By Health Editor
Geraldine Ohonba
Doctors are sounding the alarm about an unusual parasitic infection linked to trips to tropical regions such as Hawaii—one that can trigger burning or tingling sensations in the legs and feet before progressing to the brain.
A 30-year-old woman from coastal New England experienced this firsthand after returning from a three-week journey through Thailand, Japan, and Hawaii. Shortly after arriving home, she began to suffer from headaches and a burning pain in her feet that slowly crept up her legs and arms.
Initially, she sought help at two different emergency rooms, but doctors dismissed her condition as non-urgent and prescribed medication for anxiety and headaches. Her case was only taken seriously when her confusion and neurological symptoms worsened, prompting further testing.
Diagnosis: Rat Lungworm Disease
A spinal tap revealed signs of eosinophilic meningitis, an inflammation of the brain and spinal cord membranes. Further analysis pointed to angiostrongyliasis, an infection caused by the parasitic roundworm Angiostrongylus cantonensis—better known as rat lungworm.
This parasite is found in many tropical areas, including Hawaii, and spreads through a cycle involving rats, slugs, and snails. Humans usually become infected by accidentally consuming contaminated raw vegetables or undercooked foods, sometimes carrying invisible traces of snail or slug slime.
The Woman’s Travel History
Doctors believe the woman was exposed while eating salads or sushi during her stay in Hawaii. Although she avoided raw dishes in Thailand, she ate sushi multiple times in Japan and continued the habit in Hawaii. Swimming in natural waters and consuming leafy greens may also have increased her risk.
From Suspected Autoimmune Disorder to Parasite
At first, physicians considered other explanations such as Guillain–Barré syndrome, ibuprofen side effects, or eosinophilic granulomatosis. But when her spinal fluid showed abnormal immune activity, the parasitic infection became the most likely culprit.
Treatment and Recovery
The patient was quickly started on a combination of high-dose prednisone to reduce brain inflammation and albendazole, an anti-parasitic medication capable of penetrating the brain and spinal fluid. She also received gabapentin and amitriptyline to ease nerve-related pain.
By the sixth day of hospitalization, her symptoms had improved significantly, allowing her to be discharged. Doctors credited the timely diagnosis and aggressive treatment for her recovery.
Why It’s a Serious Concern
While rare, rat lungworm disease can be life-threatening if untreated. The parasite’s presence in the brain can lead to dangerous complications including seizures, stroke, coma, or permanent neurological damage. Hawaii has reported occasional outbreaks, with a spike of 19 cases in 2017, though the annual numbers have since dropped below 10.
Experts caution travelers to tropical regions to be mindful of what they eat, thoroughly wash produce, and avoid raw or undercooked foods that may be contaminated.
