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The nematode Angiostrongylus cantonensis is the most common cause of neuroangiostrongyliasis (manifested as eosinophilic meningitis) in humans. Gastropod molluscs are used as intermediate hosts and rats of various species are definitive hosts of this parasite. In this study, we identified several environmental factors associated with the presence and abundance of terrestrial gastropods in an impoverished urban region in Brazil. We also found that body condition, age and presence of co-infection with other parasite species in urban Rattus norvegicus, as well as environmental factors were associated with the probability and intensity of A. cantonensis infection. The study area was also found to have a moderate prevalence of the nematode in rodents (33% of 168 individuals). Eight species of molluscs (577 individuals) were identified, four of which were positive for A. cantonensis. Our study indicates that the environmental conditions of poor urban areas (presence of running and standing water, sewage, humidity and accumulated rain and accumulation of construction materials) influenced both the distribution and abundance of terrestrial gastropods, as well as infected rats, contributing to the maintenance of the A. cantonensis transmission cycle in the area. Besides neuroangiostrongyliasis, the presence of these hosts may also contribute to susceptibility to other zoonoses.

Introduction: Angiostrongylus cantonensis is a serious public health problem and is widely distributed in the country. When the parasite infects the snails, it becomes deeply embedded in their interior and accidentally, it can infect people and other mammals. Objective: To establish the geographical distribution of A. cantonensis intermediate hosts (Achatina fulica) and definitive hosts (Rattus spp.) in Ecuador from 2014 to 2017. Materials and methods: We collected 2,908 A. fulica specimens in 16 provinces using the capture method per unit of effort for 30 minutes. We captured 211 hosts of which 20 were Rattus rattus and 191 R. norvegicus. The specimens were transported to the Instituto Nacional de Salud Pública e Investigación in Guayaquil where the larvae L3 were identified and counted in the tissues of the snail, which were then inoculated in laboratory rats to reproduce the life cycle. In the rodents, the brains, hearts, lung arteries and lungs were dissected, and the parasites were identified by taxonomic morphology. Results: Of the snails harvested, 441 were positive for A. cantonensis (15.2%) and a total of 6,166 L3 larvae were found; 77 (36.5%) specimens of Rattus spp., were infected with A. cantonensis and a total of 220 parasites (L4-L5 larvae and adult worms) were collected. Conclusions: We confirmed the presence of A. cantonensis in several provinces, which ratifies the endemic nature of this zoonosis in the national territory. Rattus spp. specimens constitute the definitive hosts of the parasite, which together with the presence of intermediate hosts, indicates the zoonotic potential of this parasitic infection.

Angiostrongylus mackerrasae is a parasitic nematode of rats found in Australia. When first reported, it was referred to as A. cantonensis. Recent molecular studies, including the mitochondrial genome, indicate that it is highly similar to A. cantonensis. These studies did not include A. malaysiensis, another member of the A. cantonensis species complex, for comparison. The present study examined the genetic distance and phylogenetic relationship between the component taxa (A. cantonensis, A. mackerrasae and A. malaysiensis) of the A. cantonensis species complex, based on the 12 protein-coding genes (PCGs) of their mitochondrial genome. Both the nucleotide and amino acid sequences were analysed. Angiostrongylus mackerrasae and A. cantonensis are members of the same genetic lineage and both are genetically distinct from A. malaysiensis. The genetic distance based on concatenated nucleotide sequences of 12 mt-PCGs between A. mackerrasae and A. cantonensis from Thailand is p = 1.73%, while that between the Thai and Chinese taxa of A. cantonensis is p = 3.52%; the genetic distance between A. mackerrasae and A. cantonensis from China is p = 3.70%. The results indicate that A. mackerrasae and A. cantonensis belong to the same genetic lineage, and that A. mackerrasae may be conspecific with A. cantonensis. It remains to be resolved whether A. mackerrasae is conspecific with A. cantonensis or undergoing incipient speciation.

The nematode Angiostrongylus cantonensis is a zoonotic pathogen and the etiological agent of human angiostrongyliasis or rat lungworm disease. Hawai'i, particularly east Hawai'i Island, is the epicenter for angiostrongyliasis in the USA. Rats (Rattus spp.) are the definitive hosts while gastropods are intermediate hosts. The main objective of this study was to collect adult A. cantonensis from wild rats to isolate protein for the development of a blood-based diagnostic, in the process we evaluated the prevalence of infection in wild rats. A total of 545 wild rats were sampled from multiple sites in the South Hilo District of east Hawai'i Island. Adult male and female A. cantonensis (3,148) were collected from the hearts and lungs of humanely euthanized Rattus rattus, and R. exulans. Photomicrography and documentation of multiple stages of this parasitic nematode in situ were recorded. A total of 45.5% (197/433) of rats inspected had lung lobe(s) (mostly upper right) which appeared granular indicating this lobe may serve as a filter for worm passage to the rest of the lung. Across Rattus spp., 72.7% (396/545) were infected with adult worms, but 93.9% (512/545) of the rats were positive for A. cantonensis infection based on presence of live adult worms, encysted adult worms, L3 larvae and/or by PCR analysis of brain tissue. In R. rattus we observed an inverse correlation with increased body mass and infection level of adult worms, and a direct correlation between body mass and encysted adult worms in the lung tissue, indicating that larger (older) rats may have developed a means of clearing infections or regulating the worm burden upon reinfection. The exceptionally high prevalence of A. cantonensis infection in Rattus spp. in east Hawai'i Island is cause for concern and indicates the potential for human infection with this emerging zoonosis is greater than previously thought.

The nematode Angiostrongylus cantonensis is the causative agent of human angiostrongyliasis, the main clinical manifestation of which is eosinophilic meningitis. Although this parasite has been found recently in its definitive rat host in Tenerife (Canary Islands, Spain), showing a widespread distribution over the north-east part of the island, there are no available data regarding which snail and/or slug species are acting as intermediate hosts on this island. Consequently, the objective of this work was to determine the possible role of three mollusc species, Plutonia lamarckii, Cornu aspersum and Theba pisana, as intermediate hosts of A. cantonensis in Tenerife. Between 2011 and 2014, 233 molluscs were collected from five biotopes where rats had been found previously to harbor either adult worms or antibodies against A. cantonensis, and the identification was carried out on the basis of morphological features and a LAMP technique. The prevalence of A. cantonensis larvae in the mollusc samples, based on morphological identification, was 19.3%, whereas 59 out of the 98 individuals (60.2%) analyzed by LAMP were positive. Positive results were obtained for the three mollusc species analyzed and two of the positive samples, both obtained from P. lamarckii, were confirmed as positive by 18S rRNA and ITS1 PCR. Sequence analysis of 18S rRNA PCR products showed 100% similarity with previously published A. cantonensis sequences. These results may be relevant from a public health point of view, since all the biotopes from which the samples were obtained were in inhabited areas or areas with human activity, but it is also important from the perspective of a possible transmission to other accidental hosts, such as dogs and horses, animals that are present in some of the areas analyzed.

Angiostrongylus cantonensis is the most common parasite causing human eosinophilic meningitis worldwide. The geographical distribution of this disease has changed dramatically in the last few decades. Various methods have been used to detect A. cantonensis in host animals around the world. A survey of mollusks collected on the island of Hawa'i in 2005 using PCR showed an infection rate of 24-78% depending on the mollusk species. In this study, samples from intermediate, definitive, and paratenic hosts were analyzed to further determine the presence of A. cantonensis in the United States. All samples were from Hawa'i, except for the apple snails (Pomacea maculata) that were collected in New Orleans, Louisiana. Angiostrongylus cantonensis was detected in the majority of species examined, including the apple snails from New Orleans and flatworms (planarians) from Hawa'i. Among the mollusks examined, the semi-slug Parmarion martensi had the highest parasite load, with an average larval burden of 445 larvae in 25 mg of tissue, as estimated by real-time PCR. In contrast, slime excreted from these highly infected mollusks contained no or very little A. cantonensis DNA. Analysis of definitive hosts (Rattus spp.) showed discrepancies between morphological and PCR-based identification; 54% of the rats were positive based on morphology, while 100% of tissue samples from these animals were positive by real-time PCR. This indicates that necropsies of rodents could underestimate the infection rates in definitive hosts of A. cantonensis.

Angiostrongylus cantonensis is a metastrongyloid nematode in the family Angiostrongylidae. It is the cause of angiostrongyliasis (rat lungworm disease), which manifests as eosinophilic meningitis. First described in 1935 from rats in China, A. cantonensis was placed in the genus Parastrongylus in 1986, but most workers have not adopted this treatment. The taxonomy of A. cantonensis and related worms is largely based on adult morphology, notably of the male bursa. However, identification of infective third stage larvae is more difficult. The natural life cycle involves rats as the definitive host and snails or slugs as the intermediate host. Human infection, as accidental hosts, results in worms maturing in the brain, but dying there instead of moving back into the bloodstream, as in rats, thereby leading to eosinophilic meningitis. The disease is an emerging infectious disease; Angiostrongylus cantonensis continues to be reported in new regions beyond its native range.

The metastrongyloid nematode genus Angiostrongylus includes 18 species, two of which are relevant from a medical standpoint, Angiostrongylus costaricensis and Angiostrongylus cantonensis. The first was described from Costa Rica in 1971 and causes abdominal angiostrongyliasis in the Americas, including in Brazil. Angiostrongylus cantonensis, first described in 1935 from Canton, China, is the causative agent of eosinophilic meningitis. The natural definitive hosts are rodents, and molluscs are the intermediate hosts. Paratenic or carrier hosts include crabs, freshwater shrimp, amphibians, flatworms, and fish. Humans become infected accidentally by ingestion of intermediate or paratenic hosts and the parasite does not complete the life cycle as it does in rats. Worms in the brain cause eosinophilic meningitis. This zoonosis, widespread in Southeast Asia and the Pacific islands, has now been reported from other regions. In the Americas there are records from the United States, Cuba, Jamaica, Brazil, Ecuador, and Haiti. In Brazil seven human cases have been reported since 2007 from the southeastern and northeastern regions. Epidemiological studies found infected specimens of Rattus norvegicus and Rattus rattus as well as many species of molluscs, including the giant African land snail, Achatina fulica, from various regions of Brazil. The spread of angiostrongyliasis is currently a matter of concern in Brazil.

Background: The rat lungworm Angiostrongylus cantonensis can cause eosinophilic meningoencephalitis in humans. This nematode's main definitive hosts are rodents and its intermediate hosts are snails. This parasite was first described in China and currently is dispersed across several Pacific islands, Asia, Australia, Africa, some Caribbean islands and most recently in the Americas. Here, we report the genetic variability among A. cantonensis isolates from different geographical locations in Brazil using mitochondrial cytochrome c oxidase subunit I (COI) gene sequences., Methods: The isolates of A. cantonensis were obtained from distinct geographical locations of Brazil. Genomic DNAs were extracted, amplified by polymerase reaction, purified and sequenced. A partial sequence of COI gene was determined to assess their phylogenetic relationship., Results: The sequences of A. cantonensis were monophyletic. We identified a distinct clade that included all isolates of A. cantonensis from Brazil and Asia based on eight distinct haplotypes (ac1, ac2, ac3, ac4, ac5, ac6, ac7 and ac8) from a previous study. Interestingly, the Brazilian haplotype ac5 is clustered with isolates from Japan, and the Brazilian haplotype ac8 from Rio de Janeiro, São Paulo, Pará and Pernambuco states formed a distinct clade. There is a divergent Brazilian haplotype, which we named ac9, closely related to Chinese haplotype ac6 and Japanese haplotype ac7., Conclusion: The genetic variation observed among Brazilian isolates supports the hypothesis that the appearance of A. cantonensis in Brazil is likely a result of multiple introductions of parasite-carrying rats, transported on ships due to active commerce with Africa and Asia during the European colonization period. The rapid spread of the intermediate host, Achatina fulica, also seems to have contributed to the dispersion of this parasite and the infection of the definitive host in different Brazilian regions.

We conducted a pilot survey of genetic variation of A. cantonensis using small subunit (SSU) ribosomal (r) RNA and mitochondrial cytochrome c oxidase subunit I (coxI) gene sequences. Two distinct SSU genotypes (G1 and G2) were identified among 17 individual A. cantonensis worms from 17 different geographical localities in Japan, Mainland China, Taiwan, and Thailand. The partial coxI sequences were determined for 83 worms from 18 different geographical localities from Japan, Mainland China, Taiwan, and Thailand. Phylogenetic analysis showed eight distinct coxI haplotypes (ac1 to ac8). In 16 out of 18 localities, only a single coxI haplotype was found. However, in two localities, two coxI haplotypes coexisted. The common haplotypes found were: haplotype ac1 (Tokyo, Chiba, Kanagawa, Amamioshima Island, and Taichung), haplotype ac2 (Ishikawa, Shenzhen, and Lianjiang), haplotype ac5 (the Okinawa and the Ogasawara Islands), and haplotype ac7 (Miyagi, Aichi, and Kanagawa). Each of these regions is separated from the others by high mountain ranges or oceans. In addition, the lower genetic variation and particular geographical distribution of A. cantonensis in each location could indicate a founder effect, which may have resulted from multiple independent origins, and suggests that haplotypes migrated from endemic areas via human-related transportation., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Eosinophilic meningitis is an uncommon clinical entity, which is mostly caused by Angiostrongylus cantonensis, a nematode which parasitizes rat's lungs. Humans represent a dead-end in the parasite's lifecycle and become infected by ingesting snails, slugs or transport hosts. Due to uncontrolled proliferation and circulation of snails and rats, human angiostrongyliasis has emerged in new foci in continental China. The treatment, which relies upon a combination of albendazole and corticosteroids, is still a matter of debate. In order to assess the epidemiological features of two outbreaks which occurred in Kunming, capital of the Yunnan province, 2003 and 2005, along with the clinical and treatment issues, a retro-prospective study was carried out among thirty-four clinical cases of eosinophilic meningitis. Furthermore, a parasitological survey was carried out on randomized samples of snails sold in the markets of the city On admission, all cases were found to have acute headaches and an eosinophilic pleocytosis rate > 5% in the cerebro spinal fluid (CSF). All patients reported the consumption of raw snails Pomacea canaliculata, 14 days on average before the onset of headaches (range 1-30 days). Hyperesthesia due to radiculitis was observed in 68% of the cases and the meningitis syndrome was present in 41%. The average value of blood eosinophil count in CSF and in peripheral blood was 38% and 900/ml, respectively. Two treatment schedules were used (without randomization): one with progressive doses over 4 weeks; the other with immediate high doses for 10 days with 3 sessions separated by 14-day intervals. The results were compared by the Kaplan Meier log rank test. All the cases had a favorable evolution. The analysis suggested better effectiveness and tolerance of the albendazole - dexamethasone combination used at the highest dosage, namely 20mglkg daily and 10mg daily respectively. Eosinophilic meningitis appeared to be recently emerging or re-emerging in Kunming. Deep-rooted culinary habits of eating raw food, and large amount of snails sold on local markets (about one ton per day) provide ideal conditions for the outbreak, or occurrence of this disease. According to the resdjlts of this study Chinese local authorities should be urged to improve information to the population about the risks of eating raw snails, in order to strengthen the control of both rat and snail populations and reinforce the supervision of local food markets.

Introduction: 25 years ago was first reported in Cuba and in the western hemisphere an emergent disease: eosinophilic meningoencephalitis due to Angiostrongylus cantonensis larvae., Aim: To collect in a summary form the accumulated experience and the findings of the study of this parasitosis during the period in the Western hemisphere., Development and Conclusions: There have been collected the first evidences, the parasitological and malacological findings, the experimental and molecular studies on immunology and neuroimmunology, the clinic-pathological findings in children and adults with the particularities of this diseases in our environment with special emphasis in the never-before scientific findings reported. It has been documented the testimony, the main findings among the malacological studies, the role of the immunoglobulin E and the mechanism involved in the central nervous system, the intrathecal synthesis patterns of immunoglobulins and the clinical elements in children and adults.

In the West Indies Angiostrongylus cantonensis was found first in Cuba in 1973, then in Puerto Rico (1986), in the Dominican Republic (1992) and recently in Jamaica (2002). Concurrently, the presence of the parasite was detected in the Bahamas and in New Orleans (LA, USA) in 1990. To assess the occurrence of A. cantonensis in Haiti, we investigated a number of rats in Port-au-Prince in 2002. Preliminary results among 23 captured and examined rats show that 75% (three of four) Rattus norvegicus and 21% (four of 19) R. rattus harboured A. cantonensis in their cardiopulmonary systems. Haiti is, for the first time, recognized as a new enzootic area for A. cantonensis in the Caribbean. This emerging zoonosis should be considered as a new public health hazard in Haiti.

After an outbreak in 2000 of eosinophilic meningitis in tourists to Jamaica, we looked for Angiostrongylus cantonensis in rats and snails on the island. Overall, 22% (24/109) of rats harbored adult worms, and 8% (4/48) of snails harbored A. cantonensis larvae. This report is the first of enzootic A. cantonensis infection in Jamaica, providing evidence that this parasite is likely to cause human cases of eosinophilic meningitis.

The presence of Angiostrongylus cantonensis excretory secretory (ES) products was detected in the cerebrospinal fluid (CSF) of infected rats using a coagglutination assay. There was clear agglutination in 100% of CSF samples tested of the rats infected with third-stage larvae of A. cantonensis and neither of the 20 non-infected rats produced agglutination. The assay detected 250 ng/ml or more of ES products. This assay is simple, easy to perform with minimum training and requires no equipment.

Five subspecies of Oncomelania snails, Oncomelania hupensis nosophora, O.h. hupensis, O.h.chiui, O.h.formosana and O.h.quadrasi, were experimentally exposed to the first stage larvae of Angiostrongylus cantonesis. The presence of third stage larvae was observed in all of the five subspecies of Oncomelania snails 20 days after infection. Infection rates of the third stage larvae of the parasite in Oncomelania snails were 38.0-40.0%. There were no differences in preferences among Oncomelania snails. The third stage larvae in Oncomelania snails almost distributed in kidney and intestine region, and most of the larvae were active and free in tissues. The distribution pattern of the larvae in Oncomelania snails was quite different from that in Achatina fulica and Ampullarium sp. These third stage larvae were ingested by rats, and developed to adults. These data suggest that Oncomelania snails may play important role when A. cantonensis will spread, and indicate the possibility of human infection with A. cantonensis.

Rats, Rattus norvegicus, trapped in some sections (barrios) of the city of Santo Domingo, the capital of the Dominican Republic showed that 5 of them from two barrios harbored the nematode Angiostrongylus cantonensis in the pulmonary artery. Macerated and digested terrestrial snails, Subulina octona, collected from the backyards of houses where the rats were trapped contained L2 and L3 larvae of the nematode. The morphology of the adult worms and the larvae was consistent with that described for A. cantonensis in the literature. This is the first report of this Oriental and Western Pacific nematode in the Dominican Republic and the fourth in the Americas. Gastrointestinal hemorrhage, a rare symptom due to another species, the American A. costaricensis, which occurs in mesenteric arterioles of rodents and humans, is in the recent literature; the patient was a 41-year old Dominican. Thus the Dominican Republic is the first country in the Western Hemisphere to have the two species of Angiostrongylus.