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One Health Resource Center

July 30, 2018
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Rat lungworm parasite linked to consuming raw centipedes

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The Angiostrongylus cantonensis parasite, otherwise known as rat lungworm, was found in an adult mother and son in China who consumed raw centipedes, according to study results recently published in The American Journal of Tropical Medicine and Hygiene.

“We do not typically hear of people eating raw centipedes, but apparently these two patients believed that raw centipedes were good for their health,” Lingli Lu, MD. PhD, who works in the department of neurology at Zhujiang Hospital, Southern Medical University, in Guangzhou, China, said in a press release. “Instead, it made them sick.”

The researchers noted that the A. cantonensis parasite is often referred to as rat lungworm because it is commonly detected in the pulmonary arteries in rats.

Photo of a centipede
A Chinese red-headed centipede, the species of centipede the patients consumed.
Source: Yasunori Koide

A. cantonensis is mainly found in China and Southeast Asia and is usually linked to raw or undercooked snails, according to the CDC. The parasite has recently been linked to snails in Louisiana and South Florida, according to the release.

Lu and colleagues noted in the release that when the centipedes are used in dry or powder form in traditional Chinese medicine, they do not transmit the parasite.

In the study, the researchers reported on a 78-year-old woman who was admitted to the hospital in Guangzhou China, on Nov. 22, 2012, after experiencing headache, somnolence and cognitive impairment for several weeks. She had no fever or vomiting. She also reported slight neck stiffness.

MRI fluid attenuated inversion recovery (FLAIR) sequence displayed a high signal in the left midbrain and right frontal lobe. Physicians conducted a cerebrospinal fluid (CSF) examination and enzyme-linked immunosorbent assay. Serum and CSF tested positive for antibodies against A. cantonensis. Upon questioning, the woman revealed that she had consumed raw centipedes several times.

The woman was diagnosed with A. cantonensis meningoencephlitis and eosinophilic meningoencephalitis (EM). She received treatment of 40 mg per day of albendazole for 21 days and 10 mg per day of dexamethasone for 15 days. Her headache and cognitive impairment resolved after treatment, and the MRI FLAIR sequence also disappeared after treatment.

About a month after the woman presented at the hospital, a 46-year-old man identified as the woman’s son was admitted to the same hospital. He was experiencing mild headaches that lasted more than 20 days, with the only neurologic sign being neck rigidity. He also reported consuming raw centipedes.

Researchers performed a CSF examination and cranial MRI. Results indicated that both his serum and the CSF were positive for antibodies against A. cantonensis, and he was diagnosed with A. cantonensis meningitis and EM. He was treated with 40 mg per day of albendazole for 21 days and 10 mg per day of dexamethasone for 16 days, and his symptoms were relieved.

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The researchers performed etiological examinations and PCR analysis to determine if centipedes could serve as hosts for A. cantonensis. Twenty centipedes were purchased at the market where the patients had purchased theirs. The researchers noted that centipedes were caught in the wild in the Guangxi Province in China.

They found third-stage larvae A. cantonensis in the sediments of the centipedes. PCR analysis found that the plasmid corresponded to A. cantonensis rRNA gene sequence.

“Although there are no previously reported cases of infection with A. cantonensis by eating centipedes, we observed the third-instar larvae of A. cantonensis from the centipedes we purchased from the same market,” the researchers wrote.

Lu noted the importance of cooking such products if they are to be consumed.

“Centipedes can act as a transport host of A. cantonensis,” Lu told Infectious Disease News. “We should not eat raw centipedes, as well as other raw animals. We should realize that proper cooking technique is important to protect us from foodborne diseases.” – by Bruce Thiel

Disclosures: The researchers report no relevant financial disclosures.