Abstract

The parasitic nematode Angiostrongylus cantonensis is a major cause of eosinophilic meningitis in humans, and has been documented in other incidental hosts such as birds, horses, dogs and non-human primates. It is endemic in Hawaii, and there have been sporadic reports in the southern continental United States. This parasite uses rats as definitive hosts and snails as intermediate hosts. In this study, we collected potential definitive and intermediate hosts throughout Florida to ascertain the geographic distribution in the state: Rats, environmental rat fecal samples, and snails were collected from 18 counties throughout the state. Classical diagnostics and morphological identification, along with molecular techniques were used to identify nematode species and confirm the presence of A. cantonensis.Of the 171 Rattus rattus collected, 39 (22.8%) were positive for A. cantonensis, and 6 of the 37 (16.2%) environmental rat fecal samples collected in three of the surveyed counties were also positive for this parasite by real time PCR. We examined 1,437 gastropods, which represented 32 species; 27 (1.9%) were positive for A. cantonensis from multiple sites across Florida. Three non-native gastropod species, Bradybaena similaris, Zachrysia provisoria, and Paropeas achatinaceum, and three native gastropod species, Succinea floridana, Ventridens demissus, and Zonitoides arboreus, which are newly recorded intermediate hosts for the parasite, were positive for A. cantonensis. This study indicates that A. cantonensis is established in Florida through the finding of adult and larval stages in definitive and intermediate hosts, respectively, throughout the state. The ability for this historically subtropical nematode to thrive in a more temperate climate is alarming, however as the climate changes and average temperatures rise, gastropod distributions will probably expand, leading to the spread of this parasite in more temperate areas. Through greater awareness of host species and prevalence of A. cantonensis in the United States, potential accidental infections may be avoided.

Highlights

  • Angiostrongylus cantonensis, the rat lungworm [1], is a parasitic metastrongyloid nematode that is a major cause of eosinophilic meningitis in humans [2,3,4,5], and has been described in over 2800 documented cases in more than 30 countries worldwide [4, 6]

  • We can estimate the geographic range of Angiostrongylus cantonensis in Florida, with nematodes recovered from either rats, environmental rat fecal samples and/or gastropods throughout the state

  • Gastropods infected with A. cantonensis included 3 native species and 3 non-native species

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Summary

Introduction

Angiostrongylus cantonensis, the rat lungworm [1], is a parasitic metastrongyloid nematode that is a major cause of eosinophilic meningitis in humans [2,3,4,5], and has been described in over 2800 documented cases in more than 30 countries worldwide [4, 6]. Infections in humans, non-human primates and other animals such as dogs, birds, horses and opossums have been reported [6, 14,15,16,17,18,19,20,21] These hosts are incidental hosts in which the infective L3s arrest development in the central nervous system. The arrested L3s are unable to develop a patent infection, and subsequent eosinophilic meningitis develops Both paratenic and incidental hosts become infected through ingesting the infective L3 within the gastropod intermediate host. Coma or death may occur [24]

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