Torn from the Headlines: Angiostrongylus cantonensis (Rat Lungworm

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Torn from the Headlines: Angiostrongylus cantonensis (Rat Lungworm) Is Established in Florida

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n light of the recent outbreaks of rat lungworm, Angiostrongylus cantonensis, in the state of Hawaii earlier this year, and the ensuing cases of eosinophilic meningitis, Lv and co-workers just published a timely Viewpoint on the CNS parasite.1 Angiostrongylus cantonensis is a parasitic nematode whose lifecycle involves both definitive host (rats) and intermediate host (snails or slugs (gastropods)). The Angiostrongylus cantonensis larvae are neutrophic and induce inflammation in the CNS with symptoms such as headache, neck stiffness, nausea, vomiting, and paresthesia.1 Interviews with infected patients describe the infection as incredibly painful; unfortunately, there is no definitive treatment. Angiostrongylus cantonensis is endemic in Southeast Asia, Pacific Islands, and the Caribbean,1 and has recently expanded to South America... and now Florida! Yes, Angiostrongylus cantonensis is now established in multiple regions of Florida, as reported by Fox News,2 and researchers at the University of Florida refer to their findings as “alarming”.3 In Asia and the Pacific islands, such as Hawaii, the larvae are typically ingested from undercooked snails (gastropods). However, data shows that the mucus of infected snails can contaminate water and vegetables that are not properly washed or cooked.1,3 In a recent PLOS One paper,3 cited by Fox News in their report,2 Walden and co-workers have expanded the geographic distribution of Angiostrongylus cantonensis to multiple regions in the state of Florida. The team collected rats, rat feces, and snails from 18 counties throughout the state of Florida and found that 22.8% of the rats (Rattus rattus) collected were positive for Angiostrongylus cantonensis as well as 16.2% of the rat fecal samples.3 The incidence in 32 species of snails was less (1.9%), but these data still verify that Angiostrongylus cantonensis is established in both definitive and intermediate hosts in multiple counties in Florida. While rats are uniformly distributed across the United States, increasing temperatures could push intermediate hosts into more temperate climates, and thus spread risk to regions not familiar with the presentation of eosinophilic meningitis induced by Angiostrongylus cantonensis.3 Clearly, this CNS pathogen as well as the brain-eating amoeba (Naegleria fowleri)4,5 are becoming more prevalent and of growing concern in the United States. ACS Chemical Neuroscience welcomes your Viewpoints, Letters, Articles, Reviews, and Perspectives on these and other CNS pathogens. By bringing together the neuroscience, infectious disease, and medicinal chemistry communities, we hope that innovative new strategies and approaches will evolve to tackle these, and the next generation of CNS pathogens.



Views expressed in this editorial are those of the author and not necessarily the views of the ACS.



REFERENCES

(1) Lv, S., Zhou, X.-N., and Andrews, J. (2017) Eosinophilic meningitis caused by Angiostrongylus cantonensis. ACS Chem. Neurosci., DOI: 10.1021/acschemneuro.7b00233. (2) http://www.foxnews.com/health/2017/06/30/alarming-ratlungworm-parasite-spreading-through-florida-researchers-warn.html. (3) Stockdale Walden, H. D., Slapcinsky, J. D., Roff, S., Mendieta Calle, J., Diaz Goodwin, Z., Stern, J., Corlett, R., Conway, J., and McIntosh, A. (2017) Geographic distribution of Angiostrongylus cantonensis in wild rats (Rattus rattus) and terrestrial snails in Florida, USA. PLoS One 12, e0177910. (4) Pugh, J. J., and Levy, R. A. (2016) Naegleria fowleri: Diagnosis, pathophysiology of brain inflammation, and antimicrobial treatments. ACS Chem. Neurosci. 7, 1178−1179. (5) Baig, A. M. (2016) Primary Amoebic Meningoencephalitis: Neurochemotaxis and neurotropic preferences of Naegleria fowleri. ACS Chem. Neurosci. 7, 1026−1029.

Craig W. Lindsley, Editor-in-Chief AUTHOR INFORMATION

ORCID

Craig W. Lindsley: 0000-0003-0168-1445 © 2017 American Chemical Society

Published: August 16, 2017 1632

DOI: 10.1021/acschemneuro.7b00244 ACS Chem. Neurosci. 2017, 8, 1632−1632