Hawai‘i state health officials reported the first angiostrongyliasis, or rat lungworm disease case of 2019 in an adult resident from East Hawai‘i.

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The individual became ill in January and was hospitalized in early February for treatment of their symptoms. Laboratory testing though Hawai‘i Department of Health (DOH) State Laboratories Division confirmed the individual’s infection.

In addition, health officials recently learned about an adult visitor to the state who had been vacationing in North Hawai‘i last year. The visitor became ill in late December 2018 and was not diagnosed until they were hospitalized for their symptoms when they returned to the mainland.

Confirmatory testing was conducted by the Centers for Disease Control and Prevention (CDC). The individual was hospitalized for a short time and has since recovered. The adult visitor was the seventh person from Hawai‘i Island who tested positive for angiostrongyliasis in 2018, bringing the statewide total to nine confirmed cases last year.

The Parasitology interviews, Part 1

The Parasitology interviews, Part 2

The Parasitology interviews, Part 3

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The Parasitology interviews, Part 4

DOH disease investigators are conducting a detailed investigation to learn more about the patients and possible sources of infection. Both investigations are still ongoing, but it is unknown at this time exactly how or where the individuals became infected.

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 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.