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Published Date: 2019-05-26 10:24:31
Subject: PRO/AH/EDR> Angiostrongylus cantonensis - USA (03): (HI)
Archive Number: 20190526.6487791
ANGIOSTRONGYLUS CANTONENSIS - USA (03): (HAWAII)
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International Society for Infectious Diseases
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Date: Sat 25 May 2019
Source: Maui Now [edited]
https://mauinow.com/2019/05/23/three-unrelated-cases-of-rat-lungworm-confirmed/


The Hawaii Department of Health has received notification from the Centers for Disease Control and Prevention that its laboratory confirmed 3 unrelated cases of angiostrongyliasis, or rat lungworm disease, in visitors to Hawaii island.

All 3 individuals are adult residents of the US mainland and were traveling in Hawaii when they were infected with the parasite causing the disease.

One of the individuals visited East Hawaii in December 2018 and became infected by purposely eating a slug on a dare. The individual became ill in late December 2018 and was not hospitalized for their symptoms.

The adult visitor was the 8th person infected on Hawaii Island who tested positive for angiostrongyliasis in 2018, bringing the statewide total to 10 confirmed cases last year [2018].

The other individuals confirmed by the CDC laboratory were traveling on the west side of Hawaii Island during their visits. One of these individuals became ill in early January 2019 and was not hospitalized for their symptoms. After an investigation, it is not known how the individual was infected; however, they do remember eating many homemade salads while on vacation.

The other individual became ill in late February 2019 and was hospitalized for a short time. The investigation was not able to identify an exact source of infection, but the individual likely became infected while eating unwashed raw fruits, vegetables and other plants straight from the land.

With the additional cases confirmed by CDC, this brings the statewide total to 5 confirmed cases of angiostrongyliasis in 2019, all of which were contracted on Hawaii Island.

"It's important that we ensure our visitors know the precautions to take to prevent rat lungworm disease, which can have severe long-term effects," said Health Director Bruce Anderson. "Getting information to visitors about the disease is just as critical as raising awareness amongst our residents."

The Department of Health provides information to visitors traveling to Hawaii with signage in local airports and shopping centers. Anderson added, "We recognize that there is more work to be done in educating residents and visitors and making sure they know how to prevent the spread of this disease."

DOH provides the following recommendations to prevent rat lungworm disease:
- Wash all fruits and vegetables under clean, running water to remove any tiny slugs or snails. Pay close attention to leafy greens.
- Control snail, slug, and rat populations around homes, gardens and farms.
- Get rid of these vectors safely by clearing debris where they might live, and also using traps and baits.
- Always wear gloves for safety when working outdoors.
- Inspect, wash, and store produce in sealed containers, regardless of whether it came from a local retailer, farmer's market, or backyard garden.

For more information about rat lungworm disease and how to prevent its spread, see:
DOH website:
http://health.hawaii.gov/docd/disease_listing/rat-lungworm-angiostrongyliasis/
HDOA website:
http://hdoa.hawaii.gov/blog/main/rat-lungworm-information/
CTAHR website:
http://manoa.hawaii.edu/ctahr/farmfoodsafety/rat-lungworm/
CDC website:
https://www.cdc.gov/parasites/angiostrongylus/index.html

Angiostrongyliasis, commonly known as rat lungworm disease, is caused by a parasitic roundworm and can have debilitating effects on an infected person's brain and spinal cord. In Hawaii, most people become ill by accidentally ingesting a snail or slug infected with the parasite _Angiostrongylus cantonensis_ (_A. cantonensis_). Symptoms vary widely between cases, and the most common ones include severe headaches and neck stiffness. The most serious cases experience neurological problems, severe pain and long-term disability.

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Communicated by:
ProMED-mail
<promed@promedmail.org>

[_Angiostrongylus cantonensis_, the rat lungworm, is a zoonotic, parasitic nematode that uses the rat as a definitive host and gastropods as intermediate hosts. It is prevalent in parts of Asia, the Pacific islands, and the Caribbean. In the United States, _A. cantonensis_ is established in Hawaii, and in recent years has been reported in Louisiana and Florida. - Mod.EP

HealthMap/ProMED map available at:
Hawaii, United States: http://healthmap.org/promed/p/214]

See Also

Angiostrongylus cantonensis - USA (02): (HI): 20190216.6320453
Angiostrongylus cantonensis - USA: (HI) introduced snail: 20190211.6310067
2018
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Angiostrongylus cantonensis - USA (06): (HI) distribution 20180901.6001883
Angiostrongylus cantonensis - USA (05): (HI) transmission 20180825.5986667
Angiostrongylus cantonensis - USA (04): (HI) 20180818.5973796
Angiostrongylus cantonensis - USA (03): (TX) 20180805.5948810
Angiostrongylus cantonensis - USA (02): (HI) 20180226.5651881
Angiostrongylus cantonensis - USA: (HI) task force 20180114.5557708
2017
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Angiostrongylus cantonensis - USA (05): (HI) reservoir 20171221.5518125
Angiostrongylus cantonensis - USA (04): (HI) 20171001.5353796
Angiostrongylus cantonensis - USA (03): (HI) 20170514.5035328
Angiostrongylus cantonensis - USA (02): (HI) 20170502.5008629
Angiostrongylus cantonensis - USA: (HI) 20170407.4955519
2015
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Angiostrongylus cantonensis - USA (02): (HI) 20150418.3306098
Angiostrongylus cantonensis - USA: (FL) introduced snails 20150303.3204533
.................................................sb/ep/msp/dk

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