HONOLULU (KHON2) — Researchers from the University of Hawai’i at Mānoa have announced a new resource for healthcare providers to diagnose and treat rat lungworm disease

A new study has been published by University of Hawai’i researchers, professors Robert Cowie and Vernon Ansdell, as a means of educating medical professionals on how to diagnosis and treat RDL as cases increase.

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“We published this paper as a means to broaden knowledge and understanding of rat lungworm disease, especially among the medical community but also to help spread the word to the general public,” said Cowie, lead author of the study and research professor at the Pacific Biosciences Research Center in the UHM School of Ocean and Earth Science and Technology

According to the researchers, global warming is increasing the number of diagnosed cases, and the disease is spreading into parts of the world where healthcare providers have never seen any cases.

Misdiagnosis is the issue with RLD. This study aims to mitigate those misdiagnoses so that patients can receive treatment in time rather than having to wait for months to find out what is causing their symptoms.

“Currently, we believe that diagnosis in acute illness is best achieved with polymerase chain reaction [PCR] tests that detect parasite DNA in cerebrospinal fluid,” said Ansdell, associate professor at the UHM John A. Burns School of Medicine and co-author of the new study.

Rats, slugs/snails, prawns, frogs, toads, centipedes and land crabs are the hosts for these parasites as they pass through their many stages of life. RLD is contracted when a person accidentally or knowingly eats a raw or undercooked animal that is infected with the rat lungworms.

Once infected, rat lungworms make their way to the brain and spinal cord. This causes swelling with some instances leading to paralysis, death or chronically disabling neurological symptoms.

“The prevalence of human infection depends especially on eating habits, so as it spreads around the globe, people need to be made aware of how to avoid it, as best as possible,” said Cowie. “We need communities and medical professionals to be prepared with accurate information to avoid, diagnose and treat this disease.” 

RDL symptoms include headache, fever, nausea, rash, anxiety, migratory pains, tingling of the skin which may become super-sensitive and weakness with other symptoms possible.

“Concerns regarding severe inflammatory reactions with anthelmintics are proving increasingly unwarranted,” said Ansdell. “We do recommend, however, that anthelmintics are given with corticosteroids to limit any possible inflammatory reactions. There’s increasing evidence that early treatment with corticosteroids and anthelmintics is safe and effective. The hope is that early combination therapy may limit the severity of disease and complications such as long term disability.”

  • A container filled with male and female adult rat lungworms. They have candy cane color and pattern. (Photo/Randi Rollins via University of Hawai'i.
  • Lissachatina fulica or giant African snail in a puddle of water in Mānoa, Hawai'i. They are carriers of rat lungworms. (Photo/Randi Rollins via University of Hawai'i)
  • Parmarion martensi aka semi slug on taro leaf in Maikīkī Valley, Hawai'i. They are carriers of rat lungworms. (Photo/Randi Rollins via University of Hawai'i)

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“Though not yet approved for general use, more recent research has resulted in highly sensitive PCR tests that aim to detect very small amounts of rat lungworm DNA not just in spinal fluid, but also in blood, possibly alleviating the need for lumbar puncture for diagnosis,” explained Ansdell.