A 30-year-old woman from New England has become a medical mystery after a three-week trip left her with an infestation of parasitic worms in her brain.
The woman, whose identity has not been revealed, has become the subject of a New England Journal of Medicine case study.
In the February 12 document, it revealed how the woman’s symptoms got progressively worse, seeking help from three different hospitals before she was eventually diagnosed with parasitic worms infesting her brain.
It started with a headache and a burning sensation in her feet before the feeling spread to her legs and arms days later.
“It’s just so unusual,” said Robert Cowie, a researcher at the University of Hawaii and expert on the parasitic worm that infected the woman.
The woman had been traveling through Thailand, Japan, and Hawaii and began developing symptoms about 12 days after her trip.
People can get infected by rat lungworm disease after eating raw snails or slugs. Picture: iStock
“During the next two days, the burning sensation progressed to involve the legs and worsened with light touch,” the case study read.
“Treatment with ibuprofen did not alleviate her symptoms. She had concurrent fatigue, which she attributed to jet lag after returning from a three-week trip that had included travel in Thailand, Japan, and Hawaii.”
The woman returned to the emergency room when her symptoms grew worse after a week.
The test results showed everything was “reportedly normal,” aside from an elevated immune-cell count in her blood test. She was discharged and advised to have a follow-up with her primary care physician.
Rat lungworm parasite. Picture: Centres for Disease Control and Prevention
But the next morning, the woman woke up confused and started packing for a holiday that never existed. Her confusion continued for hours and couldn’t be dissuaded by a family member before her partner brought her to Massachusetts General Hospital.
A spinal tap found she had very high levels of eosinophils, a type of white blood cell that protects the body against parasites and various kinds of infections.
It took three different hospitals before doctors eventually concluded the woman was infected by a parasitic worm called Angiostrongylus cantonensis (otherwise known as rat lungworm). The larvae can be transmitted from a host rodent’s feces, which is passed to snails and slugs before potentially moving onto humans.
They noted the woman ate street food in Bangkok and raw sushi in Tokyo and enjoyed more sushi and salad as well as a swim in the ocean in Hawaii.
“During the last 10 days of the trip, she was on vacation in Hawaii, where she swam in the ocean several times and frequently ate both salad and sushi,” the case study read.
Larvae can be transmitted from rat feces. Picture: iStock
Mr. Cowie, a rat lungworm expert not involved in the New England woman’s care, said doctors “took forever” to figure out what was wrong and claims many medical professionals are “blissfully ignorant” about the rat lungworm disease.
Some symptoms can include headache, low-grade fever, nausea, vomiting, stiff neck, and tingling or painful sensations in the skin.
The Centers for Disease Control and Prevention (CDC) reports people have been infected after eating raw or uncooked snails or slugs, which is common in some cultures or can be accidentally included in some salads or vegetable juices. Some children have also gotten sick after swallowing them “on a dare.”
Rat lungworm has also been found in freshwater shrimp, crabs, and frogs. Picture: iStock
Scientists have additionally found rat lungworm infections in other animals such as freshwater shrimp, crabs, and frogs.
There have been more than 2,800 reported cases of rat lungworm in humans since 2008, although Mr. Cowie believes the disease has spread much further and is collaborating with a research partner in China who has recorded at least 7,000 cases.
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