A lovely thought as my daughters and I head out to one of the local restaurants here in Hawaii. I wonder if the organic, local salad that we order tonight was grown with any concern for good agricultural practices and inspected by a local government official, or if a local farmer grew it that simply believes that small Ag, being always good, is always safe?

So, back to rat lungworm – it is a tropical disease found in warm, moist climates that is caused by Angiostrongylus cantonensis, a parasitic worm carried by rats (the parasites live in the pulmonary arteries of rats, hence the name “rat lungworm”). The rats excrete worm larvae in their feces, which are sometimes eaten by small snails and slugs that often nestle in the folds of lettuce, peppers and other produce.

In January 2009 three people in Hawaii came down with rat lungworm disease after eating raw vegetables – and physicians fear they may have accidentally swallowed slug larvae hidden inside folds of raw peppers. One of the eaters eventually survived a coma. In May 2011 four probable cases of rat lungworm disease where discovered in Hawaii among salad eaters.

Symptoms of rat lungworm disease can include severe headaches, nausea, vomiting, neck stiffness, skin and light sensitivity, and other problems related to the brain and spinal cord, such as numbness or partial paralysis. The symptoms differ in severity, with most people recovering without ever seeking treatment. In rare instances, the worm causes potentially deadly meningitis, an infection of the fluid that bathes the spinal cord and brain. Symptoms include severe headache, stiff neck, tingling or painful feelings in the skin, low-grade fever, nausea, and vomiting. The severity of the illness seems to depend on how many worms are ingested, how strong a person’s immune system happens to be, and how long the worm stays in the central nervous system.

Keeping gardens free of rodents, snails and slugs can reduce the risk of rat lungworm disease, which means washing all raw vegetables and fruits thoroughly and visually inspecting them to be sure they are free of slugs and snails.