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NEWS RELEASE: DOH confirms two new rat lungworm disease cases on Hawaii Island

Posted on Feb 14, 2019 in Latest Department News

HONOLULU – The Hawai‘i Department of Health (DOH) has confirmed two cases of rat lungworm disease (angiostrongyliasis) contracted on Hawai‘i Island.

Health officials recently learned about an adult visitor to the state who had been vacationing in North Hawai‘i last year. The visitor became ill in late December 2018 and was not diagnosed until they were hospitalized for their symptoms when they returned to the mainland. Confirmatory testing was conducted by the Centers for Disease Control and Prevention (CDC). The individual was hospitalized for a short time and has since recovered. The adult visitor was the seventh person from Hawai‘i Island who tested positive for angiostrongyliasis in 2018, bringing the statewide total to nine confirmed cases last year.

Another case of rat lungworm disease was identified in an adult resident from East Hawai‘i. The individual became ill in January and was hospitalized in early February for treatment of their symptoms. Laboratory testing though DOH’s State Laboratories Division confirmed the individual’s infection. This is the first case of rat lungworm disease confirmed in Hawai‘i for this year.

DOH disease investigators are conducting a detailed investigation to learn more about the patients and possible sources of infection. Both investigations are still ongoing, but it is unknown at this time exactly how or where the individuals became infected.

“Our investigators are working diligently to communicate with the patients and learn more about how they may have become infected with rat lungworm disease,” said Health Director Bruce Anderson. “Determining the exact source of infection in any individual is challenging since it requires a deep dive into a person’s food consumption history as well as where they may live, work, travel and recreate. We know that most people get sick by accidentally eating infected slugs and snails. Taking precautions—such as washing all fresh produce before enjoying, and getting rid of slugs and snails around our homes and communities—can go a long way toward preventing infection.”

DOH provides the following recommendations to prevent rat lungworm disease:

  • Control snail, slug, and rat populations around homes, gardens and farms. Get rid of these vectors safely by clearing debris where they might live, and also using traps and baits. Always wear gloves for safety when working outdoors.
  • Inspect, wash and store produce in sealed containers, regardless of whether it came from a local retailer, farmer’s market, or backyard garden.
  • Wash all fruits and vegetables under clean, running water to remove any tiny slugs or snails. Pay close attention to leafy greens.

For more information about rat lungworm disease and how to prevent its spread, visit:

Angiostrongyliasis, commonly known as rat lungworm disease, is caused by a parasitic roundworm and can have debilitating effects on an infected person’s brain and spinal cord. In Hawai‘i, most people become ill by accidentally ingesting a snail or slug infected with the parasite Angiostrongylus cantonensis (A. cantonensis). Symptoms vary widely between cases, and the most common ones include severe headaches and neck stiffness. The most serious cases experience neurological problems, severe pain and long-term disability.

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