Two Hilo parents are suing the health food store that served them an avocado and lettuce sandwich that contained a two-and-a-half-inch long slug that they fear has exposed them and their infant to rat lungworm disease.

Chaunda and Shea Rodrigues’ lawsuit, filed Monday, alleges that Island Naturals Market was negligent when it failed to properly clean the sandwich ingredients and prevent their exposure to a potentially deadly parasite carried by the slug.

In the lawsuit, the couple asserts they have since had a variety of health problems.

The rat lungworm lawsuit is the third of its kind to be filed against a Hawaii eatery by a consumer within the past 12 months.

Two separate complaints filed in February alleged that restaurants in those cases had served salads that caused two people to fall ill with the debilitating disease.

The parasitic roundworm that causes rat lungworm disease is carried by slugs and snails and can be accidentally consumed by humans through unwashed produce. Anthony Quintano/Civil Beat

Rat lungworm got its name because of its life cycle and origin: a parasitic worm scientifically known as angiostrongylus cantonensis that lives within the pulmonary arteries of rats.

The tiny roundworm’s larvae are passed to snails and slugs that consume infected rat feces or soil. Humans may accidentally consume small snails or slugs via fresh produce, so the Hawaii Department of Health has urged residents to thoroughly wash or cook any fresh local fruits and vegetables.

Parasitic larvae can enter the bloodstream, find their way up to the brain and mature into microscopic worms that can cause severe damage to the brain and spinal cord.

But the disease continues to elude researchers and doctors.

Symptoms that may be misidentified as the common flu can prolong diagnosis.

A laboratory at the University of Hawaii Hilo is working on improving diagnostics for the disease, which can cause symptoms that range from fever and headaches to brain damage, paralysis, blindness or death.

New Year’s Eve Lunch Gone Wrong

Chaunda Rodrigues, 31, took two of her favorite avocado sandwiches home for a New Year’s Eve lunch from Island Naturals Market. According to the lawsuit, her husband Shea ate one sandwich, and she fed her 13-month-old son some avocado from hers.

But halfway through the sandwich, the lawsuit says, she felt part of the slug lodged in her teeth.

She froze the entire plate, including sandwich and slug, and took it to the University of Hawaii for testing. The laboratory found that the slug tested positive for the rat lungworm parasite. All three Rodrigueses sought medical attention at various clinics, according to the suit.

Hilo Medical Center’s emergency department prescribed her albendazole, an anti-worm medication, on New Year’s Day.

Chaunda Rodrigues
A screenshot from Chaunda Rodrigues’ public Facebook post, which describes the incident in detail. Chaunda Rodrigues via Facebook

Rodrigues says in the suit that the doctor told her that he did not eat local lettuce as “it’s dangerous and has little nutritional value and the risk outweigh the benefits.”

She thanked him and was discharged.

Her son was treated at Hilo Urgent Care on Jan. 2. Her husband received treatment from a naturopathic doctor on Jan. 3.

The lawsuit alleges Chaunda has felt pressure and stiffness in her shoulders, skull, neck and lower spine. Her husband has felt sensitive to light, headaches, and loss of appetite and fatigue.

The lawsuit does not indicate that any member of the Rodrigues family has received a diagnosis of rat lungworm disease.

The Rodrigues family and their lawyer did not respond to a request for an interview.

Island Naturals Market founder Russell Ruderman, a state senator representing the Big Island, declined to comment for this story.

After a food safety inspection was conducted by the Department of Health this month, Island Naturals Market was able to keep its green placard.

In its inspection report, health department officials said that Island Naturals Market plans to discontinue the use of local leafy greens in deli items and will switch to produce from the mainland. The lettuce in question was sourced from Johnson Family Farm in Pahoa, according to the report.

“Establishment (Island Naturals) is planning to discontinue using local leafy greens in deli items and switching to mainland sourced produce through Albert’s Organics or Charlie’s Produce,” the DOH inspection report says.

The report also noted that Island Naturals now substitutes sprouts for lettuce in sandwiches. Lettuce leaves are now solely used for pre-packaged summer rolls and salad mix for the self-service salad bar.

The health department can only cite restaurants for conditions it observes first-hand, said Eric Honda, district environmental health program chief in Hawaii County. Its inspection of Island Naturals found no slugs or snails.

The department’s vector control branch also sent an inspector to the farm that grew the lettuce, but such visits usually consist largely of providing education since the department has no regulatory authority over growers, Honda said.

In any case, the inspector reported that the farm was clean and well maintained.

“It just goes to show, farming, you’re out there in the environment,” Honda said. “It’s very hard to control 100% (of) all the bugs and pests and everything.”

A Growing Issue

The Rodrigues family’s lawsuit echoes two others filed last year, according to court records.

Former Maui resident Tricia Mynar sued Miyo’s Restaurant last February, alleging she contracted the disease from a salad she ate at the Big Island restaurant two years prior.

She recounted her health struggles caused by parasitic meningitis in a 2017 Civil Beat story. At the time, she had to use a walker to navigate her parent’s home.

The former preschool teacher and Kamehameha Schools administrator has since moved to Colorado and continues to deal with issues such as chronic pain, blurred vision, speech impairment and cognitive impairment, according to the lawsuit.

Another rat lungworm lawsuit also filed in February by Scott Hessler alleges that he got the disease after eating a salad made by Hana Fresh.

map Rat Lungworm UH

The University of Hawaii’s rat lungworm lab has a map of locations where slugs and snails have tested positive for rat lungworm disease on the island of Hawaii. 
University of Hawaii

According to the lawsuit, Hessler was taken to Maui Memorial Hospital after he experienced severe nausea.

“Over the next two months, his health spiraled downward to the point where he was practically paralyzed for two months, trapped in a body of excruciating pain,” the lawsuit says.

In 2019, there were eight cases of rat lungworm disease, five among residents and the remaining three among visitors. All cases were contracted on the Big Island.

According to the laboratory located at The Daniel K. Inouye College of Pharmacy at the University of Hawaii at Hilo, the majority of snails, slugs and frogs that have tested positive for the disease have been found on the east side of the Big Island near Hilo.

Shea Rodrigues weighed in about his family’s experience publicly on Facebook.

“Even local produce that is washed has the potential to carry rat lungworm,” he wrote. “It does not take biting or eating a slug to contract this terrible illness. We either need to move away from local leafy greens or require a certification for farmers that implements stringent safety measures.”

Investigations Editor John Hill contributed to this report.

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