Who Knew? Think Twice Before Drinking from the Garden Hose

A news report from Hawaii where rat lungworm, a parasitic infection, can be spread when an infected snail, one of the parasite hosts, climbs into the garden hose and then one drink water from the hose.  Okay, this parasite is not common in the continental US, but is common in Hawaii and has been found in Louisiana and Florida.  That is not to say it can't make its way to other states, because while the one definitive host is the snail, the other definitive host is the rat.

Still, something to consider before taking that gulp of water from a hose that has been laying on the ground for weeks.....you never know what could have crawled in there.

From the CDC:

• "Angiostrongylus costaricensis is a parasitic nematode (worm) that resides in rodents and uses mollusks, such as slugs, as an intermediate host. Rats, such as the cotton rat, transmit the larvae through their feces. Slugs then ingest the larvae. Humans are accidental hosts of the parasite. The parasite is not able to complete its life cycle in humans and eventually dies in the abdomen.  "
•  "In humans, juvenile worms [can] migrate to the brain, or rarely in the lungs, where the worms ultimately die." 
• "Most cases of infection are diagnosed in Southeast Asia and the Pacific Basin, but the parasite has also been found in Australia, some areas of Africa, the Caribbean, Hawaii and Louisiana."  [It has also been found in Florida]. 
• "Very few cases have been reported in the continental United States. In 1993, a boy in New Orleans got infected by swallowing a raw snail “on a dare. ” The type of snail he swallowed isn’t known. He became ill a few weeks later, with muscle aches, headache, stiff neck, a slight fever, and vomiting. His symptoms went away in about 2 weeks, without treatment of the infection."

Local News
Health officials warn parents: Don't let your kids drink from the garden hose
By:
Terri Inefuku
Posted: May 12, 2017 03:44 PM HST
Updated: May 12, 2017 03:44 PM HST

Many of us remember drinking from the garden hose as a kid.  Now, the Hawaii Department of Health is urging against it.

Officials say snails or slugs could be hiding in the hose, and could potentially spread rat lungworm disease.

So far this year, 15 people in Hawaii have gotten sick from the disease.

The disease starts out as a parasitic worm that invades the human brain. The worm is carried by rats, then spread through snails or slugs.

In humans, it can cause headaches, fever and, according to one sufferer, pain worse than childbirth.

Health officials are also reminding the public to thoroughly wash fruits and vegetables under running water, in case they carry traces of rat lungworm.

CDC Website
https://www.cdc.gov/parasites/angiostrongylus/biology.html
Parasites - Angiostrongyliasis (also known as Angiostrongylus Infection)

Causal Agents:

The nematode (roundworm) Angiostrongylus cantonensis, the rat lungworm, is the most common cause of human eosinophilic meningitis. In addition, Angiostrongylus (Parastrongylus) costaricensis is the causal agent of abdominal, or intestinal, angiostrongyliasis.

Life Cycle:

[add....snail climbs into a garden hose, man turns on hose, pressure crushes snail, man drinks from hose getting


Adult worms of A. cantonensis live in the pulmonary arteries of rats. The females lay eggs that hatch, yielding first-stage larvae, in the terminal branches of the pulmonary arteries. The first-stage larvae migrate to the pharynx, are swallowed, and passed in the feces. They penetrate, or are ingested by, an intermediate host (snail or slug). After two molts, third-stage larvae are produced, which are infective to mammalian hosts. When the mollusk is ingested by the definitive host, the third-stage larvae migrate to the brain where they develop into young adults. The young adults return to the venous system and then the pulmonary arteries where they become sexually mature. Of note, various animals act as paratenic (transport) hosts: after ingesting the infected snails, they carry the third-stage larvae which can resume their development when the paratenic host is ingested by a definitive host. Humans can acquire the infection by eating raw or undercooked snails or slugs infected with the parasite; they may also acquire the infection by eating raw produce that contains a small snail or slug, or part of one. There is some question whether or not larvae can exit the infected mollusks in slime (which may be infective to humans if ingested, for example, on produce). The disease can also be acquired by ingestion of contaminated or infected paratenic animals (crabs, freshwater shrimps). In humans, juvenile worms migrate to the brain, or rarely in the lungs, where the worms ultimately die.
Learn more  about Angiostrongylus cantonensis in this new motion graphic video.

The life cycle of Angiostrongylus (Parastrongylus) costaricensis is similar, except that the adult worms reside in the arterioles of the ileocecal area of the definitive host. In humans, A. costaricensis often reaches sexual maturity and release eggs into the intestinal tissues. The eggs and larvae degenerate and cause intense local inflammatory reactions and do not appear to be shed in the stool.

Life cycle image and information courtesy of DPDx.