For years now, residents have read about the rare but potentially deadly disease found on Hawaii Island that can strike people after eating unwashed greens from their backyard gardens.
For years now, residents have read about the rare but potentially deadly disease found on Hawaii Island that can strike people after eating unwashed greens from their backyard gardens.
But to read a scholarly study or newspaper article about the effects of rat lungworm disease and to hear directly from the people who fought to survive its crippling symptoms are two very different experiences.
That’s why researchers at the University of Hawaii at Hilo have partnered to produce an hourlong video featuring the firsthand accounts of six East Hawaii residents who contracted and survived the debilitating parasite.
“I wanted to hear their own voices,” explained UH-Hilo researcher Mark Kimura, who conducted the interviews and put the film together with Kay Howe, a tropical conservation biology and environmental science graduate student. “It feels closer than reading about it.”
Indeed, the interviews contained in the video are riveting at times as the victims detail their agonizing experiences.
Hilo residents Shawzy and Jeremai Cann were the most recent victims, having fallen ill last year around October. They said they believed they contracted the parasite from a vegetable smoothie they made with produce purchased at a farmers market.
The first week, Shawzy Cann said, involved terrible fevers, sweating and grinding of their jaws as they slept, among other symptoms. By the second week, things started to get really bad.
“Your skin starts crawling. It’s almost as if every wound, every ‘owie,’ every scar, every injury you’ve ever had in your entire life is recorded in your central nervous system,” she said. “And when this happens to you, all of those come back. … Then by the second or third week I was walking with a cane because my whole right side was paralyzed. I couldn’t walk anymore. … Your vision becomes very sensitive; You need to wear sunglasses inside the house.
“The worms go into your central nervous system … and start creating havoc. … You just feel like it’s not your body anymore and you’re not in control. … I had a headache for five days. It was excruciating. … It’s the worst headache you’ve ever had in your entire life.”
Wa‘a Wa‘a residents Sherry and Rex Palmer say they both fell ill from rat lungworm, but Sherry displayed the worse symptoms of the two.
“She was so sick,” Rex Palmer said. “I mean, I had pain, but she was really, really in agony. And I don’t ever want to see anybody go through that again.”
Hawaiian Paradise Park resident David Johnson, who said he thought he’d contracted the disease after handling dozens of slugs in his back yard, described his recovery as a long and painful process.
“I know that I wouldn’t be able to make it through a second round of this,” he said. “It’s just too hard. I don’t know how anyone can.”
In addition to sharing with the filmmakers the pain they experienced, the video’s subjects also detailed the difficulty they had in arriving at a diagnosis with their doctors, often taking a long time, with multiple visits to the hospital and to different physicians.
“They all had very similar experiences,” Kimura said. “Some doctors didn’t know about (rat lungworm) and dismissed it. There were some informed (doctors) and some misinformed ones. But that was a common theme.”
The subjects of the documentary also shared important warnings for other Hawaii residents.
Shanna Rose, a Kapoho gardener, farmer and beekeeper, said she was certain she had become ill from eating greens grown in her back yard, despite the fact that she had heard of rat lungworm and was aware of the problems slugs and snails can pose.
“I remember seeing the slugs in my garden, and thinking, ‘Well, you know, I’m going to wash these greens. It rains all the time. There was no education about it. Part of the back of my mind was like ‘Slugs? Problem? Maybe. But not enough, obviously, to pay the kind of attention I should have,” she said.
For the past 10-15 years, Hawaii Island, and more specifically the Puna district, has been ground zero for human cases of angiostrongyliasis, or rat lungworm disease — so named because of the development cycle of the parasitic worm, said Susan Jarvi, a professor and chair of the Department of Pharmaceutical Sciences at the Daniel K. Inouye College of Pharmacy.
The parasite requires two hosts to develop — rats and snails (or slugs). Ingestion of the microscopic nematode can occur through eating raw produce, through water, or potentially from skin contact.
The Centers for Disease Control and Prevention says that serious cases of angiostrongyliasis are rare, however Hawaii Island has had an abnormally high rate of infections, possibly because of the high number of people on catchment water, or the recently established population of invasive semi-slugs in Puna.
“Rat lungworm disease can and has resulted in severe neurological trauma for those individuals having a serious infection,” reads information accompanying the video on its YouTube page at youtu.be/r88WNCxAjQ8.
In an attempt to combat rat lungworm on Hawaii Island, Jarvi has set up a petition at www.thepetitionsite.com/529/190/532/demand-action-to-stop-rat-lungworm-disease-in-hawaii-now/ asking state and federal officials to provide funding for further research into the disease.
Jarvi said that rat lungworm has garnered little attention because it infects so few people, and because it is primarily found in East Hawaii, far from the state capitol.
On further research and education, she said, “the Department of Health is not doing it, the CDC is not doing it. Somebody has to do it and let the people know the potential seriousness of this disease.”
One area she says is in urgent need of further research is the possible transmission of the parasite through catchment water. Recent data show that if a slug or snail crawls into a catchment tank and drowns, the parasites can exit the host body and survive in the water up to 56 days. And informal experiments have shown that those parasites tend to drop to the bottom of the tanks, which is where the output pipes collect water for delivery into the home.
“How effective is a 20-micron filter in blocking the parasite from getting into the water supply? We need to look at that,” she said.
Jarvi said she lives off of a catchment system in Puna and she uses a combination of a 20-micron filter, a 5-micron filter and a UV filter system.
For more information, visit the Facebook Rat Lungworm Working Group page, or visit UH-Hilo’s page on the subject at pharmacy.uhh.hawaii.edu/rlw/overview.php.
Also, if you would like to donate to a GoFundMe account set up by Howe to raise money for a schools education program about rat lungworm, visit www.gofundme.com/vhehjqtg.
Email Colin M. Stewart at cstewart@hawaii tribune-herald.com.