First Reported Outbreak of Abdominal Angiostrongyliasis

Abstract

Human abdominal angiostrongyliasis is a potentially fatal disease caused by Angiostrongylus costaricensis, a nematode found in the Americas. During the period of December 1994 through August 1995, an outbreak of this disease occurred in Guatemala. We identified 22 cases of abdominal angiostrongyliasis and conducted a matched case-control study to identify risk factors for illness. The median age of the 18 cases enrolled in the study was 37 years (range, 9-68 years), and 11 (61.1%) were male. Consumption of the following six raw food items was associated with angiostrongyliasis: mint (odds ratio [OR], 6.9; 95% confidence interval [CI], 1.5-66.0), shrimp (OR, infinite; 95% CI, 1.4 to infinite), and four kinds of ceviche that reportedly contained raw mint (OR for consumption of mint or ceviche that contained mint, 7.0; 95% CI, 1.0-315). We conclude that raw mint was the likely vehicle of infection for this outbreak. To our knowledge, this is the first reported outbreak of abdominal angiostrongyliasis and the first time that a specific food item has been epidemiologically linked to the disease.

Use of heterologous antigens for the immunodiagnosis of abdominal angiostrongyliasis by an enzyme-linked immunosorbent assay

“…costaricensis crude antigens have been used for the immunodiagnosis of angiostrongyliasis since 1997 and later in the diagnosis of acute angiostrongyliasis (Graeff-Teixeira et al 1997, Geiger et al 2001. Previously used antibody-based detection systems included precipitation reactions (Sauerbrey 1977) and latex agglutination using crude antigenic preparations; the latter has been used for many years in Costa Rica (Kramer et al 1998). In addition, low molecular weight peptides (Abraham et al 2004), egg antigens (Mesén-Ramírez et al 2008) and crude excretion-secretion antigens, as well as host antibody response at both the class (IgE, IgA) and isotype (IgG1, IgG2, IgG3, IgG4) (Geiger et al 2001) levels, have been studied but not extensively evaluated in clinical or epidemiological settings.…”

Human infection by Angiostrongylus costaricensis in Venezuela: first report of a confirmed case

“…Although most cases have been reported in Costa Rica (up to 600 cases per year) 18 , the disease has been reported from the USA to Argentina, some Caribbean islands 18 , and in Zaire 2 . The first outbreak of the infection was reported from Guatemala 9 . In Venezuela, two cases were reported from surgical specimens of the ileocecal region, diagnosed as pseudo-tumoural eosinophilic ileocolitis of parasite origin, since nematode-type parasite structures were observed, but no diagnostic compromises were made 28 .…”

Abdominal angiostrongyliasis with involvement of liver histopathologically confirmed: a case report

“…Sometimes intestinal obstruction, perforation and/or hemorrhage are found 2,5,6,7 . A percentage of patients are ill for months, presenting relapsing episodes of abdominal pain 6 . Often, patients exhibit leukocytosis and eosinophilia 6,7 .…”

“…A percentage of patients are ill for months, presenting relapsing episodes of abdominal pain 6 . Often, patients exhibit leukocytosis and eosinophilia 6,7 .…”

“…Abdominal angiostrongyliasis confirmed diagnosis is made during microscopic examination of surgical specimens 6 . Lesions are most frequently found in the ileocecal region 6,7 ; however, localization in lymph nodes, omentum, liver, and testicles has also been observed 1,7,15,22 .…”