Seventh case of rat lungworm disease confirmed on Hawaii Island

  • Photo courtesy state Department of Health Humans can contract rat lungworm disease by eating food contaminated with slugs or snails, or their slime.

KAILUA-KONA — State health officials have confirmed a seventh case of rat lungworn disease this year on Hawaii Island.

The Deparment of Health Tuesday said it has received notification from the Centers for Disease Control and Prevention of a laboratory-confirmed case of angiostrongyliasis, or rat lungworm disease, in an adult visitor to Hawaii Island.


With the additional case confirmed by CDC, the department said the statewide case total stands at seven cases of individuals confirmed with angiostrongyliasis in 2019. This includes three residents and four visitors all of which likely contracted the disease on Hawaii Island.

The seventh individual was an adult resident of the U.S. mainland and was traveling in West Hawaii when they were infected with the parasite causing rat lungworm disease. The individual became ill in late June and did not seek medical care until the end of July after reoccurring dizziness, according to the health department.

The individual was hospitalized on the mainland for a short time for their symptoms. The investigation was not able to identify an exact source of infection. However, the individual reported eating a lot of fresh, local produce without washing first. They also grew a number of herbs on their lanai during their visit.

“Thoroughly inspecting and rinsing all fresh fruits and vegetables under clean, running water can go a long way in making our food safer to eat, and it is the most effective way to remove pests and other contaminants,” said Dr. Sarah Park, state epidemiologist, in a media release. “When in doubt, cooking food by boiling for 3 to 5 minutes or heating to an internal temperature of 165 degrees Fahrenheit for at least 15 seconds can kill the parasite that causes rat lungworm disease.”

The department offered the following recommendations to prevent rat lungworm disease:

• Wash all fruits and vegetables under clean, running water to remove any tiny slugs or snails. Pay close attention to leafy greens.

• 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.


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, according to the health department. In Hawaii, 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, according to the health department. The most serious cases experience neurological problems, severe pain and long-term disability.

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