Taskforce to look at rat lungworm disease

LIHUE — Wash your leafy green vegetables and maybe take a time-out from swallowing slugs if you want to avoid getting rat lungworm disease.

The risk of contracting the disease on Kauai is small, according to the state Department of Health — there has only been one documented exposure to the parasite in the last few years, and it was a visitor to the island.

Most of the cases, in fact, are confined to the Big Island but the DOH is putting together a Joint Task Force to study the threat of the disease in Hawaii.

According to Sarah Park, state epidemiologist, the task force’s creation is Gov. David Ige’s initiative, and the purpose is to gather experts from around the state to talk about issues surrounding the disease.

Other goals are to generate awareness, to teach the public about the disease and how to protect themselves, and to look at what contributes to rat lungworm disease.

According to a news release from DOH, rat lungworm disease is caused by a roundworm parasite that starts in rats. Other animals, mainly snails and slugs, eat the rat feces and become infected, and it’s the mollusks that pass the parasite to humans.

Some people don’t show any symptoms, but for others the symptoms can include headaches, stiffness of neck, tight or painful feelings in the skin, low-grade fever, and nausea or vomiting.

Sometimes, a temporary paralysis of the face may happen, as well as sensitivity to light. According to the DOH, the infection can also cause eosinophilic meningitis, which is a rare type of meningitis.

Park said DOH doesn’t know why most of the cases of rat lungworm disease have been found on the Big Island, and that’s one of the things the task force will be studying.

“There is the same amount of infection among mollusks on every island, so one of our questions is why are most of the cases on the Big Island,” she said.

The task force will also be looking into whether the parasite can be transmitted through the trial snails and slugs leave behind.

While rat lungworm disease starts in rats and was most likely brought to the islands through a rat stowaway on a ship, Park said DOH isn’t looking at the rodents as the crossing-over point for humans.

“We don’t think that people are out there with the rat poop; it’s the wrong stage in the parasite’s cycle anyway,” Park said. “With humans, we think it’s the snails and slugs.”

Most people don’t voluntarily chow down on slugs, Park said, but sometimes young children will experiment with a mouthful, or teenagers will dare each other to down a mollusk.

“We’ve definitely had cases that were associated with young people, mostly young males, doing it voluntarily,” Park said. “But other folks usually ingest them by accident.”

Snails and slugs can easily hide in the folds of leafy greens, or in appliances that are stored outside, and that’s how they get eaten.

“They are deep in the crevices at the base of leafy vegetables and they get stuck in there easily if you don’t wash them well enough,” Park explained. “Then you can chop it up with the salad and that’s probably what’s happening.”

Park said DOH suggests washing every single leaf of vegetables and to do a quick check for snails or slugs before slicing up your salad fixings. It is also recommended to store blenders, knives and other kitchen tools in places where mollusks can’t get to them, and to check them before use.

“Fortunately we don’t see many cases, except on the Big Island, but the bottom line is to try to prevent infection,” Park said. “The way to do that is to wash and inspect each leaf carefully before you eat vegetable products.”

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