Angiostrongylus Cantonensis Infection

What is Angiostrongylus Cantonensis Infection

Angiostrongylus cantonensis is a parasitic worm that lives in rats. It is also called the rat lungworm. Baby worms (larvae) pass through rat feces into soil and may be picked up by snails or slugs.

People usually develop this condition after eating raw or undercooked snails, slugs, crabs, freshwater shrimp (prawns), or frogs, or after eating raw produce that infected snails or slugs have touched.

This parasite is commonly found in parts of Asia and the Pacific Islands. It has also been reported in the Caribbean, Africa, Australia, and North America. The infection does not pass from person to person (is not contagious).

If you get infected with the parasite, it is possible to develop a type of brain inflammation called eosinophilic meningitis. However, most cases resolve without treatment because the parasite cannot survive in the human body.

What are the causes?

This condition may be caused by:

• Eating raw or undercooked snails, slugs, crabs, prawns, or frogs that are infected with the parasite.
• Eating raw produce that contains a small, infected snail or slug, a piece of an infected snail or slug, or that has been touched by an infected snail or slug.

What increases the risk?

You are more likely to develop this condition if:

• You live in or travel to areas where the parasite is common, including:
  • Southeast Asia.
  • Pacific Islands, including Hawaii.
• You eat certain raw or undercooked foods. These foods include:
  • Snails.
  • Slugs.
  • Prawns.
  • Crabs.
  • Frogs.
  • Vegetables and other produce that have not been carefully washed.

What are the signs or symptoms?

You can be infected with the parasite and not have any symptoms. If you have symptoms, they usually start 1–3 weeks after ingesting the larvae. Symptoms may last for 2–8 weeks. They may include:

• Headache.
• Stiff neck.
• Tingling or pain in the skin.
• Fever.
• Nausea and vomiting.
• Rash.
• Fatigue.

How is this diagnosed?

This condition may be diagnosed based on:

• Your medical history.
• Your symptoms.
• Whether you have traveled to areas where the parasite is common.
• What you have eaten recently.
• Blood tests.
• Lumbar puncture. This test involves removing and testing a small amount of the fluid that surrounds the brain and spinal cord (cerebrospinal fluid). This test may be done to check for signs of eosinophilic meningitis.

How is this treated?

Symptoms usually go away without treatment because the parasite cannot live inside the human body for a long time. Your body’s disease-fighting system (immune system) will eventually get rid of the infection. Your health care provider may recommend treatment to relieve symptoms, such as:

• Staying hydrated.
• Taking pain medicines to help with headaches.
• Taking medicines to reduce inflammation (corticosteroids).

Follow these instructions at home:

Eating and drinking

• Do noteat raw or undercooked:
  • Snails.
  • Slugs.
  • Prawns.
  • Crabs.
  • Frogs.
• Thoroughly wash any utensils or kitchen equipment that was used to prepare raw snails, slugs, or seafood.
• Wash all produce thoroughly before eating it.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do notdrive or use heavy machinery while taking prescription pain medicine.
• Get plenty of rest.
• Wash your hands with soap and water after handling any raw snails, slugs, or seafood, and before you eat.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you:

• Develop new or worse symptoms.

Get help right away if you:

• Have a severe headache that does not go away after you take medicine.
• Cannot eat or drink without vomiting.
• Develop a fever above 103°F (39°C).
• Have a seizure.
• Develop vision problems.
• Develop hearing problems.
• Become confused.

Summary

• Angiostrongylus cantonensis is a parasitic worm that lives in rats. Baby parasites (larvae) pass through rat feces into soil and may be picked up by snails or slugs.
• This condition is caused by eating raw or undercooked snails, slugs, crabs, freshwater shrimp (prawns), or frogs that are infected with the parasite. It can also be caused by eating raw produce that is contaminated with the parasite.
• Symptoms of this condition can include stiff neck, headache, fever, nausea and vomiting, rash, fatigue, and tingling or pain in the skin.
• Symptoms usually go away without treatment because the parasite cannot live inside the human body for a long time. Your health care provider may recommend treatment to relieve symptoms.