Eosinophilic Meningitis Attributable to Angiostrongylus cantonensis Infection in Hawaii: Clinical Characteristics and Potential Exposures

Hochberg, Natasha S.; Blackburn, Brian G.; Park, Sarah Y.; Sejvar, James J.; Effler, Paul V.; Herwaldt, Barbara L.

doi:10.4269/ajtmh.2011.11-0322

Cited by 40 publications

(47 citation statements)

References 37 publications

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“…[1][2][3] Humans become infected by ingesting the infectious third stage larvae from mollusks, by intentional or accidental ingestion of raw infected mollusks, via contaminated fresh vegetables, or possibly contaminated water. [4][5][6][7] In addition, various species of fish, shrimp, amphibians, reptiles, and planarians serving as paratenic hosts have been implicated as the source of human infections. [8][9][10][11][12][13][14] The majority of cases are self-limited with full recovery, but severe cases can be fatal or cause persistent neurological problems.…”

Section: Introductionmentioning

confidence: 99%

Real-Time Polymerase Chain Reaction Detection of Angiostrongylus cantonensis DNA in Cerebrospinal Fluid from Patients with Eosinophilic Meningitis

Qvarnström¹,

Xayavong²,

Silva³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Angiostrongylus cantonensis is the most common infectious cause of eosinophilic meningitis. Timely diagnosis of these infections is difficult, partly because reliable laboratory diagnostic methods are unavailable. The aim of this study was to evaluate the usefulness of a real-time polymerase chain reaction (PCR) assay for the detection of A. cantonensis DNA in human cerebrospinal fluid (CSF) specimens. A total of 49 CSF specimens from 33 patients with eosinophilic meningitis were included: A. cantonensis DNA was detected in 32 CSF specimens, from 22 patients. Four patients had intermittently positive and negative real-time PCR results on subsequent samples, indicating that the level of A. cantonensis DNA present in CSF may fluctuate during the course of the illness. Immunodiagnosis and/or supplemental PCR testing supported the real-time PCR findings for 30 patients. On the basis of these observations, this real-time PCR assay can be useful to detect A. cantonensis in the CSF from patients with eosinophilic meningitis.

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Section: Introductionmentioning

confidence: 99%

Real-Time Polymerase Chain Reaction Detection of Angiostrongylus cantonensis DNA in Cerebrospinal Fluid from Patients with Eosinophilic Meningitis

Qvarnström¹,

Xayavong²,

Silva³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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“…Treatment in humans consists primarily of analgesia, supportive care, and the use of steroids to decrease inflammation associated with the parasite (Kliks & Palumbo 1992;Lo Re & Gluckman 2003;Diaz 2009;RamirezAvila et al 2009;Hochberg et al 2011;). Treatment in this case was aimed at decreasing inflammation within the nervous tissues, but also decreasing the chance of bacterial translocation across the gastrointestinal epithelium, elimination of parasites, nutritional support, and increasing gastrointestinal motility.…”

mentioning

confidence: 99%

Eosinophilic meningoencephalomyelitis in an orangutan (Pongo pygmaeus) caused byAngiostrongylus cantonensis

Emerson

Walden

Peters

et al. 2013

Veterinary Quarterly

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“…Once ingested by a human, the larvae migrate aberrantly and cause neurological disorders characterized by eosinophilic meningitis and encephalitis. Although not among the major food-borne pathogens listed by CDC, lettuce and raw vegetable juice have been suspected as sources of angiostrongyliasis infections in Hawaii and other tropical regions where consumers may have unknowingly eaten small snails/slugs or been exposed to larvae transported by slime on the plant leaves [94][95][96].…”

Section: Angiostrongylus Cantonensismentioning

confidence: 99%

What is the risk from wild animals in food-borne pathogen contamination of plants?

Jay-Russell

2014

CABI Reviews

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Fresh fruits, nuts and vegetables are increasingly linked to food-borne illnesses, outbreaks and recalls. The trend represents a modern-day public health conundrum wherein consumers are encouraged to eat more fresh produce to help prevent chronic health problems such as obesity and heart disease, but at the same time consumption of contaminated produce can lead to potentially life-threatening acute food-borne disease. Identification of environmental sources responsible for the contamination of raw and minimally processed or fresh-cut plant commodities is necessary to develop prevention strategies. Produce-related outbreaks have been caused by faecal contamination of plants or surrounding watersheds following intrusion by wild or feral animals. A wild animal shedding a zoonotic food-borne pathogen could contaminate plants directly through faecal deposition or indirectly via faecal contamination of agriculture water or soil in contact with the plants. Owing to the low infectious dose of zoonotic enteric pathogens and the potential for attachment and possibly ingress into edible parts of plants, even a low level of contamination from faecal pathogens represents a significant public health concern. This review focuses on potential produce food safety risks from wild animals at the pre-harvest level, and downstream processes that may promote pathogen survival and amplification that could lead to human food-borne illnesses, outbreaks, and recalls. Microbe-plant interactions for the major zoonotic food-borne pathogens and higher risk plant commodities are reviewed. Finally, current guidelines and regulations to minimize risks related to wild animal activity in the production environment are summarized.Review Methodology: Databases used in this review included NCBI PubMed and the Center for Produce Safety Global Research Database. References from existing EndNote files and articles obtained from the database searches were also used to identify additional relevant material. Conference proceedings following two special sessions on wildlife and food safety held at the 23rd and 25th Vertebrate Pest Conferences were also reviewed. Produce and plant product safety regulations and guidance documents were found by searching agency/organization websites including the US Food and Drug Administration, Western Growers and the University of California Postharvest Technology online libraries.

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Eosinophilic Meningitis Attributable to Angiostrongylus cantonensis Infection in Hawaii: Clinical Characteristics and Potential Exposures

Cited by 40 publications

References 37 publications

Real-Time Polymerase Chain Reaction Detection of Angiostrongylus cantonensis DNA in Cerebrospinal Fluid from Patients with Eosinophilic Meningitis

Real-Time Polymerase Chain Reaction Detection of Angiostrongylus cantonensis DNA in Cerebrospinal Fluid from Patients with Eosinophilic Meningitis

Eosinophilic meningoencephalomyelitis in an orangutan (Pongo pygmaeus) caused byAngiostrongylus cantonensis

What is the risk from wild animals in food-borne pathogen contamination of plants?

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