Human Angiostrongylus cantonensis, Jamaica

摘要

To the Editor: Angiostrongyluscantonensis is the most commoncause of eosinophilic meningoen-cephalitis worldwide (1). The para-site's presence has been well docu-mented in Jamaica in rats (definitivehost) and a variety of mollusks (inter-mediate hosts); infections occur inhumans sporadically on the island.However, the mode of transmission ofinfections to humans in Jamaica,where raw or undercooked mollusksare not usually eaten, is not wellunderstood (2).An outbreak of A. cantonensisoccurred among American medicalstudents vacationing in Jamaica in2000. An epidemiologic investigationidentified the probable source of infec-tion (Caesar salad), but no biologiccontaminant was determined (2).During a field investigation of A. can-tonensis, we spoke with local farmersand vendors to identify possible routesof food contamination. While ourobservations were preliminary andanecdotal in nature, our findings pro-vide valuable insight into local trans-mission and control of this parasite.Humans can become infected byeating the intermediate hosts, slugsand snails, of A. cantonensis.Freshwater shrimp serve as paratenichosts and reservoirs of infection forhumans, both naturally and experi-mentally (3,4). Most reports ofJamaican eating practices indicatethat terrestrial snails and slugs are noteaten and that shrimp and other meatsare always eaten well cooked (5).However, during interviews with afarmer near Mavis Bank, a rural areaoutside of Kingston, and fishermen atthe Coronation Market, Jamaica'slargest fresh produce market, we dis-covered that freshwater and saltwatershrimp, as well as mussels (paratenichosts), are occasionally eaten raw.Freshwater shrimp or mussels areeaten, particularly by men, directlyfrom rivers and streams, and freshwa-ter and saltwater bait shrimp are eatenby fishermen