Angiostrongylus cantonesis
Encyclopedia
Angiostrongylus cantonensis is a parasitic nematode
(roundworm) which causes Angiostrongyliasis
, the most common cause of eosinophilic meningitis in Southeast Asia and the Pacific Basin. The nematode commonly resides in the pulmonary arteries of rats, giving it the nickname the rat lungworm. Snail
s are the primary intermediate hosts, where larvae develop until they are infective.
Humans are incidental hosts of this roundworm, and may become infected through ingestion of larvae in raw or undercooked snails or other vectors, or from contaminated water and vegetables. The larvae are then transported via the blood to the central nervous system
(CNS), where they are the most common cause of eosinophilic meningitis, a serious condition that can lead to death or permanent brain and nerve damage. Identified in 1964, Angiostrongyliasis is an infection of increasing public health importance as globalization
aids in the geographic spread of the disease.
of the phylum
Nematoda
, order
Strongylida
, and superfamily Metastrongyloidea. Nematodes are roundworms characterized by a tough outer cuticle, unsegmented bodies, and a fully developed gastrointestinal tract. The order Strongylida includes hookworms and lungworms. Metastrongyloidea are characterized as long, slender, threadlike worms that reside in the lungs of the definitive host. Angiostrongylus costaricensis
is a closely related worm that causes intestinal Angiostrongyliasis in Central and South America.
of a patient with eosinophilic meningitis by Nomura and Lim in Taiwan
in 1944. They called the parasite Haemostrongylus ratti, and noted that raw food eaten by the patient may have been contaminated by rats. Their paper, however, was not translated from the original Japanese into English until just after the parasite had been recognized in 1964, so their discovery was not widely recognized.
In 1955, Mackerass and Sanders identified the life cycle of the worm in rats, defining snails and slugs as the intermediate host and noting the path of transmission through the blood, brain, and lungs in rats.
Following World War II, A. cantonensis spread throughout Southeast Asia and Western Pacific Islands including Australia
, Melanesia
, Micronesia
, and Polynesia
. Cases were soon reported in the following nations: New Caledonia
, the Philippines
, Rarotonga
, Saipan
, Sumatra
, Taiwan and Tahiti
. In the 1960s even more cases were reported from the region from locations such as: Cambodia
, Guam
, Hawaii
, Java
, Thailand
, Sarawak
, Vietnam
and the New Hebrides (Vanuatu
).
In 1961, an epidemiological study of eosinophilic meningitis in humans was conducted by Rosen, Laigret, and Bories, who hypothesized that the parasite causing these infections was carried by fish. However Alicata noted that raw fish was consumed by large numbers of people in Hawaii without apparent consequences, and patients presenting with meningitis symptoms had a history of eating raw snails or prawns in the weeks before presenting with symptoms. This observation along with epidemiology and autopsy of infected brains confirmed A. cantonensis infection in humans as the cause of the majority of eosinophilic meningitis cases in Southeast Asia and the Pacific Islands.
Since then, cases of A. cantonensis infestations have appeared in American Samoa
, Australia, Hong Kong
, Bombay, Fiji
, India
, Honshu
, Kyushu
, New Britain
, Okinawa, Ryukyu Islands
, Western Samoa and most recently mainland China
. Other sporadic occurrences of the parasite in its rat hosts have been reported in Cuba
, Egypt
, Louisiana
, Madagascar
, Nigeria
, New Orleans and Puerto Rico
In recent years, the parasite has been shown to be proliferating at an alarming rate due to modern food consumption trends and global transportation of food products. Scientists are calling for a more thorough study of the epidemiology of A. cantonensis, stricter food safety policies, and the increase of knowledge on how to properly consume products commonly infested by the parasite.
Definitive host of Angiostrongylus cantonensis include wild rodents, especially Rattus norvegicus, Rattus rattus.
Paratenic hosts of Angiostrongylus cantonensis include: predatory land flatworm Platydemus manokwari
and amphibians Bufo asiaticus, Rana catesbeiana, Rhacophorus leucomystax and Rana limnocharis.
In 2004, a captive Yellow-tailed Black Cockatoo
(Calyptorhynchus funereus) and 2 free-living Tawny Frogmouth
s (Podargus strigoides) suffering neurological symptoms were shown to have the parasite. They were the first non-mammalian hosts discovered for the organism.
Nematode
The nematodes or roundworms are the most diverse phylum of pseudocoelomates, and one of the most diverse of all animals. Nematode species are very difficult to distinguish; over 28,000 have been described, of which over 16,000 are parasitic. It has been estimated that the total number of nematode...
(roundworm) which causes Angiostrongyliasis
Angiostrongyliasis
Angiostrongyliasis is an infection by a nematode from the Angiostrongylus genus of kidney and alimentary tract roundworms. For example, infection with Angiostrongylus cantonensis can occur after consuming raw Giant African land snails, Great Grey Slugs, or other molluscs.In humans, Angiostrongylus...
, the most common cause of eosinophilic meningitis in Southeast Asia and the Pacific Basin. The nematode commonly resides in the pulmonary arteries of rats, giving it the nickname the rat lungworm. Snail
Snail
Snail is a common name applied to most of the members of the molluscan class Gastropoda that have coiled shells in the adult stage. When the word is used in its most general sense, it includes sea snails, land snails and freshwater snails. The word snail without any qualifier is however more often...
s are the primary intermediate hosts, where larvae develop until they are infective.
Humans are incidental hosts of this roundworm, and may become infected through ingestion of larvae in raw or undercooked snails or other vectors, or from contaminated water and vegetables. The larvae are then transported via the blood to the central nervous system
Central nervous system
The central nervous system is the part of the nervous system that integrates the information that it receives from, and coordinates the activity of, all parts of the bodies of bilaterian animals—that is, all multicellular animals except sponges and radially symmetric animals such as jellyfish...
(CNS), where they are the most common cause of eosinophilic meningitis, a serious condition that can lead to death or permanent brain and nerve damage. Identified in 1964, Angiostrongyliasis is an infection of increasing public health importance as globalization
Globalization
Globalization refers to the increasingly global relationships of culture, people and economic activity. Most often, it refers to economics: the global distribution of the production of goods and services, through reduction of barriers to international trade such as tariffs, export fees, and import...
aids in the geographic spread of the disease.
Infectious agent
Angiostrongylus cantonensis is a helminthParasitic worm
Parasitic worms or helminths are a division of eukaryoticparasites that, unlike external parasites such as lice and fleas, live inside their host. They are worm-like organisms that live and feed off living hosts, receiving nourishment and protection while disrupting their hosts' nutrient...
of the phylum
Phylum
In biology, a phylum The term was coined by Georges Cuvier from Greek φῦλον phylon, "race, stock," related to φυλή phyle, "tribe, clan." is a taxonomic rank below kingdom and above class. "Phylum" is equivalent to the botanical term division....
Nematoda
Nematode
The nematodes or roundworms are the most diverse phylum of pseudocoelomates, and one of the most diverse of all animals. Nematode species are very difficult to distinguish; over 28,000 have been described, of which over 16,000 are parasitic. It has been estimated that the total number of nematode...
, order
Order (biology)
In scientific classification used in biology, the order is# a taxonomic rank used in the classification of organisms. Other well-known ranks are life, domain, kingdom, phylum, class, family, genus, and species, with order fitting in between class and family...
Strongylida
Strongylida
The Suborder Strongylida includes many of the important nematodes found in the gastrointestinal tracts of ruminants, horses, and swine, as well as the lungworms of ruminants and, the hookworms of dogs and cats.This Suborder includes The Suborder Strongylida includes many of the important nematodes...
, and superfamily Metastrongyloidea. Nematodes are roundworms characterized by a tough outer cuticle, unsegmented bodies, and a fully developed gastrointestinal tract. The order Strongylida includes hookworms and lungworms. Metastrongyloidea are characterized as long, slender, threadlike worms that reside in the lungs of the definitive host. Angiostrongylus costaricensis
Angiostrongylus costaricensis
Angiostrongylus costaricensis is a parasitic nematode.Its distribution include Brazil.- Hosts :* Limax maximus* slugs from the family Veronicellidae...
is a closely related worm that causes intestinal Angiostrongyliasis in Central and South America.
Epidemiology
Nematodes suspected to be Angiostrongylus cantonensis were first identified in the cerebrospinal fluidCerebrospinal fluid
Cerebrospinal fluid , Liquor cerebrospinalis, is a clear, colorless, bodily fluid, that occupies the subarachnoid space and the ventricular system around and inside the brain and spinal cord...
of a patient with eosinophilic meningitis by Nomura and Lim in Taiwan
Taiwan
Taiwan , also known, especially in the past, as Formosa , is the largest island of the same-named island group of East Asia in the western Pacific Ocean and located off the southeastern coast of mainland China. The island forms over 99% of the current territory of the Republic of China following...
in 1944. They called the parasite Haemostrongylus ratti, and noted that raw food eaten by the patient may have been contaminated by rats. Their paper, however, was not translated from the original Japanese into English until just after the parasite had been recognized in 1964, so their discovery was not widely recognized.
In 1955, Mackerass and Sanders identified the life cycle of the worm in rats, defining snails and slugs as the intermediate host and noting the path of transmission through the blood, brain, and lungs in rats.
Following World War II, A. cantonensis spread throughout Southeast Asia and Western Pacific Islands including Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...
, Melanesia
Melanesia
Melanesia is a subregion of Oceania extending from the western end of the Pacific Ocean to the Arafura Sea, and eastward to Fiji. The region comprises most of the islands immediately north and northeast of Australia...
, Micronesia
Micronesia
Micronesia is a subregion of Oceania, comprising thousands of small islands in the western Pacific Ocean. It is distinct from Melanesia to the south, and Polynesia to the east. The Philippines lie to the west, and Indonesia to the southwest....
, and Polynesia
Polynesia
Polynesia is a subregion of Oceania, made up of over 1,000 islands scattered over the central and southern Pacific Ocean. The indigenous people who inhabit the islands of Polynesia are termed Polynesians and they share many similar traits including language, culture and beliefs...
. Cases were soon reported in the following nations: New Caledonia
New Caledonia
New Caledonia is a special collectivity of France located in the southwest Pacific Ocean, east of Australia and about from Metropolitan France. The archipelago, part of the Melanesia subregion, includes the main island of Grande Terre, the Loyalty Islands, the Belep archipelago, the Isle of...
, the Philippines
Philippines
The Philippines , officially known as the Republic of the Philippines , is a country in Southeast Asia in the western Pacific Ocean. To its north across the Luzon Strait lies Taiwan. West across the South China Sea sits Vietnam...
, Rarotonga
Rarotonga
Rarotonga is the most populous island of the Cook Islands, with a population of 14,153 , out of the country's total population of 19,569.The Cook Islands' Parliament buildings and international airport are on Rarotonga...
, Saipan
Saipan
Saipan is the largest island of the United States Commonwealth of the Northern Mariana Islands , a chain of 15 tropical islands belonging to the Marianas archipelago in the western Pacific Ocean with a total area of . The 2000 census population was 62,392...
, Sumatra
Sumatra
Sumatra is an island in western Indonesia, westernmost of the Sunda Islands. It is the largest island entirely in Indonesia , and the sixth largest island in the world at 473,481 km2 with a population of 50,365,538...
, Taiwan and Tahiti
Tahiti
Tahiti is the largest island in the Windward group of French Polynesia, located in the archipelago of the Society Islands in the southern Pacific Ocean. It is the economic, cultural and political centre of French Polynesia. The island was formed from volcanic activity and is high and mountainous...
. In the 1960s even more cases were reported from the region from locations such as: Cambodia
Cambodia
Cambodia , officially known as the Kingdom of Cambodia, is a country located in the southern portion of the Indochina Peninsula in Southeast Asia...
, Guam
Guam
Guam is an organized, unincorporated territory of the United States located in the western Pacific Ocean. It is one of five U.S. territories with an established civilian government. Guam is listed as one of 16 Non-Self-Governing Territories by the Special Committee on Decolonization of the United...
, Hawaii
Hawaii
Hawaii is the newest of the 50 U.S. states , and is the only U.S. state made up entirely of islands. It is the northernmost island group in Polynesia, occupying most of an archipelago in the central Pacific Ocean, southwest of the continental United States, southeast of Japan, and northeast of...
, Java
Java
Java is an island of Indonesia. With a population of 135 million , it is the world's most populous island, and one of the most densely populated regions in the world. It is home to 60% of Indonesia's population. The Indonesian capital city, Jakarta, is in west Java...
, Thailand
Thailand
Thailand , officially the Kingdom of Thailand , formerly known as Siam , is a country located at the centre of the Indochina peninsula and Southeast Asia. It is bordered to the north by Burma and Laos, to the east by Laos and Cambodia, to the south by the Gulf of Thailand and Malaysia, and to the...
, Sarawak
Sarawak
Sarawak is one of two Malaysian states on the island of Borneo. Known as Bumi Kenyalang , Sarawak is situated on the north-west of the island. It is the largest state in Malaysia followed by Sabah, the second largest state located to the North- East.The administrative capital is Kuching, which...
, Vietnam
Vietnam
Vietnam – sometimes spelled Viet Nam , officially the Socialist Republic of Vietnam – is the easternmost country on the Indochina Peninsula in Southeast Asia. It is bordered by China to the north, Laos to the northwest, Cambodia to the southwest, and the South China Sea –...
and the New Hebrides (Vanuatu
Vanuatu
Vanuatu , officially the Republic of Vanuatu , is an island nation located in the South Pacific Ocean. The archipelago, which is of volcanic origin, is some east of northern Australia, northeast of New Caledonia, west of Fiji, and southeast of the Solomon Islands, near New Guinea.Vanuatu was...
).
In 1961, an epidemiological study of eosinophilic meningitis in humans was conducted by Rosen, Laigret, and Bories, who hypothesized that the parasite causing these infections was carried by fish. However Alicata noted that raw fish was consumed by large numbers of people in Hawaii without apparent consequences, and patients presenting with meningitis symptoms had a history of eating raw snails or prawns in the weeks before presenting with symptoms. This observation along with epidemiology and autopsy of infected brains confirmed A. cantonensis infection in humans as the cause of the majority of eosinophilic meningitis cases in Southeast Asia and the Pacific Islands.
Since then, cases of A. cantonensis infestations have appeared in American Samoa
American Samoa
American Samoa is an unincorporated territory of the United States located in the South Pacific Ocean, southeast of the sovereign state of Samoa...
, Australia, Hong Kong
Hong Kong
Hong Kong is one of two Special Administrative Regions of the People's Republic of China , the other being Macau. A city-state situated on China's south coast and enclosed by the Pearl River Delta and South China Sea, it is renowned for its expansive skyline and deep natural harbour...
, Bombay, Fiji
Fiji
Fiji , officially the Republic of Fiji , is an island nation in Melanesia in the South Pacific Ocean about northeast of New Zealand's North Island...
, India
India
India , officially the Republic of India , is a country in South Asia. It is the seventh-largest country by geographical area, the second-most populous country with over 1.2 billion people, and the most populous democracy in the world...
, Honshu
Honshu
is the largest island of Japan. The nation's main island, it is south of Hokkaido across the Tsugaru Strait, north of Shikoku across the Inland Sea, and northeast of Kyushu across the Kanmon Strait...
, Kyushu
Kyushu
is the third largest island of Japan and most southwesterly of its four main islands. Its alternate ancient names include , , and . The historical regional name is referred to Kyushu and its surrounding islands....
, New Britain
New Britain
New Britain, or Niu Briten, is the largest island in the Bismarck Archipelago of Papua New Guinea. It is separated from the island of New Guinea by the Dampier and Vitiaz Straits and from New Ireland by St. George's Channel...
, Okinawa, Ryukyu Islands
Ryukyu Islands
The , also known as the , is a chain of islands in the western Pacific, on the eastern limit of the East China Sea and to the southwest of the island of Kyushu in Japan. From about 1829 until the mid 20th century, they were alternately called Luchu, Loochoo, or Lewchew, akin to the Mandarin...
, Western Samoa and most recently mainland China
China
Chinese civilization may refer to:* China for more general discussion of the country.* Chinese culture* Greater China, the transnational community of ethnic Chinese.* History of China* Sinosphere, the area historically affected by Chinese culture...
. Other sporadic occurrences of the parasite in its rat hosts have been reported in Cuba
Cuba
The Republic of Cuba is an island nation in the Caribbean. The nation of Cuba consists of the main island of Cuba, the Isla de la Juventud, and several archipelagos. Havana is the largest city in Cuba and the country's capital. Santiago de Cuba is the second largest city...
, Egypt
Egypt
Egypt , officially the Arab Republic of Egypt, Arabic: , is a country mainly in North Africa, with the Sinai Peninsula forming a land bridge in Southwest Asia. Egypt is thus a transcontinental country, and a major power in Africa, the Mediterranean Basin, the Middle East and the Muslim world...
, Louisiana
Louisiana
Louisiana is a state located in the southern region of the United States of America. Its capital is Baton Rouge and largest city is New Orleans. Louisiana is the only state in the U.S. with political subdivisions termed parishes, which are local governments equivalent to counties...
, Madagascar
Madagascar
The Republic of Madagascar is an island country located in the Indian Ocean off the southeastern coast of Africa...
, Nigeria
Nigeria
Nigeria , officially the Federal Republic of Nigeria, is a federal constitutional republic comprising 36 states and its Federal Capital Territory, Abuja. The country is located in West Africa and shares land borders with the Republic of Benin in the west, Chad and Cameroon in the east, and Niger in...
, New Orleans and Puerto Rico
Puerto Rico
Puerto Rico , officially the Commonwealth of Puerto Rico , is an unincorporated territory of the United States, located in the northeastern Caribbean, east of the Dominican Republic and west of both the United States Virgin Islands and the British Virgin Islands.Puerto Rico comprises an...
In recent years, the parasite has been shown to be proliferating at an alarming rate due to modern food consumption trends and global transportation of food products. Scientists are calling for a more thorough study of the epidemiology of A. cantonensis, stricter food safety policies, and the increase of knowledge on how to properly consume products commonly infested by the parasite.
Hosts
Intermediate hosts of larvae of for Angiostrongylus cantonensis include:- land snails: Thelidomus asperaThelidomus asperaThelidomus aspera is a species of air-breathing land snail, a terrestrial pulmonate gastropod mollusk in the family Pleurodontidae.- Distribution :It occurs in Jamaica....
from Jamaica, Achatina fulica, Satsuma mercatoria, Acusta despectaAcusta despectaAcusta despecta is a species of air-breathing land snail, a terrestrial pulmonate gastropod mollusk in the family Bradybaenidae.This species is sometimes a pest on citrus trees.- Subspecies :* Acusta despecta chinensis...
, Bradybaena brevispira, Bradybaena circulus Bradybaena ravida, Bradybaena similaris, Plectotropis appanata and Parmarion martensiParmarion martensiParmarion martensi is a species of air-breathing land semislug, a terrestrial pulmonate gastropod mollusk in the family Ariophantidae.-Distribution:The probable native distribution of Parmarion martensi includes Southeast Asia....
from Okinawa and from from Hawaii, Camaena cicatricosa, Trichochloritis rufopila, Trichochloritis hungerfordianus and CyclophorusCyclophorusCyclophorus may be:* Cyclophorus , a genus of tropical land snail in family Cyclophoridae* Cyclophorus , a genus of ferns...
spp. - freshwater snails: Pila spp., Pomacea canaliculataPomacea canaliculataPomacea canaliculata, common name the channeled applesnail, is a species of large freshwater snail with gills and an operculum, an aquatic gastropod mollusk in the family Ampullariidae, the apple snails....
, Cipangopaludina chinensis, Bellamya aeruginosa and Bellamya quadrata - slugs: Limax maximus, Limax flavus Deroceras laeveDeroceras laeveDeroceras laeve, the marsh slug, is a species of small air-breathing land slug, a terrestrial pulmonate gastropod mollusk in the family Agriolimacidae.-Distribution:...
, Deroceras reticulatumDeroceras reticulatumDeroceras reticulatum, common names "grey field slug" and "grey garden slug", is a species of small air-breathing land slug, a terrestrial pulmonate gastropod mollusk in the family Agriolimacidae...
, Veronicella alte, =? Laevicaulis alte, Sarasinula plebeiaSarasinula plebeiaSarasinula plebeia, common name the bean slug, is a species of air-breathing land slug, a terrestrial pulmonate gastropod mollusk in the family Veronicellidae, the leatherleaf slugs.-Distribution:...
, Vaginulus yuxjsjs, Lehmannia valentianaLehmannia valentianaLehmannia valentiana is a species of air-breathing land slug, a terrestrial pulmonate gastropod mollusk in the family Limacidae.- Distribution :This species is known to occur in a number of countries and islands including:...
, Phiolomycus bilineatus, Macrochlamys loana, Meghimatium bilineatum and probably other species of slugs.
Definitive host of Angiostrongylus cantonensis include wild rodents, especially Rattus norvegicus, Rattus rattus.
Paratenic hosts of Angiostrongylus cantonensis include: predatory land flatworm Platydemus manokwari
Platydemus manokwari
Platydemus manokwari, also known as the New Guinea flatworm, is a species of large predatory land flatworm. It is a terrestrial turbellarian in the family Geoplanidae. It is an invasive species....
and amphibians Bufo asiaticus, Rana catesbeiana, Rhacophorus leucomystax and Rana limnocharis.
In 2004, a captive Yellow-tailed Black Cockatoo
Yellow-tailed Black Cockatoo
The Yellow-tailed Black Cockatoo is a large cockatoo native to the south-east of Australia measuring 55–65 cm in length. It has a short crest on the top of its head. Its plumage is mostly brownish black and it has prominent yellow cheek patches and a yellow tail band...
(Calyptorhynchus funereus) and 2 free-living Tawny Frogmouth
Tawny Frogmouth
The Tawny Frogmouth is an Australian species of frogmouth, a type of bird found throughout the Australian mainland, Tasmania and southern New Guinea. The Tawny Frogmouth is often mistaken to be an owl...
s (Podargus strigoides) suffering neurological symptoms were shown to have the parasite. They were the first non-mammalian hosts discovered for the organism.
Pathogenesis of Human Angiostrongylosis
The presence of parasitic worms burrowed in the neural tissue of the human CNS will cause obvious complications. All of the following will result in damage to the CNS:- Direct mechanical damage to neural tissue from the worms' motion
- Toxic by-products such as nitrogenous waste
- Antigens released by dead and living parasites
Eosinophilic meningitis
Eosinophilic meningitis is primarily caused by parasitic infestations, specifically infestations of A. cantonensis. Like other forms of meningitis, eosinophilic meningitis is marked by the inflammation of the meninges. The meninges become inflamed as the result of dying A. cantonensis larvae and the general presence of the young adult worm in the central nervous system. This inflammation can lead to mental retardation, nerve damage, permanent brain damage or death. Eosinophilic meningitis is also defined by the increased volume of eosinophils in the cerebrospinal fluid. In most cases, Eosinophil levels rise to 10 or more eosinophils per μL in the cerebrospinal fluid, accounting for at least 10% of the total CSF leukocyte count.Role of eosinophils
Eosinophils, which are white blood cells, contain granules in their cytoplasm. These granules contain proteins that are toxic to parasites. When these granules degranulate, or break down, chemicals are released that combat parasites such as A. cantonensis. Eosinophils, which are located throughout the body, are guided to sites of inflammation by chemokines when the body is infested with parasites such as A. cantonensis. Once at the site of inflammation, Type 2 cytokines are released from helper T cells, which communicate with the Eosinophils, signaling them to activate. Once activated, eosinophils can begin the process of degranulation, releasing their toxic proteins in the fight against the foreign parasite.Clinical symptoms
The clinical symptoms of Eosinophilic Meningitis are as follows:- headaches- a bitemporal character in the frontal or occipital lobe
- nausea
- vomiting
- paresthesias - tingling, prickling, or numbing of skin
- vertigo
- low-grade fever or no fever
- meningismus - neck stiffness and photophobia
- hyperesthesia
- paralysis
- blindness
Treatment
Minimal relief can be provided for the intense headaches brought on by eosinophilic meningitis. Typical analgesics and sedatives provide negligible relief so a lumbar puncture is usually resorted to. Removing Cerebrospinal fluid at regular 3 to 7-day intervals is the only proven method of significantly reducing cranial pressure. This process is performed until improvement is shown.Diagnosis
The diagnosis of Eosinophilic Meningitis can be arrived at through detection of elevated cranial pressure and increased volumes of eosinophils. The diagnosis of the cause of eosinophilic meningitis and the presence of A. cantonensis is remarkably more difficult. A spinal tap, or a sample of CSF, must be taken to search for A. cantonensis worms or larvae. A. cantonensis is virtually undetectable in the CSF of half of the infected individuals. Current methods of detecting specific antigens associated with A. cantonensis are also unreliable. Consequently, alternative approaches to detect antigen-antibody reactions are being explored, such as Immuno-PCR.External links
- Division of Parasitic Diseases, Centers for Disease Control and Prevention, Angiostrongylus cantonensis Infection
- Laboratory Identification of Parasites of Public Health Concern, Parasites and Health, Angiostrongyliasis
- Laboratory Identification of Parasites of Public Health Concern, Angiostrongyliasis Image Library
- Sydney Morning Herald story of human infection, Example of Angiostrongylus cantonensis human infection: Hard to swallow: slug-eating dare causes rare disease