Hawaii is experiencing an uptick in rat lungworm disease.  Six confirmed cases on Maui and another three confirmed cases on  the Big Island were reported over the last three months with no deaths.   That’s about as many cases as are ever experienced over the course of a year.

Some cases do get more public attention than others. Two newlyweds from San Francisco went from their two-week honeymoon in the remote Hana area on Maui to contracting rat lungworm.

Symptoms of rat lungworm are said to be like being stabbed by a hot knife.   The parasite impacts the brain and spinal cord.   How do people become infected?   Typically, rat lungworm infections come from eating raw or undercooked snails and slugs.

Rat lungworm has been endemic in Hawaii for at least the past 50 years, according to Heather Stockdale Walden, assistant professor of infectious disease and pathology at the University of Florida.  If lettuce or other raw produce is not thoroughly washed on Hawaii, there’s the risk a snail or a slug carrying the parasites might slip through.

Early symptoms include headaches, neck stiffness, nausea and vomiting.   The illness might incubate in a single day or take six weeks.  The parasite does not make people contagious, and recovery from the illness typically takes from two weeks to two months.

Snugs and snails eat rat feces and serve as intermediate hosts for the parasites.  Since the parasite cannot mature or reproduce in humans, they eventually die, but can cause physical problems.  These include eosinophilic meningitis and ocular Angiostrongylus.

In Hawaii, 80 percent of the land snails are carriers of the parasite.  Rat lungworm was responsible for two deaths in the islands since 2007.

Both the Hawaii Department of Health and the federal Centers for Disease Control (CDC) and Prevention are monitoring the current cases.

Rat lungworm disease is reported in about 30 countries in Asia, Africa, and Caribbean and Pacific Islands. Hawaii typically experiences one to 9 rat lungworm cases a year.

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