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      Angiostrongylus cantonensis Meningitis and Myelitis, Texas, USA

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          Abstract

          Infection with Angiostrongylus cantonensis roundworms is endemic in Southeast Asia and the Pacific Basin. A. cantonensis meningitis and myelitis occurred in summer 2013 in a child with no history of travel outside of Texas, USA. Angiostrongyliasis is an emerging neurotropic helminthic disease in Texas and warrants increased awareness among healthcare providers.

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          The finding of Angiostrongylus cantonensis in rats in New Orleans.

          B. Campbell, Robert M. D. Little (1988)
          Twenty of 94 (21.4%) Rattus norvegicus trapped in New Orleans, Louisiana, between April 1986 and February 1987 were infected with Angiostrongylus cantonensis (3-62 worms per rat). This is the first report of the parasite from North America. A carnivorous snail, Euglandina rosea, was found experimentally to be able to serve as both an intermediate and a paratenic host. Other locally occurring gastropods that were successfully infected experimentally included Mesodon thyroidus, Anguispira alternata, Bradybaena similaris, Subulina octona, Polygyra triodontoides, Vaginulus ameghini, Philomycus carolinianus, Deroceras laeve, Limax flavus, and Lehmannia poirieri. Laboratory reared, 4- to 5-week-old M. thyroidus and D. laeve were able to support the development of small numbers of larvae to the third stage. First stage larvae of A. cantonensis in the feces of experimentally infected rats were found not to migrate out of the fecal pellet; this behavior favors the infection of feces-consuming gastropods. Twenty heavily infected L. flavus were observed over a period of 2 months, and shedding of third stage larvae of A. cantonensis was never seen. While factors support the spread of A. cantonensis in rats in the southern United States, the probability of human infection is uncertain since the parasite is transmitted primarily by ingestion of raw intermediate and paratenic hosts.
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            Geographic Range Expansion for Rat Lungworm in North America

            Emily M. York, James Creecy, Wayne D. Lord … (2015)
            Using quantitative PCR analysis and DNA sequencing, we provide evidence for the presence of rat lungworm (Angiostrongylus cantonensis) in Oklahoma, USA, and identified a potentially novel rat host (Sigmodon hispidus). Our results indicate a geographic range expansion for this medically and ecologically relevant parasite in North America.
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              The occurrence of the rat lungworm, Angiostrongylus cantonensis, in nonindigenous snails in the Gulf of Mexico region of the United States.

              John Teem, Yvonne Qvarnstrom, Henry S. Bishop … (2013)
              Nonindigenous apple snails, Pomacea maculata (formerly Pomacea insularum), are currently spreading rapidly through the southeastern United States. This mollusk serves as an intermediate host of the rat lungworm parasite (Angiostrongylus cantonensis), which can cause eosinophilic meningitis in humans who consume infected mollusks. A PCR-based detection assay was used to test nonindigenous apple snails for the rat lungworm parasite in Louisiana, Texas, Mississippi, and Florida. Only apple snails obtained from the New Orleans, Louisiana, area tested positive for the parasite. These results provide the first evidence that Angiostrongylus cantonensis does occur in nonindigenous apple snails in the southeastern United States. Additionally, Angiostrongylus cantonensis was identified in the terrestrial species Achatina fulica in Miami, Florida, indicating that rat lungworm is now established in Florida as well as Louisiana. Although the study suggests that the rat lungworm is not widespread in the Gulf States region, the infected snail population could still pose a risk to human health and facilitate the spread of the parasite to new areas.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Emerg Infect Dis
                Journal ID (iso-abbrev): Emerging Infect. Dis
                Journal ID (publisher-id): EID
                Title: Emerging Infectious Diseases
                Publisher: Centers for Disease Control and Prevention
                ISSN (Print): 1080-6040
                ISSN (Electronic): 1080-6059
                Publication date (Print): June 2017
                Volume: 23
                Issue: 6
                Pages: 1037-1038
                Affiliations
                [1]McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
                Author notes
                Address for correspondence: Roukaya Al Hammoud, University of Texas Health, McGovern Medical School, Pediatric Infectious Diseases Division, 6431 Fannin St, Ste 3.126, Houston, TX 77030, USA; email: Roukaya.AlHammoud@ 123456uth.tmc.edu
                Article
                Publisher ID: 16-1683
                DOI: 10.3201/eid2306.161683
                PMC ID: 5443436
                PubMed ID: 28518035
                SO-VID: 3c255f81-b739-4cc2-b460-3304fd7356cc
                History
                Categories
                Subject: Research Letter
                Subject: Research Letter
                Subject: Angiostrongylus cantonensis Meningitis and Myelitis, Texas, USA

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: meningitis,texas,pediatric,angiostrongylus cantonensis,parasitic diseases,helminths,zoonoses,parasites,united states,roundworms,nematodes,myelitis
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: meningitis, texas, pediatric, angiostrongylus cantonensis, parasitic diseases, helminths, zoonoses, parasites, united states, roundworms, nematodes, myelitis

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