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Chronic neuroangiostrongyliasis: case study of chronic presentations in Hawaii

Published online by Cambridge University Press:  10 September 2020

Bernard C. Meyer Open the ORCID record for Bernard C. Meyer [Opens in a new window]
Bernard C. Meyer*
Affiliation:
East Maui Community and Tropical Medicine, PO Box 756, Hana, Hawaii96713, USA
*
Author for correspondence: Bernard C. Meyer, E-mail: hanablues@gmail.com
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Abstract

This paper describes chronic features of neuroangiostrongyliasis (NAS), a long-term outcome of the disease that has not been adequately described. Current and past literature is predominantly limited to acute manifestations of NAS, and mention of chronic, ongoing clinical symptoms is usually limited to brief notes in a discussion of severe cases. This study investigated the long-term outcomes in ten individuals who were diagnosed with acute neuroangiostrongyliasis in Hawaii between 2009 and 2017. The study demonstrates a significant number of persons in Hawaii sustain residual symptoms for many years, including troublesome sensory paresthesia (abnormal spontaneous sensations of skin experienced as ‘burning, pricking, pins and needles’; also described as allodynia or hyperesthesia) and extremity muscle pains. As a consequence, employment and economic hardships, domestic relocations, and psychological impairments affecting personal relationships occurred. The study summarizes common features of chronic disease, sensory paresthesia and hyperesthesia, diffuse muscular pain, insomnia, and accompanying emotional distress; highlights the frequently unsuccessful endeavours of individuals struggling to find effective treatment; proposes pathogenic mechanisms responsible for prolonged illness including possible reasons for differences in disease presentation in Hawaii compared to Southeast Asia.

Keywords

AllodyniaAngiostrongylus cantonensis (A. cantonensis)chronicHawaiihyperesthesiaparesthesianeuroangiostrongyliasis (NAS)Parmarion martensirat lungworm
Type
Research Article
Information
Parasitology , Volume 148 , Special Issue 2: 6th International Workshop on Angiostrongylus and Angiostrongyliasis, Hilo, Hawai'i, USA, January, 2020 , February 2021 , pp. 221 - 226
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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References

Alicata, JE (1967) Effect of freezing and boiling on the infectivity of third-stage larvae of Angiostrongylus cantonensis present in land snails and freshwater prawns. The Journal of Parasitology 53, 1064–1066.CrossRefGoogle ScholarPubMed
Barratt, J, Chan, D, Sandaradura, I, Malik, R, Spielman, D, Lee, R, Marriott, D, Harkness, Z, Ellis, J and Stark, D (2016) Angiostrongylus cantonensis: a review of its distribution, molecular biology and clinical significance as a human pathogen. Parasitology 143, 1087–1118.CrossRefGoogle ScholarPubMed
Chen, XG, Li, H and Lun, ZR (2005) Angiostrongyliasis, Mainland China. Emerging Infectious Diseases 11, 1645–1647.CrossRefGoogle ScholarPubMed
Cowie, RH (2013) Biology, systematics, life cycle, and distribution of Angiostrongylus cantonensis, the cause of rat lungworm disease. Hawaii Journal of Medicine and Public Health 72(suppl. 2), 6–9.Google ScholarPubMed
Cowie, RH (2017) Angiostrongylus cantonensis: agent of a sometimes fatal globally emerging infectious disease (rat lungworm disease). ACS Chemical Neuroscience 8, 2102–2104.CrossRefGoogle Scholar
Cowie, RH, Rollins, RL, Medeiros, MCI and Christensen, CC (2019) New records of Clausiliidae: Tauphaedusa Tau (Boettger, 1877) (Gastropoda: Heterobranchia) on O‘ahu, Hawaiian Islands, and the first global record of infection of a clausiliid land snail with Angiostrongylus cantonensis (Chen, 1935), the rat lungworm. Bishop Museum Occasional Papers 126, 11–18.Google Scholar
Eamsobhana, P, Yoolek, A and Yong, H-S (2010) Effect of Thai ‘koi-hoi’ food flavoring on the viability and infectivity of the third-stage larvae of Angiostrongylus cantonensis (Nematoda: Angiostrongylidae). Acta Tropica 113, 245–247.CrossRefGoogle Scholar
Hochberg, NS, Park, SY, Blackburn, BG, Sejvar, JJ, Gaynor, K, Chung, H, Leniek, K, Herwaldt, BL and Effler, PV (2007) Distribution of eosinophilic meningitis cases attributable to Angiostrongylus cantonensis, Hawaii. Emerging Infectious Diseases 13, 1675–1680.CrossRefGoogle ScholarPubMed
Hochberg, NS, Blackburn, BG, Park, SY, Sejvar, JJ, Effler, PV and Herwaldt, BL (2011) Eosinophilic meningitis attributable to Angiostrongylus cantonensis infection in Hawaii: clinical characteristics and potential exposures. American Journal of Tropical Medicine and Hygiene 85, 685–690.CrossRefGoogle ScholarPubMed
Hollingsworth, RG, Kaneta, R, Sullivan, JJ, Bishop, HS, Qvarnstrom, Y, da Silva, AJ and Robinson, DG (2007) Distribution of Parmarion Cf. martensi (Pulmonata: Helicarionidae), a new semi-slug pest on Hawaii island, and its potential as a vector for human angiostrongyliasis. Pacific Science 61, 457–467.CrossRefGoogle Scholar
Horio, S and Alicata, J (1961) Parasitic meningo-encephalitis in Hawaii. A new parasitic disease of man. Hawaii Medical Journal 21, 139–140.Google Scholar
Howe, K and Jarvi, SI (2017) Angiostrongyliasis (rat lungworm disease): viewpoints from Hawaii island. ACS Chemical Neuroscience 8, 1820–1822.CrossRefGoogle Scholar
Hsu, JJ, Chuang, SH, Chen, CH and Huang, MH (2009) Sacral myeloradiculitis (Elsberg syndrome) secondary to eosinophilic meningitis caused by Angiostrongylus cantonensis. British Medical Journal Case Reports doi:10.1136/bcr.10.2008.1075.Google ScholarPubMed
Johnston, DI, Dixon, MC, Elm, JL Jr, Calimlim, PS, Sciulli, RH and Park, SY (2019) Review of cases of angiostrongyliasis in Hawaii. American Journal of Tropical Medicine and Hygiene 101, 608–616.CrossRefGoogle ScholarPubMed
Kim, JR, Hayes, KA, Yeung, NW and Cowie, RH (2014) Diverse gastropod hosts of Angiostrongylus cantonensis, the rat lungworm, globally and with a focus on the Hawaiian Islands. PLoS ONE 9, e94969h.CrossRefGoogle ScholarPubMed
Kim, JR, Wong, TM, Curry, PA, Yeung, NW, Hayes, KA and Cowie, RH (2019) Modelling the distribution in Hawaii of Angiostrongylus cantonensis (rat lungworm) in its gastropod hosts. Parasitology 146, 42–49.CrossRefGoogle ScholarPubMed
Kuberski, T and Wallace, GD (1979) Clinical manifestations of eosinophilic meningitis due to Angiostrongylus cantonenis. Neurology 29, 1566–1570.CrossRefGoogle Scholar
Kuberski, T, Bart, ED, Briley, JM and Rosen, L (1979) Recovery of Angiostrongylus cantonensis from cerebrospinal fluid of a child with eosinophilic meningitis. Journal of Clinical Microbiology 9, 629–631.Google ScholarPubMed
Lim, BL and Mak, JW (1983) Human behavior and zoonotic diseases in Malaysia. In Croll, NA and Cross, JH (eds), Human Ecology and Infectious Diseases. Kuala Lumpur, Malaysia: Academic Press, pp. 49–72.CrossRefGoogle Scholar
Lv, S, Zhang, Y, Steinmann, P and Zhou, X-N (2008) Emerging angiostrongyliasis in mainland China. Emerging Infectious Diseases 1, 161–164.CrossRefGoogle Scholar
Lv, S, Zhang, Y, Liu, HX, Hu, L, Yang, K, Steinmann, P, Chen, Z, Wang, LY, Utzinger, J and Zhou, XN (2009) Invasive snails and an emerging infectious disease: results from the first national survey on Angiostrongylus cantonensis in China. PLoS Neglected Tropical Diseases 3, e368.CrossRefGoogle Scholar
Martins, YC, Tanowitz, HB and Kazacos, KR (2015) Central nervous system manifestations of Angiostrongylus cantonensis infection. Acta Tropica 141, 46–53.CrossRefGoogle ScholarPubMed
Medeiros, MCI, Rollins, RL, Echaluse, MV and Cowie, RH (2020) Species identity and size are associated with rat lungworm infection in gastropods. EcoHealth 17, 183–193 doi: 10.1007/s10393-020-01484-x.CrossRefGoogle ScholarPubMed
Morton, NJ, Britton, P, Palasanthiran, P, Bye, A, Sugo, E, Kesson, A, Ardern-Holmes, S and Snelling, TL (2013) Severe hemorrhagic meningoencephalitis due to Angiostrongylus cantonensis among young children in Sydney, Australia. Clinical Infectious Diseases 57, 1158–1161.CrossRefGoogle ScholarPubMed
Murphy, GS and Johnson, S (2013) Clinical aspects of eosinophilic meningitis and meningoencephalitis caused by Angiostrongylus cantonensis, the rat lungworm. Hawaii Journal of Medicine and Public Health 72(suppl. 2), 35–40.Google ScholarPubMed
Prociv, P and Turner, M (2018) Neuroangiostrongyliasis: the “sub-arachnoid phase” and its implications for anthelminthic therapy. American Journal of Tropical Medicine and Hygiene 98, 353–359.CrossRefGoogle Scholar
Punyagupta, S, Bunnag, T, Juttijudata, P and Rosen, L (1970) Eosinophilic meningitis in Thailand. Epidemiologic studies of 484 typical cases and the etiologic role of Angiostrongylus cantonensis. American Journal of Tropical Medicine and Hygiene 19, 950–958.CrossRefGoogle ScholarPubMed
Qvarnstrom, Y, Aramburu da Sliva, A, Teem, J, Hollingsworth, R, Bishop, H, Graeff-Teixeira, C, da Silva, A (2010) Improved molecular detection of Angiostrongylus cantonensis in mollusks and other environmental samples with a species-specific internal transcribed spacer 1-based TaqMan assay. Applied and Environmental Microbiology. doi: 10.1128/AEM.00546-10.CrossRefGoogle ScholarPubMed
Rosen, L, Loison, G, Laigret, J and Wallace, GD (1967) Studies on eosinophilic meningitis. 3. Epidemiologic and clinical observations on Pacific islands and the possible etiologic role of Angiostrongylus cantonensis. American Journal of Epidemiology 85, 17–44.CrossRefGoogle ScholarPubMed
State of Hawaii, Department of Health (2019). Disease Summary Table 1990_2018_Master-updated August 6, 2019. Retrieved from State of Hawaii, Department of Health Disease Outbreak Control Division website: Available at https://health.hawaii.gov/docd/files/2019/08/Disease-Summary-Table-2009_2018_State.pdf (Accessed 22 May 2020).Google Scholar
Tesana, S, Srisawangwong, T, Sithithaworn, P, Laha, T and Andrews, R (2009) Prevalence and intensity of infection with third stage larvae of Angiostrongylus cantonensis in mollusks from northeast Thailand. American Journal of Tropical Medicine and Hygiene 80, 983–987.CrossRefGoogle ScholarPubMed
Tseng, Y-T, Tsai, H-C, Cheng, LS, Lee, SS-J, Wann, S-R, Wang, Y-H, Chen, J-K, Wu, K-S and Chen, J-K (2011) Clinical manifestations of eosinophilic meningitis caused by Angiostrongylus cantonensis: 18 years' experience in a medical center in southern Taiwan. Journal of Microbiology, Immunology and Infection 44, 382–389.CrossRefGoogle Scholar
Wallace, GD and Rosen, L (1969) Studies on eosinophilic meningitis V. Molluscan hosts of Angiostrongylus cantonensis on Pacific islands. American Journal of Tropical Medicine and Hygiene 18, 206–216.CrossRefGoogle ScholarPubMed
Wang, Q-P, Lai, D-H, Zhu, X-Q, Chen, X-G and Lun, Z-R (2008) Human angiostrongyliasis. Lancet Infectious Diseases 8, 621–630.CrossRefGoogle ScholarPubMed
Watson, CP, Deck, JH, Morshead, C, Van der Kooy, D and Evans, RJ (1988) Post-herpetic neuralgia: post-mortem analysis of a case. Pain 34, 129.CrossRefGoogle ScholarPubMed
Watson, CP, Deck, JH, Morshead, C, Van der Kooy, D and Evans, RJ (1991) Post-herpetic neuralgia: further post-mortem studies of cases with and without pain. Pain 44, 105.CrossRefGoogle ScholarPubMed