Correspondence

More on Angiostrongylus cantonensis Infection

N Engl J Med 1995; 333:882September 28, 1995

Article

To the Editor:

To the intriguing case report by New et al. (April 20 issue)1 of eosinophilic meningitis following the ingestion of a raw snail, a further warning should be added. The nematode parasite Angiostrongylus cantonensis can be acquired in ways other than by eating raw snails or slugs. Infective third-stage larvae may be present as viable contaminants on vegetation, deposited there in the trails of slimy mucus left by the gastropod host as it feeds.2,3 Unwashed or inadequately rinsed fresh, leafy vegetables may be a rather common source of infection in some areas where the infection is endemic. Gardeners, horticulturists, produce vendors, salad chefs, and children may be at greater risk than well-informed tourists who take sensible precautions.

Thomas W. Simpson, M.D.
Johns Hopkins Medical Institutions, Baltimore, MD 21205

3 References

1. 1

   New D, Little MD, Cross J. Angiostrongylus cantonensis infection from eating raw snails. N Engl J Med 1995;332:1105-1106
   Full Text | Web of Science | Medline

2. 2

   Simpson TW, Yonamine T, Henzan E, Nishihira T, Chinen SS. Eosinophilic meningitis in Okinawa: three suspected cases of angiostrongyliasis in man. Am J Trop Med Hyg 1970;19:770-774
   Web of Science | Medline

3. 3

   Bunnag T. Angiostrongylus meningitis. In: Strickland GT, ed. Hunter's tropical medicine. 7th ed. Philadelphia: W.B. Saunders, 1991:767-71.