A brain-infesting worm increasingly showing up in Hawaiian vacation destinations has many health officials on high alert and fearing the further spread of infection.
The parasite, Angiostrongylus cantonensis, has reportedly been found in Louisiana, Hawaii, and the Caribbean, but lives primarily in the Pacific Basin and Southeast Asia, according to the Centers for Disease Control and Prevention.
It lives in the blood vessels of rats’ lungs, but its larvae are expelled in the rats’ feces and infect slugs and snails, which can pass the larvae on to humans when ingesting raw or undercooked snails or contaminated fruits and vegetables.
According to ABC News, health officials in Maui reported that at least six cases of the parasitic infection have been reported in the last three months, which indicates an increase in cases over the past decade.
State epidemiologist Dr. Sarah Park said, “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.”
One of the Maui district health officers, Dr. Lorrin Pang, appeared on a Facebook Live video last week to explain to Maui residents the dangers of this disease. Pang claimed the parasite can survive in the host’s body for several months and cause inflammation from the body’s immune response, which can damage the nervous system or result in permanent brain damage, though it is rarely fatal.
“Our body realizes this is so foreign we attack it…by that time the worm is one inch big and by then it’s a major battle,” Pang said, describing how the immune system goes to battle to attack the parasite. “There is a whole lot of collateral damage…attacking the worm attacks ourselves and that is the issue.”
The CDCP report that symptoms associated with the parasitic infection can include severe headaches, temporary facial paralysis, neck stiffness, light sensitivity and vomiting, which can begin more than six weeks after initial infection.
Treatment is rather complicated to kill off the worm and holds the risk of causing further injury to the brain or nervous system. “An anti-parasitic drug could kill the worm but the problem is that the dying organisms can create a very severe inflammatory response and the patient can get worse,” said Dr. Constantine Tsigrelis, an infectious disease specialist with University Hospitals Cleveland Medical Center.
Health officials advise that travelers should not be deterred from visiting Hawaii, though they are urged to take precautions to avoid possible infection. “If you’re going to Hawaii, enjoy the local food but take those precautions regarding washing fresh produce, making sure salads have been washed and avoiding undercooked slugs, snails, crabs,” Tsigrelis said.
Washing hands and utensils after eating or preparing raw slugs, snails, or freshwater shrimp can prevent infection, as can thoroughly cleaning raw vegetables, according to the Hawaiian Department of Health. Boiling food for three to five minutes, or freezing it at 5 degrees Fahrenheit for 24 hours or more, kills the larvae. Clearing snails, slugs, and rats from gardens and other outdoor spaces can also prevent the spread of the worm.
Below is a video when the alarm was raised about this parasite worm in March 2015.
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