What Feels Like A Jet Lag Could Be A Parasitic Worm In The Brain

A 30-year-old woman from New England one day experienced something very similar to jet lag. When she went to the doctors, they seemed puzzled. This was unusual and alarming because even the doctors did not know what to do about it. She felt a mild burning sensation in her feet, which soon spread to her legs, torso, and arms. Over the next few days, her symptoms became worse and made even light touches unbearable.

Despite hospital visits, doctors found no immediate cause. This left her even more relentless. However, ignoring this, one morning, she tried to pack her bag and that is when the condition took a turn. Upon a deeper investigation, it was finally revealed that a parasitic worm had infested her brain.

This case was published in the New England Journal of Medicine, which highlighted the dangers of Angiostrongylus cantonensis, commonly known as rat lungworm, a parasite that can cause severe neurological symptoms in humans.

From Symptoms To Diagnosis

Initially, the woman sought emergency care when she noticed that her burning sensations intensified. Doctors also noted her elevated immune cell count but found no obvious explanation. She was soon discharged with instructions to follow up with her physician. However, her condition started to worsen.

By the time she reached Massachusetts General Hospital, she experienced severe headaches and confusion. Upon a detailed examination, it was revealed that she had recently been back from a trip to Thailand, Japan, and Hawaii, where she ate street food, raw sushi and fresh salad.

Finally, it was a spinal tap, which is also known as a lumbar puncture, a medical procedure that involves inserting a needle into the lower back to collect cerebrospinal fluid, which provided the answer. The cerebrospinal fluid contained an extremely high level of eosinophils, a type of white blood cell that signals parasitic infection.

What is a Rat Lungworm?

Angiostrongylus cantonensis, or rat lungworm, as per the Center for Disease Control and Prevention (CDC) is a worm of rats, which is found in infected rats when they pass larvae of the parasite in their feces. Snails and slugs get infected by ingesting the larvae and these mature in snails and slugs but do not become adult worms. This means you can get it if you eat slugs, snails, or unwashed raw vegetables and it can cause eosinophilic meningitis or brain infection. Once inside a human host, the larvae soon migrate to the brain.

Such cases have earlier been reported in other parts of the world too, including the United States.

How Does It Infect Humans?

Humans can contract rat lungworms by consuming raw or undercooked snails, slugs, or food contaminated with their larvae. Cases have been reported in individuals who:

• Ate infected raw produce, such as salads
• Consume raw freshwater shrimp, crabs or frogs
• Swallowed slugs or snail

In some rare cases, such infections could also lead to severe complications paralysis or even death. One such case is from 2010 when Australian rugby player Sam Ballard ate a slug on a dare and developed a severe infection. He then fell into a coma and remained paralyzed until his death in 2018.

Why Does This Case Matter?

Experts like Robert Cowie, a parasitologist at the University of Hawaii, argue that rat lungworm disease is underdiagnosed due to a lack of awareness among medical professionals. He believes climate change and other environmental factors may be contributing to the parasite’s spread beyond traditionally affected areas like Hawaii and Southeast Asia.

Although only about 220 cases have been documented in the U.S.—primarily in Hawaii and the southeastern states—Cowie suspects that the real number is much higher. Researchers are now working to map the parasite’s presence in North America.

How Can You Avoid This?

Thoroughly wash the produce, especially if they are leafy greens

Cooking snails, slugs, shrimp, and crabs properly

Avoiding eating raw or undercooked animals that may carry the parasite