In the past three months, six cases of human infection from rat lungworm have occurred on the island of Maui.
Tests confirmed that Manila and Lape were infected with angiostrongylus cantonensis, also known as the rat lungworm.
Rat lungworm disease, a condition in which parasitic worm larvae infect people's brains, is carried by rats and transmitted by snails and slugs. There are three other cases on the Big Island. The newlyweds spent two weeks in Hana, but by the time they were set to return to San Francisco, Laupe was already feeling the effects from rat lungworm disease.
In an email, Okubo wrote, "The investigation is fluid and the cluster of cases, though not all confirmed, are very concerning". How do people become infected?
Are there ways to prevent rat lungworm infection? Furthermore, animals such as freshwater shrimp, crabs, or frogs, are known to have been infected with the parasite in the past, and so it may be possible to contract the parasite by eating infected undercooked or raw animals; however, "the evidence for this is not as clear as for eating infected 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. However, some say that there could be many more cases that were not reported.
Rat lungworm disease is reported in about 30 countries in Asia, Africa, and Caribbean and Pacific Islands.
Although some infected individuals do not present with any symptoms, or only experience fleeting, mild symptoms, the infection can result in eosinophilic meningitis, which is a rare type of meningitis.
Snugs and snails eat rat feces and serve as intermediate hosts for the parasites. "In children, it's more the nausea and vomiting, not so much the headache". The parasite does not make people contagious, and recovery from the illness typically takes from two weeks to two months.
The good news is the infection can not be spread from human to human.
While symptoms may resolve themselves, anyone experiencing even a hint of the more aggressive infection must seek medical evaluation. Hawaiian officials are warning people to avoid handling slugs and snails in their gardens.
Supervising infants in the garden or anywhere they might come into contact with slugs or snails is also recommended.
Cover your catchment tanks to prevent slugs and snails from having access.