by Kay Howe
Cases of eosinophilic meningitis caused by the rat lungworm parasite have risen sharply in Hawaii over the past 5 years. The parasite, a nematode (Angiostrongylus cantenosis), was carried from SE Asia to Hawaii by rats, which are the host. There is a possibility that there may be two species of the parasite in Hawaii. Angiostrongylus cantonensis has been identified in Hawaii, which causes human eosinophylic meningitis. Angiostongylus costaricensis has not yet been identified here but causes human abdominal angiostrongylisasis, affecting the digestive track and bowels. Many victims in Hawaii have had symptoms that suggest infection by Angiostongylus costaricensis.
The parasite can be transferred to slugs, flatworms and snails in the 3rd larval stage. Humans pick up the parasite by ingesting slugs/slug slime contaminated fruits /Vegetables/water or raw or undercooked slugs, snails, mollusks, prawns and monitor lizards. Humans are a dead end host, the parasite will not develop to sexual maturity and will eventually die, but may live for up to a year in the human body. While the parasite has been in Hawaii a long time, cases of illness have risen with the increase in the population of an invasive semi-slug (Parmarion martensi), which is native to SE Asia and was introduced to Hawai’I in the late 1990’s. Studies done in Hawai’i in 2005 shows 75.5% of semi-slugs collected on the Big Island to be infected with the parasite.
Severe cases of eosinophilic meningitis began to surface in the Puna district of Hawaii and in 2008 two victims became comatose from severe inflammation of the brain caused by the parasite. My son, Graham McCumber, was one of these. His body still bears the scars of the tracheal tube, stomach tube, and incisions to remove an infection caused by pneumonia that perforated the lung wall. At one point he had so many tubes coming out of his body it was hard to believe he would ever recover. The goal of this informational /educational outreach is to spare others the nightmare of pain that we, and others, have experienced.
Graham turned 24 years old in the hospital in 2009. Before he got sick he was an avid surfer and skateboarder and worked as a carpenter and stonemason. He was strong, athletic and had his whole life ahead of him. Then he got sick with rat lungworm. The parasites attacked his nervous system and brain causing severe inflammation that led to coma. Though the doctors predicted that Graham’s brain damage was so great he would never recover, today, 9 months after becoming sick with rat lungworm, he is walking, talking, eating and living. Because of damage to the brain stem and cerebellum and weakness from 3 months months in a coma he has had to relearn how to use his body. His eyesight was affected and his left eye turned completely inward from damage to nerves controlling to the ocular muscle, causing double vision. This issue is slowly reversing itself but he still has double vision, which adds to his problems with balance. Every major organ in his body was affected, which has caused a host of other problems. Even his vocal chords and voice was affected.
Currently, my entire life revolves around helping Graham get well. We have met many people who have had the disease and the majority of them still suffer from symptoms caused by neurological damage inflicted by the parasite; some are still on morphine as the pain is still so great even years later. I cannot emphasize strongly enough that you do not want to get rat lungworm!!
Symptoms are flu-like and usually start with a headache, most often severe, and stiffness in the neck. There may be fever, joint pain, fatigue and nausea. The skin may feel itchy, like something crawling under it, and then become extremely sensitive to touch. I know of people who years after having had rat lung cannot wear shirts or long pants because their skin is still so sensitive touch. There are victims who take daily doses of morphine to help them endure the nerve pain they still experience 2 and 3 years later.
In Graham’s case he had most of the above symptoms and the bladder was affected and he was unable to urinate. This symptom has been reported in other cases of rat lungworm and is called Elsberg Syndrome. Rat lung victims may also experience hallucinations, disorientation, vision problems and visual impairment. Complete paralysis may set in, as happened to Graham. Short-term memory loss, which Graham also experienced, seems to be common in serious cases. The person from Hawai’i mentioned earlier was unable to talk or walk, had partial facial paralysis and memory impairment.
Hawai’i and US mainland medical centers have very little or no experience with rat lungworm, and scientific and medical research is sorely lacking. Medical treatment in Hawaii is currently based on that used in China, Thailand and Taiwan for rat lungworm victims. If a person is hospitalized, steroids and possibly anti-parasite medication will be administered. The steroids dampen the body’s immune system response, which goes into overdrive attacking the parasite. Inflammation in the brain (meningitis) becomes the major concern, spinal taps may be used to reduce pressure in the brain/spinal column and the patient will be put on pain medication. Whether to give the patient anti-parasitic medications will be carefully weighed, as they can cause a die off of parasites and create even more inflammation. In Graham’s case there were so many parasites that their tracks could be seen in his brain MRI along with significiant swelling, inflammation and impact on neural tissue. Therefore we decided to go ahead and treat with the anti-parasite medicine. I do not know if all of Hawai’i’s medical centers have come up with a standard procedure for treatment for rat lungworm victims, but I do know the Hilo Medical Center did due to the high numbers of people who were hospitalized with serious cases it in 2008/09.
There are rat lungworm victims who have chosen to use alternative medicine. Some have had remarkable recoveries and some have not, the success rate may be the same as that of treatment with traditional western medicine. All of these alternatives are worthy of research to find a way to help rat lung victims. We have used a number of alternative medical approaches including acupuncture, the use of herbal medicines, intravenous vitamin therapy, colonics and hypnosis. I gave Graham daily doses of noni through the stomach tube on a friend’s recommendation that it helped relieve his pain. Graham did not have any skin pain when he came out of the come even though he had severe pain when he first entered the hospital. I believe noni to be a very helpful medicine for rat lung. We also gave Graham daily doses of spirulina, chlorella and a Chinese herbal medicine, Xing Nao Wan (Bu Nao Pian is similar and can also be given) to recover the function of nerve cells. This was administered in a Chinese hospital to a patient with a case similar to Graham’s and was shown to have positive results. The acupuncture treatments brought Graham back to consciousness, and even though he was still considered to be in a coma, he was very present and able to communicate through his emotional responses. He always smiled when asked if he wanted acupuncture. I believe the acupuncture protected his organs from the medications and gave them balance and vitality.
We started intravenous vitamin therapy late in Graham’s recovery as it was not something the hospital offered. I was very impressed with the recovery of a young woman who contacted a very bad case of rat lung in January 2009. The therapy consists of a vitamin injection known as a Meyers Cocktail, which has high doses of vitamin C, the B vitamins and an assortment of other vitamins and minerals. This treatment is alternated with intravenous injections of phosphidylcoline and glutathione. The combination detoxifies the body, supports nerve cell regeneration and cell membrane functions. The injections at first made Graham very tired but we began to notice an improvement in his balance and movement as well as his eyesight. His left eye began to straighten out and the muscles controlling it began to strengthen, helping his eyes to begin tracking better. His vision is not perfect but it is getting much better.
Bowel and bladder control is sometimes affected by rat lungworm. Graham was finally admitted into the hospital because he could not urinate. When he was released from the hospital he could urinate, but he has a lot of issues with his bladder, which makes it difficult to urinate quickly, especially at night. Constipation also seems to be an issue with victims of rat lungworm. We have seen good results from doing a series of colonics. Not only has it helped with the detoxification process, ridding the body of any medications, dead cells and necrotic tissue, it has also helped improve bowel function and regularity. The combination of the colonics and vitamin therapy has definitely generated an improvement in overall health, balance and vision. Experimental treatments can be administered for testing as possible treatment for victims of rat lungworm.
It is difficult to say how long Graham’s complete recovery will take and whether there will be some things he will have to learn to live with. His case is a testimony to the medical profession that a person can recover, but the body must be given proper support. I believe that Graham’s age is a large factor in his recovery, I am not at all sure that an older person would be able to recover if they were in as serious a condition. A woman was hospitalized around the same time as Graham and went into a coma just before he did. She is 14 years older than Graham. Her recovery is not very promising even though she is in a very good medical facility in Germany.
Rat lungworm can change and destroy a person’s life and has already done so here in Hawai’I. We need to get health officials in Hawaii and at the Center for Disease Control (CDC) to recognize this. The CDC website currently states that rat lungworm is not a problematic disease and symptoms will resolve themselves in 2-3 weeks. There could be nothing further from the truth. Thankfully doctors and medical centers on the Big Island are beginning to recognize the problem, due to the number of cases. Early diagnosis and treatment may have helped Graham and the other woman who went into a coma. Both of them were turned away from the hospital several times before doctors realized it wasn’t flu. My sister, who has her PhD in physiology and personally knows people who have gotten rat lung in and past 3 years, stated she believed he had rat lungworm the first time she took him to the emergency room and reiterated it the second time, asking for them to give him steroids for inflammation, but the doctors did not want to listen to her. I cannot help but wonder if things would be different if they had treated him immediately.
Rat lungworm affects everyone living in Hawaii, whether you buy your vegetables in Costco or at the local market. It affects the good work being done to support local food production and small, organic farms. It is a irresponsible and an uneducated response for the state, press or medical profession to make generalized statements that victims of rat lungworm all had one thing in common; they all were backyard gardeners and/or had /unorthodox living situations. Having a garden is not a crime or a strange thing to do. Home gardens are a part of our legacy and lifestyle, and provide solutions for many issues. The problem is not with home gardens or locally grown food, the problem lies more with invasive species finding their way to Hawaii; rats, the primary carrier, and an invasive slug that carries high loads of the parasite and whose population is increasing and spreading on the islands. It would be wise for scientists to determine if mongooses also carry the parasite, as they are quite similar to rats.
As the rainy season begins, slugs will begin to emerge and the potential for infection will become greater. Personal diligence is key to prevention until the research can provide us with more knowledgeable information, including proper food treatments that will kill nematodes on uncooked foods.