An epidemiological study of A. cantonensis in Jamaica subsequent to an outbreak of human cases of eosinophilic meningitis in 2000.

The infection status of angiostrongylosis in Jamaica was assessed in wild rats and molluscs in the 5 years following the major outbreak of eosinophilic meningitis (EM) in 2000. Parasitological analyses of 297 Rattus rattus and 140 Rattus norvegicus, and 777 terrestrial molluscs from all 14 Parishes on the island revealed Angiostrongylus cantonensis in 32·0% of the rats and in 12·5% of the molluscs. Multivariate analyses confirmed that A. cantonensis occurred significantly more frequently in R. rattus (Odds Ratio [OR] = 1·76), while mean infection intensity in R. rattus was also significantly higher (16·8) than R. norvegicus (11·3) (Mann-Whitney U-test: P = 0·01). Third-stage larvae of A. cantonensis were detected in 29% of 86 Pleurodonte spp.; in 20% of five Poteria spp.; in 18·7% of 369 Thelidomus asper; in 11% of 18 Sagda spp.; and in 6% of 24 veronicellid slugs. Most rodent infections occurred in Northeastern Jamaica (OR = 11·66), a region where infected molluscs were also abundant. Given the prevalence of A. cantonensis infection in rats has significantly increased since the 2000 outbreak, and that a survey of human infections revealed at least ten autochthonous cases in the last 15 years, angiostrongylosis persists as an important zoonosis in Jamaica.

Report of ezootic Angiostronglyus cantonesis from Jamaica [ABSTRACT]

OBJECTIVE: To study the status of infection with Angiostrongylus cantonensis in wild rats and snails in Jamaica following an outbreak of eosinophilic meningitis amongst tourists. METHODS: One hundred and thirty-one Rattus rattus and 94 R norvegicus were collected, mainly from the eastern portion of Jamaica. The animals were dissected and the heart and pulmonary arteries explored to reveal A cantonensis. Similarly, several species of land snails were collected. A portion of the head/foot was excised, fragmented and placed in separate dishes of digestion fluid (0.01 percent pepsin in 0.7 percent v/v aqeous HCI). Dishes were examined for nematode larvae 4-5 hours and 24 hours post-digestion. A microscopical comparison of larvae with museum specimens confirmed identification. RESULTS: Overall, significantly more R rattus (42.7 percent) than R morvegicus (21.3 percent) were infected (x2=11.28;p<0.0001). Considering only those parishes where 15 or more rats were collected (Hanover, Manchester, St.James, St. Elizabeth, Kingston and St.Andrew, and Portland) the prevalence of rodent infections ranged from 6 to 59 percent. Of three snails and one slug species collected, only Thelidomus asper harboured A cantonensis larvae. This snail was collected from Manchester where the highest prevalence of rodent infections also occurred. CONCLUSIONS: The findings indicate that A cantonensis is present in rats and snails in Jamaica. In the context of reports (1996, 2000) of eosinophilic meningitis on the island, we recommend that public health officials, clinical parasitologists and travel medicine practitioners consider A cantonensis as a causative agent of eosinophilic meningitis in residents and travellers to Jamaica. (AU)