Hawaii Travel Warning Rat Lungworm Disease Cases Rise

As seen on Cruise Bruise News today. Six cases of brain invading parasites, commonly known as rat lungworm disease, have so far been confirmed in Maui in the last three months, with more episodes currently being investigated.

Rat lungworm disease is caused by the parasitic roundworm Angiostrongylus cantonensis, with the adult form of the parasite found only in rats.

The infection is spread when rats carrying the parasite excrete the larvae of the roundworm in their faeces. From there, it can be picked up by other animals, such as snails, slugs, freshwater shrimp, crabs, and frogs.

CDC – What is Angiostrongylus cantonensis?

Angiostrongylus cantonensis is a parasitic worm of rats. It is also called the rat lungworm. The adult form of the parasite is found only in rodents. Infected rats pass larvae of the parasite in their feces. Snails and slugs get infected by ingesting the larvae. These larvae mature in snails and slugs but do not become adult worms. The life cycle is completed when rats eat infected snails or slugs and the larvae further mature to become adult worms.

CDC – How can people get infected?

Maui, Hawaii rat lungworm disease

People can get infected by eating raw or under-cooked snails or slugs that are infected with this parasite. In some cultures, snails are commonly eaten. Some children, in particular, have gotten infected by swallowing snails/slugs “on a dare. ” People also can get infected by accident, by eating raw produce (such as lettuce) that contains a small snail or slug or part of one.

Certain animals such freshwater shrimp, crabs, or frogs, have been found to be infected with larvae of the parasite. It is possible that eating undercooked or raw animals that are infected could result in people becoming infected, though the evidence for this is not as clear as for eating infected snails and slugs. Of note, fish do not spread this parasite.

Prevention of A. cantonensis infections involves educating persons residing in or traveling to areas where the parasite is found about not ingesting raw or under-cooked snails and slugs, freshwater shrimp, land crabs, frogs, and monitor lizards, or potentially contaminated vegetables, or vegetable juice. Removing snails, slugs, and rats found near houses and gardens should also help reduce risk. Thoroughly washing hands and utensils after preparing raw snails or slugs is also recommended. Vegetables should be thoroughly washed if eaten raw.

Treatment

Angiostrongylus cantonensis

There is no specific treatment for A. cantonensis infection. There is some evidence that certain supportive treatments may reduce the severity of headache and the duration of symptoms. Persons with symptoms should consult their health care provider for more information.

Angiostrongylus costaricensis

There is no specific treatment for A. costaricensis infections. Most infections resolve spontaneously though sometime surgical treatment is necessary to removed portions of inflamed intestine. Persons with symptoms should consult their health care provider for more information.

Nine Cases

The Hawaii State Department of Health has confirmed six cases of rat lungworm disease on the island of Maui and three cases on the Big Island over the past three months, an official said Monday. No deaths have been reported.

Heather Stockdale Walden, an assistant professor in the department of infectious diseases and pathology at the University of Florida, said rat lungworm disease has “been endemic in Hawaii for at least 50 years, so it’s been there for a while.”

Read more: Rat Lungworm Disease

Video: Beyond the Fear: A Documentary about Rat Lungworm Disease