Biology, systematics, life cycle, and distribution of Angiostrongylus cantonensis, the cause of rat lungworm disease

Abstract

Angiostrongylus cantonensis is a metastrongyloid nematode in the family Angiostrongylidae. It is the cause of angiostrongyliasis (rat lungworm disease), which manifests as eosinophilic meningitis. First described in 1935 from rats in China, A. cantonensis was placed in the genus Parastrongylus in 1986, but most workers have not adopted this treatment. The taxonomy of A. cantonensis and related worms is largely based on adult morphology, notably of the male bursa. However, identification of infective third stage larvae is more difficult. The natural life cycle involves rats as the definitive host and snails or slugs as the intermediate host. Human infection, as accidental hosts, results in worms maturing in the brain, but dying there instead of moving back into the bloodstream, as in rats, thereby leading to eosinophilic meningitis. The disease is an emerging infectious disease; Angiostrongylus cantonensis continues to be reported in new regions beyond its native range.

Keywords: Angiostrongyliasis; Angiostrongylus cantonensis; Emerging infectious disease; Eosinophilic meningitis; Parasitology; Rat lungworm disease; Slugs; Snails.

Figure 1

The natural life-cycle of Angiostrongylus cantonensis, the rat lungworm.

Figure 2

The truncated life-cycle of Angiostrongylus cantonensis, the rat lungworm, in an accidental (human) host.