First Evidence of Angiostrongyliasis Caused by Angiostrongylus cantonensis in Guadeloupe, Lesser Antilles

Abstract

Abstract. Infection by the rat lungworm Angiostrongylus cantonensis represents the most common cause of infectious eosinophilic meningitis in humans, causing central nervous system (CNS) angiostrongyliasis. Most of CNS angiostrongyliasis cases were described in Asia, Pacific Basin, Australia, and some limited parts of Africa and America.

Angiostrongylus cantonensis Infection of Central Nervous System, Guiana Shield

“…Our findings demonstrate the presence of A. cantonensis roundworms in the Guiana Shield, in the context of a recent emergence of angiostrongyliasis in Brazil ( 3 ), the Caribbean region (including other French territories of the Americas) ( 4 , 5 ), and the southern United States ( 6 , 7 ). The frequency of A. cantonensis infections in humans in the Guiana Shield is probably underestimated as a result of the spontaneous course of recovery for most cases ( 8 ), lack of knowledge of the parasite by health professionals, limited availability of laboratory diagnostic tools, and the absence of national surveillance.…”

First cases of Angiostrongylus cantonensis infection reported in Martinique, 2002–2017

“…This study reports the first eight laboratory-confirmed cases of neuroangiostrongyliasis in Martinique, which occurred between 2002 and 2017, thus extending the range of Caribbean islands with proven human cases of neuroangiostrongyliasis [12,20,44]. Given the potential lethality of neuroangiostrongyliasis, the medical community should therefore strongly consider the possibility of this infection in patients living in or returning from Martinique with eosinophilic meningitis.…”

“…Most Caribbean cases were reported in Cuba with several dozen cases since the 1980s [2,36], mainly in the cities of Havana and Villa Clara [15,16,28,37], and one case in a Swiss traveller returning from Cuba [7]. In Guadeloupeanother French West Indies islandfour autochthonous cases were diagnosed (to our knowledge) between 1999 and 2017 in young children who may have been in contact with infected molluscs ( [12] and unpublished data), corresponding to an annual incidence rate of 0.053 cases per inhabitant per year (95% CI [0.001-0.105]), close to that of Martinique. For the Dominican Republic, two suspected cases were reported in travellers returning to Europe [24,41].…”

“…In this study, most cases occurred during the rainy season, during which snails abound, particularly the giant African snail, Lissachatina fulica, which was introduced to Martinique in 1989 [31] and is known elsewhere to act as an intermediate host of A. cantonensis. In Guadeloupe, A. cantonensis infection in A. fulica was 32.4% in 2014 [12]. No doubt other snail and slug species could also act as hosts as there are close to 90 nonmarine mollusc species in Martinique [14,23].…”

Angiostrongylus costaricensisinfection in Martinique, Lesser Antilles, from 2000 to 2017

“…Finally, A. fulica snails are not considered to be major intermediate hosts in the wild, although they are capable of hosting A. costaricensis larvae in laboratory models [ 6 ]. This invasive species, first described in 1989 in Martinique, is responsible for the emergence of central nervous system angiostrongyliasis due to Angiostrongylus cantonensis in the Lesser Antilles [ 9 ].…”