Diagnosis
Currently, a spinal tap is the only method of diagnosis that the Department of Health counts for confirmed cases. However, a doctor may make a symptom-based diagnosis and prescribe treatment for patients who are unable or who don’t want to get a spinal tap. Research is currently being done on bio-assays that can be used for a less invasive diagnosis, and to get a better idea of the true extent of the disease infections in Hawaii.

Treatment
Large doses of steroids counter affect of inflammation from meningitis. Pain medication are administered to help relieve symptoms. There is some disagreement among the medical community as to whether anti-parasitic medications are advisable once symptoms are present, but there is consensus that if you know that you have eaten a slug accidentally, anti-parasitic medicines administered immediately may help prevent the infection.

Prognosis varies greatly depending upon the volumn of parasites that mature in the bloodstream and the individual immune system response.

“Immune suppression (prednisone, prednisolone, and similar steroid Rx) has been reported to reduce headache and other symptoms (Cochrane Literature Review, Sikawat Feb 2015).  In addition, the antiparasitic drugs, albendazole and mebendazole may prevent infection if used as an Emergency antiparasitic treatment immediately after a known but accidental exposure – worm eating. This has not been reported in the medical literature, but would seem a reasonable intervention based on knowledge of infection course and medication pharmacology. However, these two drugs are Class C in pregnancy, and “may have fetal effects,” so this needs to be considered before use as emergency treatment. Use of albendazole and mebendazole in treatment along with anti-inflamatory medications after symptom onset is controversial. Literature commonly states concern that their use may worsen the damage by increasing immune response to dying worms. This needs to be further studied.

Recovery-convalescence can take 4-6 months, and in severe cases residual problems may be permanent, particularly muscle strength and mobility. Memory and mental function usually are generally spared. Usual symptoms include severe and prolonged headaches, tingling sensation and muscle and body pains that move from one region to another, hypersensitivity of the skin (irritation with light touch or even breezes – if occurs is very characteristic of RLW). Fever is not that common and when present generally is not high. In more severe cases stiff neck can occur suggesting meningitis. Nausea, and abdominal pain occasionally occur. Sensitivity to light is also common.”  ~ Chad Meyer, MD

Read also> Treatment Reference for Practitioners

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