Human angiostrongyliasis outbreak in Dali, China.

<h4>Background</h4>Several angiostrongyliasis outbreaks have been reported in recent years but the disease continues to be neglected in public health circles. We describe an outbreak in Dali, southwest China in order to highlight some key problems for the control of this helminth infecti...

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Autores principales:	Shan Lv, Yi Zhang, Shao-Rong Chen, Li-Bo Wang, Wen Fang, Feng Chen, Jin-Yong Jiang, Yuan-Lin Li, Zun-Wei Du, Xiao-Nong Zhou
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2009
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/22fc598c9d964a70b3a0fd35b1d56e57
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spelling	oai:doaj.org-article:22fc598c9d964a70b3a0fd35b1d56e572021-11-25T06:33:11ZHuman angiostrongyliasis outbreak in Dali, China.1935-27271935-273510.1371/journal.pntd.0000520https://doaj.org/article/22fc598c9d964a70b3a0fd35b1d56e572009-09-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/19771154/pdf/?tool=EBIhttps://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>Several angiostrongyliasis outbreaks have been reported in recent years but the disease continues to be neglected in public health circles. We describe an outbreak in Dali, southwest China in order to highlight some key problems for the control of this helminth infection.<h4>Methodology/principal findings</h4>All available medical records of suspected angiostrongyliasis patients visiting hospitals in Dali in the period 1 October 2007-31 March 2008 were reviewed, and tentative diagnoses of varying strengths were reached according to given sets of criteria. Snails collected from local markets, restaurants and natural habitats were also screened for the presence of Angiostrongylus cantonensis. A total of 33 patients met criteria for infection, and 11 among them were classified as clinically confirmed. An additional eight patients were identified through a surveillance system put in operation in response to the outbreak. The epidemic lasted for 8 months with its peak in February 2008. Of the 33 patients, 97.0% complained of severe headache. 84.8% patients had high eosinophil cell counts either in the peripheral blood or in cerebrospinal fluid (CSF). Three-quarters of the patients were treated with a combination of albendazole and corticosteroids, resulting in significantly improved overall conditions. Twenty-two patients reported the consumption of raw or undercooked snails prior to the onset of the symptoms, and approximately 1.0% of the Pomacea canaliculata snails on sale were found to be infected with A. cantonensis. The snails were also found in certain habitats around Dali but no parasites were detected in these populations.<h4>Conclusions/significance</h4>The import and sale of infected P. canaliculata is the likely trigger for this angiostrongyliasis outbreak. Awareness of angiostrongyliasis must be raised, and standardized diagnosis and treatment are needed in order to provide clinicians with a guide to address this disease. Health education campaigns could limit the risk, and a hospital-based surveillance system should be established in order to detect future outbreaks.Shan LvYi ZhangShao-Rong ChenLi-Bo WangWen FangFeng ChenJin-Yong JiangYuan-Lin LiZun-Wei DuXiao-Nong ZhouPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 3, Iss 9, p e520 (2009)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Shan Lv Yi Zhang Shao-Rong Chen Li-Bo Wang Wen Fang Feng Chen Jin-Yong Jiang Yuan-Lin Li Zun-Wei Du Xiao-Nong Zhou Human angiostrongyliasis outbreak in Dali, China.
description	<h4>Background</h4>Several angiostrongyliasis outbreaks have been reported in recent years but the disease continues to be neglected in public health circles. We describe an outbreak in Dali, southwest China in order to highlight some key problems for the control of this helminth infection.<h4>Methodology/principal findings</h4>All available medical records of suspected angiostrongyliasis patients visiting hospitals in Dali in the period 1 October 2007-31 March 2008 were reviewed, and tentative diagnoses of varying strengths were reached according to given sets of criteria. Snails collected from local markets, restaurants and natural habitats were also screened for the presence of Angiostrongylus cantonensis. A total of 33 patients met criteria for infection, and 11 among them were classified as clinically confirmed. An additional eight patients were identified through a surveillance system put in operation in response to the outbreak. The epidemic lasted for 8 months with its peak in February 2008. Of the 33 patients, 97.0% complained of severe headache. 84.8% patients had high eosinophil cell counts either in the peripheral blood or in cerebrospinal fluid (CSF). Three-quarters of the patients were treated with a combination of albendazole and corticosteroids, resulting in significantly improved overall conditions. Twenty-two patients reported the consumption of raw or undercooked snails prior to the onset of the symptoms, and approximately 1.0% of the Pomacea canaliculata snails on sale were found to be infected with A. cantonensis. The snails were also found in certain habitats around Dali but no parasites were detected in these populations.<h4>Conclusions/significance</h4>The import and sale of infected P. canaliculata is the likely trigger for this angiostrongyliasis outbreak. Awareness of angiostrongyliasis must be raised, and standardized diagnosis and treatment are needed in order to provide clinicians with a guide to address this disease. Health education campaigns could limit the risk, and a hospital-based surveillance system should be established in order to detect future outbreaks.
format	article
author	Shan Lv Yi Zhang Shao-Rong Chen Li-Bo Wang Wen Fang Feng Chen Jin-Yong Jiang Yuan-Lin Li Zun-Wei Du Xiao-Nong Zhou
author_facet	Shan Lv Yi Zhang Shao-Rong Chen Li-Bo Wang Wen Fang Feng Chen Jin-Yong Jiang Yuan-Lin Li Zun-Wei Du Xiao-Nong Zhou
author_sort	Shan Lv
title	Human angiostrongyliasis outbreak in Dali, China.
title_short	Human angiostrongyliasis outbreak in Dali, China.
title_full	Human angiostrongyliasis outbreak in Dali, China.
title_fullStr	Human angiostrongyliasis outbreak in Dali, China.
title_full_unstemmed	Human angiostrongyliasis outbreak in Dali, China.
title_sort	human angiostrongyliasis outbreak in dali, china.
publisher	Public Library of Science (PLoS)
publishDate	2009
url	https://doaj.org/article/22fc598c9d964a70b3a0fd35b1d56e57
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Human angiostrongyliasis outbreak in Dali, China.

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