{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T10:42:43Z","timestamp":1788259363592,"version":"build-2803163510"},"reference-count":43,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,8]]},"abstract":"<jats:p><jats:italic>Angiostrongylus cantonensis<\/jats:italic> is a zoonotic, parasitic nematode causing angiostrongyliasis or rat lungworm disease. Clinical diagnosis in humans is currently confirmed by detection of parasite DNA in cerebrospinal fluid. This study estimated human exposure to <jats:italic>A. cantonensis<\/jats:italic> in volunteer participants solicitated via public venues on east Hawai\u2019i Island using blood-based tests. Antibodies were screened in sera by crude antigen ELISA, followed by a 31-kDa dot-blot test developed and validated in Thailand. Human participants (<jats:italic>n<\/jats:italic> = 435) donated blood samples and completed a questionnaire to self-report relevant symptomology or clinical diagnosis. Among symptoms reported by participants diagnosed by licensed clinicians, headaches, high eosinophil counts, stiff neck, fatigue, and joint pain were most severe during the initial 3 months of infection. ELISA results revealed 22% of the serum samples as positive, 46% as equivocal, and 32% as negative. A subset of 186 samples was tested by dot blot, with 30% testing positive and 70% testing negative. A significantly higher mean ELISA value was found among recently (2014\u20132015) clinically diagnosed participants as than among those with a diagnosis before 2010 (<jats:italic>P<\/jats:italic> = 0.027). All dot-blot positives were also ELISA positive and were significantly associated with higher ELISA values compared with dot-blot negatives (<jats:italic>P<\/jats:italic> = 0.0001). These results suggest that an ELISA using crude antigen isolated from adult <jats:italic>A. cantonensis<\/jats:italic> from Hawai\u2019i may be an effective initial screening method for estimating exposure to <jats:italic>A. cantonensis<\/jats:italic> in Hawai\u2019i and likewise suggest that dot-blot tests using the 31-kDa antigen exhibit efficacy as a diagnostic for exposure.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0242","type":"journal-article","created":{"date-parts":[[2019,11,26]],"date-time":"2019-11-26T07:00:49Z","timestamp":1574751649000},"page":"69-77","source":"Crossref","is-referenced-by-count":15,"title":["Estimating Human Exposure to Rat Lungworm (Angiostrongylus cantonensis) on Hawai\u2019i Island: A Pilot Study"],"prefix":"10.4269","volume":"102","author":[{"given":"Susan I.","family":"Jarvi","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawai\u2019i at Hilo, Hilo, Hawai\u2019i;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praphathip","family":"Eamsobhana","sequence":"additional","affiliation":[{"name":"Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Quarta","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawai\u2019i at Hilo, Hilo, Hawai\u2019i;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Howe","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawai\u2019i at Hilo, Hilo, Hawai\u2019i;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Jacquier","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawai\u2019i at Hilo, Hilo, Hawai\u2019i;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Hanlon","sequence":"additional","affiliation":[{"name":"Department of Statistics, Center for Biostatistics and Health Data Science, Virginia Tech, Roanoke, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Snook","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawai\u2019i at Hilo, Hilo, Hawai\u2019i;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"McHugh","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawai\u2019i at Hilo, Hilo, Hawai\u2019i;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachariah","family":"Tman","sequence":"additional","affiliation":[{"name":"School of Public Health, University of California, Berkeley, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Miyamura","sequence":"additional","affiliation":[{"name":"Hawai\u2019i Health Information Corporation, Kailua, Hawai\u2019i"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuilei","family":"Kramer","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawai\u2019i at Hilo, Hilo, Hawai\u2019i;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"McKayla","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawai\u2019i at Hilo, Hilo, Hawai\u2019i;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet Infect Dis","first-page":"621","article-title":"Human angiostrongyliasis","volume":"8","author":"Wang","year":"2008"},{"key":"b2","series-title":"Ann Parasit","first-page":"312","article-title":"Un nouveau nematode pulmonaire, pulmonema cantonensis, NGN sp. Des rats de Canton","volume":"13","author":"Chen","year":"1935"},{"key":"b3","series-title":"Parasitology","first-page":"1087","article-title":"Angiostrongylus cantonensis: a review of its distribution, molecular biology and clinical significance as a human pathogen","volume":"143","author":"Barratt","year":"2016"},{"key":"b4","series-title":"PLoS One","first-page":"e0177910","article-title":"Geographic distribution of Angiostrongylus cantonensis in wild rats (Rattus rattus) and terrestrial snails in Florida, USA","volume":"12","author":"Stockdale-Walden","year":"2017"},{"key":"b5","series-title":"Aust J Zool","first-page":"1","article-title":"The life history of the rat lung-worm, Angiostrongylus cantonensis (Chen) (Nematoda: Metastrongylidae)","volume":"3","author":"Mackerras","year":"1955"},{"key":"b6","series-title":"Eur J Clin Microbiol Infect Dis","first-page":"389","article-title":"Human Angiostrongylus cantonensis: an update","volume":"31","author":"Wang","year":"2012"},{"key":"b7","series-title":"Med J Aust","first-page":"517","article-title":"Parasitic meningitis: crossing paths with the rat lungworm (Angiostrongylus cantonensis)","volume":"170","author":"Prociv","year":"1999"},{"key":"b8","series-title":"Am J Trop Med Hyg","first-page":"233","article-title":"Clinical observations of eosinophilic meningitis and meningoencephalitis caused by Angiostrongylus cantonensis on Taiwan","volume":"25","author":"Yii","year":"1976"},{"key":"b9","series-title":"Med J Aust","first-page":"541","article-title":"A fatal case of angiostrongyliasis in an 11-month\u2013old infant","volume":"170","author":"Cooke-Yarborough","year":"1999"},{"key":"b10","series-title":"Am J Trop Med Hyg","first-page":"425","article-title":"Fatal autochthonous eosinophilic meningitis in a Jamaican child caused by Angiostrongylus cantonensis","volume":"70","author":"Lindo","year":"2004"},{"key":"b11","series-title":"Am J Trop Med Hyg","first-page":"353","article-title":"Neuroangiostrongyliasis: the \u201csubarachnoid phase\u201d and its implications for anthelmintic therapy","volume":"98","author":"Prociv","year":"2017"},{"key":"b12","series-title":"Am J Trop Med Hyg","first-page":"176","article-title":"Real-time polymerase chain reaction detection of Angiostrongylus cantonensis DNA in cerebrospinal fluid from patients with eosinophilic meningitis","volume":"94","author":"Qvarnstrom","year":"2016"},{"key":"b13","series-title":"Int Med Res J","first-page":"9","article-title":"Characterization of a 31-kDa specific antigen from Parastrongylus cantonensis (Nematoda: Metastrongylidae)","volume":"2","author":"Eamsobhana","year":"1998"},{"key":"b14","series-title":"Southeast Asian J Trop Med Public Health Jun","first-page":"308","article-title":"Purification of a specific immunodiagnostic Parastrongylus cantonensis antigen by electroelution from SDS-polyacrylamide gels","volume":"32","author":"Eamsobhana","year":"2001"},{"key":"b15","series-title":"Southeast Asian J Trop Med Public Health","first-page":"1","article-title":"Blinded multi-laboratory evaluation of an in-house dot-blot ELISA kit for diagnosing human parastrongyliasis","volume":"34","author":"Eamsobhana","year":"2003"},{"key":"b16","series-title":"Int J Inf Dis","first-page":"69","article-title":"Immunochromatographic test for rapid serological diagnosis of human angiostrongyliasis","volume":"73","author":"Eamsobhana","year":"2018"},{"key":"b17","series-title":"Trop Biomed","first-page":"1","article-title":"Dot-blot ELISA for the immunological detection of specific antibody to Parastrongylus cantonensis","volume":"20","author":"Eamsobhana","year":"2003"},{"key":"b18","series-title":"Hawaii J Med Public Health","first-page":"28","article-title":"Angiostrongyliaia in Thailand: epidemiology and laboratory investigations","volume":"72","author":"Eamsobhana","year":"2013"},{"key":"b19","series-title":"Jpn J Trop Med Hyg","first-page":"1","article-title":"Detection of antibodies to Parastrongylus cantonensis in human sera by gelatin particle indirect agglutination test","volume":"27","author":"Eamsobhana","year":"1999"},{"key":"b20","series-title":"Mol Biochem Parasitol","first-page":"174","article-title":"Quantitative PCR estimates Angiostrongylus cantonensis infection levels in semi-slugs (Parmarion martensi)","volume":"185","author":"Jarvi","year":"2012"},{"key":"b21","series-title":"Appl Environ Microbiol","first-page":"5287","article-title":"Improved molecular detection of Angiostrongylus cantonensis in mollusks and other environmental samples with a species-specific internal transcribed spacer 1-based TaqMan assay","volume":"76","author":"Qvarnstrom","year":"2010"},{"key":"b22","series-title":"Clin Diagn Lab Immunol","first-page":"1235","article-title":"Use of coefficient of variation in assessing variability of quantitative assays","volume":"9","author":"Reed","year":"2002"},{"key":"b23","series-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2014"},{"key":"b24","series-title":"IBM SPSS Statistics for Windows, Version 25.0","author":"IBMCorp Released","year":"2017"},{"key":"b25","series-title":"Asian Pac J Trop Med","first-page":"275","article-title":"Epidemic status of Angiostrongylus cantonensis in hainan island, China","volume":"4","author":"Hu","year":"2011"},{"key":"b26","series-title":"Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi","first-page":"74","article-title":"Investigation on serology, risk factor and awareness of Angiostrongylus cantonensis in Hainan province","volume":"29","author":"Li Y","year":"2011"},{"key":"b27","series-title":"Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi","first-page":"370","article-title":"Epidemiological investigation of Angiostrongylus cantonensis in Jiangmen of Guangdong province","volume":"26","author":"Zhang","year":"2008"},{"key":"b28","series-title":"Am J Trop Med Hyg","first-page":"685","article-title":"Eosinophilic meningitis attributable to Angiostrongylus cantonensis infection in Hawaii: clinical characteristics and potential exposures","volume":"85","author":"Hochberg","year":"2011"},{"key":"b29","series-title":"N Engl J Med","first-page":"668","article-title":"An outbreak of eosinophilic meningitis caused by Angiostrongylus cantonensis in travellers returning from the Caribbean","volume":"346","author":"Slom","year":"2002"},{"key":"b30","series-title":"Bishop Mus Occas Pap","first-page":"1","article-title":"Catalog and bibliography of the nonindigenous nonmarine snails and slugs of the Hawai\u2019ian Islands","volume":"50","author":"Cowie","year":"1997"},{"key":"b31","series-title":"Pac Sci","first-page":"457","article-title":"Distribution of Parmarion cf. martensi, a new semi-slug pest on Hawai\u2019i Island, and its potential as a vector for human angiostrongyliasis","volume":"61","author":"Hollingsworth","year":"2007"},{"key":"b32","series-title":"Hawaii J Med Public Health","first-page":"63","article-title":"Detection of rat lungworm in intermediate, definitive, and paratenic hosts obtained from environmental sources","volume":"72","author":"Qvarnstrom","year":"2013"},{"key":"b33","series-title":"PLoS One","first-page":"e0189458","article-title":"High prevalence of Angiostrongylus cantonensis (rat lungworm) on eastern Hawaii Island: a closer look at life cycle traits and patterns of infection in wild rats (Rattus spp)","volume":"12","author":"Jarvi","year":"2017"},{"key":"b34","series-title":"J Parasitol","first-page":"39","article-title":"Possible role of water in the transmission of Angiostrongylus cantonensis (Nematoda: Metastrongylidae)","volume":"50","author":"Cheng","year":"1964"},{"key":"b35","series-title":"J Parasitol","first-page":"382","article-title":"Studies on Angiostrongylus cantonensis in molluscan intermediate hosts","volume":"53","author":"Richards","year":"1967"},{"key":"b36","series-title":"Trans R Soc Trop Med Hyg","first-page":"602","article-title":"The infectivity of third stage Angiostrongylus cantonensis larvae shed from drowned Achatina fulica snails and the effect of chemical agents on infectivity","volume":"65","author":"Crook","year":"1971"},{"key":"b37","series-title":"AM J Trop Med Hyg","first-page":"206","article-title":"Studies on eosinophilic meningitis V. Molluscan hosts of Angiostrongylus cantonensis on pacific islands","volume":"18","author":"Wallace","year":"1969"},{"key":"b38","series-title":"PLoS One","first-page":"e0209813","article-title":"Water transmission potential of Angiostrongylus cantonensis: larval viability and effectiveness of rainwater catchment sediment filters","volume":"14","author":"Howe","year":"2019"},{"key":"b39","series-title":"Statistical and Methodological Myths and Urban Legends: Doctrine, Verity and Fable in the Organizational and Social Sciences","first-page":"309","article-title":"So why ask me? Are self-reported data really that bad?","author":"Chan","year":"2009"},{"key":"b40","series-title":"ACS Chem Neurosci","first-page":"1820","article-title":"Angiostrongyliasis (rat lungworm disease): viewpoints from Hawai\u2019i Island","volume":"8","author":"Howe","year":"2017"},{"key":"b41","series-title":"Med J Malaya","first-page":"162","article-title":"Prolonged survival in rats immunized by a small number of low level doses of Angiostrongylus cantonensis and challenged with a lethal level of infective larvae","volume":"20","author":"Heyneman","year":"1965"},{"key":"b42","series-title":"PLoS One","first-page":"e0123064","article-title":"Detection of Angiostrongylus cantonensis in the blood and peripheral tissues of wild Hawaiian rats (Rattus rattus) by a quantitative PCR (qPCR) assay","volume":"10","author":"Jarvi","year":"2015"},{"key":"b43","series-title":"Trans R Soc Trop Med Hyg","first-page":"614","article-title":"Immunodiagnosis and seroepidemiology of Angiostrongylus cantonensis zoonoses in man","volume":"74","author":"Welch","year":"1980"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/102\/1\/article-p69.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/102\/1\/article-p69.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/102\/1\/article-p69.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T21:56:22Z","timestamp":1722462982000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/102\/1\/article-p69.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,8]]},"references-count":43,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.18-0242","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,8]]}}}