First Rat Lungworm Case on Hawai‘i Island in 2018 Confirmed

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The rat lungworm parasite under a microscope. Photo courtesy of Dr. Susan Jarvi.

The Hawai‘i Department of Health has confirmed the first case of rat lungworm disease in the state this year in an adult resident of West Hawai‘i on the Big Island.

The individual became seriously ill earlier this month and is being treated at a hospital. Laboratory results confirmed evidence of the rat lungworm parasite in the individual’s spinal fluid.

The DOH has conducted a detailed investigation of the case and is unable to determine the exact source of the infection. The department is unable to provide more specific information on this individual’s case.

“This is a reminder for everyone to take precautions and control snail, slug and rat populations in and around properties, and especially home and school gardens and farms,” said Aaron Ueno, Hawai‘i District Health Office administrator. “We know that slugs, snails, and rats in all counties carry the parasite that can cause rat lungworm disease, and rain with wet conditions often brings more of these garden pests.”


Rat lungworm disease (angiostrongyliasis) can have debilitating effects on an infected person’s brain and spinal cord. The disease is endemic to Hawai‘i and is contracted when a person becomes infected with the parasite Angiostongylus cantonensis. In Hawai‘i, this occurs when a person accidentally consumes raw or undercooked infected slugs or snails. 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.

In 2017, there were 17 laboratory-confirmed cases of rat lungworm disease statewide.

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

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 running water, especially leafy greens, to remove any tiny slugs or snails.

Control snail, slug, and rat populations. Eliminate slugs, snails, and rats around properties, and especially around home gardens and farms.

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

DOH website


HDOA website

CTAHR website

Centers for Disease Control & Prevention (CDC) website

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