First Case of Rat Lungworm Confirmed on O‘ahu

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The Daniel K. Inouye College of Pharmacy has helped develop this book to education children about rat lungworm disease. Courtesy image.

The Hawai‘i State Department of Health confirmed one new case of rat lungworm disease in an O‘ahu resident.

This is the first case of rat lungworm disease contracted on O‘ahu in 2017, bringing the statewide total of confirmed cases to 16 for this year.

The adult case is currently hospitalized and the department confirmed their illness late on Tuesday afternoon.


The O‘ahu resident began experiencing symptoms consistent with rat lungworm disease in July. DOH staff from the Vector Control Program and Disease Investigation Branch started conducting onsite property assessments this morning in East O‘ahu. Vector Control staff surveyed for slug, snail and rat activity. Current findings do not show evidence of slugs or semi-slugs nearby.

The source of the individual’s infection is still unknown at this time, but DOH will continue investigations based on the information gathered today.

The last reported case of rat lungworm disease on O‘ahu was in 2010.


“This is a serious disease that can be acquired on any of our islands because slugs and snails throughout the state carry the parasite responsible for the illness,” said Keith Kawaoka, deputy director of Environmental Health. “This is a grim reminder that we all need to take precautions when working in our gardens and on farms, and eliminate slugs, snails and rats from our communities to reduce the risks posed by this parasitic disease.”

DOH recently announced plans to ramp up efforts to prevent rat lungworm disease statewide. This includes efforts to increase public outreach and education throughout the state—a top initiative identified by the Governor’s Rat Lungworm Disease Joint Task Force, which was convened in 2016. The Joint Task Force is comprised of local experts in medical, scientific, environmental and public health fields from across the state.

The public is urged to take the following five precautions to prevent rat lungworm disease:

  1. Carefully inspect, wash and store produce in sealed containers, regardless of whether it came from a local retailer, farmer’s market or backyard garden.
  2. All fruits and vegetables should be washed and rubbed under running water, especially leafy greens, in order to remove any tiny slugs or snails.
  3. Controlling snail, slug and rat populations is one of the most important steps in fighting the spread of rat lungworm disease.
  4. Eliminate slugs, snails and rats around properties and especially around home gardens.
  5. Farmers, food handlers and processors should increase diligence in controlling slugs, snails and rats on the farm.

Rat lungworm disease (angiostrongyliasis) is contracted when a person becomes infected with the parasite Angiostrongylus cantonensis. This often happens when a person accidentally consumes raw or undercooked infected slugs, snails, freshwater shrimp, land crabs or frogs. The most common symptoms include severe headaches and neck stiffness, but symptoms may vary widely among cases. The most serious cases experience neurological problems, pain and severe disability.

More information about the signs and symptoms of rat lungworm disease may be found online or downloaded here.

The first of a series of public service announcements about rat lungworm disease prevention is posted on the Hawai‘i Department of Agriculture’s website.

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