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A killer parasite invading the brain hides on a mid-snail / half-slug creature before slipping into a salad, just waiting to be swallowed by hungry humans. Is the plot of a movie B or a real medical threat?
Unfortunately, the threat is real. According to a new survey, the parasite "rat lungworm" carried by slugs and snails has already caused more than ten years of disease.
Between 2007 and 2017, rat lungworm disease – clinically known as angiostrongylosis – is likely to be at the root of a battery of serious neurological problems affecting 82 men and women, two of whom died as a result of their disease.
"Cases of rat lungworm have been identified in Hawaii since 1959, so it's not new to the islands," said study author David Johnston of the Ministry of Health. of Hawaii Health. However, the department only started tracking cases at the state level in 2007. Thus, only now has Johnston and his team obtained accurate figures: 51 definitive cases and 31 cases "Likely" among Hawaiian residents and visitors over a decade.
But what is it exactly? And who is really at risk?
As its name suggests, the parasite is first borne by rats, which excrete rat lungworm eggs into their excrement. These feces are then consumed by a variety of snails, slugs or semi-slugs.
In the United States, the concern is mainly limited to Hawaii. But the parasite in slugs has also been observed in other areas, particularly in the Gulf Coast region of the Southeastern United States.
And wherever the parasite goes, human exposure can follow.
Sometimes this is the result of the intentional consumption of slugs on a challenge, noted epidemiologist Johnston.
But most often, the infection is accidental, after the creatures make their way into unwashed, poorly stored or grown products, and people consume it without knowing it.
In any case, the result is the same, said Johnston. Generalized inflammation causes headaches, body aches, pains, sensitive skin and a stiff neck. Vomiting, nausea and blurred vision can also occur, as well as paralysis of the face and limbs. And children can develop fever or become irritable.
Most patients end up hospitalized. In rare cases, intense pressure accumulates in the brain, possibly causing coma or even death.
But the good news is that rat lungworm eggs do not become adult parasites. Instead, they end up dying. With time and treatment, almost all affected patients recover completely.
And despite the diagnosis of 21 Hawaiian cases in a given year, the average case was only seven patients per year between 2007 and 2017.
So, even though Hawaii has had 10 more exposures in 2018 and five more – so far – in 2019, Johnston has pointed out that the overall risk remains low.
At the same time, he and other pest experts said the solution was to increase public awareness and encourage good hygiene and increased vigilance.
In this regard, the Hawaii Department of Health has provided useful tips, said Elizabeth Scott, associate dean of the college of natural sciences, behavior and health at Simmons University in Boston.
This implies, she added, not to eat raw or undercooked snails or slugs, or to boil all snails, prawns, crabs and frogs for at least 3 to 5 minutes. Thorough cleaning of all products, especially leafy vegetables, is also recommended.
This advice was supported by Dr. Bradley Ford, Director of Clinical Microbiology at Hospitals and Clinics at the University of Iowa.
"It's a kind of charismatic and friendly snail," he said. "But it happens that the parasite is transported, although this is not the only way to get a parasite.The fish carries these things.You can eat sushi and get a parasite."
"So, in the end, the risk is low," Ford said. "But the big picture is just do not eat raw food."
Johnston's study was published online July 8 in the American Journal of Tropical Medicine and Hygiene.
More information
For more information on rat lungworm disease, see the State of Hawaii's Department of Health.
Copyright 2019 HealthDay. All rights reserved.
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