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. 2022 Jun;28(6):1163-1169.
doi: 10.3201/eid2806.212344.

Angiostrongylus cantonensis Nematode Invasion Pathway, Mallorca, Spain

Sofia Delgado-Serra, Jessica Sola, Nieves Negre, Claudia Paredes-Esquivel

Angiostrongylus cantonensis Nematode Invasion Pathway, Mallorca, Spain

Sofia Delgado-Serra et al. Emerg Infect Dis. 2022 Jun.

Abstract

Neural angiostrongyliasis is an emerging zoonosis caused by the rat lungworm, Angiostrongylus cantonensis. In humans, infection with this nematode often results in eosinophilic meningitis and other severe disorders of the central nervous system. Europe was deemed a nonendemic region until 2018, when A. cantonensis worms were detected on the Mediterranean island of Mallorca, Spain, a tourism hotspot. Since that time, a sentinel surveillance system and a molecular approach have been used to follow the invasion path of the rat lungworm on the island. A. cantonensis worms have been found in animals from 8 locations on the island over 3 consecutive years. Our preliminary results show a recognizable pattern of clinical signs in infected hedgehogs and a single mitochondrial haplotype circulating in Mallorca. We present strong evidence confirming that the rat lungworm has successfully established and colonized an island in Europe and discuss observations and possible strategies for its early detection across continental Europe.

Keywords: Angiostrongylus cantonensis; Mallorca; Spain; angiostrongyliasis; animal diseases; central nervous system; hedgehogs; helminths; human eosinophilic meningitis; infection; invasion pathway; meningitis/encephalitis; nematodes; parasites; parasitic infections; rat lungworm infection; sentinel species; vector-borne infections; zoonoses.

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Figures

Figure 1
Figure 1
Geographic location of hedgehogs infected by Angiostrongylus cantonensis rat lungworms, Mallorca, Spain, 2018–2020. Blue indicates new cases reported in this study (see Table for details), and red indicates cases reported previously (12). Inset shows location of Mallorca off the coast of southwestern Europe.
Figure 2
Figure 2
Maximum-likelihood tree showing the phylogenetic position of Angiostrongylus cantonensis rat lungworm cytochrome c oxidase subunit I gene fragments generated in study of infected hedgehogs in Mallorca, Spain, 2018–2020 (asterisks), and reference sequences retrieved from GenBank (accession numbers shown).
See this image and copyright information in PMC

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