Hawaii health officials are confirming a case of Angiostrongylus cantonensis, or rat lungworm, on Puna district on Hawaii Island and are concerned there may be more.
This is not the first time the parasitic disease has been reported in Hawaii, in fact, it appears to be firmly established on the island state. The Hawaiian government had previously reported at least 60 cases of rat lungworm disease (RLWD) have been documented in humans in Hawaii, most of them originating from the Puna district of Hawaii Island.
Angiostrongyliasis is an infection caused by the rat lungworm, Angiostrongylus cantonensis. This is aparasitic infection in rats where it matures. Mollusks like snails and slugs pick up Angiostrongylus larvae by ingesting them in rat feces.
Infection with this parasite occurs by accidentally or intentionally ingesting raw snails and slugs. Lettuce and other leafy vegetables may also be a source if contaminated by small mollusks. Eating raw or undercooked prawns and crabs that have ingested mollusks may also be a source of infection. For more infectious disease news and information, visit and “like” the Infectious Disease News Facebook page
However, as one parent whose child was infected 7 years ago said, “It’s generally assumed that most people become infected via accidental ingestion of an infected slug or snail on produce, however the majority of victims here don’t really know how they were infected”.
Angiostrongylus cantonensis infection is usually asymptomatic or mildly symptomatic. Symptoms usually appear in 1-3 weeks. The most serious disease is eosinophilic meningitis. The symptoms can includeheadache, stiff neck, tingling or painful feelings in the skin, low-grade fever, nausea, and vomiting.Symptoms may last for weeks to months. The spinal fluid exhibits eosinophilia of over 20%. Deaths are rarely reported. Angiostrongylus is well known in the Philippines.
Prevention of this nematode is by not eating raw or undercooked snails or slugs, cook crabs and prawns to kill the larvae and thoroughly clean lettuce and other produce.