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Doctors rely on clues such as what people ate, where they traveled or where they lived, to determine the possible exposure to the parasite. But this requires being constantly aware of the prevalence and distribution of worms, Dr. Martell said.
If all signs suggest an infection, the doctor can test the patient's cerebrospinal fluid. This can help relieve the intense pressure exerted on the brain and spinal nerves, as well as provide more clues for the diagnosis. A high level of eosinophils – a type of white blood cell – may indicate that the patient's immune system is attempting to fight the rat lungworm infection.
Unfortunately, a positive result does not always appear in the first test, said Sue Montgomery, parasitologist at the Centers for Disease Control and Prevention. In these cases, physicians may need to perform another painful lumbar puncture and collect cerebrospinal fluid samples. They may also request special molecular tests to confirm the presence of rat lungworm DNA.
Researchers at the University of Hawaii in Hilo hope to develop a less expensive and less invasive blood test to enable faster diagnosis. The results were promising: First data in rats indicate that the test can detect parasitic DNA circulating in the blood at different times after infection.
The team has also successfully detected rat lungworm DNA in greenhouse and coqui frogs, cane toads, centipedes, dogs, cats, mongooses and horses, according to Susan Jarvi, specialist diseases.
"Our rats in the east of the island of Hawaii are very infectedDr. Jarvi said, "so it's not surprising that the disease is occurring in other mammals."
The rat lung worm has been present in Hawaii for several decades, probably on ships coming from Southeast Asia. But a new Asian graft, a semi-slug called Parmarion martensi, may have helped spread the parasite further, said Dr. Jarvi.
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