Over the last few months, a recent outbreak of a rare disease has raised concern for those living in Hawai’i. Angiostrongyliasis, also known as rat lungworm, is a parasitic nematode (roundworm parasite) that invades the brain and spinal cord causing illnesses and death. To date, there have been 17 confirmed cases of the disease in Hawai’i, with the latest being an infant of just 11 months old. While 17 cases may seem minute, it’s the highest it has been in the last decade, with 2016 coming in at second place with a total of 11 confirmed cases.

So, why has there been a large increase in the recent years, and what can be done to prevent people from contracting the disease? The disease, which is caused by a parasitic nematode, is normally found in rats when in adult form. However, the disease can easily be contracted by slugs and snails, too. As stated by the CDC, rats host the worm which is then passed on through their feces. Slugs and snails feed on such feces, meaning the disease is now being carried by these creatures which are often found in farms and gardens, leafy greens, herbs, and other various fruits and vegetables.

According to the State of Hawai’i Department of Health you can get rat lungworm by eating food contaminated by the disease. This includes raw or undercooked snails or slugs, or raw produce that contains small amounts of infected snail or slug. In general, rat lungworm isn’t spread person-to-person. The disease can only be contracted through digesting infected produce or direct contact with infected slugs. It’s even more critical we do our part to ensure any food, whether fresh or not, is washed and cleaned as thoroughly as possible.

If you have recently eaten any sort of slug or raw produce which you believe may be infected, there are a few symptoms that may help determine whether or not you have contracted the disease. However, not everyone notices the symptoms, with some only experiencing very mild symptoms which they could easily mistake for something else. The main symptoms you should look out for if you are concerned of the disease are the following, in no specific order:

  • Severe headaches
  • Stiffness of the neck
  • Tingling or painful feeling in the skin or extremities
  • Low-grade fever
  • Nausea
  • Vomiting

Other symptoms such as a temporary paralysis of the face has also been known to happen, as well as light sensitivity. It should also be noted that the symptoms may not start 1 to 3 weeks after one has been exposed to the parasite. While there is no current cure for the disease, the symptoms normally last between 2- 8 weeks and can go away by itself. However, if you are concerned, it’s highly recommended you seek medical advice as soon as possible due to the risk of health complications to your brain and spinal cord.

To lower your chances of getting rat lungworm, Hawai’i News Now reported how health officials have provided a list they recommend you strictly follow when there is contact between slugs or when eating various produce.

  • Always inspect, wash and store produce in sealed containers.
  • Make sure your inspections are thorough.
  • Thoroughly wash fruit and vegetables under running water, especially leafy greens that are often the hideouts of snails and slugs.
  • Control snail, slug and rat pollution around your property where possible, making the environment around your home and gardens the priority. Various treatments to kill and get rid of the above can be bought over the counter.
  • Boil snails, freshwater prawns, crabs and frogs for at least 3 – 5 minutes.
  • Thoroughly wash your hands when handling slugs and snails or other creatures.
  • Where possible, completely avoid eating snails, slugs and frogs.


For more information on the Rat Lungworm Disease, see:

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