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ABSTRACT: Baylisascaris larva migrans is an important zoonotic disease caused by Baylisascaris procyonis, the raccoon roundworm, and is being increasingly considered in the differential diagnosis of eosinophilic meningoencephalitis in children and young adults. Although a B. procyonis excretory-secretory (BPES) antigen-based enzyme-linked immunosorbent assay (ELISA) and a Western blot assay are useful in the immunodiagnosis of this infection, cross-reactivity remains a major problem. Recently, a recombinant B. procyonis antigen, BpRAG1, was reported for use in the development of improved serological assays for the diagnosis of Baylisascaris larva migrans. In this study, we tested a total of 384 human patient serum samples in a BpRAG1 ELISA, including samples from 20 patients with clinical Baylisascaris larva migrans, 137 patients with other parasitic infections (8 helminth and 4 protozoan), and 227 individuals with unknown/suspected parasitic infections. A sensitivity of 85% and a specificity of 86.9% were observed with the BpRAG1 ELISA, compared to only 39.4% specificity with the BPES ELISA. In addition, the BpRAG1 ELISA had a low degree of cross-reactivity with antibodies to Toxocara infection (25%), while the BPES antigen showed 90.6% cross-reactivity. Based on these results, the BpRAG1 antigen has a high degree of sensitivity and specificity and should be very useful and reliable in the diagnosis and seroepidemiology of Baylisascaris larva migrans by ELISA.
Clinical and vaccine immunology: CVI 08/2011; 18(10):1650-5. · 2.37 Impact Factor
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ABSTRACT: Larva migrans caused by Baylisascaris procyonis is an important zoonotic disease. Current serological diagnostic assays for this disease depend on the use of the parasite's larval excretory-secretory (ES) antigens. In order to identify genes encoding ES antigens and to generate recombinant antigens for use in diagnostic assays, construction and immunoscreening of a B. procyonis third-stage larva cDNA expression library was performed and resulted in identification of a partial-length cDNA clone encoding an ES antigen, designated repeat antigen 1 (RAG1). The full-length rag1 cDNA contained a 753-bp open reading frame that encoded a protein of 250 amino acids with 12 tandem repeats of a 12-amino-acid long sequence. The rag1 genomic DNA revealed a single intron of 837 bp that separated the 753-bp coding sequence into two exons delimited by canonical splice sites. No nucleotide or amino acid sequences present in the GenBank databases had significant similarity with those of RAG1. We have cloned, expressed, and purified the recombinant RAG1 (rRAG1) and analyzed its diagnostic potential by enzyme-linked immunosorbent assay. Anti-Baylisascaris species-specific rabbit serum showed strong reactivity to rRAG1, while only minimal to no reactivity was observed with sera against the related ascarids Toxocara canis and Ascaris suum, strongly suggesting the specificity of rRAG1. On the basis of these results, the identified RAG1 appears to be a promising diagnostic antigen for the development of serological assays for specific detection of B. procyonis larva migrans.
Clinical and vaccine immunology: CVI 10/2010; 17(12):1933-9. · 2.37 Impact Factor
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ABSTRACT: Toxocaracanis and Toxocara cati of dogs and cats, respectively, can cause significant disease in people. Human seroprevalence for Toxocara antibodies varies with factors such as geographic location, socio-economic status, and dietary habits. Risk factors for infection include geophagia and low-level education. Toxocara canis is better recognized as a cause of human toxocariasis, but Toxocara cati should not be overlooked. In addition, patent infections with Baylisascaris procyonis, the raccoon ascarid, have been increasingly recognized in dogs. Pet owners need to be properly educated about zoonotic risks, and veterinarians should institute regular parasite screening and treatment for all pets. Establishment of national surveillance programs to determine the incidence and specific etiological agent in human larva migrans patients would aid in the development of targeted intervention strategies.
Trends in Parasitology 02/2010; 26(4):155-61. · 5.14 Impact Factor
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ABSTRACT: Dogs and cats are hosts to hookworms that may cause zoonotic disease, most notably, cutaneous larva migrans. Ancylostoma braziliense is most often implicated in dermatological lesions, and Ancylostoma caninum has been associated with eosinophilic enteritis and suggested as a possible cause of diffuse unilateral subacute neuroretinitis in humans. Other manifestations include eosinophilic pneumonitis, localized myositis, folliculitis, erythema multiforme, or ophthalmological manifestations. Ancylostoma eggs are morphologically indistinguishable, which complicates epidemiological studies. Surveys of dermatologists, gastroenterologists, and ophthalmologists would help to define the incidence of these zoonotic infections. Improved diagnostic tests are needed to identify the causative species involved and understand the epidemiology of hookworm disease. This review describes the discovery of the disease, the biology of the agents, and how that biology may impact disease.
Trends in Parasitology 02/2010; 26(4):162-7. · 5.14 Impact Factor
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ABSTRACT: Baylisascaris procyonis and Toxocara species are two important causes of larva migrans in humans. Larva migrans caused by Toxocara spp. is well known and is diagnosed serologically by enzyme immunoassay. Over a dozen cases of larva migrans and associated eosinophilic encephalitis caused by B. procyonis have also been reported, and at least a dozen additional cases are known. An enzyme-linked immunosorbent assay (ELISA) using the excretory-secretory (ES) antigen of B. procyonis larvae is currently being used in our laboratory as an aid in the diagnosis of this infection in humans. Clinically affected individuals show very high reactivity (measured as the optical density) on this ELISA; however, a one-way cross-reactivity with Toxocara spp. has been observed. As an approach to differentiate these two infections based on serology, we performed Western blots, wherein the B. procyonis ES antigen was reacted with serum samples from individuals known to be positive for either Toxocara spp. or B. procyonis larva migrans. Western blot results showed that B. procyonis antigens of between 30 and 45 kDa were specifically identified only by the sera from individuals with Baylisascaris larva migrans, thus allowing for differentiation between the two infections. This included human patient serum samples submitted for serologic testing, as well as sera from rabbits experimentally infected with B. procyonis. When used in conjunction with the ELISA, Western blotting could be an efficient tool for diagnosis of this infection in humans.
Clinical and vaccine immunology: CVI 10/2009; 16(11):1563-8. · 2.37 Impact Factor
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ABSTRACT: The objective of this study was to develop polymerase chain reaction (PCR) assays for detection of Baylisascaris procyonis eggs and larvae in fecal, environmental, and tissue samples. We have optimized conventional and real-time PCR assays for B. procyonis using the mitochondrial cytochrome oxidase 2 gene as the target for amplification. The lower limit of detection of the parasite genomic DNA was 10 pg in the conventional PCR and 100 fg in the real-time PCR. In both PCR assays, specific amplification of a 146 bp product was achieved with DNA extracted from a single in vitro hatched B. procyonis larva and also from canine fecal samples spiked with as few as 20 unembryonated B. procyonis eggs per gram of feces. The PCR assays were successfully used for detection of B. procyonis eggs and larvae in fecal, environmental, and tissue samples. No DNA amplification was seen when the genomic DNA of related ascarids (including B. transfuga) and a hookworm was used as template in the PCR; however, amplification was seen with the very closely related B. columnaris.
Journal of Parasitology 01/2009; 95(3):571-7. · 1.40 Impact Factor
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ABSTRACT: Neurological disease occurred in 4 Patagonian conures (Cyanoliseus patagonus), 2 crested screamer chicks (Chauna torquata), and 1 western Canadian porcupine (Erethizon dorsatum epixanthus) at a Manitoba zoo. Baylisascaris procyonis, the common raccoon roundworm, not previously identified in Manitoba, is considered the likely cause of neural larval migrans in these cases.
The Canadian veterinary journal. La revue veterinaire canadienne 10/2008; 49(9):885-8. · 1.06 Impact Factor
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ABSTRACT: Large ascarid larvae within granulomas were noted histologically in the mesenteric and pancreatic lymph nodes of 13 of 21 rhesus macaques (Macaca mulatta) euthanized as part of an experimental viral pathogenesis study. In addition, 7 of the 13 monkeys had cerebral granulomas, which in 4 animals contained nematode larvae similar to those within the lymph nodes. Despite the lesions, the animals did not show clinical signs associated with the parasitic infections. Characteristics of the larvae included, on cross-section, a midbody diameter of approximately 60 to 80 mum, a centrally located and slightly compressed intestine flanked on either side by large triangular excretory columns, and prominent single lateral cuticular alae. The morphology of the larvae was compatible with Baylisascaris spp. Baylisascariasis is a well-described infection of animals and humans that is caused by migrating larvae of the raccoon roundworm, Baylisascaris procyonis. A similar species, B. columnaris, is found in skunks and can cause cerebrospinal nematodiasis, but most reported cases of baylisascariasis have been due to B. procyonis. Our macaques were born free-ranging on an island in the southeastern United States where raccoons, but not skunks, were found to be common inhabitants, indicating that B. procyonis was the most likely parasite involved. These cases are similar to the low-level or covert cases of Baylisascaris infection described to occur in humans and provide further evidence of the existence of this parasite in the southeastern United States.
Journal of the American Association for Laboratory Animal Science: JAALAS 08/2008; 47(4):64-7. · 0.71 Impact Factor
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ABSTRACT: Infection by Baylisascaris procyonis is an uncommon but devastating cause of eosinophilic meningitis. We report the first case-patient, to our knowledge, who recovered from B. procyonis eosinophilic meningitis without any recognizable neurologic deficits. The spectrum of illness for this organism may be wider than previously recognized.
Emerging infectious diseases 07/2007; 13(6):928-30. · 6.17 Impact Factor
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ABSTRACT: The raccoon roundworm, Baylisascaris procyonis, is the most common and widespread cause of clinical larva migrans in animals. In addition, it is increasingly recognized as a cause of devastating or fatal neural larva migrans in infants and young children and ocular larva migrans in adults. Humans become infected by accidentally ingesting infective B. procyonis eggs from raccoon latrines or articles contaminated with their feces. Two features distinguish B. procyonis from other helminthes that cause larva migrans: (i) its aggressive somatic migration and invasion of the central nervous system and (ii) the continued growth of larvae to a large size within the central nervous system. Typically, B. procyonis neural larva migrans presents as acute fulminant eosinophilic meningoencephalitis. Once invasion of the central nervous system has occurred, the prognosis is grave with or without treatment. To date, despite anthelmintic treatment of cases of B. procyonis neural larva migrans, there are no documented neurologically intact survivors. Epidemiologic study of human cases of neural larva migrans demonstrate that contact with raccoon feces or an environment contaminated by infective eggs and geophagia or pica are the most important risk factors for infection. In many regions of the United States, increasingly large populations of raccoons, with high rates of B. procyonis infection, live in close proximity to humans. Although documented cases of human baylisascariasis remain relatively uncommon, widespread contamination of the domestic environment by infected raccoons suggests that the risk of exposure and human infection is probably substantial. In the absence of early diagnosis or effective treatment, prevention of infection is the most important public health measure.
Clinical Microbiology Reviews 11/2005; 18(4):703-18. · 16.13 Impact Factor
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ABSTRACT: The raccoon roundworm, Baylisascaris procyonis, is increasingly recognized as a cause of zoonotic visceral, ocular, and neural larva migrans and, in particular, of devastating encephalitis in young children. Exposure occurs mainly at raccoon latrines, where large numbers of infective eggs may be accidentally ingested. Risk factors for infection include contact with raccoon latrines, pica/geophagia, age of <4 years, and male sex. The severity of central nervous system (CNS) disease depends on the number of eggs ingested, the extent and location of larval migration, and the severity of ensuing inflammation and necrosis. Diagnosis of Baylisascaris encephalitis is based on clinical CNS disease, peripheral and cerebrospinal fluid eosinophilia, deep white matter lesions visible by magnetic resonance imaging, and positive results of serologic tests. Treatment efficacy in clinical cases is poor, but albendazole prevents disease if given promptly after infection. Considering the seriousness of this disease and limitations of diagnosis and treatment, prevention of infection with eggs is of utmost importance.
Clinical Infectious Diseases 11/2004; 39(10):1484-92. · 9.15 Impact Factor
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ABSTRACT: The raccoon roundworm, Baylisascaris procyonis, is increasingly recognized as a cause of serious or fatal larva migrans disease in humans and animals. We assessed the potential for infection in three northern California communities by determining the density and distribution of raccoon latrines, where transmission primarily occurs, and the prevalence of eggs at private residences. We collected fecal samples from 215 latrines and found that 44%-53% of the latrines contained B. procyonis eggs and that 16%-32% contained infective eggs. Among the properties surveyed, 28%-49% harbored at least one latrine that was positive for B. procyonis eggs. The latrine densities in these communities were higher than any previously reported. The presence of B. procyonis eggs in raccoon latrines was common, widespread, and closely associated with human habitation. Where raccoon densities are high, education of the public and removal of raccoons may be necessary.
Emerging infectious diseases 01/2004; 9(12):1516-22. · 6.17 Impact Factor
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ABSTRACT: To report childhood infection with Baylisascaris procyonis (raccoon round worm) manifesting as diffuse unilateral subacute neuroretinitis (DUSN) and choroidal infiltrates in association with neurologic disease (neural larva migrans).
Observational case series, one with eye manifestations of DUSN, the other with choroidal infiltrates, both with severe neurologic degeneration.
Indirect immunofluorescence assays on serum and cerebrospinal fluid were positive for B. procyonis in one and serially positive and increasing in the other. Both children had a history of pica and raccoon exposure.
Baylisascaris procyonis infection is associated with two cases of severe neurologic degeneration with ocular lesions: DUSN and choroidal infiltrates. Although B. procyonis is known to cause DUSN, these cases indicate that concomitant ocular migration may accompany neural larva migrans. These are the third and forth cases in the US literature of neural larva migrans due to B. procyonis with eye findings.
American Journal of Ophthalmology 07/2003; 135(6):888-90. · 4.22 Impact Factor
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ABSTRACT: Baylisascaris procyonis, the common raccoon roundworm, is a rare cause of devastating or fatal neural larva migrans in infants and young children. We describe the clinical features of two children from suburban Chicago who developed severe, nonfatal B. procyonis neural larva migrans. Despite treatment with albendazole and high dose corticosteroids, both patients are neurologically devastated. In many regions of North America, large populations of raccoons with high rates of endemic B. procyonis infection live in proximity to humans, which suggests that the risk of human infection is probably substantial. In the absence of effective treatment, prevention of infection remains the most important public health strategy.
The Pediatric Infectious Disease Journal 11/2002; 21(10):971-5. · 3.58 Impact Factor
