Rat lungworm treatment guidelines updated: University of Hawaiʻi

University of Hawaiʻi

two pictures, a rat and rat lungworms, with words Rat Lungworm Disease below it

In Hawaiʻi, rat lungworm disease is responsible for many cases of debilitating illness every year sometimes resulting in death. The clinical subcommittee of the state’s Joint Task Force on Rat Lungworm Disease has recently revised the preliminary guidelines for the diagnosis and treatment of rat lungworm disease. Led by Vernon Ansdell, an internist and associate professor at the University of Hawaiʻi at Mānoa John A. Burns School of Medicine (JABSOM), the updated recommendations were published in the journal Parasitology.

ansdell headshot
Vernon Ansdell

Most people in Hawaiʻi are believed to become infected after eating green leafy vegetables contaminate d with slugs or snails infected with Angiostrongylus cantonensis, a nematode worm. Cases of rat lungworm disease appear to be more severe in Hawaiʻi than in other parts of the world, possibly due to recently introduced semi-slugs that often contain large numbers of A cantonensis larvae.

Ansdell says the new guidelines emphasize both early diagnosis and early treatment using high dose corticosteroids to reduce inflammation in the central nervous system, and antiworm treatment with albendazole to kill worms at an early stage before they grow and cause significant damage. In addition, new, more sensitive tests of the cerebrospinal fluid and blood being developed by the National Institutes of Health may help with earlier diagnosis.

“Early diagnosis is very difficult because most cases present with vague, nonspecific symptoms, resulting in significant delays in treatment,” said Ansdell. “Current evidence suggests that early diagnosis and treatment could result in improved outcomes with long-term disabilities and deaths.”.

“We need detailed information on cases in Hawaiʻi

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