Saturday, August 25, 2018

PRO/AH/EDR> Angiostrongylus cantonensis - USA (05): (HI) transmission

ANGIOSTRONGYLUS CANTONENSIS - USA (05): (HAWAII) TRANSMISSION
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Date: Sat 25 Aug 2018
From: Richard I. Frankel <rfrankel@hawaii.edu> [edited]


A comment to the ProMED post "Angiostrongylus cantonensis - USA (04):
(HI) http://promedmail.org/post/20180818.5973796" published 18 Aug
[2018], in which the moderator states that transmission requires the
ingestion of the infected snail or slugs: I find the best source of
information to be the article by Cowie [Cowie RH. Pathways for
transmission of angiostrongyliasis and the risk of disease associated
with them. Hawaii J Med Public Health 2013;72(6 Suppl 2):70-74]. Cowie
presents data supporting the statement that ingestion of snails and
slugs is the main mode of acquisition of this nematode and the ensuing
illness, if any.

There are other methods of acquisition, some documented, some possible
but not proven. My initial comment to the moderator concerned the
possible role of slug or snail mucus or slime in transmission. Because
of the low number of _A. cantonensis_ larvae found in studies of slime
and mucus, Cowie concludes, "While slime trails may represent a source
of sporadic infections, the evidence suggests that this is not one of
the main routes of transmission of the parasite nor a major cause of
disease." Anecdotal information in Hawaii suggests that this may not
be rare, but there is no good scientific evidence to support this.

Cowie presents data confirming acquisition of _A. cantonensis_ by
animal hosts, which carry the nematode but do not become infected.
Included are freshwater prawns and shrimps, land crabs, frogs and
toads (including tadpoles), monitor lizards, and planarians. He also
mentions animals that are common food sources that can be
experimentally infected and could conceivably be a source of infection
if not properly cooked, but he did not find any data to demonstrate
that such a route of infection occurs.

As angiostrongyliasis may be increasing in incidence and is also being
found in a wider geographic range than previously noted, it is
important to keep in mind the variety of ways in which this pathogen
may be acquired.

--
Richard I. Frankel, MD, MPH, FACP
Emeritus Professor of Medicine
University of Hawai'i John A. Burns School of Medicine
Honolulu, Hawaii
<rfrankel@hawaii.edu>

[ProMED thanks Professor Frankel for these comments on other modes of
transmission than ingesting of infected snails and slugs. - Mod.EP

HealthMap/ProMED-mail map:
Hawaii, United States: <http://healthmap.org/promed/p/214>]

[See Also:
Angiostrongylus cantonensis - USA (04): (HI):
http://promedmail.org/post/20180818.5973796
Angiostrongylus cantonensis - USA (03): (TX):
http://promedmail.org/post/20180805.5948810
Angiostrongylus cantonensis - USA (02): (HI):
http://promedmail.org/post/20180226.5651881
Angiostrongylus cantonensis - USA: (HI) task force
http://promedmail.org/post/20180114.5557708
2017
----
Angiostrongylus cantonensis - USA (05): (HI) reservoir
http://promedmail.org/post/20171221.5518125
Angiostrongylus cantonensis - USA (04): (HI)
http://promedmail.org/post/20171001.5353796
Angiostrongylus cantonensis - USA (03): (HI)
http://promedmail.org/post/20170514.5035328
Angiostrongylus cantonensis - USA (02): (HI)
http://promedmail.org/post/20170502.5008629
Angiostrongylus cantonensis - USA: (HI)
http://promedmail.org/post/20170407.4955519
2015
----
Angiostrongylus cantonensis - Viet Nam: CM, contaminated snails
http://promedmail.org/post/20150716.3515583
Angiostrongylus cantonensis - Australia: (NS) canine
http://promedmail.org/post/20150511.3354007
Angiostrongylus cantonensis - USA (02): (HI)
http://promedmail.org/post/20150418.3306098
Angiostrongylus cantonensis - USA: (FL) introduced snails
http://promedmail.org/post/20150303.3204533]
.................................................ep/rd/lxl
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