A Saturday morning meeting at Hilo Medical Center demonstrated how strongly area health providers want to strengthen their knowledge about rat lungworm disease.
A Saturday morning meeting at Hilo Medical Center demonstrated how strongly area health providers want to strengthen their knowledge about rat lungworm disease.
About 45 people attended the first such rat lungworm session for Big Island health providers, including ER doctors, pharmacists and even mental health experts, among others. Hospital spokeswoman Elena Cabatu said more sessions will be scheduled for health providers and the public.
Hilo Medical Center Medical Director Dr. Jon Martell said an old joke now has serious implications.
What’s worse than finding a slug in your salad?
Finding half.
“There is an enormous psychological burden that goes along with finding that half a slug in your salad,” Martell said.
Rat lungworm disease occurs when a human ingests a slug infected with rat lungworm larvae from rat droppings, which the slugs eat. Martell told attendees that rat lungworm could be a horror movie plot.
“This is the stuff of nightmares,” Martell said.
He said affected patients and their loved ones have complained about being turned away from emergency rooms because rat lungworm’s symptoms vary so much that it gets mistaken for other ailments.
At about day three to five, larvae enter the human central nervous system and burrow through the brain lining. Neck stiffness, difficulty urinating, migrating skin pain and severe headaches can occur.
Blood tests probably still won’t be helpful at this point, Martell said. The next ER visit, he said, will likely be for crisis — incoherence, coma, even death.
“When you get right down to it, we are pretty lousy at diagnosing rat lungworm disease,” he said. “But everybody is pretty lousy at diagnosing rat lungworm disease. There’s no standard blood test or set of symptoms. The only way to confirm this disease is to do a spinal tap.”
If a patient is comatose, he told the health providers, “don’t give up — it’s going to take a very long time. Most people will come out the other end — they will come out significantly impaired — but they will still be with us.”
Email Jeff Hansel at jhansel@hawaiitribune-herald.com.