Abdominal pain secondary to neuroinvasive Angiostrongylus cantonensis; first European case. Some reflections on emerging parasitosis

What do we know about Angiostrongylus cantonensis in Spain? Current knowledge and future perspectives in a globalized world

Angiostrongylus cantonensis is an important emerging and zoonotic nematode that has been reported worldwide since its first description in Asia 86 years ago. Among places where this parasite has been recently described, insular regions of northwest Africa seem to be particularly relevant. We performed a systematic review in scientific databases to search and extract information about all reports describing cases of A. cantonensis in Spain until July 2021. As a result, seven surveys about the presence of this pathogen in Spanish insular regions were found, especially in the Canary Islands, as well as a non-autochthonous report of A. cantonensis in the mainland Spain. The lack of reliable information about the presence or absence of this nematode in the Iberian Peninsula highlights the need for further studies concerning this emerging pathogen since rodents acting as competent definitive hosts of A. cantonensis are widely distributed in the mainland. Moreover, the high maritime traffic daily registered in Spanish ports could be a main entrance pathway for A. cantonensis or its intermediate hosts in the country due to the frequent and direct connection between these points and regions where this pathogen is endemic. We encourage to focus further efforts on investigating the current epidemiological situation of A. cantonensis in the Iberian Peninsula, just as in other Mediterranean countries with similar epidemiological, ecological and geographical characteristics. In this sense, the relevant implications of this parasite for animal and public health make necessary to act integrating different viewpoints under the One Health perspective.