The helminthic infections that can cause eosinophilic meningitis (EM) share many of the characteristics of emerging infectious diseases, such as the influences of international trade and travel on pathogen dissemination in a warming ecosystem. In order to assess the evolving epidemiology of EM worldwide, define the case diagnosis of EM based on cerebrospinal fluid (CSF) microscopy, and stratify the causes of EM as infectious versus non-infectious; this review analyzes scientific articles selected by MEDLINE search, 1966-2009. In addition, this review compares the clinical manifestations, management, and outcomes of the most common causes of helminthic EM worldwide in order to alert clinicians to populations at increased risk of helminthic EM as a result of age, ethnicity, lifestyle, food choices, location of permanent residence, or recent travel. The most common helminthic causes of EM worldwide are angiostrongyliasis and gnathostomiasis. Angiostrongyliasis, a rodent zoonosis endemic in Southeast Asia, was imported to North and South America and the Caribbean following the embarkation of infected rodents from cargo ships. Gnathostomiasis, a zoonosis of wild carnivores in Southeast Asia and Latin America, has been recently recognized as an emerging cause of EM in travelers returning to England and the United States (US). Baylisascariasis, a North American raccoon zoonosis, is an additional, although unusual, emerging cause of EM, that has extended distribution range across the US since the 1980s, and was exported to Japan by the exotic pet trade. Although EM occurs worldwide, its differential diagnosis is limited to infectious and non-infectious etiologies with non-infectious etiologies, such as intracranial hardware and malignancies, causing more cases, especially in regions that are not endemic for the most common causative parasites. Most cases of helminthic EM can be prevented by public health education, human behavior modification, and proper food preparation.

Seafood is an important source of dietary protein worldwide, especially for coastal and island dwellers who now comprise 70% of the world’s population. Besides being high in protein and providing 40% of the world’s protein intake, seafood is low in cholesterol and saturated fatty acids and contains unique long-chain omega-3 polyunsaturated fatty acids (PUFAs). Two seafood PUFAs, eicosapentanoic acid (EPA) and docosahexanoic acid (DHA) inhibit platelet aggregation and reduce mortality from myocardial infarction (MI) and ischemic stroke. Although the United States (U.S.) scientific community has recommended a Mediterranean-type diet, based on beneficial PUFAs in seafood, the European scientific community has cautioned that the increasing methylmercury levels in seafood may counteract any cardioprotective effects of PUFAs and actually increase risks of MI. This review describes the health benefits of seafood consumption and makes recommendations for the safe selection and preparation of seafood. In addition, this review describes the burden of seafood-borne diseases, separates seafood-borne toxic, heavy metal, and pesticide poisonings from seafood-borne infectious diseases; and makes recommendations for the management and prevention of seafood-borne illnesses. With the exception of some of the toxic seafood-borne illnesses, most seafood-borne infectious diseases, heavy metal poisonings, and pesticide poisonings can be prevented by careful selection and preparation of fresh seafood and adherence to weekly seafood consumption advisories, especially for those at highest risk of methylmercury poisoning, such as women who are pregnant, breastfeeding, or of child-bearing age, and children age seven and younger. A balanced diet combining protein from a variety of sources, including carefully selected and prepared seafood, along with natural antioxidants from fruits and vegetables is recommended to prevent seafood-borne diseases and to promote health and longevity.