Preliminary Guidelines for the Diagnosis and Treatment of Human Neuroangiostrongyliasis (Rat Lungworm Disease) in Hawai’i

Preliminary Guidelines for the Diagnosis and Treatment of Human Neuroangiostrongyliasis (Rat Lungworm Disease) in Hawai’i

Diagnosis and Treatment, RLW Educational Material
Preliminary Guidelines for the Diagnosis and Treatment of Human Neuroangiostrongyliasis (Rat Lungworm Disease) in Hawai'i Authors: Clinical Subcommittee* of the Hawaii Governor’s Joint Task Force on Rat Lungworm Disease RLWD Preliminary Clinical Guidelines From Hawaii Department of Health Press Release: Preliminary Guidelines for the Diagnosis and Treatment of Human Neuroangiostrongyliasis (Rat Lungworm Disease) in Hawaii August 29, 2018 The Clinical Subcommittee of the Hawaii Governor’s Joint Task Force on Rat Lungworm Disease has published its report, “Preliminary Guidelines for the Diagnosis and Treatment of Human Neuroangiostrongyliasis (Rat Lungworm Disease) in Hawaii”. The full document can be read here; below are the key points of the report. Clinicians in Hawaii should have a high index of suspicion for neuroangiostrongyliasis. Suspect cases should be discussed with the Department of Health (DOH) Disease…
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Island Issues podcasts: interviews on RLW

Diagnosis and Treatment, Food Safety, In the news, RLW Communication
Sherry Bracken did a four-part series of interviews on LAVA 105.3 regarding rat lungworm disease, that are available now as podcasts on their website. Click the title of each podcast to go to the page where the audio can be download. Rat Lungworm–the basics with Dr Jon Martell, Dr Susan Jarvi, Marlena Dixon We begin our updates on angiostrongylus, rat lungworm, a truly horrific disease, with a rebroadcast of our 2015 basics with Dr. Jon Martell of Hilo Medical Center, Dr Susan Jarvi of UH Hilo College of Pharmacy, and Marlena Dixon, representing State Department of Health.  In coming weeks we get an update from Drs Martell and Jarvi, plus an interview with State Department of Health about the $1 million they’ve been allocated for the disease and with members of the…
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Lumbar puncture safe, effective in RLW diagnosis & treatment

Diagnosis and Treatment, In the news
Honolulu Civil Beat has an article on efforts to treat RLW, with this important information about diagnosis via lumbar puncture (aka spinal taps): For example, lumbar punctures, commonly known as spinal taps, have been misrepresented as an invasive, painful procedure. Information obtained from a lumbar puncture provides priceless information that helps physicians make very important decisions regarding diagnosis and treatment of patients. In fact, it is a common, very safe procedure that is typically a critical part of the work up for rat lungworm disease. Local anesthetic makes it relatively painless and, as an added benefit, a spinal tap will usually dramatically relieve the headaches, which typically accompany an infection.
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East Hawaii Protocol for treating RLW

Diagnosis and Treatment, In the news
From the Hawaii-Tribune Herald: One of the most challenging aspects of rat lungworm disease is the lack of a standardized treatment protocol. But that might have changed. “We think we found a good recipe for helping these patients recover,” said Hilo Medical Center spokeswoman Elena Cabatu. Dr. Jon Martell, the hospital’s medical director, described to the Tribune-Herald what might become known as the East Hawaii protocol for treatment of rat lungworm. Any patient whose symptoms are severe enough to visit the emergency room, Martell said, needs high-dose intravenous steroids to reduce inflammation. After two days of steroid treatment, deworming medication called albendazole should be used. Read the rest...
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Experts say more research is needed

Diagnosis and Treatment, Food Safety, In the news
“We all should consider that a good portion of rats, slugs and snails in Hawaii are likely infected. It’s important to inspect, wash and store all produce carefully, and reduce or prevent snails/slugs from entering gardens by using raised beds, copper tape and poison control,” Dela Cruz said. “Like many health issues, prevention is key.” http://westhawaiitoday.com/5675310.html
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Rat Lungworm Disease in East Maui ~ by Chad Meyer MD

Rat Lungworm Disease in East Maui ~ by Chad Meyer MD

Diagnosis and Treatment, Food Safety, RLW Communication, RLW Educational Material, Vector Control
Fortunately dengue virus did not become established in east Maui as a result of the 2001 dengue fever outbreak. Effective interventions included community responses to decrease mosquito breeding sites, and a vigorous campaign by local public health personnel and resources from CDC Atlanta and Puerto Rico. It is also worth noting that dengue fever outbreaks generally occur in crowded urban settings and that rural conditions in east Maui were in our favor. (more…)
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