Hawaii sees spike in brain-infecting parasite

What you need to know about the brain-invading parasite called rat lungworm disease

Health officials in Maui, Hawaii, said six cases of a brain-invading parasite called rat lungworm disease have been reported on the island over the past three months. 

Three of the cases have been confirmed, while a seventh involves a Maui woman who believes she contracted the parasite on the Big Island, Maui District Health Officer Dr. Lorrin Pang said Tuesday.

A highly magnified image of rat lungworm parasite larva. U.S. Centers for Disease Control and Prevention

Hawaii’s second largest island has seen only two cases of the disease -- known to the medical community as Angiostrongylus -- in the past decade.

Rat lungworm disease is a condition in which parasitic worm larvae infect people’s brains. It is carried by rats and transmitted by snails and slugs.

Officials say residents can reduce the risk of contracting the potentially life-threatening disease by thoroughly washing fruits and vegetables before consumption.

Experts are still determining the best way to get rid of the invasive slugs, Pang said. Smashing, burying or burning them does not deter rats from eating them and restarting the cycle of rat lungworm.

“The slug is easy to kill, but the parasite, it’s not so easy,” he said.

State epidemiologist Dr. Sarah Park said there is an average of about 10 rat lungworm cases each year statewide and that the recent spike is concerning. A vast majority of Hawaii’s cases are reported on the Big Island.

The infection can cause a rare type of meningitis that triggers severe headaches and stiffness of the neck, tingling or painful feelings in the skin or extremities, fever, nausea and vomiting, according to the state Department of Health Disease Investigation Branch. Temporary paralysis of the face and light sensitivity may also occur.

“If you could imagine, it’s like having a slow-moving bullet go through your brain and there’s no rhyme or reason why it’s going to hang out in this part of the brain or that part of the brain,” Park said.

There is no specific treatment for the infection, according to the U.S. Centers for Disease Control and Prevention. Most infections resolve spontaneously, but sometimes surgery is required to remove portions of inflamed intestine.

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