A Hawaii brain parasite has been identified in nine people on Maui and the Big Island over the last few months, causing major concern among health department officials in the state, though they've stopped short of calling the influx an epidemic.
A parasitic worm makes its way into the human brain and leads to rat lungworm disease. The larvae is carried by rats and then spread through snails or slugs that crawl onto fruits and vegetables, according to KHON-TV.
State officials told the television station that they are investigating what has triggered the upswing in identified cases. Over the last decade, there have been just two cases of the disease reported on the island, The Associated Press reported.
"Investigations are pretty intense there," epidemiologist Joe Elm told KHON-TV. "It goes hand in hand with the rat population. It goes up and down with the weather. On the outer islands we see fairly big populations in the wild when there's lots of rain and stuff for them to consume."
Health officials told residents that they can reduce their risk of contracting rat lungworm by washing fruits and vegetables thoroughly before eating. Officials also caution people to not handle snails or slugs with their bare hands, according to CNN.
People should boil snails, freshwater prawns, crabs, and frogs for at least three to five minutes before eating, health officials suggest. They added that catchment tanks for rainwater should be covered to prevent slugs and snails from gaining access, CNN noted.
In the meantime, officials continue to work to rid the islands of the parasite.
"If you could imagine, it's like having a slow-moving bullet go through your brain, and there's no rhyme or reason why it's going to hang out in this part of the brain or that part of the brain," state epidemiologist Dr. Sarah Park told the AP.
The rat lungworm, or angiostrongylus cantonensis, causes eosinophilic meningitis and is prevalent in Southeast Asia and tropical Pacific islands, according to the Centers for Disease Control and Prevention. It has also been identified in Africa, the Caribbean, and the United States.
Illnesses caused by the parasite include nausea, vomiting, neck stiffness, and headaches that are often global and severe, the CDC noted. The agency stated that more serious complications occue rarely, but can lead to neurologic dysfunction or death.