Second rat lungworm disease case this year confirmed on Hawaii Island

Local News

Officials say a home-gardener in North Hawaii became ill in January, required hospitalization and has since recovered. 

Dr. Bruce Anderson, director of the State Department of Health, believes an accidentally eaten slug or snail from the home garden was the likely infection source.

The slugs and snails Anderson is talking about are tiny and hard to see — about the size of the word Liberty on a nickel — so leafy greens have to be checked very carefully.

You’ll find slugs and snails in any crevice in the plant. Obviously plants like kale have a lot of crevices and places where snails can hide would be of most concern.

Health officials say the best way to avoid rat lungworm disease is to thoroughly wash produce under running water, especially if it’s to be eaten raw.

Anderson says none of the products that claim to disinfect produce has yet proven effective — however, researchers on the Big Island are looking at ways to assure consumer safety.

They’ve talked about using (ultraviolet) radiation, many different types of disinfection, including solutions and some seem to work okay, others don’t work at all, and I think it’ll be six months or more before we know.

There were nine reported cases of rat lungworm disease last year, and as this is the second, Anderson says we’re on-par with last year. He also says confirming the disease requires a painful and expensive spinal tap.

Health officials believe there are many more people who get infected with rat lungworm disease that the department doesn’t hear about — but fortunately for them, they have mild symptoms and recover quickly.

The department will host a community meeting in north hawaii next month to give residents more information about rat lungworm disease — including ways to protect themselves. 

The meeting is tentatively scheduled for 6 p.m. Monday, April 22, at the North Kohala Public Library — and the department will release more details once arrangements are confirmed.


The Hawaii Department of Health (DOH) has confirmed a case of rat lungworm disease (angiostrongyliasis) contracted on Hawaii Island. The individual is a resident of North Hawaii and is the second person from Hawaii County to test positive for angiostrongyliasis in 2019, bringing the statewide total to two cases this year.

Health officials learned recently about the adult resident of North Hawaii, who became ill in January. Laboratory testing though DOH’s State Laboratories Division confirmed the individual’s infection in late February. The individual was hospitalized for a short time and has since recovered.

Disease investigators conducted a detailed investigation to learn more about possible sources of infection. The exact source of infection could not be identified, but investigators learned the individual had a home garden on their property. It is likely the individual accidentally consumed a slug or snail while eating produce from their garden.

“In Hawaii, we need to treat all slugs and snails as if they are infected with the parasite that causes rat lungworm disease, and this means washing all produce no matter where it comes from, whether it’s from the grocery store, the farmer’s market or grown in our own home gardens and yards,” said Health Director Bruce Anderson. “Washing all produce carefully and thoroughly using clean, running water is the most effective way to remove unwanted slugs or snails from fresh fruits and vegetables.”

DOH will host a community meeting in North Hawaii in late April to provide residents in the area with information about rat lungworm disease and how they can protect themselves. Health officials and experts on prevention will be on hand to answer questions and share information. The meeting is tentatively scheduled at the North Kohala Public Library for Monday, April 22, at 6 p.m. More details about the event and will be shared with the public at a later time.

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.

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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