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A killer in the garden

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Cate Bryant: Willow.

Cate Bryant: She had these big eyes and this red hair and a big smile.

Cate Bryant: Willow, are you getting wet? Willow. Are you getting wet? You're soaking!

Cate Bryant: They told us that she'd consumed a parasite called Rat Lungworm. It's just exploded inside of her.

Richard Cairns: The worst thing was seeing Grace who was, you know, a gorgeous, gorgeous little girl just get so weak.

Sam Cairns: I remember saying to the doctor at one stage "What do you really think it is? What's your gut feel?" and I remember her saying, you know, "I'm pretty sure it's the worm". She said "The scan looks like the worm. She said "We just can't find it."

Katie Ballard: My rough-and-tumble Sam. You would never, in a million years, expect that eating that slug would have done what it's done. The only picture I can bring to mind is of that 'Alien' movie when you see, you know, a picture of, you know, things growing out of people's heads. Horrific, absolutely horrific.

John D'Arcy: The public health department didn't want you to talk about this?

Michael Bryant: They were of concern that it would create fear in the community.

Sam Cairns: They didn't want to create public panic.

Richard Cairns: The disease is out there.

John D'Arcy: One of the most frightening parasites on the planet is on the move. Rats infected with Rat Lungworms have spread from Queensland to New South Wales and are now moving further south. There are few diseases more terrifying than Rat Lungworm. The worm's larvae are passed on through rat droppings which are devoured by snails and slugs who can then spread the contamination to humans through their slime - say, on a lettuce leaf - or if they're eaten. Once ingested, the larvae find their way into spinal fluid and then, to the brain, where they hatch into needle-like worms and begin burrowing. In March this year, a baby girl called Willow Mae Bryant was playing in the backyard of this Sydney home.

Cate Bryant: She had these big eyes and this red hair. And a big smile.

John D'Arcy: Cate Bryant was 38 when Willow was born. She had two older sisters who loved her dearly.

Cate Bryant: Are you waving to Willow? Say "Hi, Willow!"

John D'Arcy: On Match 20 this year, 10-month-old Willow fell ill.

Cate Bryant: Well, in the weeks leading up to her getting sick it'd been really wet, so we'd had lots of slugs out on our deck.

John D'Arcy: And Willow loved to play on the deck.

Cate Bryant: It was just an ordinary day until I went to put her to bed
and she just wouldn't sleep all night. She had this little rattle in her chest and so the doctor had said "Take her down to emergency and get a chest X-ray." They couldn't pinpoint anything.

John D'Arcy: Willow's condition was rapidly deteriorating. She was transferred to Sydney Children's Hospital.

Cate Bryant: She'd just gone like a floppy doll.

John D'Arcy: Two weeks later after falling ill, Willow slipped into a coma. Doctors had no idea what was wrong with Willow. They'd never seen a case like hers before but they soon would. A few days after Willow
was admitted to hospital, another little girl on the same street, in the next suburb, fell seriously ill with exactly the same symptoms.

Sam Cairns: I decided to take her to the GP because she'd had a really restless night of waking up crying. Maybe she had a bit of bronchitis or chest sounded a bit rattly.

John D'Arcy: Grace, who looks a lot like Willow, is the daughter of Sam and Richard Cairns.

Richard Cairns: She was, you know, learning to crawl, almost learning to walk.

John D'Arcy: And, like Willow, 15-month-old Grace loved to crawl outside. Initially, doctors thought she had a mild throat infection but her mum Sam, a former paediatric nurse, suspected something more serious. Over the next week, she took Grace to seven different doctors but none of them could tell her what was wrong. All Sam knew was that her baby was getting worse. You ended up taking Grace to the hospital?
What happened?

Sam Cairns: By that stage, I thought there was something wrong with her head. I could feel that her fontanel - so, the soft spot on her head -
was raised. It wasn't flat anymore and it was kind of a bit hard.

John D'Arcy: Most incidents of Rat Lungworm disease pass harmlessly but in the worst cases, the worms eat into the brain which is why early detection is so important. But Grace's doctors were baffled.

Richard Cairns: It was a mystery to us but it also seemed to be a mystery to the doctors that were treating her.

John D'Arcy: Grace was sent to Westmead Children's Hospital for more intensive tests and scans. By now, there were suspicions she might have Rat Lungworm disease.

Sam Cairns: I remember saying to the doctor at one stage, "What do you really think it is? What's your gut feel?" And I remember she - her saying, "I'm pretty sure it's the worm. She said "We just can't find it." And that was when they told us that there was another child that seemed to have similar illness to Grace. It was horrifying - particularly when they said she lived in the next suburb, pretty much, from us.

John D'Arcy: 30km away in Sydney's Children's Hospital, Willow was still in a coma. Doctors were also beginning to suspect it was Rat Lungworm.

Cate Bryant: You know, she was only nine months old and just started to crawl. They did ask us whether she'd come across snails and I tried to think then - I knew that because of all the rain, we'd had slugs.

John D'Arcy: The damage to Willow's tiny brain was so extensive, doctors said she couldn't be saved.

Cate Bryant: At that point, they said that there'd been a lot of damage to her brain and her nervous system, that, um, she would no longer survive without the machines. And even at that point, I did think
that she would come through.

John D'Arcy: What happened?

Cate Bryant: We made the decision that, um, we wouldn't want her to suffer any more. We got our girls together and spent the night in the hospital with her and, um, and then said goodbye the next day.

John D'Arcy: Willow had fallen ill on March 20. She died 19 days later.
Only then was her killer was positively identified. This is what Rat Lungworms look like.

Dr Rogan Lee: They get to about 3cm in length so if you got a large number of those in your brain, they'll cause severe damage. That's how we identified the worm in the young girl.

John D'Arcy: From an autopsy specimen?

Dr Rogan Lee: That's right, yes.

John D'Arcy: Right. The day after Willow's funeral, doctors finally confirmed to her parents that Rat Lungworm was the cause of their daughter's death.

Cate Bryant: She'd ingested it somehow, gone into her stomach and it worked its way up the spinal column into her brain. But in the ride back home, we realised that we've got neighbours with two young girls, that we have to tell them um, so we did, and gradually, we started telling people the story and everyone's reaction was "I had no idea."

John D'Arcy: At this point, you have to ask the question why the public
and health professionals weren't warned by the health department.
If I'd known the dangers of Rat Lungworm disease, then I could have given appropriate advice. It's terribly important that doctors in the community aren't kept in the dark because potentially, that could put lives at risk.

Helen Smith: I'm not sure why NSW Health Department didn't want to spread the word of Lungworm. I think people deserve the right to know and to understand more about this disease and to understand that it's preventable.

John D'Arcy: Helen Smith from Sydney University is investigating ways to stop the spread of the rats that carry the disease. The area is just teeming with black rats.

Helen Smith: We see a trend that the first case of Lungworm appeared in Brisbane, other cases in Sydney and as far south as Jervis Bay. It appears that the incidence is, um, is on the uprise.

John D'Arcy: What makes this story even more concerning is that Willow and Grace were not the first cases for NSW Health. 11-months earlier and 15km away, another victim - Sam Ballard, a strapping 20-year-old rugby player.

Katie Ballard: My rough-and-tumble Sam. Invincible - nothing will ever happen to him. I suppose the word I would use to describe him was a 'larrikin'. This was Sam before he was infected.

John D'Arcy: This is Sam today. G'day, mate. How are ya?

Katie Ballard: Are you going to look up at John, darling?

John D'Arcy: He can, too.

Katie Ballard: There you go. Just takes a while for the messages to get through.

John D'Arcy: Absolutely. Like most of us, Sam had no idea a snail or slug could be dangerous.

MAN: Come on, I dare ya.

John D'Arcy: What he did was silly. At a party, as a dare, he ate one.

Man: Don't be a sook.

Katie Ballard: 20-year-old boys, red wine, alcohol, sitting at some mate's table, a slug goes onto the table, someone banters about a dare.

Man: Eat it. I dare you.

John D'Arcy: Sam ate the slug.

Katie Ballard: Boys will be boys.

Man: Eat it. Eat it. I dare you.

John D'Arcy: Sam would be in intensive care for 420 days – a new record
for Royal North Shore Hospital. Like Willow and Grace, the rat lungworm ravaged his brain.

Katie Ballard: It's devastated, changed his life forever, changed my life forever. It's huge. The impact is huge.

John D'Arcy: Do you think it's an unusual coincidence that all three cases live within 30km of one other?

Katie Ballard: No, not anymore. I honestly believe that it's not a one-off thing.

John D'Arcy: In 2010, NSW Health issued one media release warning of the dangers of eating slugs and snails. No warnings were issued after Grace and Willow were infected this year. Officials told their parents the cases were unrelated and telling the public might cause alarm.

Michael Bryant: They were of concern that it would create, you know, fear in the community which is not really the message - it's just being aware that this thing can happen and take a little bit of precaution rather than, rather than creating fear.

Cate Bryant: They kind of gave us the impression they didn't want to create public, uh - what's the word? - public, uh...

Richard Cairns: Panic?

Sam Cairns..panic, but the more people I talk to and the more, you know, we told Grace's story, people were like "Oh, my goodness - "I didn't know you could get something like that from a snail."

Richard Cairns: But the reality is, we're adjacent suburbs. The disease was transferred at almost an identical point in time. The disease is out there.

John D'Arcy: Grace was in hospital for 45 days. Intensive steroid treatment reduced the swelling on her brain long enough for the worms to die. She's now home and still on heavy medication. We are very lucky.

Richard Cairns: We're very lucky that Sam persisted to get Grace checked, very lucky that the doctors intervened early with the right medication and very lucky that, you know, Grace is now home and recovering.

John D'Arcy: Grace's parents are awaiting further tests to learn if she suffered long-term damage. Sam is making small improvements every week.
Well done. Well done. For Willow's mum, her dad and two sisters, there's a new chapter of life ahead. For you, Cate, some changes?

Cate Bryant: Um, I'm now pregnant again. Um, we had discussed having another baby when Willow was about six months old and we were really lucky to get pregnant first time, so...

John D'Arcy: Bittersweet?

Cate Bryant: It iS bittersweet.