Ninth case of rat lungworm disease in 2019 confirmed on Kaua‘i

Rat lungworm photos: Juvenile Parmarion martensi on a nickel (credit: HDOH); Veronicella cubensis (Credit: Rob Cowie, UH Mānoa)

The Hawai‘i Department of Health has confirmed a case of angiostrongyliasis, or rat lungworm disease, in an adult on the island of Kaua‘i.

With the additional case, this brings the statewide total to nine cases of individuals confirmed with angiostrongyliasis in 2019. This includes eight individuals who likely contracted the disease on Hawai‘i Island, according to department officials.

The ninth individual was an adult resident of Kaua‘i who had travelled to Hawai‘i Island in mid-December and became ill later that month. The individual experienced symptoms of headaches, nausea, vomiting, neck stiffness and joint pain and sought medical care. The investigation was not able to identify an exact source of infection.

“Thoroughly inspecting and rinsing all fresh fruits and vegetables under clean, running water can go a long way in making our food safer to eat, and it is the most effective way to remove pests and other contaminants,” said Dr. Sarah Park, state epidemiologist. “When in doubt, cooking food by boiling for 3 to 5 minutes or heating to an internal temperature of 165 degrees Fahrenheit for at least 15 seconds can kill the parasite that causes rat lungworm disease.”

DOH provides the following recommendations to prevent rat lungworm disease:
Wash all fruits and vegetables under clean, running water to remove any tiny slugs or snails. Pay close attention to leafy greens.
Control snail, slug, and rat populations around homes, gardens and farms. Get rid of 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.

For more information about rat lungworm disease and how to prevent its spread, visit:

DOH website: https://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 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.