FIRST REPORTED OUTBREAK OF ABDOMINAL ANGIOSTRONGYLIASIS

Human abdominal angiostrongyliasis is a potentially fatal disease caus ed by Angiostrongylus costaricensis, a nematode found in the Americas. During the period of December 1994 through August 1995, an outbreak o f this disease occurred in Guatemala. We identified 22 cases of abdomi nal angiostrongyliasis and conducted a matched case-control study to i dentify risk factors for illness. The median age of the 18 cases enrol led in the study was 37 years (range, 9-68 years), and 11 (61.1%) were male. Consumption of the following six raw food items was associated with angiostrongyliasis: mint (odds ratio [OR], 6.9; 95% confidence in terval [CI], 1.5-66.0), shrimp (OR, infinite; 95% CI, 1.4 to infinite) , and four kinds of ceviche that reportedly contained raw mint COR for consumption of mint or ceviche that contained mint, 7.0; 95% CI, 1.0- 315). We conclude that raw mint was the likely vehicle of infection fo r this outbreak. To our knowledge, this is the first reported outbreak of abdominal angiostrongyliasis and the first time that a specific fo od item has been epidemiologically linked to the disease.