For the first time, Alaska health officials reported a case of the parasitic infection, angiostrongyliasis, aka rat lungworm disease.


The case was in a traveler to Hawaii where it is endemic–18 cases in 2017 and three cases to date in 2019.

The Department of Epidemiology reports in a bulletin this week:

On January 28, 2019, the Section of Epidemiology (SOE) was notified of a suspected case of angiostrongyliasis in a middle-aged woman who presented to an Anchorage emergency department
with a 4-week history of headache, low back pain, dry cough, and transient pruritic rash that started 1 week after a 10-day trip to Hawaii.

SOE staff contacted CDC to arrange for PCR testing of CSF, where the diagnoses was ultimately confirmed.

The patient’s symptoms did ultimately resolve without specific treatment.

As part of the investigation, an interview with the patient revealed she consumed a variety of raw produce while dining at restaurants and eating food prepared for her in a private home. She reported that she had not knowingly consumed any snails, crabs, shrimp, prawns, or other shellfish.

Angiostrongyliasis is caused by a parasitic roundworm and can have debilitating effects on an infected person’s brain and spinal cord. 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.

Alaska officials remind travelers to Hawaii or other destinations with known transmission of A. cantonensis should adhere to the following precautions:

  • avoid eating raw or undercooked snails or slugs;
  • only handle snails or slugs with gloves and wash hands
  • thoroughly inspect and rinse produce (especially leafy
    greens) in potable water; and
  • boil snails, freshwater prawns, crabs, and frogs for at least
    3–5 minutes prior to consumption.

Rat lungworm: Half of cases in CONUS locally transmitted

Rat lungworm: High percentage of rats test positive in Hawaii

Hawaii ramps up rat lungworm prevention after reporting the most cases in a decade

Rat lungworm found in 5 Florida counties

The Parasitology interviews, Part 1

The Parasitology interviews, Part 2

The Parasitology interviews, Part 3

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The Parasitology interviews, Part 4