Thursday morning Hawaii’s Kilauea shot ash and smoke into the air and blew a volcanic cloud that could reach 30,000 feet into the sky. The volcano has been spewing lava for weeks, prompting thousands of nearby residents to evacuate. Volcanic ash can prompt a multitude of health risks…not only from a particulate standpoint but also from the sulfur dioxide levels. Sulfur dioxide is a colorless, though stinky gas that can cause irritation to skin, eyes, and respiratory system linings.

 

 

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Let’s break these health risks down:

Respiratory Illness

 

Volcanic ash can irritate the respiratory passages causing the following symptoms:

  • Runny nose
  • Sore throat
  • Wheezing
  • Coughing
  • Mucous production
  • Shortness of breath
  • Painful breathing

 

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Those with asthma, COPD, chronic bronchitis or other respiratory ailments may find themselves having exacerbations of their symptoms. Oxygen requirements will increase. Those requiring oxygen or inhalers will need to have extra supply during this time (medical offices may be closed during ash clean up so don’t wait until the last minute.)

Eye Issues

 

Volcanic ash has large and small particles that can irritate the eyes increasing their sensitivity to light and making vision difficult.  Moreover ash can irritate the cornea and conjunctiva causing redness, discharge and itching.

 

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Skin Reactions

 

Skin may become irritated during these times and those with skin allergies or eczema may find themselves having flare-ups.

 

Road Visibility

 

During a volcanic eruption, smoke plumes not only change the air quality but also visibility. During times of day when there is less light, road visibility obscures pedestrians and nearby cars. Drivers are urged to avoid the road during these smoky times.

 

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Water

 

Water quality can become affected by the ash or pH changes if supply becomes  contaminated. Moreover, water use increases for cleanup so shortages may ensue.

Short blood supply


Those who donate blood in nearby areas may be less likely to donate during this difficult time leading to local blood shortages.  Those who can donate blood are urged to contact the American Red Cross, United Blood Services, or Blood Bank of Hawaii.

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Daliah Wachs is a guest contributor to GCN news. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in Health

This year, nine confirmed cases of rat lungworm disease have surfaced in Hawaii (Maui and the Big Island), and a couple in California who recently traveled to the Aloha State  came down with symptoms after they returned home from their honeymoon. Four additional cases have been suspected since the start of the year and fortunately no deaths have been reported. The Hawaii Department of Health confirmed 11 cases in 2016, and between 2007 and 2015, 42 cases were reported.  Here are your questions answered.

What is Rat Lungworm?

 

Rat lungworm is in the family of roundworms (nematodes), named Angiostrongylus.   Angiostrongylus cantonensis is a parasite that can cause neurological infections such as meningitis, and its sister species, Angiostrongylus costaricensis, can cause severe gastrointestinal illness.  The specific meningitis, or inflammation of the brain, caused by A. cantonensis is an eosinophilic meningitis, where the main blood cell involved is an eosinophil, prevalent in parasitic infections as opposed to a bacterial or viral meningitis.

 

It's found primarily in Southeast Asia and the Pacific Basin but up until recently it's been extremely rare in the United States.  In 2015 a study published in the Journal of Parasitology cited cases had been reported in Florida, Alabama, California, Louisiana, and Hawaii.

 

It primarily lives in rodents but the larvae can be passed to other species through rat feces.  Adult nematodes live in the pulmonary arteries of rats.  The females lay eggs and these, once they hatch and become first stage larvae, may migrate to the rat’s throat and then enter the GI system, eventually exiting through feces.

What are the symptoms of Rat Lungworm?

 

Symptoms include severe headache, fever, neck stiffness, visual disturbances, difficulty looking at light (photophobia), nausea, vomiting, numbness, temporary paralysis of the face and possibly coma and death.

The incubation period, on average, can be anywhere from a week to three weeks and symptoms could start within that time and possibly last for months.  Neurological sequelae of the survivors can last for extended periods of time.

How does one contract Rat Lungworm?

 

An individual could become exposed to A. cantonensis when one eats undercooked slugs, snails, frogs, shrimp, mollusks and contaminated fruits and vegetables.  Slime from slugs may also be a source of contamination of the deadly parasite.

 

 

How do we know Rat Lungworm is the cause of one’s symptoms?

 

If a person presents with symptoms of meningitis, the cerebrospinal fluid, or fluid surrounding the brain and spinal cord is able to be sampled during a lumbar puncture. The needle entering through the back could aspirate enough of a sample for laboratory technicians to determine if the meningitis is caused by bacteria, virus or parasites, the latter of which causing a higher concentration of eosinophils to be demonstrated in the CSF fluid as well as the blood.

 

What is the treatment for Rat Lungworm?

 

Currently there is no official treatment of the parasite.  The parasite will die on its own but can do so in a relatively short amount of time such as days, or become latent for months.  Dead worms could also cause severe neurological symptoms. Symptomatic measures of the patient are instituted to help with pain, although some have been treated with steroids and antiparasitic medications.

 

How do we avoid Rat Lungworm?

 

Make sure all raw vegetables are washed thoroughly,  Handle slugs and snails with gloves and wash hands diligently.  The University of Hawaii recommends boiling snails for at least 3-5 minutes prior to preparing for consumption.  And keep rodents, snails and slugs away from your food and kitchen counters.

 

For more on prevention of Rat Lungworm infections, read: Avoid Contracting Angiostrongyliasis (Rat Lungworm Infection): Wash Fresh Fruits and Vegetables Before Eating!

 

 

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Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00am-2:00pm and Saturday from Noon-1:00pm (Central) at GCN.

 

 

Published in News & Information