Microbiology
Helminth (not to be confused with Hellmouth, where Sunnydale High located) includes A. cantonensis and A. costaricensis.
Epidemiologic Risks
Humans are accidental hosts.
Angiostrongylus cantonensis (rat lungworm) is transmitted between rats and mollusks (slugs or snails). Other animals can become infected such as freshwater shrimp, land crabs, frogs, and planarians of the genus Platydemus that are transport hosts transmitting the infection to humans if eaten raw or undercooked. So avoid slug sushi, although on occasion there are chopped slugs in that lettuce melange on your sandwich.
In SE Asia associated with eating undercooked crabs, shellfish and snails. And raw, yes raw, frogs (PubMed). And raw, wait for it, centipedes (PubMed).
A. costaricensis cycles between rats and slugs.
There have been cases in both France, Tennessee, and Texas. Nice to know these parts of the world have something in common. I remember when my son was 2 he found a slug and et it before I could react.
In the US, besides eating slugs, eating fresh from the garden vegetables, and with it slugs, is a risk (PubMed).
40% of rats in New Orleans have it (PubMed), so be careful with that rat jambalaya.
Syndromes
A. cantonensis: eosinophilic meningitis. A big problem in Vietnam.
A. costaricensis: eosinophilic gastroenteritis.
Treatment
A. cantonensis: mebendazole 100 mg po bid x 5 d or, perhaps best, albendazole 20 mg/kg dexamethasone 3 mg daily for 7 days (PubMed).
A. costaricensis: mebendazole 200-400 mg po tid x 10 d or thiabendazole 75 mg/kg divided tid x 3 d.
Notes
Last update: 12/02/18