Angiostrongyliasis is a parasitic infection caused by roundworms of the Angiostrongylus genus, primarily Angiostrongylus cantonensis, or rat lungworm. This zoonotic disease affects the central nervous system, leading to eosinophilic meningitis—a rare but severe condition involving inflammation of the brain and spinal cord membranes.
Humans acquire the infection by consuming raw or undercooked intermediate hosts such as snails, slugs, freshwater prawns, or crabs. Contaminated vegetables, fruits, and water are additional sources. After ingestion, infective larvae migrate to the brain, triggering a cascade of neurological symptoms.
Symptoms typically emerge within one to four weeks and range from mild to severe. Patients often experience intense headaches, neck stiffness, nausea, and vomiting. Neurological symptoms, including numbness, tingling, and hypersensitivity, are common. Severe cases can progress to paralysis, coma, or even death. Although fatalities are rare, the infection's neurological complications can lead to long-term disability.
Diagnosing angiostrongyliasis is challenging due to its nonspecific symptoms. Clinicians rely on a combination of patient history—particularly exposure to potential infection sources—and the presence of elevated eosinophils in cerebrospinal fluid. Advanced imaging techniques like MRI can help identify inflammation in the central nervous system, but definitive diagnosis requires specialized laboratory tests, including PCR for parasite DNA.
Currently, no specific antiparasitic drug is approved for treating angiostrongyliasis. Management focuses on alleviating symptoms. Corticosteroids help reduce inflammation, while pain relievers address severe headaches. In some cases, lumbar punctures are performed to relieve intracranial pressure. Experimental treatments, such as albendazole and other anthelmintics, have shown promise but require further study.
Preventive measures are critical. Thoroughly washing and cooking food, especially leafy vegetables, and avoiding raw or undercooked snails and slugs are essential. Public health education in endemic regions, including Southeast Asia, the Pacific Islands, and parts of the Americas, plays a pivotal role in reducing infection rates.
In conclusion, angiostrongyliasis poses a significant public health threat in endemic areas. Heightened awareness, rigorous hygiene practices, and research into effective treatments are vital for mitigating its impact.
Angiostrongyliasis: A Parasitic Threat to the Nervous System
