- Signs & Symptoms
- Risk Factors
- Treatment Options
- Eosinophilic Meningitis
Rat lungworm (Angiostrongylus cantonensis) is a parasitic roundworm. Death from rat lungworm is rare. However, this parasite causes life-altering disabilities.
- The person may become severely crippled and have chronic pain.
- Because humans are not natural hosts, the parasite cannot complete its natural lifecycle and dies over time.
- The infection is self-limiting.
In human hosts, this parasite tends to migrate to the brain and less commonly, the lungs. Rat lungworm can induce eosinophilic meningitis if it gets lodged and dies in the brain. Severe infections can result in coma or death.
The movement of the worm and the body’s immune system trying to fight off the worm cause significant damage to the body. Most people who have symptoms recover completely with symptomatic treatment over days, weeks, or months.
The infection can occasionally develop serious meningitis that needs specialized care.
What are the signs and symptoms of people with rat lungworm infections?
Symptoms of rat lungworm are diverse, making it difficult to diagnose. It is important to note that the signs and symptoms of rat lungworm infection can vary depending on the individual and the severity of the infection.
The Centers for Disease Control and Prevention (CDC) lists the following signs and symptoms of rat lungworm infection:
- Stiff neck
- Tingling or painful sensations in the skin or extremities
- Low-grade fever
- Nausea and vomiting
- Loss of appetite
- Pain in the abdomen
Severe neurological symptoms of rat lungworm infection
- Loss of coordination and balance
- Weakness in the muscles
- Facial drooping
- Difficulty speaking
- Confusion and disorientation
Additional signs and symptoms of rat lungworm
- Loss of consciousness
- Sensitivity to light
- Vision changes
- Rapid heart rate
- High blood pressure
- Swollen lymph nodes
- Difficulty concentrating
Some infected individuals have no or moderate symptoms. The symptoms could get severe and long-lasting.
The symptoms usually appear one to three weeks after exposure to the parasite but may take up to six months. Depending on the severity, symptoms can continue anywhere from a few weeks to several years. According to CDC, symptoms normally last two to eight weeks.
How are humans infected with rat lungworm?
Rat lungworm is a parasitic nematode that can cause a condition called angiostrongyliasis.
Potential causes of rat lungworm may include:
- Eating contaminated food
- The most common cause of rat lungworm infection. Raw or undercooked snails or slugs are known to carry the worm.
- People may intentionally eat raw or undercooked snails or slugs as part of their diet.
- Rat lungworms can transmit via other intermediate hosts, such as freshwater shrimp, land crabs, and frogs. These intermediate hosts can become infected with the parasite if they consume infected snails or slugs.
- Accidentally consuming infected water or soil
- Handling contaminated animals, such as snails, slugs, or rats
To reduce the risk of infection, thoroughly cook all snails and slugs before eating them. Because rat lungworm is not directly transmitted from person to person, it cannot be spread through casual contact with infected individuals.
Who are at risk of getting infected with rat lungworm?
The rat lungworm can be found worldwide, including in the United States, Southeast Asia, and the Caribbean. The parasite is most common in the southeastern states and Hawaii in the United States. The risk of rat lungworm infection varies because of factors, including the parasite's prevalence in the area and an individual's likelihood of coming into contact with infected animals or their feces.
Consuming raw or undercooked snails or slugs is one of the most dangerous risk factors. The heat from cooking can kill the parasite and prevent infection.
Other risk factors include:
- Living in or traveling to an area where the rat lungworm is prevalent
- Working in a profession that involves handling snails or slugs
- Poor hygiene habits
If you suspect you may have been infected with the rat lungworm, it is important to seek medical attention immediately. Your doctor will be able to diagnose the infection and recommend the appropriate treatment.
Can I get a rat lungworm infection from my pets?
It is highly unlikely that you can get rat lungworm from your pets. Rat lungworm is a parasitic roundworm that primarily infects rodents, such as rats. Animals, including pets, can get infected by the worm, but this is not a common occurrence. Additionally, the infection is typically not transmitted directly from animals to humans.
However, it is still advised to maintain good hygiene and wash your hands thoroughly after handling any animal, including your pets, to reduce the risk of infection.
How to diagnose rat lungworm
The diagnosis of rat lungworm infection typically involves a combination of medical history, physical examination, and laboratory testing.
A doctor will typically ask about the following:
- Travel history
- Potential exposure to infected animals or their feces
A physical examination could be performed to assess health and identify signs of infection:
- Blood tests to look for evidence of the parasite in the blood.
- Imaging tests, such as CT or MRI, could be recommended look for signs of infection in the brain or spinal cord.
- In some cases, the parasite could be identified in the person’s feces, cerebrospinal fluid, or tissue biopsy.
The symptoms of rat lungworm infection can be similar to those of other infections and illnesses, so a doctor needs to rule out other potential causes. In some cases, multiple tests could be needed to confirm the diagnosis.
What are the treatment options for people with rat lungworm?
The treatment for angiostrongyliasis (rat lungworm infection) typically involves a combination of medications and supportive care. The specific treatment plan will depend on the severity of the infection and the presence of any complications.
Medications used to treat rat lungworm infection may include:
- Antiparasitic drugs: Albendazole and mebendazole could be used to kill the worm and clear the infection.
- Corticosteroids: Reduces inflammation and swelling in the brain and spinal cord. They could be used to treat severe cases of rat lungworm infection or prevent complications, such as meningitis or brainstem encephalitis.
- Analgesics: Acetaminophen and ibuprofen relieve pain and discomfort.
- Anticonvulsants: Phenytoin and valproic acid control seizures, which is a common complication of rat lungworm infection.
- Other treatments: In addition to medication, supportive care is an important part of treating rat lungworm infection. This may include intravenous fluids and electrolytes to prevent dehydration and maintain adequate hydration and respiratory support.
The success of treatment for rat lungworm infection can vary depending on the severity of the infection and the presence of complications. In some cases, the infection may resolve without treatment.
Treatment could be necessary to clear the infection and prevent complications.
What is eosinophilic meningitis?
Eosinophilic meningitis is a rare complication of worm infection. Rat lungworm infection (angiostrongyliasis) is the most common cause of this rare condition.
Eosinophilic meningitis is characterized by the presence of a high number of eosinophils (a type of white blood cell) in the cerebrospinal fluid. In severe cases, the condition can cause neurological problems, coordination difficulties, coma, and death.
There is currently no specific treatment for eosinophilic meningitis. Treatment is generally focused on relieving symptoms and preventing complications. This may involve using medications to reduce inflammation, alleviate pain, and control nausea and vomiting.
- In some cases, hospitalization could be necessary to provide supportive care, such as intravenous fluids and medications.
- In severe cases, treatment may involve using steroids to help reduce inflammation and swelling in the brain.
How can I prevent myself from rat lungworm?
To prevent rat lungworm infections, take the following measures:
- Avoid eating raw or undercooked snails or slugs or foods that could be contaminated with their mucus.
- Wash your hands thoroughly with soap and water after handling snails or slugs or gardening in areas where they could be present.
- Store and prepare food properly by covering them, preventing snails or slugs from accessing them.
- Keep your home and garden clean and free of debris, which can attract snails and slugs.
- Keep your pets from hunting or eating snails or slugs. Regularly check them for any signs of infection.
- Use gloves and protective clothing when gardening. Clean any snail or slug infestations as soon as possible.
- Do not touch or handle snails or slugs with your bare hands or any part of your face or mouth after handling them.
- If you are traveling to areas where rat lungworm infection is common, take extra precautions to avoid exposure to snails or slugs. Follow all recommended food and water safety guidelines.
What is the outcome of rat lungworm?
The outcome of rat lungworm (Angiostrongylus cantonensis) infection can vary depending on the severity of the infection and the overall health of the affected individual.
In some cases, the infection may cause no symptoms and resolve without treatment. Headache, stiff neck, fever, nausea, and other mild symptoms may require medical treatment. Rarely, the infection can lead to more severe complications, such as meningitis or brain damage, which may need hospital care and specialist treatments.
Seek medical attention if you believe you have been exposed to rat lungworm.
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Parasites - Angiostrongyliasis (also known as Angiostrongylus Infection). https://www.cdc.gov/parasites/angiostrongylus/gen_info/faqs.html
Angiostrongyliasis (Rat Lungworm). https://health.hawaii.gov/docd/disease_listing/rat-lungworm-angiostrongyliasis/
Rat Lungworm: A Nasty Parasite With an Uglier Name. https://www.webmd.com/a-to-z-guides/news/20170630/rat-lungworm-nasty-parasite
Angiostrongyliasis (Rat Lungworm Disease): Viewpoints from Hawai‘i Island. https://pubs.acs.org/doi/10.1021/acschemneuro.7b00299
Rat Lungworm is a Thing. https://www.pestworld.org/news-hub/pest-health-hub/rat-lungworm-is-a-thing/
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