Saturday, September 1, 2018

PRO/AH/EDR> Angiostrongylus cantonensis - USA (06): (HI) distribution

ANGIOSTRONGYLUS CANTONENSIS - USA (06): (HAWAII) DISTRIBUTION
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Date: Fri 31 Aug 2018
Source: The Molokai Dispatch [edited]
<https://themolokaidispatch.com/rat-lungworm-parasite-found-on-molokai/>


A recently released University of Hawaii study has confirmed the
presence of rat lungworm on Molokai and on every island throughout the
state except Lanai. Rat lungworm [_Angiostrongylus cantonensis_] is a
parasite that has a complicated lifecycle that requires slugs or
snails as well as rats to mature. Ingesting a slug or snail infected
with the parasite can cause neurological damage, pain and disability,
and Hawaii has seen a recent influx of cases of the rare disease.

Researchers tested 11 sites on Molokai starting in 2004, and 2 sites
had a total of 4 slugs or snails that tested positive for rat
lungworm, according to Robert H. Cowie, University of Hawaii research
professor and senior author on the study. The 2 sites were central
Molokai near the forest reserve and east end near Halawa Valley.
Although the study showed limited dispersal of the disease-causing
parasite on Molokai, Cowie said it does not mean that it is not more
widespread. "Non-detection in a particular area does not mean it is
absent in that area, just that we did not detect it in our samples,"
he said, via e-mail. "And as you can see, we did not do a very broad
survey of the island. So it could be more widespread on Molokai than
our data show."

Nonetheless, just as elsewhere, rat lungworm is not in every
snail/slug. Across the state, researchers used molecular techniques to
screen almost 1300 snails and slugs representing 37 species from
almost 200 sites on each main island. In general, the study found the
spread of rat lungworm to be more prevalent at lower elevation sites
with warmer temperatures and higher rainfall. Researchers also
developed mathematical models to make predictions on the parasites
growth under anticipated climate conditions in the year 2100.

"Under these future climate conditions, rat lungworm was predicted to
expand its range to higher elevations in Hawaii," stated a University
of Hawaii release. "The findings imply that the parasite could also
expand its primarily tropical and subtropical range globally to
regions that are currently more temperate."

Although rat lungworm disease has existed for years, the Hawaii cases
increased after the invasive semi-slug came to the islands in the
early 2000s, according to Department of Health's District Health
Officer Dr. Lorrin Pang, who visited Molokai last year [2017] to
educate the community on the disease. According to Pang, the semi-slug
is known as the most common type to carry the parasite, but Cowie said
the snails or slugs that tested positive on Molokai were of 3
different species.

Humans can contract the disease by ingesting an infected snail or
slug, or its slime. Although symptoms generally include extremely
painful headaches, Pang said an infected individual will not notice
any symptoms until the parasite has reached the brain -- which happens
within about 18 hours of eating it. Once in the brain, he said there
is no treatment, and it cannot be removed but the parasite will die
there.

So far this year [2018], there have been 5 confirmed cases of rat
lungworm disease in Hawaii, with a toddler from Hawaii Island
contracting it [in August 2018]. Experts agree the best prevention is
to thoroughly wash all produce before eating it. Pang said "to hand
rinse each vegetable leaf -- soaking in water won't work.
Alternatively, you can cook the heck out of it, or freeze it for 24
hours." Pang also said boiling for at least 3 to 5 minutes will kill
the parasite. "No doubt people are mostly aware of the [Department of
Health's] media efforts to inform people that they should thoroughly
wash produce, taking special care with leafy greens in which a small
snail/slug could easily hide and be missed and then inadvertently
eaten," said Cowie.

"All produce, not just local produce, should be washed anyway, as
there are other harmful things like bacteria and pesticides that could
be on produce regardless of where it came from. Experts suggest
controlling the snail, slug and rat populations as a way to help
prevent the spread of the disease. But remember rat lungworm disease
is rare, despite the headlines, so there is no need to panic," added
Cowie.

[Byline: Catherine Cluett Pactol]

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

[The original study: Kim JR, Wong TM, Curry PA, et al. Modelling the
distribution in Hawaii of _Angiostrongylus cantonensis_ (rat lungworm)
in its gastropod hosts. Parasitology 2018;21 Jun:1-8. doi:
10.1017/S0031182018001026.
<https://www.ncbi.nlm.nih.gov/pubmed/29925459>. - Mod.EP

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

[See Also:
Angiostrongylus cantonensis - USA (05): (HI) transmission:
http://promedmail.org/post/20180825.5986667
Angiostrongylus cantonensis - USA (04): (HI)
http://promedmail.org/post/20180818.5973796
Angiostrongylus cantonensis - USA (03): (TX)
http://promedmail.org/post/20180805.5948810
Angiostrongylus cantonensis - USA (02): (HI)
http://promedmail.org/post/20180226.5651881
Angiostrongylus cantonensis - USA: (HI) task force
http://promedmail.org/post/20180114.5557708
2017
----
Angiostrongylus cantonensis - USA (05): (HI) reservoir
http://promedmail.org/post/20171221.5518125
Angiostrongylus cantonensis - USA (04): (HI)
http://promedmail.org/post/20171001.5353796
Angiostrongylus cantonensis - USA (03): (HI)
http://promedmail.org/post/20170514.5035328
Angiostrongylus cantonensis - USA (02): (HI)
http://promedmail.org/post/20170502.5008629
Angiostrongylus cantonensis - USA: (HI)
http://promedmail.org/post/20170407.4955519
2015
----
Angiostrongylus cantonensis - Viet Nam: CM, contaminated snails
http://promedmail.org/post/20150716.3515583
Angiostrongylus cantonensis - Australia: (NS) canine
http://promedmail.org/post/20150511.3354007
Angiostrongylus cantonensis - USA (02): (HI)
http://promedmail.org/post/20150418.3306098
Angiostrongylus cantonensis - USA: (FL) introduced snails
http://promedmail.org/post/20150303.3204533]
.................................................sb/ep/rd/dk
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