Seventh Case of Rat Lungworm Confirmed in Visitor to Hawai‘i Island

The Hawai‘i Department of Health has received notification from the Centers for Disease Control and Prevention of a laboratory-confirmed case of angiostrongyliasis, or rat lungworm disease, in an adult visitor to Hawai‘i Island. With the additional case confirmed by CDC, this brings the statewide total to seven cases of individuals confirmed with angiostrongyliasis in 2019. This includes three residents and four visitors all of which likely contracted the disease on Hawai‘i Island.

The seventh individual was an adult resident of the U.S. mainland and was traveling in West Hawai‘i when they were infected with the parasite causing rat lungworm disease. The individual became ill in late June and did not seek medical care until the end of July after reoccurring dizziness. They were hospitalized on the mainland for a short time for their symptoms. The investigation was not able to identify an exact source of infection. However, the individual reported eating a lot of fresh, local produce without washing first. They also grew a number of herbs on their lanai during their visit.

“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 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.

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

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.

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