Updated Rat Lungworm Treatment Protocol

[HereOnThePrimalEdge]

In the wake of the recent 6th International Workshop on Angiostrongylus and Angiostrongyliasis, Hilo Medical Center has released a statement with the latest treatment information for rat lungworm, including an over the counter medication. An excerpt:


“Based on this recent research, we will inform patients that pinworm medication might have benefit if taken immediately after accidental consumption of a snail or slug,” says Dr. Martell. “The potential, though not proven, benefits appear to outweigh the minimal risk of the treatment. Snails and slugs in East Hawaii often carry the parasite and the pinworm medicine is available over-the-counter and safe if given as instructed on the package. We are recommending that people who have been exposed read the patient information for the medication and make an informed decision. The sooner you take the pinworm medication the more likely it is to help. We also recommend that you get the snail or slug tested later if you can, and absolutely go to see your primary care provider within a couple of days for assessment and possible use of additional treatment.”



Updated Treatment Guidelines for Albendazole for Children

Treatment recommendations for children who have swallowed a snail or slug using the antiparasitic medication, albendazole, were updated based on the September 2019 Children’s Health Queensland Hospital and Health Services, “Paediatric guideline: Snail and slug ingestion (Prophylaxis against Angiostrongylus cantonensis infection).”

“We are making this information public and are recommending that patients and physicians use this information to make an informed decision about whether they want to follow the Australian guidelines,” says Dr. Martell.
https://www.bigislandvideonews.com/2020/...-protocol/

[terracore]

A few years ago we were shopping for pinworm medicine locally and it was really hard to find. Everybody was sold out. We wound up buying it online. I only post this because you need to use it right away after RLW exposure for it to be effective and waiting for an online shipment to arrive if nobody has it locally may be too long.

There is the bulk solution like this one (we bought it for under ten dollars on sale, so maybe shop around):

https://www.amazon.com/gp/product/B07622...tl?ie=UTF8&psc=1&linkCode=ll1&tag=pw016-20&linkId=7cfc80645b06e694c32b65be86656fca&language=en_US

The stuff you find locally looks more like this:

https://www.amazon.com/Reeses-Pinworm-Me...m+medicine&qid=1579226139&sr=8-7&linkCode=ll1&tag=pw016-20&linkId=a15100dab171a40e71252bbf5df98b94&language=en_US

You can also get all the dewormers (including ones that are Rx for humans) at the feed stores, but of course you'll have to know about adjusting dosages.

[geochem]

anyone have an idea what the shelf life of this stuff is? would probably buy some and keep it on hand, just in case...

[terracore]

Expiration dates are largely based on how long the product is expected to last after it is opened and stored in the worst possible conditions. FEMA and the military have both done studies and found that most unopened medicine has no expiration date. I recall the FEMA study they tested medicine that was 15 years past it's date because that was the oldest medicine they had in storage and it was identical to new medicine. This article references that if considering expired medicine to skip the liquid varieties and opt for the tablets:

"The original purpose of the SLEP program was twofold: to determine the actual shelf life of stockpiled military medications for future use, and to save government dollars.5 Over 3000 lots, representing 122 different drug products, were assessed in the SLEP program. Based on stability data, expiration dates on 88% of the lots were extended beyond their original expiration date for an average of 66 months. Of these 2652 lots, only 18% were terminated due to failure. Examples of common drug products that were tested with no failures included amoxicillin, ciprofloxacin, diphenhydramine, and morphine sulfate injection. Drug expiration extension dates on these products ranged from 12 months to 184 months (over 15 years)...Solid dosage forms, such as tablets and capsules, appear to be most stable past their expiration date. Drugs that exist in solution or as a reconstituted suspension, and that require refrigeration (such as amoxicillin suspension), may not have the required potency if used when outdated."

https://www.drugs.com/article/drug-expir...dates.html

[geochem]

Very interesting information Terracore. Thanks.

[HereOnThePrimalEdge]

88% of the lots were extended beyond their original expiration date

I keep all my medications, supplements, etc in the fridge. I generally toss about 5 years after the expiration date, some longer. Aspirin always works, everything else too, and none have ever made me ill.

I think the key is as terracore noted "Expiration dates are largely based on... the product... stored in the worst possible conditions." For most products, cool and dry (in ziplock bags) in the fridge would be the best possible conditions for the average homeowner.

[terracore]

I recently took some medicine that was made and originally opened in the 1900's. It worked as well as when I bought it. If medicine isn't crumbling, discolored (as if I can remember original color?) or otherwise raises any red flags I'm in no hurry to throw it out.

"Aspirin always works, everything else too, and none have ever made me ill"

Digressing comment coming but still on topic: A friend of ours works for one of the largest pharmaceutical companies in the world. While all the opiates etc get the press for pain pills the golden standard for pain management is aspirin: when they are evaluating the efficacy of new drugs the comparison they use for effectiveness is basically the same formula of aspirin from 1899 which varies little from salicylic teas that date back to 400 BC (opium was also used in antiquity). I've found that the lowest dose aspirin pills (usually 81mg, though sometimes I have to take 2-3 of them) are more effective at pain management than anything a doctor can prescribe. The downside to aspirin is that some people cannot take it due to stomach problems or they are on blood thinners etc. Basically pain management has become more EXPENSIVE over time but little has been invented in over 2,000 years that is any better than what came before it.

[HereOnThePrimalEdge]

A patient on Kauai was treated with the new rat lungworm treatment, and the results are very promising:


Woman’s speedy rat lungworm recovery could offer insight on treatment options

“I wasn’t going to take an anti-parasitic initially, and then the Big Island docs were like, ‘No, you need to take the anti-parasitic albendazole for two weeks. You need to take the stronger steroids,’” said Garcia.

After missing three weeks of work, Garcia is once again helping patients as a physical therapist at Wilcox Medical Center. She said her health is almost back to normal.

“Unfortunately, we’ve had other cases where they’ve gone on to severe, crippling disease,” explained Dr. Jon Martell, the facility’s chief medical officer. “Part of it is how much exposure the person had, and how long it took them to get treatment.”

Instead of waiting for symptoms to appear, the facility now recommends taking over-the-counter pinworm medication as a preventative step.

"If you can take it early, right after a snail or slug is ingested, you may paralyze the worms. They won't get into your system," said Martell. "There's no human studies, but it's a safe drug."

https://www.hawaiinewsnow.com/2020/02/04...t-options/

[Chunkster]

This is good news, and I'm glad you posted it, HOTPE. It is encouraging that the woman who developed symptoms before getting treatment has had such a good recovery. It probably helped that she was a Hawaii medical professional treated by someone with some familiarity with the disease and a willingness to consult experts. In other cases where it took much longer for a diagnosis to be made, the treatments have apparently been less successful. The pinworm treatment is promising, too, but doesn't it depend on awareness that a slug has been ingested? Seems like the victims often don't recall having eaten one, and only realize that was what happened in retrospect. In any case, progress is being made, and that's important.

[randomq]

Glad they finally found a protocol that works! I wonder if pumpkin seeds would be helpful, since they also tend to paralyze intestinal parasites. Might be an option if albendazole is not immediately available.