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Home My WebLink AboutCOM 0115.001 2016-2018Eileen O'Hara Council Member Council District 4 Chair: Environmental Management Committee Phone: (808) 965-2712 Fax: (808) 961-8912 Email: eileen.ohara@hawaiicounty.gov Vice Chair: Planning Committee and Agriculture, Water & Energy Sustainability Committee County of Hawaii Hawaii County Council 25 Aupuni Street, Suite 1402 • Hilo, Hawaii 96720 DATE: March 3, 2017 TO: Valerie T. Poindexter, Council Chair and Members of the Hawaii County Council ,AN ev FROM: T ileen O'Hara, Council Member SUBJECT: Informational materials regarding Rat Lung presentation COUNTY CLERK COUNTY OF HAWAII RECEIVED Time03 fn. % DateMAR 3 E11f%'""—"" Attached please find a Power Point that will be referred to in the EMC meeting on March 7, 2017 during the presentation on Rat Lung disease. Dr. Jarvi has provided the power point to aid in the discussion after the presentation. Thank you for your attention to this matter. EO:bI Att. Comm. No, Ref. To: Ref. Date y+ o: lapUYP cot,FC Rat Lungworm Disease: Advances in Education, G � UNIVERSITY of HAWAII Outreach, and Research HILo FR SOF HAwPt Susan Jarvi, Professor, Pharmaceutical Sciences and The Hawaii Island Rat Lungworm Working Group Susan I. Jarvi PhD', William C. Pitt PhDZ, Margaret Farias', Kathleen Howe', Steven Jacquier', Robert McHugh', Michael Severino', Laura Shiels',Z, Aaron B. Shiels PhD 2, Karis Amano', Blaine Luiz', Daisy Maher', Maureen Allison', Krystal Yamamoto' , Zachariah Holtquist', Neil Scheibelhut' LaTasha Riddick', Akio Yanigasawa' 'Matt Chen', Jill Villarosa' , Ann Txal<eeyang' , Joann Phan' , Jenny Ueno, Stefano Quarta' , Patricia Macomber' , Shawzy Cann' , Jeremiah Cann' , Patrick Edwards' , Smiley Burrows' , Kuilei Kramer' , McKayla Meyers, Noelle Lovesy, Crystal DaSalla 'Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, Hilo HI 96720 2USDA APHIS Wildlife Services, National Wildlife Research Center, Hawaii Field Station, Hilo HI 96720 .dom + The cast of characters. Frogs, prawns, crabs, shrimp, water monitor lizards (paratenic hosts) Rats (definitive host) Flatworms, (paratenic hosts) The nematode Angiostrongylus cantonensis, the rat lungworm EM Slugs and snails :ermediate host) Invasive slugs and snails f . a ;' : _ ,� ;; �; 0.e- R 4 r" �.`\ � i r�� rmediate infective Humans, horses, dogs, primates, birds, and other species con be infected. They are called accidental hosts. Infection can occur from ingestion of raw or undercooked slugs, snails, paratenic hosts, contaminated produce, or contaminated water, including improperly filtered rainwater from catchment tanks. The rat lungworm parasite is found in at least 30 countries. It is established on all of the Hawaiian Islands, with the possible exception of Lanai, and in the Southeast U.S. mainland states of southern Florida, Louisiana, and Texas. It was recently found in southeastern Oklahoma. This is an emerging disease and it is spreading with climate change. The parasite attacks the brain and central nervous system, causing a painful disease. In Hawaii, rat lungworm disease has caused deaths and permanent disability. It has caused loss of income and loss of quality of life. HAWAII HEALTH INFORMATION CORPORATION Discharges (ER, Inpatient) for Rat Lungworm Impact all Age Groups Including the Very Young. 00-04 Yr -- 05-14 r;05-14 Yrs 15-24 Yrs 25-34 Yrs 35-44 Yrs 45-54 Yrs 55.64 Yrs 65-74 Yrs Patients by Age 0 1 2 ? 4 5 ■ UniQue Patients Iia! t.0 g%* m do!v.od Dy /CD9 coon =!28 B and iCDr0 code = 8832 -rrne Pen00 Janwry 2010 • Septe1*01 2015 6 7 9 7 HAWAII HEALTH INFORMATION CORPORATION Hawaii Statewide Emergency and Inpatient Discharges for Rat Lungworm have Increased Significantly Since the 4th Quarter of 2015. Patients Treated (ER, Inpatient) - Rat Lungworm 14 12 2015 2016 Population - based Rates for Rat Lungworm has Increased 10 -fold in Previous Year. Hawaii County is Preferentially Impacted. Rbf L�pwvr». A V -*VN Vyri+S 00,40 O/ iCOL c 00 =128 8 a d (CO f0 caro = 8832 c d Y 20 - 0 HAWAII HEALTH INFORMATION CORPORATION The Big Island (Denoted as Hawaii in the Chart Below) is Most Affected by Rat Lungworm. Patients Treated (ER, Inpatient) by Region - Rat Lungworms Hawaii Hdo • -aura.: South `i aui Nolc •:a - ! ana - East Other US North Hawaii Kona Kauai East Oahu Kaneohe - Kailua Rat Lurgargrn. A,4;k sr Vyku$ cenbnens.s. d&f~ by 1CD9 COO& -:28 8 Bb =10 Code -8&V '7m Pe cd Jam ary 2010 • Seoternoer 2016 Why east Hawaii? Ongoing studies: Educate friends, family and the public Integrate RLW education into public school system, develop IPM, increase public awareness Conduct studies to find out where the RLW 'hotspots- are. • Develop test to estimate the number of larvae in slugs and snails and bring information to public Determine how effective various solutions are at killing RLW larvae. • Develop o "death assay" to determine that larvae are dead, thus non -infective. Evaluate the possibility of RLW transmission in water. • Determine how long larvae can live in water outside host, test catchment filters to see how effective they are. Determine if RLW DNA can be detected in rat blood. • Can it be detected in humans? Determine efficacy of a vaccine against A. costaricensis to A. cantonensis. • We might break the transmission cycle by vaccinating rats Conduct a pilot study to determine the extent of human RLW exposure in east Hawaii Island. Develop a blood -based diagnostic with proteins isolated from Hawaii A. cantonensis. Education and outreach 1st project Rat Lungworm Lifecycle T T M01J beck To CIeaB--, MAT I took Over 10, 00 copies distributed and used in schools and garden projects in Hawaii. Aligned with the Hawaii Science Standards for 2nd grade. Produced by the Hawaii Island Rat Lungworm Working Group at the Daniel K. Inouye College of Pharmacy under the directorship of Dr. Susan Jarvi I'M A CERTIFIED +I .�•a+r.•o+.Ire SLUG .LUGGER ! e. t. -10Y f+..0°Y4LLID 6 HAVE LEARNED ABOUT - + RAT LUNGWORM DISEASE AND I KNOW HOW TO BEST STAY HEALTHY. 2nd Project. Five partner schools were chosen from the1 windward side of Hawaii to H on o kaa participate in a pilot project using integrated pest 'Ax ,A� fllll management (IPM) to control ...,,, .., .=A OBS. ER';;T0R`S u Miura KeD j� ay Bay slugs and snails in school KalaOa PN1ZUxA fF1drERa ' FOR1hrASTROOM AsrR�uAur xA"U.IIA .MA fA'� to upofis S2amount " ilua-K on a AR UA'UM FErAU gardens. Holualoa FdAUNALOA ,. OBSERVATORYuntain HAWAII View .H10A V HEiAUSTATE190NLYAFI ir,: I buna Loa olcano • Waimea • Laupahoehoe"d • Mountain View x-L-F'T�R'B'�JSp Pa''a • Volcano - °• �, • I<a oho N Content may not. reflect National Geographic's current map policy. Sou.-.. Integrated Pest Management (IPM) The program is based on prevention, monitoring, and control using least toxic methods of population reduction. IPM employs adaptive management. OqfttU4 9AAWA IA b"A11,ft 4210104k v��lsa��t�► �. ; SBA 6"'a& 1' � '`or, sa Edi!• tiludy ", Int�cgrated Pest malliageolent . 1U1 the INVA5IVE) control of non -indigenous snails and slugs,�rt..aFtYt r. �l�y..'""�P wltlulr'µtinkmF welt Ynu na ."Dow ,., ,y�F p lrw � �,rM' tur• a+n MtnF — woo*Mni�NAMod. dvs. aP�m Owww rv. dello 44 The use of shelters Slugs and snails will follow the slime trail of others to find a cool, moist spot to wait out the heat of day. We employed 2 sets of 5 different shelter type and each school to determine what material created a more attractive shelter to snuggle under. s.� Identification There are at least 46 different species of invasive slugs and snails established throughout Students learned to identify most of the different species of invasive slugs and snails found in their school garden. Rosy Wolfsnail Euglandina rosea )EUG ROS) I have a: Thick, Jong pink -brown sheh. ) have curved long lips, which i use to eat other snailsl {7 30 cm long I can be found in: Hawa"r'i, Pacific Islands, Asia, Caribbean, Mainland. east Afrlta, Papua New Guinea I'm from: Southeastern USA, Gulf region Nor C -SM it'. - .4 ► . .1 0001I -f�'Aiw,a Safety Our #1 Priority • Wear gloves • Never pick up slugs, snails, or flatworms with bare hands • Dispose of slugs and snails in a slug jug • Don't look directly into the slug jug when you put one in and avoid splashing. Life cycles and interdependence Students learned the complex lifecycle of the rat lungworm and its host inter -relationships using 3D modeling. r 1111k,111": ,00l Code --- Le Weather Rainfall amt. rr' Data collected V e #� Card species Plastic species woos species Mesh species Ref board 11 1; I IE )mments 11 We analyzed our data to determine population numbers, shelter -type capture rates, and statistics between and among schools. Waimea Laupahoehoe Number captured - Volcano Mt. View Kapoho Laupahoehoe Waimea Kapoho We made bar graphs and pie charts to show our results. All schools Volcano Mountain View Shelter Type Capture Rate - cardboard - mesh plastic reflective 75% wood other To - T r roo3 asst shorel.rP,e!.. °h 1 �MI eAis f m levamn� • .. Volcano Common spec'les n the vic nity & V.I ono School of Arts & Sc enoe Some species found st this high elevat on she were also found atour midA-stlun sites. =-j Sap,"", e *4 We removed 4126 invasive slugs, snails, and flatworms from 5 schools during the fall semester. p _nn.�wv.mo^oawon tau nunl The new cup^ea nat..i:m Iweeadanl Spies found at Kua o ka La, i n the Kapoho area L a u p a h o e h o e mnkelMc nl;t(VER CBtTh, UEanslug Mountain View darenl�:^e aew,l I mwm —^ , Species found at Na Wai Ola, in the Mountain View area Pg(m .R, !(.fl�MAftl[ha semi -lag resew .^.wn� EPAx n+uN itre I rl� 1�rI+.�. netrectivn h45tmwe.xwnew^rm w,asnel rk�uo•aua4�htvrncugl .. "& �'%� � � �. . *h � rnecamnswg . Aai. k v vvd/a, 0.wp¢rni}p Kapoho t SubvJinvafonv (SUB 9cr1 \' the yellow booi4d Snail �" y - � Th leopartl dig Students discussed how to wash your vegetables. Students become community educators Project incorporates: • IPM • Place -based, project -based learning • Integrated and STEM curriculum • Common core math, next generation science and Hawaii DOE standards-based. 11 ACA ArcGIS online Story Mapping: published story map of this project Hawaii Island School Garden Projects Take on Rat Lungworm Disease with Integrated Pest Management Food security is an important issue for the isolated Hawaiian Wands, where approximately 65% of fresh fruits and vegetables are imported and a fresh produce inventory that would last onlyten days. To address this situation, a Grow Local, Eat Local movement has been sweeping the state, resulting in a growing number of residential gardens, small farms, farmers markets, school garden projects, and passage of the Farm to School bill, which supplies schools with locally grown produce. However, https://uh h.maps.arcgis.com/apps/MapJournaI/index.htmI?appid=5ccc2fa5cf7b441fa2711c5b60e853b6 Students at Na Wai Ola PCS (Mt. View) continue to research slug barriers under the supervision of School Garden Teacher Shari Frias- Copper Wire Test Kay Howe received the 2016 Hawaii Invasive Species Council Community Hero Award for her work on RLWD education Research Conduct studies to find out where the RLW 'hotspots' are. • Develop gPCR test to estimate the number of larvae in slugs and snails and bring information to public, target for rat and slug control. Puna survey to determine infection levels in slugs/snails. To date have tested 166 Cuban and 211 Semi -slugs. Hollingsworth et al Puna collected 2005 77.5% (31/40) of semi -slugs positive 24.3% (9/37) of Cuban slugs positive Lisa Kaluna Instructor Hawaii s Community College. HCC INBRE SIRE campus coordinatorLb ,'�� vNiO Jarvi lab Puna collected 2012-14 64.5% (136/211)semi-slugs positive 4.8% (8/166) Cuban slugs positive Jon Botticelli INBRE SIRE student HCC/UHH Determine how effective various solutions are at killing RLW larvae We have tried many solutions to see how they impact RLW larvae, some immobilize them, but are they dead therefore non -infective? Develop a "death assay" Procedures based on: Ferreira et ol., 2015. A new methodology for evaluation of nematode viability. Biomed Research International. V 2015, ID 879263. We are using multiple stains to determine if larvae are in fact dead, therefore non -infective: Hoechst dye to stain DNA (will stain living or dead cells) Propidium Iodide will stain only dead cells Larvae visualized on the Operetta Ina Klasner, sophomore Hilo High Mahalo to Dr. Ingo Koomoa-Lange V Live larvae Bright field Hoechst/Propidium Iodide Dead larvae Bright field Hoechst/Propidium Iodide Propidium Iodide only Propidium Iodide only N 301,000-601,000 people in the state of Hawaii rely on catchment water for household water; the majority are in the Puna, Ka'u, and Hamakua districts of the Island of Hawaii (Macomber 2010). N.Kohala 195 11% N. Hamakua ilo S Kohala 259 1,541 12% 12% 59-- 33%., 100/0 'S.Hilo N.Kona :% 2367 2,899 14% 28% Puna 8,363 1,26 75% S.Kona 41% Kau 954 43% Big Island Districts: Number of households without municipal water Percentage of households without municipal water Slide kindly provided by Patricia MaComber Some victims believe consumption of catchment water may have caused their infection. • Richards and Merritt 1967 Rats became infected by drinking RLW L3 contaminated water. L3 larvae were active in freshwater up to a week. If rats can become infected by RLW contaminated water, it is likely that humans can too. Kay Howes studies have shown: • Whole semi -slugs Pormarion martensi will shed rat lungworm parasites when they drown in water, whereas some other species, such as the leatherback slug (Veronicella sp.), need to be damaged to shed the parasite. • The first stage larvae will exit the slug within 24-48 hours, they are not capable of surviving acid. The third stage larvae will exit the dead host approximately 72-96 hours after the slug dies. • First stage larvae are capable of living outside the dead slug/snail host for at least 56 days, third stage larvae are capable of living for at least 21 days outside the dead slug/snail host. Strong evidence suggests that the increase in RLWD cases in Hawaii County could be related to the introduction of the semi -slug and residential and agricultural catchment use. Is a 20 micron filter sufficient to block nematodes from entering a household on a catchment system? What types of filters are most effective? Lisa Kaluna -44RI I HCC Instructor INBRE SIRE campus coordinator Bruce Torres Fischer INBRE SIRE HCC student In collaboration with the Hawaii Catchment Co, Keaau HI We captured and bred wild adult rats to produce uninfected progeny. Collaborator: USDA -APHIS Determine if RLW DNA can be detected in rat blood 15 Adult F1 rats were gavaged with either 10 larvae, 50 larvae or none (control). Parasite DNA was detected by gPCR in blood at <1 hr, 1.5 hours, 18 hours, 5 weeks and 6 weeks PI. Conclusion: RLW DNA can be detected in rat blood at certain time points throughout infection. Could it also be detected in human blood? This project was supported by the Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, USDA -APHIS National Wildlife Research Center's National Wildlife Disease Program, University of Hawaii at Hilo Research Council, and a grant from the National Institute of General Medical Sciences, National Institutes of Health, award number: P20GM 103466. Table 2. Results of gPCR for detection of RLW DNA in blood or tissue of rats involved in Trial I and Tria High dose infection (HD, 50 larvae/ml gavage), low dose (LD, 10 larvae/ml gavage), control (C, 0 larvae/ml gavage). Trial I n = 5 rats/treatment Trial II n = 2 rats/treatment Number of Number of Number of Number of gPCR rats gPCR rats Treatment Time PI replicates/ rat' positive2 Time PI replicates/ rata positive2 Control pre -bleed 4 0 pre-bleed4,8 0 4-7 hrs 4 0 45-55 mins 4 0 21-24 hrs 4 0 2-2:20 hrs 4 0 day 2 4 0 14-15 hrs4 0 day 3 4 0 16-17 hrs 4 0 week 1 4 0 18-19 hrs 4 0 week 2 4 0 Week 4 2,4 0 wk6cardiac 2 0 Week 2 0 wk 6tail 8 0 Week 214 0 Low dose pre -bleed 4 0 pre -bleed 2 0 4-7 hrs 4 0 30-35 mins 2 0 21-24 hrs 4 0 1:30 hrs 216 1 day 2 4 0 14-15 hrs2 0 day 4 0 16-17 hrs 2 0 week 1 4 0 18-19 hrs 2 0 week 2 4 0 Week 4 214 0 week 6 cardiac 2 5 Week 5 4 1 wk 6tail 12 3 Week 2,4 2 High dose pre -bleed 4 0 pre -bleed 2 0 4-7 hrs 4 0 50-60 mins 2,6 1 21-24 hrs 4 0 2-2:15 hrs 2 0 day 2 4 0 14-15 hrs2 0 day 3 4 0 16-17 hrs 2 0 week 1 4 0 18-19 hrs 2 1 week 2 4 0 Week 4 2 0 week 6 cardiac 2 5 Week 5 4, 5 1 wk 6tail 12 5 Week 2 4 'One extraction per individual except wk 6tail: tail tissue which had two extractions per individual for controls, 3 extractions per individual for infected. Positive = clear signal in large proportion of replicates 31fthe number of replicate gPCR tests differed between the two individuals, they are reported separately. Determine efficacy of a vaccine against A. costaricensis to Hawaii A. cantonensis. • We found no significant differences between vaccinated and unvaccinated rats in spleen weight (p=0.963), spleen length (p=0.830), lung weight (p=0.830) or number of worms collected from the heart and lungs (p=0.882), suggesting the vaccine does not provide adequate protective immunity to guard against infection by A. contonensis in wild Hawaiian rats. • Joann Phan tested cDNA from spleens with TagMan Array 96 well Fast Plates containing assays for 11 cytokines (IL1, IL2, IL4, ILS, IL6, IL9, IL10, IL13, IL17, IFNV, TGFP, TNFa). No differences between vaccinated and non -vaccinated were detected. • Collaborators: Antonio Osuna PhD, Director Institute of Biotechnology, University of Granada, Spain, and USDA -APHIS Average Spleen Weight Spleen length lungs weight number of rat weight (g) (mg) (mm) (g) worms 174.2 504.25 29.26 2.85 23.9 176.56 506.62 29.00 2.88 22.43 192.15 162.5 23.05 1.07 0 • Joann Phan tested cDNA from spleens with TagMan Array 96 well Fast Plates containing assays for 11 cytokines (IL1, IL2, IL4, ILS, IL6, IL9, IL10, IL13, IL17, IFNV, TGFP, TNFa). No differences between vaccinated and non -vaccinated were detected. • Collaborators: Antonio Osuna PhD, Director Institute of Biotechnology, University of Granada, Spain, and USDA -APHIS Conduct a pilot study to determine the extent of human RLW exposure in East Hawaii Island • Currently a lumbar puncture is required for diagnoses which is risky, expensive, and must be conducted at a hospital. Antibody -based blood tests are less invasive and don't require hospitalization. • Initially screening for antibodies by ELISA using crude RLW antigen isolated from Hawaii RLW adults, followed by dot -blot ELISA using 31 kDa antigen (kindly provided by Dr. Praphathip Eamsobhana, Thailand). • To document exposure information, acute and longer-term symptoms, treatment provided due to RLWD through the completion of a self-reported questionnaire. Blood sample collection was conducted by Puna Community Medical Center and Clinical Labs of Hawaii (plasma, serum and whole blood in DNA lysis buffer). Total of 435 samples collected from volunteers between June 11 -Aug 27, 2015. C CLINT AL LABS UNiveas[Trof Hnwn['I• � O F HAWAII HILO JNIAMDOL UNIVERSITY ,NpU� COLLfC6 o ')"OF HnwP��P Of 435 human volunteers most reported they were from Pahoa and Keaau 10,2% 6,1% 1:1 :10/- 57% • Pahoa • I<eaau Unknown • Hilo Other Mt. View • Mainland Kahala ec'n't M.... K— N 'rtl;) WD111k Makwa L— ------- it--- N 'rtl;) Most reported catchment as a water source n = 435 338.,78% -v ■ Catchment ■ Municipal N/A ELISA Results :435 Reliably Tested Samples 26% were positive or likely positive 150,35% 40,9% 171,39% 74,17% Positive Likely Positive Equivocal Negative Total ELISA -Dot Blot Results: n = 186 131, 30% were positive ■ Positive ■ Negative i&- � �� A � CO Of those who were definitively diagnosed (n = 15), 7 were positive by dot -blot. Antibody production reduces over time which likely explains the dot -blot negatives. ■ Positive ■ Negative Of the 120 who thought they had RLWD (self-diagnosis) 60 were tested by dot - blot and 33% tested positive. 20, 33% 40, 67% ■ Positive ■ Negative Of the 315 who did not think they ever had RLWD, 126 were tested by dot -blot and 28% tested positive. ■ Positive ■ Negative Summary • We detected no negatives among the definitively diagnosed samples and no samples were dot blot positive and ELISA negative, thus the ELISA test using crude antigen isolated from adult RLW from Hawaii appears to be an effective initial screening method. • All dot blot positives were also ELISA positive suggesting good efficacy as a diagnostic for exposure to RLW. • 28% (35/126) of volunteers who did not think they ever had RLWD tested positive by dot -blot, suggesting exposure to RLW is higher than previously thought (mild symptoms). • We tested 58 blood samples (including the 55 dot—blot positive samples) by gPCR (Jarvi et al., 2012) for the presence of RLW DNA and no clear positive signal was detected from any samples except from positive controls. • Next study is to repeat dot -blots with the 31 kDa proteins isolated from Hawaii A. contonensis. To produce a Hawaii -specific blood test, we need many adult Hawaii rat lungworms to use as starting material. Working with CDC, we are collecting at least 10 grams of adult worms. We are collaborated with USDA -APHIS and Hawaii Island DOH Vector Control to process 562 wild - captured rats. 94 % of them were visually positive for RLW. If you are squeamish, please don't look at the next slide! Environment and native species School garden and agriculture projects, Farm to :hoot Bil Sustainability Food and Water Security Rat lungworm Human health, quality of life Animal Health P--� Economy: Farmers, grocers, restaurants consumers In the 1950's and 60's, before zoning laws were introduced, Hawaii County approved the development of many large subdivisions in the Puna and Kau. Today, many residents in these subdivisions lack the infrastructure to access county or private water companies, and in some cases power (Hawaii County Department of Planning, 2015). The amount of rainwater catchment use in agriculture on Hawaii Island is unknown. Rainwater catchment systems are not regulated by any state or federal agency in Hawaii. Slugs and snails are often reported found in catchment tanks by both residents and professional catchment tank maintenance companies. We have spoken with rat lungworm victims who believe they were infected by catchment water. One of the more recent cases of diagnosed angiostrongyliasis occurred in 2015 after a resident syphoned water from his tank due to a power outage. Larvae very similar in size and shape to A. contonensis were found in a 20mL water sample for a catchment tank from a man who perished from angiostrongyliasis. Based on number of cases reported by the DOH (2005-2014): Giardia, Camplyobacter„ E. coli, Salmonella, Leptosporosis and RLW. Hawaii County has a higher percentage of waterborne disease than the rest of the state of Hawaii 100% 80% 60% 8,980 81,633 Non - 40% Waterbourne 20% Waterborne 0% 2,008 8,707 Hawaii Rest of the County State A comparison of the number of cases of waterborne disease across islands from 2005- 800 2014 0 0 e 600 CL IU 400 0 a s 200 0 Hawaii Honolulu Kauai Maui Essential needs for Hawaii County • Vector Control Residents (especially catchment users) Farmers (especially suppliers of Farm to School) School Garden Projects • Research Diagnostics/treatment Water treatment studies Vegetable rinse studies Reducing infection rates in the rat (e.g. deworming rats?) Identifying RLW `hotspots' • Education Residents and tourists Medical Professionals School Garden Projects Food handlers -Hawaii Island food safety concerns Farmers Island -wide catchment education and assistance Links to informative documentaries, interviews, a RLWD website, and a petition site produced by or associated with the Hawaii Island Rat Lungworm Working Group • We created a 54 -minute documentary video of RLWD victims, Mark Kimura videographer: https://www.facebook.com/1owerpuna/posts/486483071518532 • RLWD wash your veggies, Mark Kimura videographer https://www.youtube.com/watch?v=PZ2t6CnBFEQ • Watch "Safeguarding Hawaii Island School Gardens Against Rat Lungworm Disease," a forum held at UH -Hilo May 2016, on our video on demand http://naleo.ty/rat-lungworm-disease/ • http://www.bigislandvideonews.com/2015/04/02/video-rat-lungworm-disease-concerns-renewed/ • http://hawaiipublicradio.org/post/researchers-lool<-more-funding-rat-lung-worm-disease HPR Wayne Yoshioka • http://www. lava 1053.com/episode/island-issues-03-29-2015/ Lava 105.3 Sherry Bracken • This is a link to a Beyond the Fear: a Documentary about RLWD produced by Mariful Films: https://www.youtube.com/watch?v= cybPTbX-4 • We also launched an online petition: • http://www.thepetitionsite.com/529/190/532/demand-action-to-stop-rat-Iungworm-disease-in-hawaii-now/ • For more information please see the RLW Working Group website: http://pharmacV.uhh.hawaii.edu/rlw/ includes link to 2011 Rat Lungworm Forum held at DKICP, online educational resources, FAQ's and other interesting inffirmatinn. References • Eamsobhana P, Tungtrongchitr A, Wanachiwanawin D, Yong HS, Mak 1W. 1998 Characterization of a 31-kDa specific antigen from Parastrongylus cantonensis Nematoda: Metastrongylidae . Int Med Res J;2:9-12 • Eamsobhana P and Yong HS, 2009 Immunological diagnosis of human angiostrongyliasis due to Angiostrongylus cantonensis Nematoda: Angiostrongylidae . IntJ of Infectious Diseases 13: 425-431. • Eamsobhana P, Yoolek A, Kreethapon N 2003 . Blinded multi -laboratory evaluation of an in-house dot -blot ELISA kit for diagnosing human parastrongyliasis. Southeast Asian J Trop Med Public Health. Mar;34 1 :1-6. • Eamsobhana P, Yoolek A, Punthuprapasa P. 2003 Dot -blot ELISA for the immunological detection of specific antibody to Parastrongylus cantonensis. Trop Biomed;20:1-6. • Hochberg NS, Park SY, Blackburn BG, Sejvar JJ, Gaynor K, Chung H, Leniek K, Herwaldt BL, and Effler PV. 2007. Distribution of Eosinophilic Meningitis Cases Attributable to Angiostrongylus cantonensis, Hawaii Emerging Infectious Diseases. Vol. 13, No. 11, November • Jarvi S.I., Farias, M.E.M., Howe, K., Jacquier, S., Hollingsworth, R. & Pitt, W. 2012. Quantitative PCR estimates Angiostrongylus cantonensis infection levels in semi -slugs (Parmarion martensi). Molecular and Biochemical Parasitology 185: 174-176. • Kim, J.R., Hayes,K.A., Yeung, N.W., Cowie, R.H., 2014. Diverse gastropod hosts of Angiostrongylus cantonensis, the rat lungworm, globally and with a focus on the Hawaiian Islands. PLOS One. 9:1-10. • Qvarnstrom Y, Aramburu da Silva AC, Teem JL, Hollingsworth R, Bishop H, Graeff-Teixeira, da Silva AJ. 2010. Improved molecular detection of Angiostrongylus cantonensis in Mollusks and other environmental samples with a species-specific internal transcribed spacer 1 -based TagMan assay. App and Envir Microbiology, Aug 5287-5289. • Wang QP, Lai DH, Zhu XU, Chen X -G, Lun ZR. Human angiostrongyliasis. Lancetlnfectious Diseases 2008;8:621-30. • Wang QP, Wu ZD, Wei RL, Owen ZR, Lun ZR. 2012. Human Angiostrongylus cantononsis:an update. European Journal of Clinical Microbiology and Infectious Diseases ;31:389-95, http://dx.doi.org/10.1007/s10096-011-1328-5. i `NpU1'6 cot" G 2 CLINICAL LABS o M ahalo v' OF HAWAII F K UNIVERSITY of HAWAII° HILO �ryoF HAwP<�� Many thanks to the volunteers, students and scientists who have been a part of the Hawaii Island Rat Lungworm Working Group. Thanks to our collaborators: • Antonio Osuna PhD, Director Institute of Biotechnology, University of Granada, Spain • Praphathip Eamsobhana PhD, Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand • Puna Community Medical Center, Clinical Labs of Hawaii, Hawaii Catchment Co. I<eaau, HI, Hawaii Island School Garden Network, USDA -APHIS, Hawaii Island DOH Vector Control. Funding provided by the Hawaii Community Foundation Medical Research, UH Research Council, USDA -APHIS, and the ° MAHIDOL h UNIVERSITY Daniel K Inouye College of Pharmacy.