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Rat Lungworm Informational Meeting on Lanai

The Hawaii State Department of Health (DOH), Maui District Health Office, will hold a public informational meeting on rat lungworm disease on Tuesday, July 6, 2017 at the ILWU Hall in Lanai City, Lanai from 5 p.m. to 6:30 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 the DOH, College of Tropical Agriculture & Human Resources (CTAHR), the Maui Invasive Species Committee (MISC) and Maui School Garden Network.

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 Hawaii for 2017, including nine (9) from Hawaii 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, DOH has held community meetings on Maui and Molokai 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 prevention.

For additional information on the disease, go online to https://mauiready.org/ratlungworm/ or http://health.hawaii.gov/docd/disease_listing/rat-lungworm-angiostrongyliasis/. Call the DOH office on Lanai at (808) 565-7114 or on Maui at (808) 984-8201 for more details on the meeting.

Hawaii Tourism Authority Statement: Rat Lungworm Disease is Very Rare and Easily Preventable in Hawaii

George D. Szigeti, president and CEO of the Hawaii Tourism Authority (HTA), issued the following statement to reassure Hawaii’s tourism industry and visitors planning trips to the Hawaiian Islands that rat lungworm disease is very rare and easily preventable.

“Some national media attention has been devoted recently to rat lungworm disease in Hawaii, raising concerns among visitors and groups planning trips to the Hawaiian Islands. It is important that people not overreact and gather reliable information before making any assumptions.

“On the recommendation of the Hawaii State Department of Health, residents and visitors of Hawaii can be assured there is nothing to fear about getting infected as long as they use smart common sense when washing, preparing and storing food.

“The key facts that everyone needs to remember about rat lungworm disease is that it is very rare, it is very uncommon for people to get infected, and the disease is easily preventable by properly washing and storing all food, especially produce, before eating.

“To the visitors already in the Hawaiian Islands or planning a trip here in the coming months, there is no need to be overly concerned. Please patronize our restaurants and enjoy the delicious island cuisine and fresh produce that helps to make Hawaii such a beloved travel experience.

“I would strongly recommend anyone wanting trusted information about rat lungworm disease to visit the Department of Health website (health.hawaii.gov) and learn the facts.

“Hawaii, which has 1.4 million residents and welcomed more than 8.9 million visitors in 2016, typically has between one to 11 cases of rat lungworm disease reported annually, according to the Department of Health.

“Thus far in 2017, 11 people have been infected with the disease, nine residents and two visitors. While the cause of two cases is still being investigated, the Department of Health reports that the remaining nine cases could have been prevented with better hygiene and by properly washing, preparing and storing food.

“We hope knowing this information helps allay concerns about travel to the Hawaiian Islands, which continues to be the cleanest, healthiest, safest and most welcoming destination in the world.”

Big Island Residents Catch Rat Lungworm – Residents Consumed Drink Tainted by Slug

The Hawaii State Department of Health (DOH) today confirmed two new cases of individuals with rat lungworm illness on Hawaii Island. In addition, four related cases are considered highly probable based on clinical indications, a common discrete exposure, and symptoms consistent with the illness. All six cases are adults who were hospitalized and their illnesses reported to the department over the past weekend.

The adults became infected with the parasite Angiostrongylus cantonensis at a home in Keaau on Hawaii Island a few weeks after drinking homemade kava which they had left out in uncovered buckets after preparing the drink at the home. The kava was poured into a large bowl and after consuming most of the contents, the individuals noticed a slug at the bottom of the bowl. The department’s investigation determined the source of the infections was likely the homemade kava tainted by slugs.

“The department is continuing to monitor this serious illness spread to individuals by infected slugs and snails,” said Health Director Dr. Virginia Pressler. “Cases like this recent cluster are especially concerning because they can be prevented with basic precautions such as storing food in covered containers and properly inspecting and washing food before eating. These healthy habits can protect against food contamination and prevent serious illnesses.”

With the addition of the two illnesses confirmed today, there have been a total of 11 confirmed cases of rat lungworm infection this year in the state.

Earlier this year, four Maui resident cases, two non-resident cases who were visitors to Maui, and three Hawaii Island resident cases were confirmed. The two cases confirmed today were Hawaii Island residents and of the four probable cases, three were Hawaii Island residents and one was a resident of Maui who traveled to Hawaii Island.

The Hawaii Department of Health advises everyone to carefully store, inspect and wash produce, especially leafy greens. Always store food in covered containers, wash all produce thoroughly and supervise young children playing outdoors to prevent them from putting snails or slugs into their mouths. Controlling snail, slug, and rat populations is one of the most important steps in fighting the spread of rat lungworm disease. Take precautions to control 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.

The Department of Health’s Food Safety Program continues to inspect and educate food establishments statewide on safe food handling and preparation to prevent contamination and food borne illness. Food establishments statewide are reminded to use only approved and licensed sources and carefully inspect and wash all produce during food preparation.

The most common symptoms of angiostrongyliasis or rat lungworm include severe headache and neck stiffness, but symptoms may vary widely among cases. Seek medical attention for headache, fever, stiff neck, tingling or painful feelings in the skin or extremities. The most serious cases experience neurological problems, pain and severe disability. Healthcare providers should monitor and support patients’ symptoms, and report any persons they suspect may be infected. More information on the signs and symptoms of rat lungworm infection are at: http://health.hawaii.gov/docd/files/2015/07/angio-fact-sheet-20150716.pdf

Four Meetings on Rat Lungworm Begins Tonight on Maui

Mayor Alan Arakawa and the Maui District Health Office jointly announced two community meetings to provide information on safety measures and vector control practices to help prevent Rat Lungworm Disease (Angiostrongyliasis):

  • Haiku Community Center: Monday, April 17, 2017; doors open at 5:00 p.m.; session begins at 5:30 p.m.
  • Hannibal Tavares Community Center (Pukalani): Wednesday, April 26, 2017; Doors open at 5:00 p.m.; session begins at 5:30 p.m.

At these two town hall-type meetings, presentations will be given on the Rat Lungworm parasite, current research and measures for controlling slugs, rats and snails; a demonstration on how to wash and care for vegetables and fruits; a personal story of one person’s experience with Rat Lungworm Disease; and Q&A.

Dr. Lorrin Pang (center, standing) talks with Sara Routley, DOH Health Educator, in a standing-room-only crowd gathered for the Hana community meeting on Rat Lungworm Disease held April 6th. Credit: Dept. of Health / Maui District Health Office.

Presenters include Maui District Health Officer Dr. Lorrin Pang; Dept. of Health staff; and Adam Radford, Manager, Maui Invasive Species Committee. For more information on these meetings, call ph. 984-8201.

Informational sessions also have been scheduled by the UH Manoa Cooperative Extension for Thursday, April 20 at 6:00 p.m. at the Kula Elementary School Cafeteria and on Tuesday, April 25 at 5:30 p.m. at the Univ. of Hawaii-Maui College Community Service Building.

  • Thursday, April 20, 2017 at Kula Elementary School Cafeteria, Maui at 6:00 p.m.
  • Tuesday, April 25, 2017 at the UH – Maui College Community Service Building at 5:30 p.m.

These sessions will target growers, landscapers and gardeners and will focus on managing rat, snail and slug populations, as well as inspection and sanitation measures to minimize the spread of Rat Lungworm parasites. Presenters include Cynthia Nazario-Leary, Kylie Wong, Lynn Nakamura-Tengan, and Dept. of Health staff. For more information on this meeting, call Kylie or Lynn at ph. 244-3242.

Local and State agencies participating in the above joint outreach efforts include the Maui District Health Office including Public Health, Vector Control and Environmental Health; the County of Maui; the Office of Mayor Alan M. Arakawa; the Maui County Emergency Management Agency (formerly Civil Defense); the State Dept. of Agriculture; Maui Invasive Species Committee (MISC); the Univ. of Hawaii at Manoa Cooperative Extension; The Univ. of Hawaii College of Tropical Agriculture and Human Resources (CTAHR); Univ. of Hawaii-Hilo; the Maui County Farm Bureau; and the Hawaii Farmers Union United.

For general information on Rat Lungworm Disease, visit www.mauiready.org.

Joint Task Force Established to Combat Rat Lungworm Disease in Hawaii

The Hawaii State Department of Health (DOH) and the East Hawaii Liaison to the Office of the Governor announced today the establishment of a Joint Task Force to assess the threat of rat lungworm disease (Angiostrongyliasis) in Hawaii. The mission of the task force is to share scientific knowledge in the application of diagnostics, treatment, mitigation and public education activities.

rat lungworm

Rat lungworm disease is caused by a nematode, which is a roundworm parasite called Angiostrongylus cantonensis. The parasitic nematode can be passed from the feces of infected rodents to snails, slugs and certain other animals, which become intermediate hosts for the parasite. Humans can become infected when they consume, either intentionally or otherwise, infected raw or undercooked intermediate hosts.

Although rat lungworm has been found throughout the state, Hawaii Island has a majority of the cases. Some infected people don’t show any symptoms or only have mild symptoms. For others, the symptoms can be much more severe, which can include headaches, stiffness of the neck, tingling or painful feelings in the skin or extremities, low-grade fever, nausea, and vomiting. Sometimes, a temporary paralysis of the face may also be present, as well as light sensitivity. This infection can also cause a rare type of meningitis (eosinophilic meningitis).

“Establishing a joint task force with local experts in the medical field and leaders in government will produce a set of best practices that be used to target rat lungworm disease not only on Hawaii Island, but on a statewide scale as well,” said Wil Okabe, East Hawaii Liaison to the Office of the Governor. “There is no specific treatment yet identified for this disease, so finding the best ways to prevent its spread and educate the public is crucial.”

The members of the task force are as follows:

  • Wil Okabe (Facilitator), East Hawaii Governor’s Liaison Office
  • Robert Cowie, Ph.D., Pacific Biosciences Research Center, University of Hawaii at Manoa
  • Robert Hollingsworth, Ph.D., U.S. Department of Agriculture (USDA)
  • Sue Jarvi, Ph.D., School of Pharmacy, University of Hawaii at Hilo
  • Jerry Kahana, Hawaii State Department of Agriculture
  • Kenton Kramer, Ph.D., Department of Tropical Medicine, John A. Burns School of Medicine (JABSOM)
  • John Martell, M.D., Hilo Medical Center
  • Marian Melish, M.D., Pediatric Infectious Disease, Kapiolani Medical Center
  • Donn Mende, Research and Development, County of Hawaii
  • DeWolfe Miller, Ph.D., Tropical Medicine Microbiology and Pharmacology, JABSOM
  • Peter Oshiro, Sanitation Branch, DOH
  • Sarah Park, M.D., F.A.A.P., State Epidemiologist, DOH
  • Joanna Seto, Save Drinking Water Branch, DOH
  • Aaron Ueno, Hawaii District Health Office, DOH
  • Chris Whelen, Ph.D., State Laboratories Division, DOH
  • Jonnie Yates, M.D., Kaiser Permanente

Update On One of the Rat Lungworm Victims… Doctors Say He Will Make a Full Recovery

Here is a quick update on one of the victims that got infected with the rat lungworm disease while visiting Puna here on the Big Island.

a holidaymaker, who traveled to Hawaii to learn about organic farming, found himself in hell, after catching a flesh-numbing parasite.22-year-old Eric Reinert was confined to a wheel chair when his nervous system was attacked by a crippling disease-rat lungworm.  

The rare microscopic organism lives in rats and can be caught by eating fruit and vegetables that have not been thoroughly washed.

Now the former state wrestler is having to learn to walk again, CBS News reported.

‘Every movement was just dreaded – horrible, awful, terrible,’ said Reinert.

The young man left Watertown, Minnesota last November to travel to Hawaii to indulge his passion for organic farming…

Crippling disease: 22-year-old Eric Reinert has been confined to a wheel chair since his nervous system was attacked by paralysing disease rat lungworm

…Doctors diagnosed him with rat lungworm.After a month in hospital he was allowed home and is now making small steps to get back to health.  Doctors say he will make a full recovery.

‘A lot of people in Hawaii don’t know this exists, I didn’t know it existed. I wasn’t told about it because I’m sure the people I lived with didn’t know it exists,’ Reinert told CBS.

‘Honestly … this left side of my face is still numb,’ said Reinert.

‘Every day it gets a little better. It’s kind of a roller coaster with the pain but overall, that’s what I tell everybody. Overall, I’m getting better every day,’ he said.

Monster Inside Me… Rat Lungworm and Silka Strauch Video

A very interesting clip on Rat Lungworm produced by Animal Planet:

Monster Inside Me… Rat Lungworm (2 minutes)

The following is an interesting video that shows Puna Resident Silka Strauch in the Hospital recovering from her battle with Rat Lungworm Disease as well as a lot of other stuff I don’t understand.


I wish I could understand the language being spoken.

If anyone can translate this, I would be interested in the English Version.

Here is a website that the Strauch family has set up to help in the medical costs incurred:

Hilfe für Silka Strauch

Puna Rat Lungworm Victim Recovering Slowly

Honolulu Advertiser
Graham McCumber

Graham McCumber

When Graham McCumber was able to speak again in early April, he thought he had been in the hospital for just three days.

But the 24-year-old carpenter’s apprentice and surfer had been hospitalized since just after Christmas — much of the time in a coma brought on by one of the most severe cases of rat lungworm disease ever seen in Hawai’i.

In January, doctors reviewed the damage to his brain from the rare, parasite-born disease and told his family that even if he survived he might never eat or talk again.

“They gave us three choices, none of them good,” McCumber’s mother Kay Howe said. “I said, ‘I choose a fourth alternative. I choose a miracle.’ “

She feels like she got what she prayed for.

Though weak and thin compared to his former athletic build, McCumber on Sunday was able to sit up propped by pillows and move all his limbs in his first interview since leaving Hilo Medical Center April 30.

“I’m stretching on mats on the floor and practicing walking,” McCumber said.

He’s happy to be out of the hospital.

“I used to be tube man,” he joked, reflecting on the breathing tubes, feeding tubes and tubes that removed drainage from his lungs not that long ago.

It wasn’t until mid-April that McCumber was officially declared completely out of his coma, his aunt Lyn Howe said.

Moving his arms and looking around the sunlit bedroom, McCumber said he knows his vision has been affected, as have most parts of his body (especially the left side). He still takes nerve pain medications, and is getting treatments for nerve regeneration and strength building.

He still chooses his words slowly.

His short-term goal is “maybe walking in a couple of months, without a wheelchair or anything,” he said. Now, he needs a walker and two people supporting him to take even a few steps.

Longer-term goals include surfing and playing the guitar again. And ultimately, he’d like to go to Bali and study Ayurvedic medicine.

A healer from Bali, Pak Mangku, was among many people doing nontraditional healing work on McCumber, his mother said.

“The Western doctors did a fine job of fighting the infections and other problems that arose from being in the hospital,” she said. But she said acupuncture, Chinese herbs and the long-distance energy work of Pak Mangku were crucial to her son’s recovery.

Tiny slugs ingested

McCumber’s memory of life before rat lungworm is good, though he still has no idea what particular food might have contained tiny slugs or their slime, introducing the rat lungworm (Angiostrongylus cantonensis) parasite into his body.

“I tried to think back on it, and I don’t know exactly,” McCumber said. He does remember that he had seen slugs crawling on the floor in the place he lived when he got sick.

McCumber is one of three Big Island residents diagnosed with particularly severe cases of rat lungworm disease in December. The others are Silka Strauch, 38, and Zsolt Halda, 36.

Strauch, a yoga instructor who went into a coma Dec. 8 from the disease, remains in Hilo Medical Center. She’s able to respond to people with her eyes and hands much of the time and clearly understands what people are saying to her except during periods when she is “not there,” her friend Kristina Mauak said.

Strauch cannot talk because of the breathing tube in her throat, but smiles and cries.

Strauch’s parents, who came from Germany to be with her, have set up a German Web site and are doing interviews with German television in an attempt to raise money to take her back to their home country, Mauak said.

Before travel is even considered, however, Strauch has to be completely weaned from a breathing machine and free of infections.

Halda was treated for the disease and released in January.

strong recovery

Hilo Medical Center’s Dr. Jon Martell said of McCumber: “He’s made a strong recovery. The recovery for both of them (Strauch and McCumber) has been stronger than we expected.”

McCumber has maintained his humor despite his ordeal. When he first started talking in early April, his mother mentioned that his voice sounded like Darth Vader from the “Star Wars” movies. McCumber responded with, “Luke, I am your father.”

Minutes later, McCumber said, “I have been fasting a really long time. I’m really hungry.”

Both statements brought immense hope to his family.

“No one was sure if he would have to relearn how to speak, like a stroke victim,” Kay Howe said.

“Once he knew he could talk, you couldn’t get him to stop,” Lyn Howe said.

“It seemed like speech made his being back in the world real,” his mother said. In addition to English, he’s recalling Indonesian and Spanish.

Via an e-mail from his aunt, McCumber sent this additional comment on his situation to The Advertiser Tuesday: “Life really is like a box of chocolates; sometimes you get a chocolate-covered cherry and sometimes you get rat lung. In my case it was rat lung.”

His advice to others: “Don’t let a slug make you afraid to eat your vegetables.”

Fundraiser for Rat Lungworm Victim Silka Strauch


“Butt Ugly” Grew 4 Inches on Me!

In December I blogged about an 8 inch “Butt Ugly” worm.


Well I think the Bipalium Kewense grew on me!  I just found this one outside that is almost a foot long!

Lighter added to show size

Lighter added to show size

I know these buggahs are harmless… but they sure are friggin gross little worms… or in this case big!  I have to wonder what type of germs they carry with the recent Rat Lungworm problems we have been having in Puna.

Tomorrow: Informational Meeting on Rat Lungworm… Zsolt Halda Released From Hospital

Hat tip to Richard Ha:

Rat Lungworm Meeting this Saturday, Jan. 31, at noon at SPACE in Kalapana Seaview Estates. We hope to have many well-informed people attending as the purpose of this meeting is informational. Zsolt Halda, who has just been released from the hospital, will be there.


Jane Whitefield gives us these directions to SPACE, which is hosting the Rat Lungworm meeting mentioned here this Saturday, 1/31/09:

You drive down Hwy. 130 toward Kalapana. When you dead end at the lava, turn left. This is Hwy. 137. Drive toward Kehena and Kalapana Seaview Estates (it’s probably a 10-minute drive and very hilly, but overlooks the ocean – Spectacular!). Turn left into Seaview. Travel up the entrance road until you see the sign on the right that says “SPACE,” with a hand pointing to the left. Follow that to the entrance and parking lot.

She tells us, too, that there is a Yahoo group called Parasites out of Paradise if anyone is interested in learning more.

There is some other good information that is coming out now.

I previously blogged about this here, here and here.