Rat lungworm disease has again reared its ugly head in Hawaii, specifically the Big Island, where five people have fallen ill this year. None are quite sure how they were infected with the parasitic worm, though one traveler recalls "eating many homemade salads" on a trip, while another had eaten raw, unwashed produce straight from the land, said health officials, who warned that all produce should be carefully washed. The worm lives in rats, and can be passed to humans through snails and slugs that eat infected rat poop and then feast on produce. Eating uncooked snails, shrimp, or frogs also is a danger. This week, the state health department described three recent, unconnected cases affecting travelers from the mainland US, reports CNN.
Hawaii, where 80% of land snails are believed to carry the parasite, averages about 10 cases a year, a number reached in 2018. Three toddlers and a child were among those sickened last year, per the Washington Post. The parasite, which is not contagious, has been confined to adults in 2019. Still, "it's important that we ensure our visitors know the precautions to take to prevent rat lungworm disease, which can have severe long-term effects," says the state's health director. While symptoms are often mild or non-existent, the disease can also lead to "neurologic dysfunction or death," according to the CDC. (A man died eight years after eating a slug on a dare.)