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The Maui News - The first case of rat lungworm disease on Maui this year was confirmed last month, the state Department of Health reported Wednesday.
The individual became ill in mid-February and was briefly hospitalized, the Health Department said. Spokeswoman Anna Koethe said Wednesday afternoon that the Health Department could not disclose where on the island the person resides due to privacy concerns.
The department believes the infection "likely" occurred on Maui but cannot say conclusively because the adult individual "had so much travel history," she said. The individual traveled to Oahu and Hawaii island during the time the infection occurred.
There were six confirmed cases of the rat lungworm disease on Maui from January to March last year, two visitors and four residents. The island had previously gone a decade with only two recorded cases.
All of the six people were in Hana during the exposure period, according to department officials.
While she could not be more specific about the town where the resident resides, Koethe said it is clear that the invasive semi-slugs, the vector for transmission to humans, are found on all islands.
The Maui case of rat lungworm was one of two confirmed last month. The other case involved a visiting adolescent from New York state who traveled with family to Hawaii island in January. The person was hospitalized after returning home in late January, the Health Department said.
Laboratory testing confirmed a rat lungworm, or angiostrongyliasis, infection in mid-March. Department officials have been in contact with clinicians treating the individual and public health officials in New York.
The two cases bring the number of confirmed rat lungworm infections in Hawaii to three in 2018. There were 18 reported cases last year.
"These recent cases are a reminder that the risk of rat lungworm disease exists statewide, and we all need to take precautions to prevent infection," said Dr. Sarah Park, state epidemiologist. "We can all do our part to eliminate risks around our homes, gardens and farms by controlling rats, slugs and snails, especially during the rainy season. Inspecting and thoroughly washing produce under clean, running water can go a long way in preventing rat lungworm disease."
The disease is commonly spread through contact with the semi-slug. Rats host the worm and pass larvae through their feces. Slugs feed on that, and they contaminate fruits and vegetables eaten raw by humans, who then become infected.
Angiostrongyliasis, or rat lungworm disease, is caused by a parasitic roundworm and can have debilitating effects on an infected person's brain and spinal cord. Symptoms vary widely, but the most common ones include severe headaches and neck stiffness. The most serious cases experience neurological problems, severe pain and long-term disability.
There is no cure for the disease.
After the spike in cases in East Maui last year, there was an extensive education and vector control effort. Koethe lauded Dr. Lorrin Pang, the department's Maui District health officer, as "a role model" for efforts to battle the disease.
Tips to prevent rat lungworm disease include:
• Inspecting, washing and storing produce in sealed containers, regardless of whether it came from a local retailer, farmers market or backyard garden.
• Washing all fruits and vegetables under clean, running water to remove any tiny slugs or snails. Pay close attention to leafy greens.
• Controlling snail, slug and rat populations around homes, gardens and farms. Get rid of them safely by using traps and baits and always wear gloves.
For more information about rat lungworm disease and how to prevent its spread, visit the following websites:
• Health Department, health.hawaii.gov/docd/disease_listing/rat-lungworm-angiostrongyliasis/.
• Agriculture Department, hdoa.hawaii.gov/blog/main/rat-lungworm-information/.
• University of Hawaii College of Tropical Agriculture and Human Resources, manoa.hawaii.edu/ctahr/farmfoodsafety/rat-lungworm/.
• Centers for Disease Control and Prevention, www.cdc.gov/parasites/angiostrongylus/index.html.