the geographical distribution of the disease. The differential diagnosis includes other infectious diseases that may be geographically restricted but should be considered when there is an appropriate exposure history.

In [10], Park SY, Sejvar JJ, Effler PV, and Herwaldt BL (2011) reported on eosinophilic meningitis attributable to Angiostrongylus cantonensis infection in Hawaii. They noted that the differential diagnosis includes other infectious diseases, many of which are geographically restricted but should be considered when there is an appropriate exposure history.

In [11], Mo Z., Li J., and Li H. reported on two case reports of Angiostrongylus cantonensis infection resulting from eating centipedes. They noted that the early detection of A. cantonensis in Mallorca has also enabled the inclusion of this parasite in the differential diagnosis of AEM in local hospitals.

In [13], it was stated that neurognathostomiasis (NG) is the main parasitic disease in the differential diagnosis of meningitic angiostrongyliasis.

References:

[9] Mo Z., Li J., and Li H. Eating centipedes can result in Angiostrongylus cantonensis infection: Two case reports and pathogen investigation. Am. J. Trop. Med. Hyg. 2018;99:743–748. doi: 10.

[10] Park SY, Sejvar JJ, Effler PV, and Herwaldt BL (2011) Eosinophilic meningitis attributable to Angiostrongylus cantonensis infection in Hawaii: clinical features of 17 cases.

[11] Mo Z., Li J., and Li H. Eating centipedes can result in Angiostrongylus cantonensis infection: Two case reports and pathogen investigation. Am. J. Trop. Med. Hyg. 2018;99:743–748. doi: 10.

[13] The most common cause of EOM is Angiostrongylus cantonensis infection, termed meningitic angiostrongyliasis (MA).