First case of rat lungworm disease confirmed this year on Oahu

Photo: Susan Jarvi

The Hawaii State Department of Health (DOH) confirmed one new case of rat lungworm disease in an Oahu resident.

This is the first case of rat lungworm disease contracted on Oahu in 2017, bringing the statewide total of confirmed cases to 16 for this year.

The adult case is currently hospitalized and the department confirmed the illness late Tuesday afternoon.

The Oahu resident began experiencing symptoms consistent with rat lungworm disease in July.

DOH staff from the Vector Control Program and Disease Investigation Branch started conducting onsite property assessments Wednesday morning in East Oahu, where the patient works and lives. Vector Control staff surveyed for slug, snail, and rat activity. Current findings do not show evidence of slugs or semi-slugs nearby.

The source of the individual’s infection is still unknown at this time, but DOH will continue investigations based on the information gathered today.

“The initial response from the team said they did not find any of those (evidence of slugs, semi-slugs, or rats),” said Keith Kawaoka, deputy director, DOH Environmental Health Administration. “That does not mean the disease or parasites are not there. It just wasn’t observed when we’re out there.”

Rat lungworm laboratory-confirmed case counts in 2017 by county

Hawaii: 9
Maui: 6
Oahu: 1
Kauai: 0

“Do you have reason to believe it was contracted locally or did the patient travel?” KHON2 asked.

“That, we’re not sure. That’s part of the investigation right now to see whether the patient might have gone on the island or away from island and see what potential exposure that person might have had,” Kawaoka replied.

The last reported case of rat lungworm disease on Oahu was in 2010.

Health officials say they were surprised to learn of this latest case, because there had not been a new case of rat lungworm disease in two months. But, they add, it was only a matter of time.

“This is a serious disease that can be acquired on any of our islands because slugs and snails throughout the state carry the parasite responsible for the illness,” said Kawaoka. “This is a grim reminder that we all need to take precautions when working in our gardens and on farms, and eliminate slugs, snails and rats from our communities to reduce the risks posed by this parasitic disease.”

If you think you’re out of the woods because you don’t live in East Oahu, think again.

“It should be an island-wide, state-wide concern,” Kawaoka said. “Same with dengue. When we identify potential cases on one part of the island, the other part of the island is like, ‘Well, I’m not part of that area so I’m okay.’ You can’t think like that.”

DOH recently announced plans to ramp up efforts to prevent rat lungworm disease statewide. This includes efforts to increase public outreach and education throughout the state— a top initiative identified by the governor’s Rat Lungworm Disease Joint Task Force, which was convened in 2016. The Joint Task Force is comprised of local experts in medical, scientific, environmental, and public health fields from across the state.

The public is urged to take the following precautions to prevent rat lungworm disease:

  • Carefully inspect, wash and store produce in sealed containers, regardless of whether it came from a local retailer, farmer’s market, or backyard garden.
  • All fruits and vegetables should be washed and rubbed under running water, especially leafy greens, in order to remove any tiny slugs or snails.
  • Controlling snail, slug, and rat populations is one of the most important steps in fighting the spread of rat lungworm disease. Eliminate slugs, snails, and rats around properties, and especially around home gardens.
  • Farmers as well as food handlers and processors should increase diligence in controlling slugs, snails, and rats on the farm.

Rat lungworm disease (angiostrongyliasis) is contracted when a person becomes infected with the parasite Angiostrongylus cantonensis. This often happens when a person accidentally consumes raw or undercooked infected slugs, snails, freshwater shrimp, land crabs or frogs.

“We can’t go out there and control things by treating the area or don’t grow this because it harbors snails. It’s really the public that needs to take the information and be part of your own consumption habits,” Kawaoka said.

The most common symptoms include severe headaches and neck stiffness, but symptoms may vary widely among cases. The most serious cases experience neurological problems, pain and severe disability.

More information about the signs and symptoms of rat lungworm disease is available online here.

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