Awareness is key in preventing and treating rat lungworm, the prevalent and serious disease often found in East Hawaii residents.
Franny Brewer, program manager at Big Island Invasive Species Committee, hosted an information session Saturday in Hawaiian Paradise Park about rat lungworm as part of BIISC’s education series.
About 30 people attended the meeting at HPP’s community center to learn about the best practices for preventing and treating the disease, which is caused by a nematode parasite found in snails and slugs.
“Every resident and visitor should be aware of rat lungworm and know the basics of protecting themselves from it,” Brewer said. “Awareness is key in increasing the sphere of protection. It’s a ton of information, but a lot of it is fairly straightforward.”
Brewer used most of the time Saturday talking and answering questions about protective measures that East Hawaii residents should take to prevent the spread of rat lungworm.
Controlling pest populations — specifically rats, slugs and snails — through poisonous bait, trapping, reduction of habitats and the use of repellents is difficult but effective in preventing rat lungworm from developing through its life cycle.
Brewer suggested using “slug jugs” that contain six parts water and one part salt — a combination that ultimately kills the slugs, snails and the parasite.
“Take an hour at night during the rainy season with a headlamp and just look for the slugs, pick them up with gloves, chopsticks or tongs, and put them in the slug jug,” Brewer said.
One of the most imperative preventative measures is to always inspect and clean every piece of raw vegetables and fruits, because slugs and snails are often consumed accidentally when people eat leafy greens or other produce.
During the presentation, Brewer specifically focused on catchment water, which is used by a majority of Puna residents and can become a habitat for rat lungworm larvae.
The Jarvi Lab at the University of Hawaii at Hilo Daniel K. Inouye College of Pharmacy is studying the rat lungworm larvae in water systems and found that the most common catchment filter system — sediment filters followed by ultraviolet light — may not be enough to keep out all larvae.
While the safest practice is to only consume and cook with potable water, the Jarvi Lab is experimenting with different methods to create a “veggie wash” that would reduce risk of infection.
Steel Argon, a researcher with the Hawaii Island Rat Lungworm Working Group, presented findings from the Jarvi Lab after they tested the effects of ozone, ultrasound and the combination of both on the larvae living in water.
All three methods showed promise in reducing the risk of rat lungworm after accidental consumption. However, ozone is highly reactive and a significant safety concern for everyday water treatment.
“Researchers at the Jarvi Lab are some of the only folks out there doing ongoing tests on treatments to water, particularly with catchment systems” Brewer said. “The paper published in 2022 can be difficult to comprehend, so it was great having him come out to speak directly and answer questions.”
Argon said the lab is continuing to test methods of water treatment, but common practices are still the safest option.
Brewer said that a commonly available over-the-counter pinworm medicine, containing the active ingredient pyrantel pamoate, could mitigate the development of serious rat lungworm disease if taken within six hours of accidental ingestion.
“If there are no parasites in the body, the medicine causes no harm, so I always try to encourage people to keep a box at home just in case” Brewer said. “We tell everyone that if they think they have rat lungworm to advocate for themselves, because this is newer to the medical community, especially for doctors from the mainland that haven’t been to Hawaii or know of tropical illnesses.”
Symptoms can be nonspecific in the beginning and evolve to more specific ones over the following weeks. Nausea, vomiting and abdominal pain could begin a few hours to a few days after ingestion, and then progress to headaches and other neurological symptoms.
More specific symptoms can include constant headache, neck stiffness and pain, tingling or burning of the skin, double vision, bowel or bladder difficulties and seizures.
While there are active studies about the disease, Brewer and Argon urge everyone to consistently follow common preventative measures for the safest outcome.
“If you live here, particularly in East Hawaii, the basics are critical to health. There are many survivors living with lifelong disabilities due to the illness,” Brewer said. “Now with climate change, we’ve seen it originate on the mainland, so this is part of the future for many people, and we should all take it seriously.”
BIISC hosts its education series for free every third Saturday of the month at the community center in HPP. For more resources and information, visit biisc.org.
More information about the Jarvi Lab can be found at pharmacy.uhh.hawaii.edu/research/jarvi-lab.
Email Kelsey Walling at kwalling@hawaiitribune-herald.com.