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Mendonça CLF, Caldeira RL, Carvalho OS, D'ávila S, Gomes SR. Semperula wallacei (Mollusca, Veronicellidae) um hospedeiro natural recém-descoberto de Angiostrongylus cantonensis (Nematoda, Angiostrongylidae) na Bacia do Pacífico. J Helminthol 2024; 98:e7. [PMID: 38225903 DOI: 10.1017/s0022149x23000809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
Semperula wallacei (Issel, 1874) is a species of terrestrial slug that occurs in southeast China and the Pacific Basin and is the only species of its genus that occurs beyond the Oriental region and to the east of Wallace's line in the Australian region, where it has probably been introduced. In this study, we report for the first time S. wallacei as an intermediate host for Angiostrongylus cantonensis (Chen, 1935) based on histological and molecular analyses of slugs from Tuamasaga, Samoa, deposited at the Medical Malacological Collection (Fiocruz-CMM). DNA was obtained from the deparafinized tissues scraped from specimen slides. Polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) targeted to the internal transcribed spacer 2 (ITS2) region were carried out using the restriction enzyme Cla I. The RFLP profile observed for our larval specimen of S. wallacei was identical to the profile previously established for A. cantonensis, demonstrating that S. wallacei can be naturally infected with A. cantonensis and is likely to be an intermediate host for this parasitic nematode species in the field. The potential for geographical range expansion of S. wallacei in the Pacific Basin, its small size, and the general role of veronicellids as crop pests and hosts of nematodes, indicate the significance of S. wallacei as an invasive species in the Pacific Basin. Our work also highlights the importance of biological collections for investigating the environmental impact of invasive species on agriculture, public health, and biodiversity conservation.
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Affiliation(s)
- C L F Mendonça
- Coleção de Malacologia Médica, Instituto René Rachou/FIOCRUZ, Brazil
- Laboratório de Helmintologia e Malacologia Médica, Instituto René Rachou/FIOCRUZ, Brazil
- Instituto de Ciências Biológicas e da Saúde, Pontifícia Universidade Católica de Minas Gerais, Brazil
| | - R L Caldeira
- Coleção de Malacologia Médica, Instituto René Rachou/FIOCRUZ, Brazil
- Laboratório de Helmintologia e Malacologia Médica, Instituto René Rachou/FIOCRUZ, Brazil
| | - O S Carvalho
- Laboratório de Helmintologia e Malacologia Médica, Instituto René Rachou/FIOCRUZ, Brazil
| | - S D'ávila
- Museu de Malacologia Prof. Maury Pinto de Oliveira, Universidade Federal de Juiz de Fora, Brazil
| | - S R Gomes
- Laboratório de Malacologia, Instituto Oswaldo Cruz/FIOCRUZ, Brazil
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Solórzano Álava L, Bedoya Pilozo C, Hernandez Alvarez H, Rojas Rivera L, Rodriguez Ortega M, Fraga Nodarse J, Pereira LDM, Simões RDO, Vilela RDV. In the Dawn of an Early Invasion: No Genetic Diversity of Angiostrongylus cantonensis in Ecuador? Pathogens 2023; 12:878. [PMID: 37513725 PMCID: PMC10384297 DOI: 10.3390/pathogens12070878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/30/2023] [Accepted: 05/01/2023] [Indexed: 07/30/2023] Open
Abstract
The nematode Angiostrongylus cantonensis has been reported worldwide. However, some basic questions remain unanswered about A. cantonensis in Ecuador: (1) Was the invasion of A. cantonensis in Ecuador unique, or did it occur in different waves? (2) Was this invasion as recent as historical records suggest? (3) Did this invasion come from other regions of South America or elsewhere? To address these issues, we assessed the genetic diversity of MT-CO1 gene sequences from isolates obtained in 11 of Ecuador's 24 provinces. Our Bayesian inference phylogenetic tree recovered A. cantonensis as a well-supported monophyletic group. All 11 sequences from Ecuador were identical and identified as AC17a. The haplotype AC17a, found in Ecuador and the USA, formed a cluster with AC17b (USA), AC13 (Thailand), and AC12a-b (Cambodia). Notably, all the samples obtained in Ecuadorian provinces' different geographic and climatic regions had no genetic difference. Despite the lack of genetic information on A. cantonensis in Latin America, except in Brazil, our finding differs from previous studies by its absence of gene diversity in Ecuador. We concluded that the invasion of A. cantonensis in Ecuador may have occurred: (1) as a one-time event, (2) recently, and (3) from Asia via the USA. Further research should include samples from countries neighboring Ecuador to delve deeper into this.
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Affiliation(s)
- Luis Solórzano Álava
- Hospital Luis Vernaza, Junta de Beneficencia de Guayaquil, Guayaquil 090101, Ecuador
| | - Cesar Bedoya Pilozo
- Hospital Luis Vernaza, Junta de Beneficencia de Guayaquil, Guayaquil 090101, Ecuador
| | | | | | | | | | | | - Raquel de Oliveira Simões
- Departamento de Parasitologia Animal, Instituto de Veterinária, Universidade Federal Rural do Rio de Janeiro, Seropédica 23890-000, RJ, Brazil
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Pandian D, Najer T, Modrý D. An Overview of Angiostrongylus cantonensis (Nematoda: Angiostrongylidae), an Emerging Cause of Human Angiostrongylosis on the Indian Subcontinent. Pathogens 2023; 12:851. [PMID: 37375541 DOI: 10.3390/pathogens12060851] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
Human angiostrongylosis is an emerging zoonosis caused by the larvae of three species of metastrongyloid nematodes of the genus Angiostrongylus, with Angiostrongylus cantonensis (Chen, 1935) being dominant across the world. Its obligatory heteroxenous life cycle includes rats as definitive hosts, mollusks as intermediate hosts, and amphibians and reptiles as paratenic hosts. In humans, the infection manifests as Angiostrongylus eosinophilic meningitis (AEM) or ocular form. Since there is no comprehensive study on the disease in the Indian subcontinent, our study aims at the growing incidence of angiostrongylosis in humans, alongside its clinical course and possible causes. A systematic literature search revealed 28 reports of 45 human cases from 1966 to 2022; eosinophilic meningitis accounted for 33 cases (75.5%), 12 cases were reported as ocular, 1 case was combined, and 1 case was unspecified. The presumed source of infection was reported in 5 cases only. Importantly, 22 AEM patients reported a history of eating raw monitor lizard (Varanus spp.) tissues in the past. As apex predators, monitor lizards accumulate high numbers of L3 responsible for acute illness in humans. For ocular cases, the source was not identified. Most cases were diagnosed based on nematode findings and clinical pathology (primarily eosinophilia in the cerebrospinal fluid). Only two cases were confirmed to be A. cantonensis, one by immunoblot and the other by q-PCR. Cases of angiostrongylosis have been reported in Delhi, Karnataka, Kerala, Maharashtra, Madhya Pradesh, Puducherry, Telangana, and West Bengal. With a population of more than 1.4 billion, India is one of the least studied areas for A. cantonensis. It is likely that many cases remain undetected/unreported. Since most cases have been reported from the state of Kerala, further research may focus on this region. Gastropods, amphibians, and reptiles are commonly consumed in India; however, typical preparation methods involve cooking, which kills the nematode larvae. In addition to studying rodent and mollusk hosts, monitor lizards can be used as effective sentinels. Sequence data are urgently needed to answer the question of the identity of Angiostrongylus-like metastrongylid nematodes isolated from all types of hosts. DNA-based diagnostic methods such as q-PCR and LAMP should be included in clinical diagnosis of suspected cases and in studies of genetic diversity and species identity of nematodes tentatively identified as A. cantonensis.
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Affiliation(s)
- Divakaran Pandian
- Department of Veterinary Sciences, Faculty of Agrobiology, Food and Natural Resources/CINeZ, Czech University of Life Sciences Prague, 16500 Prague-Suchdol, Czech Republic
| | - Tomáš Najer
- Department of Veterinary Sciences, Faculty of Agrobiology, Food and Natural Resources/CINeZ, Czech University of Life Sciences Prague, 16500 Prague-Suchdol, Czech Republic
| | - David Modrý
- Department of Veterinary Sciences, Faculty of Agrobiology, Food and Natural Resources/CINeZ, Czech University of Life Sciences Prague, 16500 Prague-Suchdol, Czech Republic
- Department of Botany and Zoology, Faculty of Science, Masaryk University, 61137 Brno, Czech Republic
- Biology Center, Institute of Parasitology, Czech Academy of Sciences, 37005 Ceske Budejovice, Czech Republic
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Graeff-Teixeira C, Sawanyawisuth K, Lv S, Sears W, Rodríguez ZG, Álvarez HH, Arias PC, Schultz LKW, Rojas A, Jacob J, Jarvi S, Kramer K. Neuroangiostrongyliasis: Updated Provisional Guidelines for Diagnosis and Case Definitions. Pathogens 2023; 12:pathogens12040624. [PMID: 37111510 PMCID: PMC10144755 DOI: 10.3390/pathogens12040624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/06/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
Angiostrongylus cantonensis is the main causative agent for eosinophilic meningoencephalitis in humans. Larvae are rarely found in the cerebral spinal fluid (CSF). Consequently, serology and DNA detection represent important diagnostic tools. However, interpretation of the results obtained from these tools requires that more extensive accuracy studies be conducted. The aim of the present study is to update guidelines for diagnosis and case definitions of neuroangiostrongyliasis (NA) as provided by a working group of a recently established International Network on Angiostrongyliasis. A literature review, a discussion regarding criteria and diagnostic categories, recommendations issued by health authorities in China and an expert panel in Hawaii (USA), and the experience of Thailand were considered. Classification of NA cases and corresponding criteria are proposed as follows: minor (exposure history, positive serology, and blood eosinophilia); major (headache or other neurological signs or symptoms, CSF eosinophilia); and confirmatory (parasite detection in tissues, ocular chambers, or CSF, or DNA detection by PCR and sequencing). In addition, diagnostic categories or suspected, probable, and confirmatory are proposed. Updated guidelines should improve clinical study design, epidemiological surveillance, and the proper characterization of biological samples. Moreover, the latter will further facilitate accuracy studies of diagnostic tools for NA to provide better detection and treatment.
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Affiliation(s)
- Carlos Graeff-Teixeira
- Center for Health Sciences, Universidade Federal do Espírito Santo, Vitória 29075-910, ES, Brazil
| | - Kittisak Sawanyawisuth
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40000, Thailand
| | - Shan Lv
- Chinese Center for Disease Control and Prevention, National Institute of Parasitic Diseases, Shanghai 200025, China
| | - William Sears
- Laboratory of Parasitic Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Zhaily González Rodríguez
- Reference National Parasitology Laboratory, Instituto de Medicina Tropical "Pedro Kourí" (IPK), Havana 11400, Cuba
| | - Hilda Hernández Álvarez
- Reference National Parasitology Laboratory, Instituto de Medicina Tropical "Pedro Kourí" (IPK), Havana 11400, Cuba
| | - Pedro Casanova Arias
- Reference National Parasitology Laboratory, Instituto de Medicina Tropical "Pedro Kourí" (IPK), Havana 11400, Cuba
| | | | - Alicia Rojas
- Departamento de Parasitologia, Facultad de Microbiologia, Universidad de Costa Rica, San Jose 11501-2060, Costa Rica
| | - John Jacob
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, Hilo, HI 96720, USA
| | - Susan Jarvi
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, Hilo, HI 96720, USA
| | - Kenton Kramer
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96822, USA
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Meesing A, Khamsai S, Sawanyawisuth K, Tiamkao S, Maleewong W, Limpawattana P, Sawunyavisuth B, Ngamjarus C, Boonsawat W. Transmission sources and severe rat lung worm diseases in travelers: a scoping review. Trop Dis Travel Med Vaccines 2023; 9:2. [PMID: 36759878 PMCID: PMC9912548 DOI: 10.1186/s40794-022-00184-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 11/18/2022] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Rat lung worm disease (RLWD) has several clinical forms including eosinophilic meningitis (EOM) and two severe forms, eosinophilic meningoencephalitis (EOME) and eosinophilic radiculomyelitis (EORM). It remains unclear whether transmission sources are associated with severe forms of RLWD. This study aimed to evaluate if transmission factors are related to the severity of RLWD among travelers by using a scoping review of case reports. METHODS This was a review using five databases to retrieve case reports and case series of travelers with RLWD. Clinical data and transmission sources of reported cases diagnosed as RLWD were retrieved. The outcome of the study was occurrence of severe forms of RLWD defined as EOME, EORM, and combined EOME/EORM. RESULTS We retrieved 1,326 articles from five databases and 31 articles were included in the analysis. There were 84 cases eligible from 15 countries. Four cases were excluded. Seventy cases were in EOM group and 10 cases had EOME or EORM. Compared with the EOM group, the EOME, EORM, and combination EOME/EORM group had similar age, sex, and risk factors of consumptions of apple snails, shrimp and prawn, and salad/vegetables. The EOME group had higher proportion of consumption of African snails than the EOM group (60% vs 13.8%). However, only one study reported the consumption of African snails and the heterogeneity between studies and the small sample size impeded direct comparisons between groups. CONCLUSIONS RLWD in travelers can be found in most continents and mostly get infected from endemic countries of RLWD. Further studies are required to evaluate the association between transmission vectors and severity of RLWD.
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Affiliation(s)
- Atibordee Meesing
- grid.9786.00000 0004 0470 0856Department of Medicine, Faculty of Medicine, Khon Kaen University, 123 Mitraparp Road, Khon Kaen, Thailand 40002
| | - Sittichai Khamsai
- Department of Medicine, Faculty of Medicine, Khon Kaen University, 123 Mitraparp Road, Khon Kaen, Thailand, 40002.
| | - Kittisak Sawanyawisuth
- Department of Medicine, Faculty of Medicine, Khon Kaen University, 123 Mitraparp Road, Khon Kaen, Thailand, 40002.
| | - Somsak Tiamkao
- grid.9786.00000 0004 0470 0856Department of Medicine, Faculty of Medicine, Khon Kaen University, 123 Mitraparp Road, Khon Kaen, Thailand 40002
| | - Wanchai Maleewong
- grid.9786.00000 0004 0470 0856Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand 40002
| | - Panita Limpawattana
- grid.9786.00000 0004 0470 0856Department of Medicine, Faculty of Medicine, Khon Kaen University, 123 Mitraparp Road, Khon Kaen, Thailand 40002
| | - Bundit Sawunyavisuth
- grid.9786.00000 0004 0470 0856Department of Marketing, Faculty of Business Administration and Accountancy, Khon Kaen University, Khon Kaen, Thailand 40002
| | - Chetta Ngamjarus
- grid.9786.00000 0004 0470 0856Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand 40002
| | - Watchara Boonsawat
- grid.9786.00000 0004 0470 0856Department of Medicine, Faculty of Medicine, Khon Kaen University, 123 Mitraparp Road, Khon Kaen, Thailand 40002
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Zeng X, Shen J, Li D, Liu S, Feng Y, Yuan D, Wang L, Wu Z. CEBPα/miR-101b-3p promotes meningoencephalitis in mice infected with Angiostrongylus cantonensis by promoting microglial pyroptosis. Cell Commun Signal 2023; 21:31. [PMID: 36747241 PMCID: PMC9903543 DOI: 10.1186/s12964-023-01038-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 01/02/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Angiostrongylus cantonensis (A. cantonensis) infection can induce acute inflammation, which causes meningoencephalitis and tissue mechanical injury to the brain. Parasite infection-induced microRNAs play important roles in anti-parasite immunity in non-permissive hosts. miR-101b-3p is highly expressed after A. cantonensis infection; however, the role of miR-101b-3p and the transcription regulation of miR-101b-3p in A. cantonensis infection remain poorly characterized. RESULTS In the present study, we found that miR-101b-3p inhibition alleviated inflammation infiltration and pyroptosis in A. cantonensis infection. In addition, we found that CCAAT/enhancer-binding protein alpha (CEBPα) directly bound to the - 6-k to - 3.5-k region upstream of miR-101b, and CEBPα activated miR-101b-3p expression in microglia. These data suggest the existence of a novel CEBPα/miR-101b-3p/pyroptosis pathway in A. cantonensis infection. Further investigation verified that CEBPα promotes pyroptosis by activating miR-101b-3p expression in microglia, and microglial pyroptosis further promoted inflammation. CONCLUSIONS Our results suggest that a CEBPα/miR-101b-3p/pyroptosis pathway may contribute to A. cantonensis infection-induced inflammation and highlight the pro-inflammatory effect of miR-101b-3p. Video Abstract.
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Affiliation(s)
- Xingda Zeng
- grid.12981.330000 0001 2360 039XDepartment of Parasitology of Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080 China ,grid.12981.330000 0001 2360 039XKey Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-Sen University, Guangzhou, 510080 China ,Provincial Engineering Technology Research Center for Biological Vector Control, Guangzhou, 510080 China
| | - Jia Shen
- grid.12981.330000 0001 2360 039XDepartment of Parasitology of Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080 China ,grid.12981.330000 0001 2360 039XKey Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-Sen University, Guangzhou, 510080 China ,Provincial Engineering Technology Research Center for Biological Vector Control, Guangzhou, 510080 China
| | - Dinghao Li
- grid.12981.330000 0001 2360 039XDepartment of Parasitology of Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080 China ,grid.12981.330000 0001 2360 039XKey Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-Sen University, Guangzhou, 510080 China ,Provincial Engineering Technology Research Center for Biological Vector Control, Guangzhou, 510080 China
| | - Shurui Liu
- grid.12981.330000 0001 2360 039XDepartment of Parasitology of Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080 China ,grid.12981.330000 0001 2360 039XKey Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-Sen University, Guangzhou, 510080 China ,Provincial Engineering Technology Research Center for Biological Vector Control, Guangzhou, 510080 China
| | - Ying Feng
- grid.79703.3a0000 0004 1764 3838School of Medicine, South China University of Technology, Guangzhou, 510006 China
| | - Dongjuan Yuan
- grid.20561.300000 0000 9546 5767College of Veterinary Medicine, South China Agricultural University, Guangzhou, 510642 China
| | - Lifu Wang
- Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases, KingMed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, 510180, China.
| | - Zhongdao Wu
- Department of Parasitology of Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510080, China. .,Key Laboratory of Tropical Disease Control, Ministry of Education, Sun Yat-Sen University, Guangzhou, 510080, China. .,Provincial Engineering Technology Research Center for Biological Vector Control, Guangzhou, 510080, China.
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Cowie RH, Ansdell V, Panosian Dunavan C, Rollins RL. Neuroangiostrongyliasis: Global Spread of an Emerging Tropical Disease. Am J Trop Med Hyg 2022; 107:1166-1172. [PMID: 36343594 PMCID: PMC9768254 DOI: 10.4269/ajtmh.22-0360] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/18/2022] [Indexed: 11/09/2022] Open
Abstract
Neuroangiostrongyliasis (NAS) is an emerging parasitic disease caused by the neurotropic nematode Angiostrongylus cantonensis. Since it was first discovered, in rats in southern China in the 1930s, this tropical to subtropical parasite has spread to much of Southeast Asia, the Pacific Islands (including Hawaii), Australia, Japan, South America, the southeastern United States, the Caribbean, Africa, the Canary Islands, and the Balearic Islands. The parasite completes its natural life cycle in snails and slugs (intermediate hosts), and rats (definitive hosts). Humans become accidental hosts after ingesting infective third-stage larvae contained within uncooked or undercooked intermediate or paratenic hosts, an event that sometimes results in NAS, also known as rat lungworm disease. Although A. cantonensis larvae cannot complete their life cycle in humans, their migration into the brain and spinal cord combined with a powerful inflammatory reaction often leads to eosinophilic meningitis and can, in rare instances, lead to coma, paralysis, and death or, in other cases, chronic, disabling neurologic sequelae. Symptoms of NAS are diverse, which often makes it difficult to diagnose. Treatment may include administration of analgesics, corticosteroids, anthelminthics, and repeat lumbar punctures to reduce intracranial pressure. Unfortunately, few medical providers, even in endemic areas, are familiar with A. cantonensis or its epidemiology, diagnosis, and treatment. As the parasite continues to spread and NAS affects more people, medical practitioners, as well as the general public, must become more aware of this emerging zoonosis and the potentially devastating harm it can cause.
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Affiliation(s)
- Robert H. Cowie
- Pacific Biosciences Research Center, University of Hawaii, Honolulu, Hawaii;,Address correspondence to Robert H. Cowie, Pacific Biosciences Research Center, University of Hawaii, 3050 Maile Way, Gilmore 408, Honolulu, HI 96822. E-mail:
| | - Vernon Ansdell
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
| | | | - Randi L. Rollins
- Pacific Biosciences Research Center, University of Hawaii, Honolulu, Hawaii;,School of Life Sciences, University of Hawaii, Honolulu, Hawaii
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Dumidae A, Subkrasae C, Ardpairin J, Thanwisai A, Vitta A. Genetic analysis of a 66-kDa protein-encoding gene of Angiostrongylus cantonensis and Angiostrongylus malaysiensis. Parasitology 2022; 150:1-17. [PMID: 36472511 PMCID: PMC10090599 DOI: 10.1017/s0031182022001573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/18/2022] [Accepted: 10/24/2022] [Indexed: 12/12/2022]
Abstract
The rat lungworm Angiostrongylus cantonensis is globally known to be the cause of oeosinophilic meningitis in humans. Another congener, Angiostrongylus malaysiensis, is closely related to A. cantonensis and has been described as a potential human pathogenic parasite. These 2 worms are similar in terms of life cycle, host range and morphological and genetic information. However, there are limited studies about their genetic diversity based on the 66-kDa protein-encoding gene. The objective of this study was to explore the 66-kDa protein sequence variation of A. cantonensis and A. malaysiensis collected from Thailand. Two adult and 53 third-stage larval specimens of Angiostrongylus from 4 geographic locations in Thailand were molecularly identified using the 66-kDa protein gene. The phylogenetic trees (Bayesian inference tree and maximum-likelihood tree) showed that Angiostrongylus formed a monophyletic clade with a clear separation between A. cantonensis and A. malaysiensis. The genetic distance between A. cantonensis and A. malaysiensis varies from 0.82 to 2.86%, with a total of 16 variable sites. The analysis of genetic diversity revealed 1 and 5 new haplotypes of A. cantonensis and A. malaysiensis, respectively, and showed genetic differences between the populations of A. cantonensis and A. malaysiensis. The haplotype networks of A. cantonensis and A. malaysiensis populations in Thailand are similar to those of populations in some countries, indicating the range expansion of genomic origin between populations in different areas. In conclusion, the 66-kDa protein gene was a good genetic marker for studying genetic diversity and discriminating between A. cantonensis and A. malaysiensis.
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Affiliation(s)
- Abdulhakam Dumidae
- Department of Microbiology and Parasitology, Faculty of Medical Science, Naresuan University, Phitsanulok 65000, Thailand
| | - Chanakan Subkrasae
- Department of Microbiology and Parasitology, Faculty of Medical Science, Naresuan University, Phitsanulok 65000, Thailand
| | - Jiranun Ardpairin
- Department of Microbiology and Parasitology, Faculty of Medical Science, Naresuan University, Phitsanulok 65000, Thailand
| | - Aunchalee Thanwisai
- Department of Microbiology and Parasitology, Faculty of Medical Science, Naresuan University, Phitsanulok 65000, Thailand
- Centre of Excellence in Medical Biotechnology, Faculty of Medical Science, Naresuan University, Phitsanulok 65000, Thailand
- Center of Excellence for Biodiversity, Faculty of Sciences, Naresuan University, Phitsanulok 65000, Thailand
| | - Apichat Vitta
- Department of Microbiology and Parasitology, Faculty of Medical Science, Naresuan University, Phitsanulok 65000, Thailand
- Centre of Excellence in Medical Biotechnology, Faculty of Medical Science, Naresuan University, Phitsanulok 65000, Thailand
- Center of Excellence for Biodiversity, Faculty of Sciences, Naresuan University, Phitsanulok 65000, Thailand
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Khamsai S, Chotmongkol V, Tiamkao S, Maleewong W, Limpawattana P, Boonsawat W, Sawunyavisuth B, Aekphachaisawat N, Sawanyawisuth K. Eosinophilic meningitis epidemiological data from a national database in Thailand's Department of Disease Control: a pragmatic, retrospective analytical study. Orphanet J Rare Dis 2022; 17:393. [PMID: 36303188 PMCID: PMC9615179 DOI: 10.1186/s13023-022-02532-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/30/2022] [Accepted: 10/02/2022] [Indexed: 11/23/2022] Open
Abstract
Background Eosinophilic meningitis (EOM) is a rare neurological disease that can be misdiagnosed or underdiagnosed. Based on reported cases in the literature, there have been 2,827 cases worldwide since 1945. There are limited data on the prevalence and trends of EOM in a real-world setting, even in Thailand, the country with the highest prevalence of EOM. Therefore, this study aimed to evaluate the prevalence of EOM and EOM epidemiological data in a real-world setting. Methods This was a pragmatic, retrospective analytical study using a national database. We retrieved EOM epidemiological data reported from government hospitals to Thailand’s Bureau of Epidemiology, within the Ministry of Public Health’s Department of Disease Control (DDC), between 2014 and 2019. The study was conducted by retrieving the data of all patients diagnosed with EOM and reported to the DDC. Diagnosis of EOM is made clinically by evidence of eosinophils of 10% or more of the total white blood cells in cerebrospinal fluid. Details of each patient were retrieved from the 506 Report Form, including age, month of reported case, zone of country, occupation, and mortality. Data regarding infection rate in each year and each zone were reported in rate/100,000 population, while data regarding age, month of reported case, and occupation were reported by year. Differences between means of age group, month of reported case, and occupation were tested by one-way analysis of variance (ANOVA). For those factors with significant differences among groups, Bonferroni method was used to compute pairwise differences. Results There were 1,083 EOM cases reported in Thailand during the six-year study period. The average annual incidence of EOM was 180.5 cases, or 0.27 cases/100,000 population. The northeast zone had the highest rate, with 0.89/100,000 population. The common age groups were 25–54 years, with the highest rate among the 35–44 age group, with a mean of 38.3 persons/year. These age groups were significantly different from other age groups (F value 39.23; p < 0.001). A relatively high cumulative monthly incidence (> 100 cases) was seen in four months, including January (117 cases), September (103 cases), October (112 cases), and November (103 cases), though these rates were not significantly different from the other months’ rates. Regarding occupation, the top two occupations with EOM diagnoses were farmers and laborers, which were significantly different from other occupations (F value 99.95; p < 0.001). There was no reported case of death during the study period. Conclusion EOM is common in Northeast Thailand among people of working age. The disease can be found throughout the year but is more common in the last quarter of the year. Farmers and laborers have the highest infection rate. To better understand the burden and outcomes of EOM, a national EOM reporting system with a better reporting form is required in endemic countries. Such a report form should include more details on risk exposure, symptoms, signs, treatment, and outcomes.
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Affiliation(s)
- Sittichai Khamsai
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Verajit Chotmongkol
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Somsak Tiamkao
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Wanchai Maleewong
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Panita Limpawattana
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Watchara Boonsawat
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Bundit Sawunyavisuth
- Department of Marketing, Faculty of Business Administration and Accountancy, Khon Kaen University, Khon Kaen, Thailand
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10
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Liu J, Tao J, Chen W, Wang T, Chen X, Shen M, Ou Q, Zhang Y, Ding Y, Wu J, Cheng X, Lu G, Yan G. The application of metagenomic next-generation sequencing for Angiostrongylus eosinophilic meningitis in a pediatric patient: A case report. Front Public Health 2022; 10:1003013. [PMID: 36339212 PMCID: PMC9631770 DOI: 10.3389/fpubh.2022.1003013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/05/2022] [Indexed: 01/27/2023] Open
Abstract
Background Angiostrongylus eosinophilic meningitis (AEM) is a rare yet emerging disease caused by Angiostrongylus cantonensis infection. Its atypical symptoms may delay the diagnosis and cause fatal outcomes, especially in the early stages of infection and among children. Case presentation Here we reported the use of metagenomic next-generation sequencing (mNGS) to facilitate the diagnosis and treatment of an 8-year-old boy with severe A. cantonensis infection. The mNGS tests consistently identified the infection of A. cantonensis prior to the detection by the immunologic method and confirmed it as AEM. Owing to the multidisciplinary team (MDT)-administrated treatments and close disease monitoring based on regular clinical tests and sequential mNGS tests, the patients eventually fully recovered from severe infectious conditions. Conclusion This case demonstrated the advantages of mNGS for early diagnosis of AEM in pediatric patients, highlighting its application for pan-pathogen detection, as well as disease monitoring for severe A. cantonensis infection.
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Affiliation(s)
- Jing Liu
- Pediatric Intensive Care Unit, Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China
| | - Jinhao Tao
- Pediatric Intensive Care Unit, Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China
| | - Weiming Chen
- Pediatric Intensive Care Unit, Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China
| | - Tingting Wang
- Department of Research and Development, Nanjing Geneseeq Technology Inc., Nanjing, China,Department of Research and Development, Nanjing Dinfectome Technology Inc., Nanjing, China
| | - Xin Chen
- Geneseeq Research Institute, Nanjing Geneseeq Technology Inc., Nanjing, China
| | - Meili Shen
- Department of Medical, Nanjing Dinfectome Technology Inc., Nanjing, China
| | - Qiuxiang Ou
- Geneseeq Research Institute, Nanjing Geneseeq Technology Inc., Nanjing, China
| | - Yunjian Zhang
- Department of Neurology, Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China
| | - Yifeng Ding
- Department of Neurology, Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China
| | - Jufang Wu
- Institute of Antibiotics, Huashan Hospital of Fudan University, Shanghai, China
| | - Xunjia Cheng
- Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Guoping Lu
- Pediatric Intensive Care Unit, Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China,*Correspondence: Guoping Lu
| | - Gangfeng Yan
- Pediatric Intensive Care Unit, Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China,Gangfeng Yan
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11
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Turck HC, Fox MT, Cowie RH. Paratenic hosts of Angiostrongylus cantonensis and their relation to human neuroangiostrongyliasis globally. One Health 2022; 15:100426. [PMID: 36277113 PMCID: PMC9582568 DOI: 10.1016/j.onehlt.2022.100426] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/02/2022] [Accepted: 08/02/2022] [Indexed: 11/26/2022] Open
Abstract
The nematode parasite Angiostrongylus cantonensis (rat lungworm) has a complex life cycle involving rats (definitive hosts) and gastropods (intermediate hosts), as well as various paratenic hosts. Humans become infected and develop rat lungworm disease (neuroangiostrongyliasis) when they consume intermediate or paratenic hosts containing the infective parasite larvae. This study synthesizes knowledge of paratenic hosts of A. cantonensis and investigates their role in causing human neuroangiostrongyliasis worldwide. A literature review was conducted by searching PubMed, JSTOR and Scopus, pooling additional information from sources accumulated over many years by RHC, and snowball searching. The review identified 138 relevant articles published between 1962 and 2022. Freshwater prawns/shrimp, crayfish, crabs, flatworms, fish, sea snakes, frogs, toads, newts, lizards, centipedes, cattle, pigs and snails were reported to act as paratenic hosts in various regions including South and Southeast Asia, Pacific islands, the USA and the Caribbean, as well as experimentally. Human cases of neuroangiostrongyliasis have been reported from the 1960s onwards, linked, sometimes speculatively, to consumption of freshwater prawns/shrimp, crabs, flatworms, fish, frogs, toads, lizards and centipedes. The potential of paratenic hosts to cause neuroangiostrongyliasis depends on whether they are eaten, how frequently they are consumed, the preparation method, including whether eaten raw or undercooked, and whether they are consumed intentionally or accidentally. It also depends on infection prevalence in the host populations and probably on how high the parasite load is in the consumed hosts. To prevent human infections, it is crucial to interrupt the transmission of rat lungworm to humans, from both intermediate hosts and frequently consumed paratenic hosts, by adhering to safe food preparation protocols. Educating the general public and the medical community about this largely neglected tropical/subtropical disease is key. Neuroangiostrongyliasis, an emerging parasitic disease of humans and wildlife. Caused by the nematode Angiostrongylus cantonensis (rat lungworm). Infection primarily via ingestion of stage 3 larvae of the parasite. People eat raw intermediate or paratenic hosts infected with stage 3 larvae. Comprehensive review of paratenic hosts’ role in neuroangiostrongyliasis globally.
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12
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Eosinophilic Meningitis (Angiostrongylus spp. and Gnathostoma spp.). CURRENT TROPICAL MEDICINE REPORTS 2022. [DOI: 10.1007/s40475-022-00256-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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13
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Morelli S, Diakou A, Di Cesare A, Colombo M, Traversa D. Canine and Feline Parasitology: Analogies, Differences, and Relevance for Human Health. Clin Microbiol Rev 2021; 34:e0026620. [PMID: 34378954 PMCID: PMC8404700 DOI: 10.1128/cmr.00266-20] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Cats and dogs are treated as family members by most pet owners. Therefore, a high quality of veterinary care and preventive medicine is imperative for animal health and welfare and for the protection of humans from zoonotic pathogens. There is a general perception of cats being treated as "small dogs," especially in the field of clinical parasitology. As a result, several important differences between the two animal species are not taken into proper consideration and are often overlooked. Dogs and cats are profoundly different under evolutionary, biological, ethological, behavioral, and immunological standpoints. These differences impact clinical features, diagnosis, and control of canine and feline parasites and transmission risk for humans. This review outlines the most common parasitoses and vector-borne diseases of dogs and cats, with a focus on major convergences and divergences, and discusses parasites that have (i) evolved based on different preys for dogs and cats, (ii) adapted due to different immunological or behavioral animal profiles, and (iii) developed more similarities than differences in canine and feline infections and associated diseases. Differences, similarities, and peculiarities of canine and feline parasitology are herein reviewed in three macrosections: (i) carnivorism, vegetarianism, anatomy, genetics, and parasites, (ii) evolutionary adaptation of nematodes, including veterinary reconsideration and zoonotic importance, and (iii) behavior and immune system driving ectoparasites and transmitted diseases. Emphasis is given to provide further steps toward a more accurate evaluation of canine and feline parasitology in a changing world in terms of public health relevance and One Health approach.
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Affiliation(s)
- Simone Morelli
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - Anastasia Diakou
- Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Angela Di Cesare
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | | | - Donato Traversa
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
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14
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Odani J, Sox E, Coleman W, Jha R, Malik R. First Documented Cases of Canine Neuroangiostrongyliasis Due to Angiostrongylus cantonensis in Hawaii. J Am Anim Hosp Assoc 2021; 57:42-46. [PMID: 33260206 DOI: 10.5326/jaaha-ms-6989] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2020] [Indexed: 11/11/2022]
Abstract
Two young dogs domiciled in Honolulu, Hawaii, were presented in November and December 2018 (respectively) for spinal hyperesthesia, hindlimb weakness, and proprioceptive ataxia. Both dogs had neurologic findings referable to spinal cord disease. Both dogs had a combination of lower motor neuron signs (reduced muscle mass, decreased withdrawal reflexes, low tail carriage) and long tract signs (conscious proprioceptive deficits, crossed extensor response, increased myotatic reflexes). Peripheral eosinophilia was present in the second case, but hematology and serum biochemistries were otherwise unremarkable. Plain radiographs and computed tomography scans ± contrast were unremarkable. Cerebrospinal fluid (CSF) from both patients demonstrated eosinophilic pleocytosis, and real-time polymerase chain reaction testing demonstrated Angiostrongylus cantonensis deoxyribonucleic acid in CSF, confirming a diagnosis of neuroangiostrongyliasis. Treatment included glucocorticoid therapy, ± anthelmintic (fenbendazole). Both dogs made a complete recovery. These are the first confirmed cases of autochthonous neuroangiostrongyliasis in canine patients in the United States and the first dogs anywhere to be diagnosed definitively with A cantonensis infection based on real-time polymerase chain reaction testing of CSF. A clinician examining a patient with severe spinal hyperesthesia and a combination of upper and lower motor signs should consider A cantonensis as a differential, especially in endemic areas.
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Affiliation(s)
- Jenee Odani
- From the University of Hawai'iat Mānoa College of Tropical Agriculture and Human Resources, Honolulu, Hawaii (J.O., R.J.); Veterinary Emergency + Referral Center of Hawaii, Honolulu, Hawaii (E.S., W.C.); and Centre for Veterinary Education, University of Sydney, Sydney, Australia (R.M.)
| | - Erika Sox
- From the University of Hawai'iat Mānoa College of Tropical Agriculture and Human Resources, Honolulu, Hawaii (J.O., R.J.); Veterinary Emergency + Referral Center of Hawaii, Honolulu, Hawaii (E.S., W.C.); and Centre for Veterinary Education, University of Sydney, Sydney, Australia (R.M.)
| | - Will Coleman
- From the University of Hawai'iat Mānoa College of Tropical Agriculture and Human Resources, Honolulu, Hawaii (J.O., R.J.); Veterinary Emergency + Referral Center of Hawaii, Honolulu, Hawaii (E.S., W.C.); and Centre for Veterinary Education, University of Sydney, Sydney, Australia (R.M.)
| | - Rajesh Jha
- From the University of Hawai'iat Mānoa College of Tropical Agriculture and Human Resources, Honolulu, Hawaii (J.O., R.J.); Veterinary Emergency + Referral Center of Hawaii, Honolulu, Hawaii (E.S., W.C.); and Centre for Veterinary Education, University of Sydney, Sydney, Australia (R.M.)
| | - Richard Malik
- From the University of Hawai'iat Mānoa College of Tropical Agriculture and Human Resources, Honolulu, Hawaii (J.O., R.J.); Veterinary Emergency + Referral Center of Hawaii, Honolulu, Hawaii (E.S., W.C.); and Centre for Veterinary Education, University of Sydney, Sydney, Australia (R.M.)
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15
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Watthanakulpanich D, Jakkul W, Chanapromma C, Ketboonlue T, Dekumyoy P, Lv Z, Chan AHE, Thaenkham U, Chaisiri K. Co-occurrence of Angiostrongylus malaysiensis and Angiostrongylus cantonensis DNA in cerebrospinal fluid: Evidence from human eosinophilic meningitis after ingestion of raw snail dish in Thailand. Food Waterborne Parasitol 2021; 24:e00128. [PMID: 34458598 PMCID: PMC8379478 DOI: 10.1016/j.fawpar.2021.e00128] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/23/2021] [Accepted: 07/27/2021] [Indexed: 11/24/2022] Open
Abstract
Angiostrongylus cantonensis, the main causative agent of human neuroangiostrongyliasis, is a food-borne parasitic zoonosis, particularly in Southeast Asia and Mainland China. Angiostrongylus malaysiensis, a cryptic species, has not been unequivocally identified as a causative agent for human angiostrongyliasis. Here, we investigated a local incidence of human angiostrongyliasis in Kalasin Province, northeastern part of Thailand. Field and laboratory investigations, clinical symptoms, and treatment of the disease are also discussed. Five sera and three cerebrospinal fluid samples were taken from each patient who displayed clinical symptoms of mild or severe headache without neck stiffness after ingesting a local dish containing Pila virescens. With molecular evidence using PCR and DNA sequencing approaches, we confirmed the presence of A. malaysiensis and A. cantonensis DNA in the patient samples. In addition, P. virescens and Pomacea canaliculata collected in the vicinity were also examined for the existence of angistrongylid larvae. The rate of infection in the snail population was 33.3% (18 infection out of 54 examined), with A. cantonensis as the predominant species. Notably, two snails were found to be co-infected with both A. malaysiensis and A. cantonensis. This discovery comes after several years of suspicion that it could be a zoonotic pathogen. Therefore, our findings are important for public health and clinical diagnosis since clinicians are not aware of the zoonotic potential of A. malaysiensis in humans. A. malaysiensis as a potential zoonotic pathogen of human angiostrongyliasis. A. cantonensis and A. malaysiensis coexist in snails where human cases detected. Discussions on related clinical manifestations and patient profiles of Angiostrongylus spp. co-infection.
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Affiliation(s)
- Dorn Watthanakulpanich
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Wallop Jakkul
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Chaichana Chanapromma
- Crown Prince Kuchinarai Hospital, Kuchinarai District, Kalasin Province 46110, Thailand
| | - Thawatchai Ketboonlue
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Paron Dekumyoy
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Zhiyue Lv
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong 510080, PR China
| | - Abigail Hui En Chan
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Urusa Thaenkham
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Kittipong Chaisiri
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Corresponding author at: Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchavithi Rd., Ratchathewi, Bangkok 10400, Thailand.
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16
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Jacob J, Steel A, Lin Z, Berger F, Zöeller K, Jarvi S. Clinical Efficacy and Safety of Albendazole and Other Benzimidazole Anthelmintics for Rat Lungworm Disease (Neuroangiostrongyliasis): A Systematic Analysis of Clinical Reports and Animal Studies. Clin Infect Dis 2021; 74:1293-1302. [PMID: 34448480 PMCID: PMC8994584 DOI: 10.1093/cid/ciab730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Indexed: 12/25/2022] Open
Abstract
The safety and efficacy of benzimidazole anthelmintics for the treatment of rat lungworm disease (neuroangiostrongyliasis) have been questioned regardless of numerous experimental animal studies and clinical reports. In this review, 40 of these experimental animal studies and 104 clinical reports are compiled with a focus on albendazole. Among the 144 articles involving an estimated 1034 patients and 2561 animals, 4.1% were inconclusive or vague regarding the use of benzimidazoles. Of the remaining 138 articles, 90.5% found benzimidazoles to be safe and effective (885 patients, 2530 animals), 4.3% as safe but ineffective (73 patients, 3 animals), and 5.0% caused adverse reactions (7 patients, 28 animals). Among those clinical reports that described a confirmed diagnosis of neuroangiostrongyliasis in which albendazole monotherapy was used, 100% reported high efficacy (743 patients, 479 animals). In those where albendazole-corticosteroid co-therapy was used, 97.87% reported it to be effective (323 patients, 130 animals).
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Affiliation(s)
- John Jacob
- University of Hawaii at Hilo, Daniel K. Inouye College of Pharmacy, Hilo, USA
| | - Argon Steel
- University of Hawaii at Hilo, Daniel K. Inouye College of Pharmacy, Hilo, USA
| | - Zhain Lin
- University of Hawaii at Hilo, Daniel K. Inouye College of Pharmacy, Hilo, USA
| | - Fiona Berger
- University Clermont Auvergne, Department of Pharmacy, Clermont Ferrand, France
| | - Katrin Zöeller
- Goethe University Frankfurt, Department of Pharmacy, Frankfurt, Germany
| | - Susan Jarvi
- University of Hawaii at Hilo, Daniel K. Inouye College of Pharmacy, Hilo, USA
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17
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The returned traveler with neurologic manifestations: could my patient have a parasite? Curr Opin Infect Dis 2021; 34:245-254. [PMID: 33769967 DOI: 10.1097/qco.0000000000000732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE OF REVIEW The present review focuses on parasitic infections of the central nervous system (CNS) that can affect the international traveler. RECENT FINDINGS The epidemiology of imported parasitic infections is changing and clinicians are treating increasing numbers of returned travelers with parasitic infections in the CNS with which they are not familiar. SUMMARY The epidemiology, life cycle, clinical manifestations, diagnosis, and treatment of parasites that affect the CNS will be discussed.
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18
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Chen M, Huang D, Chen J, Huang Y, Zheng H, Tang Y, Zhang Q, Chen S, Ai L, Zhou X, Zhang R. Genetic Characterization and Detection of Angiostrongylus cantonensis by Molecular Approaches. Vector Borne Zoonotic Dis 2021; 21:643-652. [PMID: 34242520 DOI: 10.1089/vbz.2020.2734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Angiostrongylus cantonensis constitutes a major etiologic agent of eosinophilic meningoencephalitis. The detection methods for angiostrongyliasis mainly depend on morphology or immunology. A firmer diagnosis could be reached by directly detecting the parasite in the cerebrospinal fluid or through laboratory assays that are specific for Angiostrongylus-induced antibodies or the parasite's DNA. A. cantonensis detection could be carried out by larva release from the tissue upon pepsin digestion. However, the procedure requires live mollusks, which might complicate the analysis of large amounts of samples. Since morphological assays are limited, multiple molecular techniques have been put forward for detecting A. cantonensis, including PCR amplification of targets followed by fragment length or DNA sequence analysis. This allows rapid and accurate identification of A. cantonensis for efficient infection management and epidemiological purposes. In this study, we reviewed the current methods, concepts, and applications of molecular approaches to better understand the genetic characterization, molecular detection methods, and practical application of molecular detection in A. cantonensis.
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Affiliation(s)
- Muxin Chen
- Institute of Pathogenic Biology, Shenzhen Center for Disease Control and Prevention, Shenzhen, China.,Health Education and Detection Center, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China.,Health Education and Detection Center, NHC Key Laboratory for Parasitology and Vector Biology, Shanghai, China.,Health Education and Detection Center, WHO Collaborating Center for Tropical Diseases, Shanghai, China.,Health Education and Detection Center, National Center for International Research on Tropical Diseases, Shanghai, China
| | - Dana Huang
- Institute of Pathogenic Biology, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Jiaxu Chen
- Health Education and Detection Center, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China.,Health Education and Detection Center, NHC Key Laboratory for Parasitology and Vector Biology, Shanghai, China.,Health Education and Detection Center, WHO Collaborating Center for Tropical Diseases, Shanghai, China.,Health Education and Detection Center, National Center for International Research on Tropical Diseases, Shanghai, China.,Health Education and Detection Center, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shenzhen Center for Disease Control and Prevention, Joint Laboratory for Imported Tropical Disease Control, Shanghai, China
| | - Yalan Huang
- Institute of Pathogenic Biology, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Huiwen Zheng
- Institute of Pathogenic Biology, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yijun Tang
- Institute of Pathogenic Biology, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Qian Zhang
- Institute of Pathogenic Biology, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Shaohong Chen
- Health Education and Detection Center, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China.,Health Education and Detection Center, NHC Key Laboratory for Parasitology and Vector Biology, Shanghai, China.,Health Education and Detection Center, WHO Collaborating Center for Tropical Diseases, Shanghai, China.,Health Education and Detection Center, National Center for International Research on Tropical Diseases, Shanghai, China
| | - Lin Ai
- Health Education and Detection Center, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China.,Health Education and Detection Center, NHC Key Laboratory for Parasitology and Vector Biology, Shanghai, China.,Health Education and Detection Center, WHO Collaborating Center for Tropical Diseases, Shanghai, China.,Health Education and Detection Center, National Center for International Research on Tropical Diseases, Shanghai, China.,Department of One Health, School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaonong Zhou
- Health Education and Detection Center, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, China.,Health Education and Detection Center, NHC Key Laboratory for Parasitology and Vector Biology, Shanghai, China.,Health Education and Detection Center, WHO Collaborating Center for Tropical Diseases, Shanghai, China.,Health Education and Detection Center, National Center for International Research on Tropical Diseases, Shanghai, China.,Health Education and Detection Center, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shenzhen Center for Disease Control and Prevention, Joint Laboratory for Imported Tropical Disease Control, Shanghai, China.,Department of One Health, School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Renli Zhang
- Institute of Pathogenic Biology, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
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19
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Newly developed SYBR Green-based quantitative real-time PCRs revealed coinfection evidence of Angiostrongylus cantonensis and A. malaysiensis in Achatina fulica existing in Bangkok Metropolitan, Thailand. Food Waterborne Parasitol 2021; 23:e00119. [PMID: 33817357 PMCID: PMC8005753 DOI: 10.1016/j.fawpar.2021.e00119] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 03/01/2021] [Accepted: 03/04/2021] [Indexed: 11/22/2022] Open
Abstract
Angiostrongylus cantonensis is a well-known pathogen causing eosinophilic meningitis associated with angiostrongyliasis. Humans, as accidental hosts, are infected by consuming undercooked snails containing third-stage larvae. A. malaysiensis is closely related to A. cantonensis and has been described as a potential human pathogen. The two species distribution was recently reported to overlap in the same endemic area, particularly in the Indochina Peninsula. Similar morphological characteristics of the third-stage larva in the snail-intermediate host often lead to misidentification of the two species. Thus, we aimed to develop a sensitive and specific method to detect and discriminate Angiostrongylus third-stage larva by designing species-specific primers based on the mitochondrial cytochrome b gene. We developed the SYBR Green quantitative real-time PCR (qPCR) method for two species-specific detection assays, which could be conducted simultaneously. The method was subsequently employed to detect and identify third-stage larvae of Angiostrongylus isolated from infected Achatina fulica collected from six public parks in Bangkok Metropolitan, Thailand. The method was also a preliminary applied to detect parasite tissue debris in the patients' cerebrospinal fluid (CSF). SYBR Green qPCRs quantitatively detected approximately 10−4 ng of genomic DNA from one larva, facilitating species-specific detection. Based on the pools of third-stage larvae isolated individually from the tissue of each infected A. fulica collected from the public parks, the qPCR results revealed that A. malaysiensis was the predominant species infecting 5.26% of the collected snails. In comparison, coinfection between A. malaysiensis and A. cantonensis was 5.97%, and no single infection of A. cantonensis was detected in A. fulica. Our SYBR Green qPCR method is a useful and inexpensive technique for A. cantonensis and A. malaysiensis discrimination, and the method has sufficient sensitivity to detect isolated larvae from a snail-intermediate host. The ratio of A. cantonensis and A. malaysiensis larvae infecting the snails can also be estimated simultaneously. Our qPCRs can be employed in a molecular survey of A. cantonensis and A. malaysiensis within intermediate hosts and for clinical diagnosis of angiostrongyliasis with CSF specimens in future studies. The SYBR Green qPCRs were developed to detect and discriminate Angiostrongylus third-stage larvae by designing species-specific primers based on the mitochondrial cytochrome b gene. A. malaysiensis is the predominant species in Bangkok Metropolitan, Thailand. Coinfection between A. cantonensis and A. malaysiensis has occurred in the Achatina fulica population in Bangkok
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Corticosteroid treatment reduces headache in eosinophilic meningitis: a systematic review. Drug Target Insights 2021; 15:1-4. [PMID: 33840995 PMCID: PMC8025843 DOI: 10.33393/dti.2021.2197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 02/04/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Eosinophilic meningitis (EOM) is an emerging parasitic disease that can be found worldwide, of which acute severe headache is a presenting symptom. Although such headaches may persist for up to 2 months, studies have found corticosteroid to be effective in reducing this symptom. As the most recent systematic review was published in 2015, the aim of this study was to provide a more up-to-date examination of the role of corticosteroids in EOM. Methods: We included randomized controlled trials of corticosteroid treatment for EOM regardless of comparators. Research articles published in five databases were searched and evaluated. The primary outcome was headache, which was compared among various treatment regimens. Results: We found a total of 257 articles after duplication removal. Of those, two met the study criteria. According to these studies, oral prednisolone alone or in a combination of albendazole resulted in fewer patients with headache after a 2-week course of treatment compared with placebo (maximum of 9.1% vs. 45.5%). The duration of headache was also shorter in the prednisolone arm vs. placebo (maximum of 5 vs. 13 days). There were no serious side effects reported. Conclusion: A 2-week course of treatment with oral corticosteroid with or without albendazole reduced headaches in patients with EOM.
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Wun MK, Malik R, Yu J, Chow KE, Lau M, Podadera JM, Webster N, Lee R, Šlapeta J, Davies S. Magnetic resonance imaging in dogs with neuroangiostrongyliasis (rat lungworm disease). Parasitology 2021; 148:198-205. [PMID: 32951620 PMCID: PMC11010213 DOI: 10.1017/s0031182020001742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 09/01/2020] [Accepted: 09/11/2020] [Indexed: 11/06/2022]
Abstract
The magnetic resonance imaging (MRI) appearance of the brain and spinal cord in humans with neuroangiostrongyliasis (NA) due to Angiostrongylus cantonensis infection has been well reported. Equivalent studies in animals are lacking. This case series describes clinical and MRI findings in 11 dogs with presumptively or definitively diagnosed NA. MRI of the brain and/or spinal cord was performed using high-field (1.5 T) or low-field (0.25 T) scanners using various combinations of transverse, sagittal, dorsal and three-dimensional (3D) T1-weighted (T1W), transverse, sagittal and dorsal T2-weighted (T2W), T2W fluid-attenuated inversion recovery (FLAIR) and T2*-weighted (T2*W) gradient echo (GRE), dorsal T2W short tau inversion recovery (STIR) and post-gadolinium transverse, sagittal, dorsal and 3D T1W and transverse T2W FLAIR sequences. In 4/6 cases where the brain was imaged, changes consistent with diffuse meningoencephalitis were observed. Evidence of meningeal involvement was evident even when not clinically apparent. The spinal cord was imaged in 9 dogs, with evidence of meningitis and myelitis detected in regions consistent with the observed neuroanatomical localization. Pathognomonic changes of neural larva migrans, as described in some human patients with NA, were not detected. NA should be considered in the differential diagnosis of dogs with MRI evidence of focal or diffuse meningitis, myelitis and/or encephalitis, especially in areas where A. cantonensis is endemic. If not precluded by imaging findings suggestive of brain herniation, cerebrospinal fluid (CSF) collection for cytology, fluid analysis, real-time polymerase chain reaction (qPCR) and enzyme-linked immunosorbent assay (ELISA) testing should be considered mandatory in such cases after the MRI studies.
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Affiliation(s)
- Matthew K. Wun
- Veterinary Specialist Services, 1-15 Lexington Rd, Underwood, QLD4119, Australia
| | - Richard Malik
- Centre for Veterinary Education, The University of Sydney, Camperdown, NSW2006, Australia
- School of Veterinary and Animal Science, Charles Sturt University, Wagga Wagga, NSW 2650, Australia
| | - Jane Yu
- Sydney School of Veterinary Science, The University of Sydney, Camperdown, NSW2006, Australia
| | - Kathleen E. Chow
- Sydney Veterinary Emergency & Specialists, 675 Botany Rd, Rosebery, NSW2018, Australia
| | - Michelle Lau
- Sydney School of Veterinary Science, The University of Sydney, Camperdown, NSW2006, Australia
| | - Juan M. Podadera
- Sydney School of Veterinary Science, The University of Sydney, Camperdown, NSW2006, Australia
| | - Natalie Webster
- IDEXX Telemedicine Consultants, 124/45 Gilby Rd, Mount Waverley, VIC 3149, Australia
| | - Rogan Lee
- Centre for Infectious Diseases & Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Westmead Hospital, NSW 2145, Australia
| | - Jan Šlapeta
- Sydney School of Veterinary Science, The University of Sydney, Camperdown, NSW2006, Australia
| | - Sarah Davies
- Veterinary Imaging Associates, 52-56 Atchison St, St Leonards, NSW 2065, Australia
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Lee R, Pai TY, Churcher R, Davies S, Braddock J, Linton M, Yu J, Bell E, Wimpole J, Dengate A, Collins D, Brown N, Reppas G, Jaensch S, Wun MK, Martin P, Sears W, Šlapeta J, Malik R. Further studies of neuroangiostrongyliasis (rat lungworm disease) in Australian dogs: 92 new cases (2010-2020) and results for a novel, highly sensitive qPCR assay. Parasitology 2021; 148:178-186. [PMID: 32829721 PMCID: PMC11010165 DOI: 10.1017/s0031182020001572] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/17/2020] [Accepted: 08/17/2020] [Indexed: 02/07/2023]
Abstract
The principal aim of this study was to optimize the diagnosis of canine neuroangiostrongyliasis (NA). In total, 92 cases were seen between 2010 and 2020. Dogs were aged from 7 weeks to 14 years (median 5 months), with 73/90 (81%) less than 6 months and 1.7 times as many males as females. The disease became more common over the study period. Most cases (86%) were seen between March and July. Cerebrospinal fluid (CSF) was obtained from the cisterna magna in 77 dogs, the lumbar cistern in f5, and both sites in 3. Nucleated cell counts for 84 specimens ranged from 1 to 146 150 cells μL-1 (median 4500). Percentage eosinophils varied from 0 to 98% (median 83%). When both cisternal and lumbar CSF were collected, inflammation was more severe caudally. Seventy-three CSF specimens were subjected to enzyme-linked immunosorbent assay (ELISA) testing for antibodies against A. cantonensis; 61 (84%) tested positive, titres ranging from <100 to ⩾12 800 (median 1600). Sixty-one CSF specimens were subjected to real-time quantitative polymerase chain reaction (qPCR) testing using a new protocol targeting a bioinformatically-informed repetitive genetic target; 53/61 samples (87%) tested positive, CT values ranging from 23.4 to 39.5 (median 30.0). For 57 dogs, it was possible to compare CSF ELISA serology and qPCR. ELISA and qPCR were both positive in 40 dogs, in 5 dogs the ELISA was positive while the qPCR was negative, in 9 dogs the qPCR was positive but the ELISA was negative, while in 3 dogs both the ELISA and qPCR were negative. NA is an emerging infectious disease of dogs in Sydney, Australia.
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Affiliation(s)
- Rogan Lee
- Parasitology Laboratory, Centre for Infectious Diseases and Microbiology Lab Services, Level 3 ICPMR, Westmead Hospital, NSW, Australia
| | - Tsung-Yu Pai
- Parasitology Laboratory, Centre for Infectious Diseases and Microbiology Lab Services, Level 3 ICPMR, Westmead Hospital, NSW, Australia
| | - Richard Churcher
- North Shore Veterinary Specialist Centre, 63 Herbert St, Artarmon, NSW2064, Australia
| | - Sarah Davies
- Veterinary Imaging Associates, PO Box 300, St. LeonardsNSW1590, Australia
| | - Jody Braddock
- Sydney Veterinary Emergency and Specialists, 675 Botany Road, RoseberryNSW2018, Australia
| | - Michael Linton
- Sydney Veterinary Emergency and Specialists, 675 Botany Road, RoseberryNSW2018, Australia
| | - Jane Yu
- Sydney School of Veterinary Science, University of SydneyNSW2006, Australia
| | - Erin Bell
- Sydney Veterinary Emergency and Specialists, 675 Botany Road, RoseberryNSW2018, Australia
| | - Justin Wimpole
- Small Animal Specialist Hospital, Level 1, 1 Richardson Place, North Ryde, NSW2113, Australia
| | - Anna Dengate
- Northside Veterinary Specialists, 335 Mona Vale Rd, Terrey Hills, NSW2084, Australia
| | - David Collins
- Northside Veterinary Specialists, 335 Mona Vale Rd, Terrey Hills, NSW2084, Australia
| | - Narelle Brown
- Animal Referral Hospital, 250 Parramatta Rd, HomebushNSW2140, Australia
| | - George Reppas
- Vetnostics, 60 Waterloo Road, 60 Waterloo Rd, Macquarie ParkNSW2113, Australia
| | - Susan Jaensch
- Vetnostics, 60 Waterloo Road, 60 Waterloo Rd, Macquarie ParkNSW2113, Australia
| | - Matthew K. Wun
- Veterinary Specialist Services, 1-15 Lexington Rd, Underwood, QLD4119, Australia
| | - Patricia Martin
- Veterinary Pathology Diagnostic Services (VPDS), Building B14, the University of Sydney NSW2006, Australia
| | - William Sears
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - Jan Šlapeta
- Sydney School of Veterinary Science, University of SydneyNSW2006, Australia
- Veterinary Pathology Diagnostic Services (VPDS), Building B14, the University of Sydney NSW2006, Australia
| | - Richard Malik
- Centre for Veterinary Education, B22, University of Sydney, NSW2006, Australia
- School of Veterinary and Animal Science, Charles Sturt University, Wagga Wagga, NSW2678, Australia
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23
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Cattaneo C, Hoarau M, Valois S, Chamouine A, Dembele Y, Collet L, Sarton R. Tetraventricular Hydrocephalus Following Eosinophilic Meningitis due to Angiostrongylus cantonensis in a 14-Month-Old Boy From Mayotte: A Case Report. Open Forum Infect Dis 2021; 8:ofab031. [PMID: 33728356 PMCID: PMC7944387 DOI: 10.1093/ofid/ofab031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/21/2021] [Indexed: 11/12/2022] Open
Abstract
Angiostrongylus cantonensis is endemic in Mayotte, and cases of meningitis due to angiostrongyliasis are regularly diagnosed in young children. In a 14-month-old boy with slow-onset psychomotor regression, brain magnetic resonance imaging revealed communicating hydrocephalus. Reverse transcription polymerase chain reaction for A. cantonensis on cerebrospinal fluid was positive. The evolution was favorable with repeated lumbar punctures and a 2-week treatment with albendazole and high-dose corticosteroids.
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Affiliation(s)
- Chiara Cattaneo
- Department of Paediatrics, Centre Hospitalier de Mayotte, Mamoudzou, France.,Division of Infectious Diseases, Department of Medicine II, University of Freiburg, Freiburg, Germany
| | - Marion Hoarau
- Department of Paediatrics, CHU La Réunion Groupe Hospitalier du Sud, Saint Pierre, France
| | - Sophie Valois
- Department of Paediatrics, CHU La Réunion Groupe Hospitalier du Sud, Saint Pierre, France
| | | | - Yacouba Dembele
- Department of Radiology, Centre Hospitalier de Mayotte, Mamoudzou, France
| | - Luis Collet
- Medical Biology Laboratory, Centre Hospitalier de Mayotte, Mamoudzou, France
| | - Raphaëlle Sarton
- Department of Paediatrics, CHU La Réunion Groupe Hospitalier du Sud, Saint Pierre, France
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Valerio Sallent L, Moreno Santabarbara P, Roure Díez S. Abdominal pain secondary to neuroinvasive Angiostrongylus cantonensis; first European case. Some reflections on emerging parasitosis. GASTROENTEROLOGIA Y HEPATOLOGIA 2020; 44:566-567. [PMID: 33187744 PMCID: PMC7654301 DOI: 10.1016/j.gastrohep.2020.07.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/10/2020] [Accepted: 07/28/2020] [Indexed: 12/04/2022]
Affiliation(s)
- Lluís Valerio Sallent
- Institut Català de la Salut. Programa de Salud Internacional (PROSICS) Metropolitana Norte. Hospital Universitario Germans Trias i Pujol, Badalona, Cataluña, España.
| | - Pau Moreno Santabarbara
- Institut Català de la Salut. Servicio de Cirugía General y Digestiva. Hospital Universitario Germans Trias i Pujol, Badalona, Cataluña, España
| | - Sílvia Roure Díez
- Institut Català de la Salut. Programa de Salud Internacional (PROSICS) Metropolitana Norte. Servicio de Enfermedades Infecciosas. Hospital Universitario Germans Trias i Pujol, Badalona, Cataluña, España
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Sawanyawisuth K, Sawanyawisuth K, Senthong V, Limpawattana P, Intapan PM, Maleewong W, Prasongdee T, Naonongwai S, Tiamkao S, Chotmongkol V, Khamsai S. Clinical features and course of Angiostrongylus cantonensis eosinophilic meningitis in patients receiving supportive therapy. Food Waterborne Parasitol 2020; 21:e00095. [PMID: 33294648 PMCID: PMC7689049 DOI: 10.1016/j.fawpar.2020.e00095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/08/2020] [Accepted: 09/14/2020] [Indexed: 11/24/2022] Open
Abstract
Acute severe headache is the main presentation of eosinophilic meningitis (EOM) caused by Angiostrongylus cantonensis. Oral corticosteroid treatment is effective in reduction of duration of headache but may be contraindicated in particular patients. This study investigated clinical features and clinical course of eosinophilic meningitis caused by A. cantonensis if left untreated. Additionally, factors associated with duration of headache were evaluated. We conducted a retrospective study between 1997 and 2019 at a university hospital in Thailand. The inclusion criteria were adult patients who were diagnosed with EOM, had a positive serological test for A. cantonensis, received only supportive treatment, and had the complete clinical course documented. Factors associated with duration of headache were executed by multivariate linear regression analysis. A total of 54 patients were used in the final analysis. Of those, 39 patients (79.2%) were male and the mean ± SD age of all patients was 33.7 ± 12.2. The mean ± SD duration of headache was 16.0 ± 12.4 days with the longest duration of 49 days. The only factor associated with duration of headache was gender (p = 0.036). The male gender had a coefficient of −8.4 (95% CI: −16.2, −0.6). The median duration of headache in male and female patients was 11 and 20 days, respectively. In conclusion, A. cantonensis eosinophilic meningitis can cause long lasting headache, and gender may be associated with duration of headache.
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Affiliation(s)
| | | | - Vichai Senthong
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Panita Limpawattana
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pewpan M Intapan
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Wanchai Maleewong
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Thidarat Prasongdee
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sureeporn Naonongwai
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Somsak Tiamkao
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Verajit Chotmongkol
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sittichai Khamsai
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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26
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Abstract
A subcommittee of the Hawaii Governor's Joint Task Force on Rat Lungworm Disease developed preliminary guidelines for the diagnosis and treatment of neuroangiostrongyliasis (NAS) in 2018 (Guidelines, 2018). This paper reviews the main points of those guidelines and provides updates in areas where our understanding of the disease has increased. The diagnosis of NAS is described, including confirmation of infection by real-time polymerase chain reaction (RTi-PCR) to detect parasite DNA in the central nervous system (CNS). The treatment literature is reviewed with recommendations for the use of corticosteroids and the anthelminthic drug albendazole. Long-term sequelae of NAS are discussed and recommendations for future research are proposed.
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27
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Elghawy AA, Skopis M, Davis J, Bag-Ozbek A. Angiostrongyliasis infection masquerading as granulomatosis with polyangiitis: a case-based review. Rheumatol Int 2020; 40:1171-1176. [PMID: 32424614 DOI: 10.1007/s00296-020-04601-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 05/04/2020] [Indexed: 11/25/2022]
Abstract
Pulmonary angiitis is a small vessel vasculitis commonly reported in granulomatosis with polyangiitis (GPA) but is rarely attributed to angiostrongyliasis. We report a case of a patient with well-controlled rheumatoid arthritis, who was treated for GPA based on lung biopsy results with glucocorticoids (GC). Upon re-review of the initial pathology, along with peripheral eosinophilia and history of recent travel, the patient was eventually diagnosed with angiostrongylus-like nematode infection. GCs were subsequently discontinued and instead, the patient was treated with anthelmintics with complete resolution of symptoms. Commonly associated with eosinophilic meningitis or abdominal angiostrongyliasis in humans, clinical pulmonary manifestations of this parasite species are rare. With parasitic infiltration of the pulmonary vessels mimicking clinical GPA, diagnosis and treatment can be difficult in these patients. We discuss the third-reported case and first-reported survivor of Angiostrongylus-induced pulmonary angiitis followed by a focused review of the literature.
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Affiliation(s)
- Ahmed Aly Elghawy
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, SUNY Stony Brook University Hospital, Stony Brook, NY, USA.
| | - Maria Skopis
- Department of Medicine, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - James Davis
- Department of Pathology, SUNY Stony Brook University Hospital, Stony Brook, NY, USA
| | - Ayse Bag-Ozbek
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, SUNY Stony Brook University Hospital, Stony Brook, NY, USA
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Dard C, Tessier E, Nguyen D, Epelboin L, Harrois D, Swale C, Cabié A, de Meuron K, Miossec C, Desbois-Nogard N. First cases of Angiostrongylus cantonensis infection reported in Martinique, 2002-2017. ACTA ACUST UNITED AC 2020; 27:31. [PMID: 32394891 PMCID: PMC7216674 DOI: 10.1051/parasite/2020032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 04/28/2020] [Indexed: 11/29/2022]
Abstract
Neuroangiostrongyliasis is a parasitic disease caused by the accidental ingestion of the nematode Angiostrongylus cantonensis in its larval form. Human infection can lead to eosinophilic meningitis, sometimes complicated by life-threatening radiculomyelitis or encephalitis. Although some cases have been reported from other Caribbean Islands, no cases have been diagnosed in Martinique so far. Here, we report the first eight laboratory-confirmed cases of neuroangiostrongyliasis on the island of Martinique, French West Indies, between 1 January 2002 and 31 December 2017. One case was fatal and five resulted in neurological sequelae. The medical community should consider the risk of A. cantonensis infection in patients living in or returning from Martinique.
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Affiliation(s)
- Céline Dard
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire Grenoble Alpes, CS 10217, 38043 Grenoble Cedex 9, France - Institute for Advanced Biosciences (IAB), INSERM U1209 - CNRS UMR5309, Université Grenoble Alpes, 38700 La Tronche, France
| | - Eve Tessier
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Martinique, Fort-de-France, 97200 Martinique, France
| | - Duc Nguyen
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Martinique, Fort-de-France, 97200 Martinique, France
| | - Loïc Epelboin
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Andrée Rosemon, Cayenne, 97300 Guyane, France
| | - Dorothée Harrois
- Laboratoire de Biologie Médicale, Centre Hospitalier de Basse-Terre, Basse-Terre, 97100 Guadeloupe, France
| | - Christopher Swale
- Institute for Advanced Biosciences (IAB), INSERM U1209 - CNRS UMR5309, Université Grenoble Alpes, 38700 La Tronche, France
| | - André Cabié
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Martinique, Fort-de-France, 97200 Martinique, France - INSERM CIC 1424, Centre Hospitalier Universitaire de Martinique, Fort-de-France, 97200 Martinique, France - Université des Antilles, EA7524, 97200 Martinique, France
| | - Katia de Meuron
- Maison de la Femme, de la Mère et de l'Enfant, Centre Hospitalier Universitaire de Martinique, Fort-de-France, 97200 Martinique, France
| | - Charline Miossec
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Martinique, Fort-de-France, 97200 Martinique, France
| | - Nicole Desbois-Nogard
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Martinique, Fort-de-France, 97200 Martinique, France
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29
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Federspiel F, Skovmand S, Skarphedinsson S. Eosinophilic meningitis due to Angiostrongylus cantonensis in Europe. Int J Infect Dis 2020; 93:28-39. [PMID: 31972289 DOI: 10.1016/j.ijid.2020.01.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/03/2020] [Accepted: 01/13/2020] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES To describe and analyse the epidemiological and clinical characteristics of imported human angiostrongyliasis in Europe. METHODS A systematic literature review of cases of human angiostrongyliasis in Europe was performed. Seven databases were searched. The epidemiological and clinical characteristics were extracted from included records and simple summary statistics were performed on extracted data. RESULTS Twenty-two cases reported between 1988 and 2019 were identified. They were mainly from French Polynesia, Southeast Asia, and the Caribbean Islands. The dominant suspected mode of transmission was ingestion of prawns, shrimp, or salad. For patients with data, 90% had a history of headache, often lasting, and half had paresthesia. Eighty-nine percent had eosinophilia, 93% had cerebrospinal fluid (CSF) eosinophilia, and 92% had elevated CSF protein. Central nervous system (CNS) imaging was normal in most cases. Two-thirds received albendazole or mebendazole treatment, although this is not currently recommended. CONCLUSIONS We have increased previous numbers to 22 reported cases in total since 1988. Angiostrongyliasis should generally be suspected in patients with a lasting headache who have returned from Southeast Asia, China, the Caribbean Islands, Australia, or French Polynesia, as well as parts of North America and Tenerife, Spain, although one autochthonous case from mainland Europe has also been reported. A dietary history should focus on prawns, shrimp, and salad, whilst also including slugs and snails and other paratenic hosts where relevant. The clinical diagnosis is supported by the presence of blood eosinophilia, CSF eosinophilia, and elevated CSF protein. A definitive laboratory diagnosis should be sought, and CNS imaging should be used to support, not to rule out the diagnosis. The most up-to-date evidence should always be consulted before initiating treatment. Current recommendations include analgesics, corticosteroids, and periodic removal of CSF for symptom relief, while antihelminthic treatment is debated.
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Affiliation(s)
- Frederik Federspiel
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom.
| | - Sofie Skovmand
- Department of Microbiology, Odense University Hospital, Søndre Blvd. 29, 5000 Odense C, Denmark.
| | - Sigurdur Skarphedinsson
- Clinical Centre of Emerging and Vector-borne Infections, Department of Infectious Diseases, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Søndre Blvd. 29, 5000 Odense C, Denmark.
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30
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Brummaier T, Bertschy S, Arn K, Treumann T, Ruf MT, Nickel B, Paris DH, Neumayr A, Blum J. A blind passenger: a rare case of documented seroconversion in an Angiostrongylus cantonensis induced eosinophilic meningitis in a traveler visiting friends and relatives. TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES 2019; 5:6. [PMID: 31016026 PMCID: PMC6466724 DOI: 10.1186/s40794-019-0084-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 04/08/2019] [Indexed: 01/11/2023]
Abstract
Background Eosinophilic meningitis (EOM) is a rare condition that is caused by various communicable and non-communicable factors. The rat-lungworm Angiostrongylus cantonensis, which is associated with consumption of raw or undercooked paratenic or intermediate hosts, is the most common cause of parasitic eosinophilic meningitis worldwide. While the majority of A. cantonensis cases are reported from endemic regions, cases in travelers pose a challenge to clinicians in non-endemic countries. Here we report a rare case of eosinophilic meningitis caused by A. cantonensis in a Swiss traveler who was diagnosed after returning from Thailand. Case presentation A 33-year old woman with a travel history to rural north-eastern Thailand presented to an emergency department in Switzerland with severe headache and vomiting. Eosinophilic meningitis was confirmed as the cause of the symptoms; however, serologic investigations failed to confirm an A. cantonensis infection on the first evaluation. Nevertheless, empirical treatment with an anthelminthic and steroid regimen led to a rapid alleviation of symptoms. Repeated serology confirmed seroconversion 2 weeks after treatment initiation. Discussion Parasitic etiology must be considered in returning travelers who present with symptoms compatible with a central nervous system infection. A thorough medical history, including types of food consumed, is paramount and can often suggest differential diagnosis. Neuroangiostrongyliasis is rare and might be missed if serology does not cover possible seroconversion.
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Affiliation(s)
- Tobias Brummaier
- 1Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland.,2Faculty of Medicine, University of Basel, Basel, Switzerland.,3Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.,4Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, UK
| | - Sonja Bertschy
- 5Department of Infectiology, Luzerner Kantonsspital, Luzern, Switzerland
| | - Kornelius Arn
- 6Division of Hematology and Hematology Laboratory, Luzerner Kantonsspital, Luzern, Switzerland
| | - Thomas Treumann
- 7Division of Nuclear Medicine and Radiology, Luzerner Kantonsspital, Luzern, Switzerland
| | - Marie-Therese Ruf
- 1Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland.,2Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Beatrice Nickel
- 1Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland.,2Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Daniel H Paris
- 1Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland.,2Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Andreas Neumayr
- 1Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland.,2Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Johannes Blum
- 1Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland.,2Faculty of Medicine, University of Basel, Basel, Switzerland
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