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Dr. is In

Updated: 
June 30, 2017 - 12:30am

Most of us have grown up hearing that we need to eat five servings of fruits and veggies a day. More than eight countries and the World Health Organization have had campaigns on this five-a-day public health topic.

Here in Hawaii, we have abundance in our gardens and markets due to the supportive climate. Yet, there is also an obstacle to our best intentions to eat five or more servings of health-supporting produce a day: rat lungworm disease, also known as angiostrongyliasis.

A roundworm called Angiostrongylus cantonensis or A. cantonesis for short, causes this disease. This roundworm is a parasitic nematode, meaning it needs a host to live, and its chosen home is commonly in the lung arteries of rats, thus the name of the disease, rat lungworm. Humans can get A. cantonesis through snails and slugs, which are an intermediate host for the roundworm where the larvae develop into maturity, at which point they are fully infective.

Humans are not a regular host in the A. cantonesis lifecycle but can become one accidentally by eating raw or undercooked snails, prawns, shrimp, crabs or frogs. People can also get it from water, fruits or vegetables that have been exposed to the roundworm, or from snails or slugs that are hosting the immature larvae.

In a person, the larvae travels through the bloodstream to the central nervous system and can cause eosinophilic meningitis, a serious condition that causes swelling of the brain, nerve damage or even death in rare cases.

To prevent this disease in humans, and your pets, here are a few simple tips to follow from the State of Hawaii Department of Health, among others:

1) Remove rats, slugs and snails from your gardens. When removing slugs use gloves or tongs to prevent cross contamination from your hands.

2) Start with clean surfaces when preparing food, including cutting boards, knives, counters and hands.

3) Wash all of your produce, even the skins of fruits and vegetables you peel or cut, under running water using a scrubbing motion with your hands or a brush.

4) Wash each leaf of lettuce or other leafy greens separately, removing and discarding the outer leaves. This is to remove any slug slime that may contain immature roundworm.

5) Thoroughly inspect your produce for any traces of roundworm as they like to saunter over fruits and through lettuce.

6) When cooking any food products that may possibly have been in contact with A. cantonesis, such as snails, crab, opihi, prawns, etc., cook thoroughly for five minutes to kill any possible parasites. This also holds true for cooked curly greens such as kale.

So, please don’t give up on your five-a-day regimen. Studies continue to show that eating five, or better yet 10, portions of fruits and vegetables a day is associated with a reduced risk of many chronic diseases such as type 2 diabetes, and a 24-38 percent reduced risk of heart disease, stroke, hypertension, cardiovascular disease and premature death. In addition, total cancer risk is decreased by 13 percent.

Just follow these tips to keep your greens clean and enjoy your fruits and veggies — the more the better.

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