Hawai‘i state health officials have recently reported two additional confirmed cases of rat lungworm disease in individuals from Hawai‘i Island, bringing the state total this year to seven.


One of the cases was a toddler from East Hawaii. The child became ill in October and was hospitalized. Since then, the toddler has been transferred to Oahu for further case management.

An investigation is ongoing into determining how the child got infected.

“With the rainy season in full swing, we may expect to see more slugs and snails around our homes and gardens,” said Health Director Dr. Bruce Anderson. “We can reduce the risk of rat lungworm disease by taking precautions to safely eliminate rats, slugs and snails in our communities. Keeping our young children away from these harmful vectors as well as thoroughly washing all produce before consuming it is crucial.

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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 Hawaii, 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.

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Hawaii 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.

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