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    ABSTRACT: Laboratory diagnosis of angiostrongyliasis relies on serological techniques, since definitive diagnosis is insensitive. Modern antibody detection methods focus on antibodies to the 29 and 31 kDa proteins of the parasite. Antigen detection may ultimately prove to be more reliable than antibody detection but no method has been adopted for clinical diagnostic use. Diagnosis using PCR amplification of DNA sequences specific to Angiostrongylus cantonensis have been developed but have not yet been validated for clinical use. Diagnostic tests have not been developed commercially and in the United States tests developed experimentally by non-commercial laboratories have to be approved by the Food and Drug Administration before they can be sold to other laboratories for diagnostic purposes.
    Hawai'i journal of medicine & public health : a journal of Asia Pacific Medicine & Public Health 06/2013; 72(6 Suppl 2):55-7.
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    ABSTRACT: Angiostrongylus cantonensis, the rat lungworm, is a major cause of eosinophilic meningitis in humans. This short paper reviews what is known about the pathways of infection and assesses the probable importance of each in causing disease. Rats are the definitive hosts. People can become infected by eating, both deliberately and inadvertently, raw or under-cooked intermediate hosts (snails or slugs) or paratenic hosts such as freshwater shrimp, crabs and frogs. Food preparation prior to cooking can leave debris from which infection can also occur. It may be possible to become infected by consuming snail/slug slime (mucus) on produce or by transferring mucus from hands to mouth after handling snails/slugs. Infection from consuming drinking water contaminated by snails/slugs and infection via open wounds may be theoretically possible but no cases have been reported. The severity of the disease is probably related to the number of infective larvae ingested as well as to the precise location of the worms in the host and the host's inflammatory response. Strategies for reducing human infection should include snail and slug control to reduce chances of accidental ingestion, cooking of intermediate and paratenic hosts, and public education on food preparation.
    Hawai'i journal of medicine & public health : a journal of Asia Pacific Medicine & Public Health 06/2013; 72(6 Suppl 2):70-4.
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    ABSTRACT: The emerging infectious disease angiostrongyliasis (rat lungworm disease) is caused by ingesting snails and slugs infected by the nematode Angiostrongylus cantonensis. The definitive hosts of A. cantonensis are rats and the obligatory intermediate hosts are slugs and snails. Many cases result from accidentally ingesting infected snails or slugs on produce (eg, lettuce). This study assessed three readily available household products as washing solutions for removing snails and slugs from produce (romaine lettuce) to lower the probability of accidentally ingesting them. The solutions were acetic acid (vinegar), sodium hypochlorite (bleach), and sodium chloride (domestic salt). Snail and slug species known to be intermediate hosts and that are common in the Hawaiian Islands were used in the experiments: the alien snail Succinea tenella, the alien semi-slug Parmarion martensi, and the alien slugs Veronicella cubensis and Deroceras laeve. None of the products was any more effective than washing and rinsing with tap water alone. Most snails and slugs were removed after treatment but some remained on the lettuce even after washing and rinsing the produce. Only washing, rinsing, and then rinsing each leaf individually resulted in complete removal of all snails and slugs. The study did not address removal of any remaining slime left by the snails and slugs, nor did it address killing of worms.
    Hawai'i journal of medicine & public health : a journal of Asia Pacific Medicine & Public Health 06/2013; 72(6 Suppl 2):83-6.
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