CDC confirms three unrelated cases of rat lungworm disease in Hawaii island visitors

Local News

The Centers for Disease Control and Prevention (CDC) confirmed three unrelated cases of rat lungworm disease in visitors to Hawaii island — one of which came to be after eating a slug on a dare. 

All three individuals are adult residents of the U.S. mainland who were traveling in Hawaii when they were infected with the parasite, causing the disease, according to the Hawaii Department of Health — who received notification about it. 

One of the individuals visited East Hawai‘i in December 2018 and became infected by purposely eating a slug on a dare.

The individual became ill in late December and was not hospitalized for their symptoms. The adult visitor was the eighth person infected on Hawai‘i Island who tested positive for rat lungworm disease in 2018, bringing the statewide total to 10 confirmed cases last year.

State health officials tell us, this is not the first time someone’s eaten a slug or snail on purpose and got sick.

“There have been other incidences where we know that it wasn’t a dare so much as it was a bet,” said State Epidemiologist Dr. Sarah Park. 

The other individuals confirmed by the CDC laboratory were traveling on the west side of Hawai‘i Island during their visits.

One of these individuals became ill in early January 2019 and was not hospitalized for their symptoms. After an investigation, it is not known how the individual was infected, however, they do remember eating many homemade salads while on vacation.

The other individual became ill in late February 2019 and was hospitalized for a short time. The investigation was not able to identify an exact source of infection, but the individual likely became infected while “grazing,” or eating unwashed raw fruits, vegetables, and other plants straight from the land.

With the additional cases confirmed by CDC, this brings the statewide total to five confirmed cases of rat lungworm disease in 2019, all of which were contracted on Hawai‘i Island.

“It’s important that we ensure our visitors know the precautions to take to prevent rat lungworm disease, which can have severe long-term effects,” said Health Director Bruce Anderson. “Getting information to visitors about the disease is just as critical as raising awareness among our residents.”

Dr. Park says visitors may be unaware of rat lungworm disease or think it’s never going to happen to them.

“We do make a huge effort especially now that we have the funding from the legislation to be able to work with the Department of Transportation, airports, and other tourism partners on educating our visitors,” said Dr. Park. 

The Department of Health provides information to visitors traveling to Hawai‘i with signage in local airports and shopping centers. Anderson added, “We recognize that there is more work to be done in educating residents and visitors and making sure they know how to prevent the spread of this disease.”

Each time rat lungworm cases are reported, the state goes into action.

“It’s part of why we are conducting a survey on feed and water consumption habits. It’s why we continue to investigate every case that we learn about very thoroughly,” said Dr. Park. 

“A lot of vigilance is needed to prevent from getting the disease because it is 100-percent preventable,” said Peter Oshiro, environmental health program manager.

Oshiro says residents and visitors need to be vigilant about what they put in their mouths and what their children could be eating. 

“It’s very simple, just keep on washing your vegetables before you eat it because we are in a tropical climate and there is a chance if things are growing outdoors you are going to have things on them insects and bugs,” said Oshiro. 

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.

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