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Baby in Puna Catches Rat Lungworm Disease – Hawaii Department of Health Confirms 17th Case of Rat Lungworm Disease in Hawaii for 2017

The Hawaii State Department of Health (DOH) has confirmed an additional case of rat lungworm disease in an infant from the Puna District of Hawaii Island. This is the tenth laboratory-confirmed case of rat lungworm disease contracted on Hawaii Island this year, bringing the statewide total to 17 cases in 2017. After a detailed investigation, DOH learned the infant became infected likely after accidentally consuming a slug or snail.

“Kane’s slowly getting better but it will take time. He had RAT LUNGWORM for 9 DAYS & i took him to his doctor, urgent care & hilo medical center MULTIPLE TIMES before they finally listened to me & did a blood sample on him. Can you imagine if my baby would have died from this? & Me knowing that i did my best to tell doctors to check his blood because in my gut i could feel that it wasn’t the flu or him teething. I hope you guys feel real dumb for ignoring my instincts, i am glad that i was firm because the ER wanted to SEND US HOME AGAIN WITHOUT A BLOOD SAMPLE, but i refused to let that happen a 2nd time around. Any ways, i am grateful that he is a fighter & i am positive that he will make a full recovery.” Santini N Dylan Tauanuu

“This is an extremely unfortunate incident, with the infant currently hospitalized and receiving care,” said Aaron Ueno, Hawaii Island District Health Officer. “While the department is unable to provide specific information on this individual case, we can take this time to remind parents and caregivers about the importance of preventing infants and young children from putting slugs, snails, or other items in their mouths. We know that slugs, snails, and rats in all counties carry the parasite that can cause rat lungworm disease, so watching over young children is especially important.”

He added, “The Hawaii Island District Health Office is making a concerted effort to reach parents and caregivers of infants and young children by providing education and resources about rat lungworm disease prevention to our Women, Infants and Children (WIC) and Early Intervention Services clients and our partners, including pediatricians and other healthcare providers.”

DOH recommends all parents and caregivers of infants and young children take extra precautions, including:

  • Watch infants, toddlers, and children carefully while they are playing and make sure they are not picking up slugs, snails, or other objects from the ground and putting those into their mouths.
  • Help children properly wash their hands after playing and/or on the ground using running water and soap.
  • When consuming food and drinks, close and seal containers when not in use to prevent slugs and snails from crawling inside, especially when left on or near the ground.

The public is urged to take the following precautions to prevent rat lungworm disease:

  • Carefully inspect, wash, and store produce in sealed containers, regardless of whether it came from a local retailer, farmer’s market, or backyard garden.
  • All fruits and vegetables should be washed and rubbed under running water, especially leafy greens, to remove any tiny slugs or snails.
  • Controlling snail, slug, and rat populations is one of the most important steps in fighting the spread of rat lungworm disease. Eliminate slugs, snails, and rats around properties, and especially around home gardens.
  • Farmers as well as food handlers and processors should increase diligence in controlling slugs, snails, and rats on the farm.

Rat lungworm disease (angiostrongyliasis) is contracted when a person becomes infected with the parasite Angiostrongylus cantonensis. This happens when a person accidentally consumes raw or undercooked infected slugs, snails, freshwater shrimp, land crabs or frogs. The most common symptoms include severe headaches and neck stiffness, but symptoms may vary widely among cases. The most serious cases experience neurological problems, pain, and severe disability.

More information about the signs and symptoms of rat lungworm disease may be found at http://health.hawaii.gov/docd/disease_listing/rat-lungworm-angiostrongyliasis/ and https://health.hawaii.gov/docd/files/2017/01/RLD-rackcard-version1_06152017.pdf. The first in a series of public service announcements about rat lungworm disease prevention is posted on the Hawaii Department of Agriculture’s website at http://hdoa.hawaii.gov/blog/main/rat-lungworm-information/.

Hawaii Governor Announces Stepped Up Efforts to Prevent Rat Lungworm Disease and Expanded Role of Joint Task Force

Gov. David Y. Ige, together with the Hawai‘i Department of Health (DOH) and the Hawai‘i Department of Agriculture (HDOA) announced today the state’s plans to place a stronger emphasis on the prevention of rat lungworm disease.

This year, the state confirmed a total of 15 cases of the serious parasitic infection, which is the highest number of cases reported in the state over the last decade.

“We are bringing together local experts from relevant fields to increase public awareness, improve our response activities, and explore ways to control and treat the disease,” said Gov. Ige. “They will work together with the Joint Task Force we established last year to step up prevention efforts beyond Hawai‘i Island, where the first cases were reported.”Dr. Kenton Kramer, Associate Professor of the Department of Tropical Medicine, Medical Microbiology and Pharmacology with the University of Hawai‘i John A. Burns School of Medicine (UH-JABSOM), who is serving as Joint Task Force chair said, “The Joint Task Force to combat rat lungworm disease will reconvene in August. Experts from the medical, scientific, environmental, and public health communities will collaborate to develop guidelines for schools, farms, food establishments, physicians and other groups on best practices to prevent, control, and treat rat lungworm disease.”

The Joint Task Force, established in May 2016, consists of members from UH-JABSOM, Pacific Biosciences Research Center; The Daniel K. Inouye College of Pharmacy at UH Hilo; HDOA’s Plant Industry and Quality Assurance Divisions; USDA Agriculture Research Service; Kaiser Permanente Hawaii; Hilo Medical Center; Kapiolani Medical Center for Women and Children; Hawaii County; and the DOH’s State Laboratories Division, District Health Offices of Hawaii Island, Maui, and Kaua‘i, Vector Control Branch, Safe Drinking Water Branch, Disease Outbreak Control Division, and Sanitation Branch.

Because of rising concerns over the recent increase in confirmed cases this year, the 2017 Hawai‘i State Legislature appropriated $1 million ($500,000 over two years) to the DOH to increase public education and improve control and prevention of rat lungworm disease. The funding will make possible a statewide media campaign in partnership with the Hawai‘i Association of Broadcasters to build public awareness of ways to prevent the spread of the parasitic disease.

Health Director Dr. Virginia Pressler said, “We appreciate the Legislature’s support in allowing the state to accelerate our efforts on this important initiative. The funds will provide much needed resources for our public health communications efforts as well as strengthen our disease investigation and vector control measures for rat lungworm disease.”

In addition to a statewide public awareness campaign, the DOH will work in partnership with the U.S. Centers for Disease Control and Prevention, the University of Hawai‘i, HDOA, and other agencies to conduct a targeted rat, slug and snail study to identify disease routes and provide data on disease risks from these vectors. A statewide study of this kind has never been conducted in Hawaii before because of limited resources. Findings from the study will guide vector control activities for rat lungworm prevention.

Funding from the Legislature will also support two temporary full-time staff positions to coordinate prevention efforts between county, state, federal, and private sector partners.

Currently, the DOH’s food safety inspectors and vector control staff are collaborating with HDOA to investigate any reports of produce shipments from any farmer or vendor (local or mainland) with an infestation of slugs or snails. If the shipment is traced to a local farm, inspectors work with the farmer to ensure proper pest reduction measures are implemented.

Rat lungworm disease is caused by a parasitic roundworm called Angiostrongylus cantonensis. The parasite can be passed from the feces of infected rodents to snails, slugs and certain other animals, which become intermediate hosts for the parasite. People can become infected when they consume infected raw or undercooked intermediate hosts (slugs, snails, freshwater prawns, frogs, crayfish, and crabs).

Although the rat lungworm parasite has been found in slugs and snails throughout the state, Hawai‘i Island has experienced the majority of the confirmed cases. Some infected people don’t show any symptoms or have mild symptoms. For others, the symptoms can be much more severe and debilitating, and can include headaches, stiffness of the neck, tingling or pain on the skin or in extremities, low-grade fever, nausea, and vomiting.

Sometimes, a temporary paralysis of the face may occur, as well as light sensitivity. This infection can also cause a rare and serious type of meningitis (eosinophilic meningitis).

To prevent the spread of rat lungworm infection, the public is urged to take these important steps:

  • Always practice safe eating habits by inspecting, thoroughly washing, and properly storing raw produce, especially leafy greens, regardless of where it came from, and/or cooking it properly to kill any parasites. Washing raw vegetables and fruits thoroughly under running water before eating not only prevents rat lungworm, but also rinses off other contaminants.
  • Eliminate snails, slugs and rats — all of which are potential vectors for the disease  — both around residential home gardens and agricultural operations of all scales.
  • Prevent the consumption of snails and slugs by covering all containers, from water catchment tanks to drink and food dishes. Supervise young children while playing outdoors to prevent them from putting a slug or snail in their mouths.

Watch todays video here: https://www.facebook.com/GovernorDavidIge/videos/856480491194011/

For more information on preventing rat lungworm disease, go to the DOH website at www.health.hawaii.gov

Public Informational Meeting on Rat Lungworm Disease on Molokai

The Hawai‘i State Department of Health (DOH), Maui District Health Office, will hold a public informational meeting on rat lungworm disease on Tuesday, May 30, 2017 at the Mitchell Pauole Community Center on Molokaʻi from 5:30 p.m. to 7 p.m. The meeting will include an opportunity for the public to ask questions.

A number of public health experts and community partners will be present to share their findings and recommendations on preventing the spread of rat lungworm, including Lorrin W. Pang, M.D., Maui District Health Officer; Sara Routley, Health Educator; Alton Arakaki from the University of Hawai‘i’s College of Tropical Agriculture and Human Resources (CTAHR); Harmonee Williams of Sustʻaina-ble Molokaʻi; and Lori Buchanan from the Nature Conversancy of Hawai‘i.

Rat lungworm is a rare disease caused by the parasite Angiostrongylus cantonensis which is found in rats, slugs and snails. The disease affects the brain and spinal cord and occurs when a person ingests raw or undercooked snails or slugs or unwashed raw produce such as leafy greens. To date, DOH has confirmed 15 cases of the illness in Hawai‘i for 2017, including nine (9) from Hawai‘i Island, four (4) Maui residents and two (2) Maui visitors.

DOH has launched a number of initiatives to address rat lungworm. Together with partner agencies, community meetings have been held across Maui to educate the public on rat lungworm and to share best practices on the prevention of this disease, including the proper care and washing of produce, as well as rodent and slug control. DOH food safety inspectors have also worked with permitted food establishments on hygiene and food preparation, and medical advisories were sent to physicians and hospitals to increase awareness of the disease. DOH is planning future public information efforts to educate residents and visitors about rat lungworm.

The informational meeting on Moloka‘i is also supported by Rosie Davis from Huli Au Ola Area Health Education Center (AHEC); Maui Mayor Alan Arakawa and staff; Luana Alcon from the Maui County Parks & Recreation-Moloka‘i District; Margaret Makekau and DOH staff-Moloka‘i Office; State Senator J. Kalani English; and State Representative Lynn DeCoite.

Please call the AHEC at (808) 646-9037 or the DOH Maui District Health Office at (808) 984-8201 for more information on the meeting.

A Message From Senator Kahele – Rat Lungworm Disease

Aloha,

For this week’s legislative update, I want to focus on Senate Bill 272, Senate Draft 2, House Draft 1 (SB272 SD2 HD1), Relating to Rat Lungworm Disease. With the recent flurry of news stories covering Rat Lungworm Disease in the Honolulu Star-Advertiser, Civil Beat and even the Atlantic, I feel it particularly important to update you on what the legislature is doing to address the situation.

SB272 SD2 HD1 appropriates an unspecified amount of funds to the University of Hawai`i at Hilo for programs, studies, and activities related to the prevention and eradication of rat lungworm disease. We know that we have to appropriately fund these efforts to put an end to this menace.

Currently, SB272 SD2 HD1 has passed third reading in the House. The Senate has already communicated its disagreement to the HD1 version because it changes the effective date to July 31, 2150. This strategy is known as “defecting the effective date” and either kills the bill or forces it into conference since it is a forgone conclusion that neither house will pass a bill with such an unrealistic implementation date.

Hopefully, this bill will go to conference. If it does, Representative Richard Creagan and I will likely be the lead-chairs for the conference committee and we’ll be able to work with our colleagues to put out a draft both houses can support.

As we move forward, stay up-to-date on this effort by following its progress on our capitol website or our weekly updates. Mahalo for all your support!

Me ka ha’aha’a,
Kaiali’i Kahele