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Angiostrongylus cantonensis: a review of its distribution, molecular biology and clinical significance as a human pathogen

Published online by Cambridge University Press:  26 May 2016

JOEL BARRATT ,
DOUGLAS CHAN ,
INDY SANDARADURA ,
RICHARD MALIK ,
DEREK SPIELMAN ,
ROGAN LEE ,
DEBORAH MARRIOTT ,
JOHN HARKNESS ,
JOHN ELLIS  and
DAMIEN STARK
JOEL BARRATT*
Affiliation:
i3 Institute, University of Technology Sydney, Ultimo, NSW, Australia School of Life Sciences, University of Technology Sydney, Ultimo, NSW, Australia
DOUGLAS CHAN
Affiliation:
i3 Institute, University of Technology Sydney, Ultimo, NSW, Australia School of Life Sciences, University of Technology Sydney, Ultimo, NSW, Australia Department of Microbiology, SydPath, St. Vincent's Hospital, Victoria St., Darlinghurst, NSW, Australia
INDY SANDARADURA
Affiliation:
Department of Microbiology, SydPath, St. Vincent's Hospital, Victoria St., Darlinghurst, NSW, Australia School of Medicine, University of Notre Dame, Sydney, Australia
RICHARD MALIK
Affiliation:
Centre for Veterinary Education, B22, The University of Sydney, NSW 2006, Australia
DEREK SPIELMAN
Affiliation:
Faculty of Veterinary Science, The University of Sydney, Sydney, NSW 2006, Australia
ROGAN LEE
Affiliation:
ICPMR, Westmead Clinical School, Westmead Hospital, Westmead, NSW 2065, Australia
DEBORAH MARRIOTT
Affiliation:
Department of Microbiology, SydPath, St. Vincent's Hospital, Victoria St., Darlinghurst, NSW, Australia
JOHN HARKNESS
Affiliation:
Department of Microbiology, SydPath, St. Vincent's Hospital, Victoria St., Darlinghurst, NSW, Australia
JOHN ELLIS
Affiliation:
School of Life Sciences, University of Technology Sydney, Ultimo, NSW, Australia
DAMIEN STARK
Affiliation:
Department of Microbiology, SydPath, St. Vincent's Hospital, Victoria St., Darlinghurst, NSW, Australia
*
*Corresponding author: University of Technology Sydney, School of Life Sciences/iThree Institute, PO Box 123 Broadway, NSW 2007, Australia. E-mail: joel.barratt-1@uts.edu.au
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Summary

Angiostrongylus cantonensis is a metastrongyloid nematode found widely in the Asia-Pacific region, and the aetiological agent of angiostrongyliasis; a disease characterized by eosinophilic meningitis. Rattus rats are definitive hosts of A. cantonensis, while intermediate hosts include terrestrial and aquatic molluscs. Humans are dead-end hosts that usually become infected upon ingestion of infected molluscs. A presumptive diagnosis is often made based on clinical features, a history of mollusc consumption, eosinophilic pleocytosis in cerebral spinal fluid, and advanced imaging such as computed tomography. Serological tests are available for angiostrongyliasis, though many tests are still under development. While there is no treatment consensus, therapy often includes a combination of anthelmintics and corticosteroids. Angiostrongyliasis is relatively rare, but is often associated with morbidity and sometimes mortality. Recent reports suggest the parasites’ range is increasing, leading to fatalities in regions previously considered Angiostrongylus-free, and sometimes, delayed diagnosis in newly invaded regions. Increased awareness of angiostrongyliasis would facilitate rapid diagnosis and improved clinical outcomes. This paper summarizes knowledge on the parasites’ life cycle, clinical aspects and epidemiology. The molecular biology of Angiostrongylus spp. is also discussed. Attention is paid to the significance of angiostrongyliasis in Australia, given the recent severe cases reported from the Sydney region.

Keywords

AngiostrongyliasisAngiostrongylusDiagnosisEosinophilic meningitisMolluscsRatLungwormClinical significanceEpidemiologyMolecular biology

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Type
Review Article
Information
Parasitology , Volume 143 , Issue 9 , August 2016 , pp. 1087 - 1118
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Copyright © Cambridge University Press 2016 

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Footnotes

†

These authors contributed equally to this manuscript.

References

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