2nd Rat Lungworm Disease Case Confirmed on Big Island in 2019

The Hawai‘i Department of Health (DOH) has confirmed another case of rat lungworm disease (angiostrongyliasis) contracted on Hawai‘i Island. The individual is a resident of North Hawai‘i and is the second person from Hawai‘i County to test positive for angiostrongyliasis in 2019, bringing the statewide total to two cases this year.

Health officials learned recently about the adult resident of North Hawai‘i, who became ill in January. Laboratory testing though DOH’s State Laboratories Division confirmed the individual’s infection in late February. The individual was hospitalized for a short time and has since recovered.

Disease investigators conducted a detailed investigation to learn more about possible sources of infection. The exact source of infection could not be identified, but investigators learned the individual had a home garden on their property. It is likely the individual accidentally consumed a slug or snail while eating produce from their garden.

“In Hawai‘i, we need to treat all slugs and snails as if they are infected with the parasite that causes rat lungworm disease, and this means washing all produce no matter where it comes from, whether it’s from the grocery store, the farmer’s market or grown in our own home gardens and yards,” said Health Director Bruce Anderson. “Washing all produce carefully and thoroughly using clean, running water is the most effective way to remove unwanted slugs or snails from fresh fruits and vegetables.”

DOH will host a community meeting in North Hawai‘i in late April to provide residents in the area with information about rat lungworm disease and how they can protect themselves. Health officials and experts on prevention will be on hand to answer questions and share information. The meeting is tentatively scheduled at the North Kohala Public Library for Monday, April 22, at 6 p.m. More details about the event and will be shared with the public at a later time.

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:

• DOH website: http://health.hawaii.gov/docd/disease_listing/rat-lungworm-angiostrongyliasis/
• HDOA website: http://hdoa.hawaii.gov/blog/main/rat-lungworm-information/
• CTAHR website: http://manoa.hawaii.edu/ctahr/farmfoodsafety/rat-lungworm/
• CDC website: https://www.cdc.gov/parasites/angiostrongylus/index.html

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 parasiteAngiostrongylus 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.