Rat lungworm

Angiostrongylus cantonensis

An Anchorage woman was found earlier this year to have contracted rat lungworm disease while vacationing in Hawaii, according to a report Thursday from the Alaska Department of Health and Social Services.

The incident was the first such report of rat lungworm disease reported to the department’s Section of Epidemiology. The disease is medically termed angiostrongyliasis, in reference to the parasite Angiostrongylus cantonensis, commonly referred to as rat lungworm.

The U.S. Centers for Disease Control and Prevention states that the Angiostrongylus family parasites can cause severe gastrointestinal or central nervous system disease in humans, depending on the species. The species A. cantonensis, which had infected the Anchorage woman, can cause meningitis.

The report from the state Department of Health and Social Services described the case as “an unusual condition of public health importance.”

The patient, described in the report only as “middle-aged,” was vacationing in Hawaii in December. She reported eating “a variety of raw produce while dining at restaurants and eating food prepared for her in a private home,” the report reads.

“Although the source of infection was not identified, the patient likely became

infected by eating raw produce that contained an infected snail or slug,” the state report reads.

The woman told health officials she had not knowingly eaten any snails, crabs, shrimp, prawns, or other shellfish.

Upon returning to Alaska, the woman began experiencing symptoms that included headache, low back pain, dry cough, and a rash that started one week after her 10-day stay in Hawaii.

She had a brief episode of left facial weakness and arm tingling, and then went to an Anchorage emergency department after four weeks of the symptoms, according to the report.

“Several weeks after her initial evaluation, the patient’s symptoms had largely resolved without specific intervention,” the report reads

Hawaii Department of Public Health staff interviewed the woman in mid-February determined the case to be isolated.

The roundworm A. cantonensis is mostly found in tropical environments, according to Thursday’s report, but is also found in wildlife in some parts of the United States. It is not found in Alaska.

“Slugs and snails are intermediate hosts and rats are definitive hosts for A. cantonensis,” the state report reads. “Humans become accidental hosts for A. cantonensis by ingesting raw/undercooked infected snails or slugs or pieces of snails and slugs inadvertently consumed with chopped vegetables.

“It may also be possible for humans to become infected by ingesting the slime of infected snails/slugs or by eating undercooked transport hosts (e.g., freshwater shrimp, land crabs, or frogs,” it adds.

The state advises that people traveling to Hawaii or other locations in which the parasite might be present to take the following precautions:

• Avoid eating raw or undercooked snails or slugs.

• Only handle snails or slugs with gloves and wash hands afterward.

• Thoroughly inspect and rinse produce (especially leafy greens) in potable water.

• Boil snails, freshwater prawns, crabs, and frogs for at least three to five minutes prior to consumption.

Contact News-Miner Editor Rod Boyce at 459-7585. Follow him on Twitter: @FDNMeditor.