“It was like someone suddenly took a lei needle and pushed it through the soft spot on top of my head, then pushed it down below my left ear, then up to my left temple, then moved from back to front behind my right eye. As the lei needle pain shot out through my right eye there were flashing white lights.”
Tricia Mynar started feeling under the weather on February 24. She initially thought she had the flu, but it didn’t take long for her to realize that something far more serious was going on.
The preschool teacher felt her first symptoms of angiostrongyliasis – also known as rat lungworm disease – while temporarily assigned to work for a month on Hawaii Island.
She discussed her ordeal in a recent interview with Tad Bartimus of Honolulu Civil Beat, and the details are terrifying.
Mynar said she had chills, and thought she had the flu. Her doctor gave her Tamiflu.
But a few days later, Mynar noticed a new and unusual symptom: pain, and lots of it.
“My flu was better but I had this weird sensation in my right foot, like someone had dropped a suitcase on it.”
More pain came, this time shooting from her scalp down her spine into her back.
“I became so sensitive to any kind of wind that blew through my house I had to stand up and rest my head on the kitchen counter to get any kind of sleep. I couldn’t lay down on anything because of the pain.”
She was given medication for the pain. Two days later, the pain was spreading, and Mynar suspected the flu wasn’t the culprit.
Mynar flew back to Maui, and her doctor did some blood tests. Her results showed a parasitic level of 19. She told Bartimus the normal range is 6 or lower.
Her doctor told her to go to the ER, and there, she saw a physician who had heard of rat lungworm disease. Mynar agreed to a lumbar puncture to test her spinal fluid, which is the only way to confirm the diagnosis. Her results came back positive. She was admitted and spent the next week in the hospital.
Mynar is now recovering under her parents’ care, but her ordeal is far from over:
“I have parasitic meningitis,” Mynar said. “The parasites are in the lining of my brain, moving around. Because I work with children I try to tell stories through word pictures. My visual graphic for what’s happening is that every once in a while somebody opens the top of my head, sets a hot iron inside my brain, then pushes the steam button.
“I have a half dozen medicine bottles, several for pain because any movement of my head spikes my pain level to 12. I don’t see any improvement, just that every day is a different day, different pain. Tremors are the hardest part. They affect me so bad that sometimes I can’t hear my own speech. My whole walker starts shaking.”
Mynar is not alone. Six cases of rat lungworm have been reported on Maui over the past three months — tripling the amount of cases the island has seen in the past decade, Maui District Health Officer Dr. Lorrin Pang said Tuesday.
What IS rat lungworm disease? Maui News explains:
The disease is commonly spread through contact with the invasive “semi-slug,” which is prevalent on the Big Island, where the vast majority of cases are reported in Hawaii. Rats host the worm and pass larvae through their feces, which are eaten by the slugs. Humans are then infected after eating raw fruits and vegetables contaminated by the slug.
The infection can cause a rare type of meningitis that causes severe headaches and stiffness of the neck, tingling or painful feelings in the skin or extremities, low-grade fever, nausea and vomiting, according to the state Department of Health Disease Investigation Branch. Temporary paralysis of the face may also occur as well as light sensitivity.
There is no cure, and the disease is quite serious.
“It’s pretty bad,” Pang said of the worm, which attacks the brain and spinal cord. “Some of the damage is permanent.”
KHON2 talked to Mynar, and to experts about how to prevent the disease.
Hawaii State epidemiologist Dr. Sarah Park also talked to KHON2, and she said the number of current cases is concerning.
Very few cases have been reported in the continental United States. In 1993, a boy in New Orleans got infected by swallowing a raw snail “on a dare.” The type of snail he swallowed isn’t known. He became ill a few weeks later, with muscle aches, headache, stiff neck, a slight fever, and vomiting. His symptoms went away in about 2 weeks, without treatment of the infection.
According to the Centers for Disease Control and Prevention (CDC), it is possible that eating undercooked or raw animals that are infected could result in people becoming infected, though the evidence for this is not as clear as for eating infected snails and slugs. Of note, fish do not spread this parasite.
To avoid infection, the CDC recommends the following precautions:
Don’t eat raw or undercooked snails or slugs, frogs or shrimp/prawns. If you handle snails or slugs, wear gloves and wash your hands. Always remember to thoroughly wash fresh produce. When travelling in areas where the parasite is common, avoid eating uncooked vegetables.
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Lily Dane is a staff writer for The Daily Sheeple. Her goal is to help people to “Wake the Flock Up!”