Preventing rat lungworm disease
Angiostrongyliasis, or rat lungworm disease, is a very clear and present danger here, specifically in East Maui.
So far, the state Department of Health confirms six people infected by rat lungworm, with three cases still under investigation.
The disease stems from a parasitic worm, Angiostrongylus cantonensis, the adult form of which is only found in rodents. Infected rats pass the larvae in their feces, which are then ingested by snails, slugs and other mollusks.
We humans can then be infected by eating these snails or slugs, most often while they are hidden in produce. But really you can be infected by ingesting anything that has been tainted by the slime trail of the slugs or snails, including drinking water or eating freshwater animals such as prawns, frogs or crabs.
Most recently some individuals on Hawaii Island contracted the disease after drinking homemade kava, a ceremonial beverage that was left out in uncovered buckets. After consuming the kava, it was noticed that there was a slug at the bottom of the ceremonial bowl; the individuals became ill a few weeks later with two confirmed cases of rat lungworm disease and four more highly probably cases that are pending confirmation.
According to the Centers for Disease Control, symptoms include headache, stiff neck, tingling or a painful feeling in the skin, low-grade fever, nausea and vomiting. The infection can affect the central nervous system and cause great pain, and even with treatment the damage to the central nervous system may become permanent. Patients may suffer from chronic pain and incapacitation for years, or for the rest of their lives.
As a community, we must work together to protect each other and limit the spread of this potentially debilitating disease. Remember to always wash your hands, separate leaves before rinsing produce and clean and sanitize any area that has contact with your food, such as your kitchen counter. If you have a backyard area or garden make sure you take steps to trap, kill and properly dispose of rats, slugs, snails and other pests. Before eating fresh, raw produce, inspect and wash it thoroughly. When consuming any snails, freshwater prawns, etc., do not eat them raw — be sure to cook them for 3 to 5 minutes at an internal temperature of 165 degrees. Alternatively, you can freeze produce, prawns and snails for 24 hours to kill the parasite.
A helpful slogan to share with your kids, grandparents, friends and neighbors reminds us of simple yet effective ways to remove or kill the parasite: “Rinse, Cook, Freeze: Prevent Rat Lungworm Disease.” Also be sure to inspect water catchment systems.
The Maui District Health Office is partnering with a number of other local agencies to host community meetings you can attend to learn more about the disease and its prevention. The next meeting will be held at 5:30 p.m. Wednesday at the Mayor Hannibal Tavares Community Center in Pukalani. Stay tuned for more community meetings in Central Maui and Lahaina that will be scheduled in early May.
The University of Hawaii at Manoa’s Extension Service also is partnering with the Maui County Farm Bureau, Health Department and other agencies to educate landscapers, growers and gardeners. An informational session will be held at 5:30 p.m. Tuesday at the UH-Maui College Community Service Building.
Meanwhile, tensions are mounting regarding North Korea, and whether Hawaii is on its list of targets should the North Koreans decide to attack the United States. The Department of Homeland Security has been in touch with our state and county emergency management agencies, and we are monitoring the situation. Otherwise, this is not something our residents need to be concerned about right now, and personally I feel the rat lungworm situation is a much more pressing issue.
That being said, I would ask that residents prepare for a possible international incident much like they do for a hurricane or tsunami. Keep an updated emergency kit handy, make a family plan and stay informed.
In the meantime, wash your vegetables.
* “Our County,” a column from Maui County Mayor Alan Arakawa, discusses county issues and activities of county government. The column usually appears on the first and third Fridays of the month.