On January 31, 2013, the Taiwan Centers for Disease Control (Taiwan CDC) announced a case of angiostrongyliasis (also known as angiostrongylus infection) in a 48-year-old male who experienced discomfort such as headache and neck stiffness on December 30, 2012. On January 23, 2012, the case was reported as a suspected case of angiostronglyiasis by the hospital and the infection was later confirmed. According to the investigation conducted by the health authority, the case consumed snail soup several days prior to his disease onset. The case might have become infected for ingesting the parasite larvae because the snail might have been undercooked. Taiwan CDC has provided anti-parasitic drugs to the case for treatment. As of now, the case’s clinical symptoms have been relieved and the case is currently hospitalized in the general ward. The other five people who shared the same soup have not developed any discomfort.

Besides the abovementioned case, 9 other people, including 6 Thai workers and 3 Taiwanese citizens, contracted angiostrongyliasis in Taiwan last year. Of the 9 cases, 8 consumed land snails or apple snails prior to disease onset. Fortunately, they have all recovered after receiving proper treatment. The primary route for the transmission of human angiostrongyliasis is through ingesting undercooked, contaminated apple snails, land snails or slugs and water or vegetables contaminated with slime of infected snails. The incubation period is approximately 2 to 3 days, but it can last as long as 47 days. Ingested larvae usually migrate to the central nervous system and cause neurologic symptoms. Meningitis and acute severe headache are two of the most commonly seen symptoms. Other symptoms include fever, nausea, vomiting, neck pain, and neck stiffness might occur. Symptoms of eye invasion include eyesight deterioration. Cases with a heavy load of parasites can be fatal.

According to some of the earliest epidemiological investigations conducted in Taiwan, the primary source of infection for angiostrongyliasis is undercooked giant African land snail and most cases are children. However, cases that occurred during the past decade are mostly foreign workers who consumed undercooked snails such as apple snails.

Taiwan CDC reminds the public to avoid consuming raw or undercooked snails. It is recommended to always wear gloves when handling snails and thoroughly wash hands and the chopping board after handling snails. In addition, it is advised to thoroughly clean fruits and vegetables when eating them raw to lower the risk of infection. For more information, please call the toll-free Communicable Disease Reporting and Care Hotline, 1922, or 0800-024582 if calling from a cell phone, or visit the Taiwan CDC’s website at http://www.cdc.gov.tw.