Rat lungworm’s prevalence in Puna affirmed

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Questions submitted during a Thursday forum hosted by the Hawaii Health Systems Corporation East Hawaii Regional Board of Directors brought a Puna-focused medical topic into focus.

Questions submitted during a Thursday forum hosted by the Hawaii Health Systems Corporation East Hawaii Regional Board of Directors brought a Puna-focused medical topic into focus.

Dr. Jon Martell, Hilo Medical Center Acute Care medical director, replied to the audience that in the past 12 months, the hospital has treated “21 highly suspected” cases of rat lungworm.

“We suspect it’s a bigger problem than that. The folks in Puna are right to be concerned about this,” Martell said. “Puna remains the epicenter of this.”

Determining a treatment protocol for rat lungworm has been difficult because there’s not clear medical literature showing that antiparasitics work. Some think they cause more side effects than healing. Martell said a suggested rat lungworm hotline will be beneficial, but it will have to be integrated with some other service because rat lungworm calls don’t happen often enough, on their own, to staff a phone line.

But when the calls come, they are urgent. Should antiparasitics be given to someone with known exposure to slugs or snails that carry the rat lungworm larvae?

That’s controversial, Martell said.

But “our experience is that it’s safe and probably effective on adults,” he said.

Rat lungworm carries an emotional burden, Martell said, and there might be a need for counseling, physical therapy and chronic-pain management. Martell also expressed interest in an audience member’s suggestion for a support group to help those affected by the disease.