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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 as they arise,” Ansdell added. ”Collaborative international clinical research will help us to learn more about the diagnosis and treatment of this challenging disease.”

Read more on the JABSOM website.

This work is an example of UH Mānoa’s goal of Excellence in Research: Advancing the Research and Creative Work Enterprise (PDF), one of four goals identified in the 2015–25 Strategic Plan (PDF), updated in December 2020.

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