Wash your produce and skirt disease, ill man urges

A 22-year-old Minnesota man recovering from a rare, debilitating and sometimes fatal form of meningitis wants to warn others about the rat lungworm disease he contracted in Hawaii.

Eric Reinert was hospitalized on Nov. 10 for seven weeks at the Hilo Medical Center, where he battled the parasitic disease that struck his nervous system. The pain and hypersensitivity were so extreme, he said, that he would cry out if even a piece of a napkin fell on his chest.

He suffered numbness in his limbs, blurry and double vision, numbness to the left side of his face, and was hypersensitive to heat and cold. Even his bladder and bowels shut down.

The strapping, 5-foot-10, 200-pound former high school wrestler shrank to 155 pounds.

"I want to have people know how bad it is and make sure they take precautions," Reinert said last week from his Watertown, Minn., home, urging people in Hawaii to carefully wash produce to avoid inadvertently ingesting slugs or snails that spread the parasitic disease.

Reinert contracted the disease on Nov. 3, and is one of 37 cases confirmed or tested probable for eosinophilic meningitis, which is caused by the parasite Angiostrongylus cantonensis, in Hawaii from 2005 to 2011.

According to the state Department of Health, since 2005 when it began collecting data, the disease has killed one person: a Hawaii island baby.

All but three of the 37 cases were contracted on Hawaii island.

The Health Department has made a concerted effort to educate Hawaii County residents, farmers and home gardeners about the disease. A tiny slug commonly found on that island, the Cuban slug, is a common carrier.

The disease is most often transmitted by eating raw leafy vegetables and inadvertently ingesting the tiny slugs and snails, which pick up the parasite carrying the disease by slithering in rat feces. Thorough cooking and freezing of produce kills the parasitic worm.

Raw or undercooked shrimp and prawns can also be a source of infection.

In October, Reinert, a horticulture major, traveled to and worked at an organic farm near Pahoa in Puna for what was to be a five-month trip to learn farming.

Reinert believes he got the disease by eating unwashed fruit — possibly guava or passion fruit — growing wild on an abandoned experimental farm a half-mile from Island Harvest Organics, the farm he was working on.

He also ate oranges and lemons but no vegetables.

His doctor deemed it unlikely that untreated irrigation water he drank once from a faucet could have caused it.

But Health Department officials say slugs and snails could contaminate the water in catchment tanks and, if left unfiltered and untreated, could contain the microscopic parasites.

Reinert first experienced muscle weakness and hypersensitivity to every part of his body.

"It was unbelievable," said Reinert, who was a state wrestling champion in high school. "It seemed like I was in a new body. When your arms and your legs are so skinny, it doesn’t seem right. It was not normal."

When Reinert first went to the Hilo Medical Center’s emergency room, he was sent home with antibiotics for the flu. Back at the farm in bed, as people walked on the wooden floor, he could feel the vibrations.

"It was torturous," he said. "It was painful."

When Reinert returned to the emergency room, Dr. Jon Martell recognized his symptoms and started him on anti-parasitic medication and steroids. The disease was confirmed on the third of five spinal taps.

His mother, Linda, flew to be at his bedside and remained with her son for the seven weeks.

The Reinerts believe early diagnosis and treatment is what spared Eric from lingering symptoms or going into a coma, as did Graham McCumber, a Kapoho man who was in a coma for three months and paralyzed for a couple of months.

"Dr. Martell had seen this before," Linda Reinert said. "His symptoms looked like everybody else’s. He said, ‘Let’s just treat this,’" rather than waiting for confirmation from the U.S. Centers for Disease Control.

Reinert returned to his Minnesota home Dec. 23 and had to learn how to walk again. He is now out of his wheelchair and able to move without a walker or cane but is still learning to regain his balance and is healing from minor injuries from falling.

"He’s handling it really well and has a positive attitude," his mother said.

Joe Elm, supervisor of the Health Department’s disease outbreak field investigators, said cases are counted as confirmed when the worm is found in the spinal fluid, and as probable if an experimental test by the CDC comes back positive. For those who refuse to have a painful spinal tap, the disease cannot be confirmed.

Linda Reinert believes the disease is more widespread than the numbers show. The Reinerts met four people who had previously been afflicted with the disease, some with milder symptoms. But some refused a spinal tap, so the disease was never confirmed.

Reinert is grateful for the aloha shown to her and her son by strangers in Hawaii, and the many kindnesses shown by friends at home.

A man named Tony and his wife drove her to the hospital when she arrived at the airport.

After sleeping for two weeks on a hospital cot, she was invited by a nurse named Lana to stay at her home.

"They had a pot of coffee in the morning for me — just sweet, wonderful things that made this tough journey much easier," she said.

"People were knitting me socks. I had all kinds of love," she said. "Somebody would take care of my laundry. They baked Christmas cookies, trying to make us feel better. I was just blown away."

A friend donated his miles so Eric’s father could fly to Hawaii for a week.

Back in tiny Watertown, about 160 local residents came out Jan. 1 in below-zero temperatures to "Run for Ric," raising $3,000 for medical expenses.