Johnnie Yates, Honolulu Site Director, has alerted us to an increase in Angiostrongylus cases in Hawaii. Angiostrongylus cantonensis is endemic in Hawaii and the number of cases averages about 9 per year. However, so far this year there have been 11 cases – 6 from the Big Island (also referred to as the island of Hawaii) and 5 from Maui. A couple from California contracted the disease earlier this year while on their honeymoon in Maui. A recent cluster on the Big Island stemmed from residents drinking homemade kava that was sitting out in an uncovered container overnight; when they finished drinking the kava, a slug was found at the bottom of the container. ProMED had a post on April 7 re: the situation in Hawaii, but at that time only six cases were confirmed. Have you seen any cases from this area? The department of health has advised clinicians to consider Angiostrongyliasis in patients presenting with headache (with or without additional neurologic symptoms), particularly if there is a history of raw produce consumption. Eosinophilic meningitis is the classic presentation and peripheral eosinophilia can also occur. Aside from meningitis symptoms, sensory symptoms such as paresthesias or hyperesthesia are common. The incubation period is typically 1-3 weeks. Intending travelers should be advised that snails, slugs, fresh water shrimp and crabs should be thoroughly cooked before they are eaten. Vegetables should be thoroughly washed if eaten raw.
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Johnnie Yates, Honolulu Site Director, has alerted us to an increase in Angiostrongylus cases in Hawaii. Angiostrongylus cantonensis is endemic in Hawaii and the number of cases averages about 9 per year. However, so far this year there have been 11 cases – 6 from the Big Island (also referred to as the island of Hawaii) and 5 from Maui. A couple from California contracted the disease earlier this year while on their honeymoon in Maui. A recent cluster on the Big Island stemmed from residents drinking homemade kava that was sitting out in an uncovered container overnight; when they finished drinking the kava, a slug was found at the bottom of the container. ProMED had a post on April 7 re: the situation in Hawaii, but at that time only six cases were confirmed. Have you seen any cases from this area? The department of health has advised clinicians to consider Angiostrongyliasis in patients presenting with headache (with or without additional neurologic symptoms), particularly if there is a history of raw produce consumption. Eosinophilic meningitis is the classic presentation and peripheral eosinophilia can also occur. Aside from meningitis symptoms, sensory symptoms such as paresthesias or hyperesthesia are common. The incubation period is typically 1-3 weeks. Intending travelers should be advised that snails, slugs, fresh water shrimp and crabs should be thoroughly cooked before they are eaten. Vegetables should be thoroughly washed if eaten raw.