title: Eosinophilic meningitis attributable to Angiostrongylus cantonensis infection in Hawaii: clinical characteristics and potential exposures.
abstract: The most common infectious cause of eosinophilic meningitis is Angiostrongylus cantonensis, which is transmitted largely by consumption of snails/slugs. We previously identified cases of angiostrongyliasis that occurred in Hawaii from 2001 to 2005; the highest incidence was on the island of Hawaii. We now report symptoms, laboratory parameters, and exposures. Eighteen patients were evaluated; 94% had headache, and 65% had sensory symptoms (paresthesia, hyperesthesia, and/or numbness). These symptoms lasted a median of 17 and 55 days, respectively. Three persons recalled finding a slug in their food/drink. Case-patients on the island of Hawaii were more likely than case-patients on other islands to consume raw homegrown produce in a typical week (89% versus 0%, P < 0.001) and to see snails/slugs on produce (56% versus 0%, P = 0.03). Residents and travelers should be aware of the potential risks of eating uncooked produce in Hawaii, especially if it is from the island of Hawaii and locally grown.
authors: Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. nhoch@bu.edu
authors: Natasha S
authors: NS
authors: Hochberg
authors: Brian G
authors: BG
authors: Blackburn
authors: Sarah Y
authors: SY
authors: Park
authors: James J
authors: JJ
authors: Sejvar
authors: Paul V
authors: PV
authors: Effler
authors: Barbara L
authors: BL
authors: Herwaldt
mesh_terms: D000293:Adolescent; D000328:Adult; D017185:Angiostrongylus cantonensis / Q000302:isolation & purification*; D000818:Animals; D004802:Eosinophilia / Q000150:complications*; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D008581:Meningitis / Q000150:complications*; D008875:Middle Aged