New rat lungworm cases confirmed by Department of Health on Hawaii Island

Photo: Susan Jarvi


Two new cases of rat lungworm on Hawaii Island were confirmed today by the Hawaii Department of Health. Another four cases are considered highly probable due to exposure through the same method.

All six cases are adults who were hospitalized, and their illnesses reported to the department over the past weekend.

The adults became infected with rat lungworm at a home in Keaau a few weeks after drinking homemade kava. They left the prepared kava in uncovered buckets overnight. The kava was poured into a large bowl and after consuming most of it, they noticed a slug at the bottom of the bowl.

The department said it is not clear what type of slug caused the infections.

“Cases like this recent cluster are especially concerning because they can be prevented with basic precautions such as storing food in covered containers and properly inspecting and washing food before eating. These healthy habits can protect against food contamination and prevent serious illnesses,” Health Director Dr. Virginia Pressler said.

There have been a total of 11 confirmed cases of rat lungworm infection this year in the state.

Earlier this year, four Maui resident cases, two non-resident cases who were visitors to Maui, and three Hawaii Island resident cases were confirmed.

The two cases confirmed today were Hawaii Island residents and of the four probable cases, three were Hawaii Island residents and one was a resident of Maui who traveled to Hawaii Island.



State Senator Josh Green is a physician on Hawaii Island and says while he appreciates the health department providing public information, he’d like to see them ramp up their efforts.

A report from the Robert Wood Johnson Foundation says while Hawaii scored high in areas like providing information when an emergency happens and medical testing, the state scored low when it came to community engagement. They report at residents willingness to help each other, and the ability to coordinate a medical response if a health emergency were to happen.


DOH reminds the public to carefully store, inspect and wash produce, especially leafy greens. Always store food in covered containers, wash all produce thoroughly and supervise young children playing outdoors to prevent them from putting snails or slugs into their mouths.

Officials also said that controlling snail, slug, and rat populations is one of the most important steps in fighting the spread of rat lungworm disease, especially around home gardens.

The Department of Health’s Food Safety Program continues to inspect and educate food establishments statewide on safe food handling and preparation to prevent contamination and foodborne illness. Food establishments statewide are reminded to use only approved and licensed sources and carefully inspect and wash all produce during food preparation.

The most common symptoms of angiostrongyliasis or rat lungworm include severe headache and neck stiffness, but symptoms may vary widely among cases. The department says to seek medical attention for headache, fever, stiff neck, tingling or painful feelings in the skin or extremities.

The most serious cases experience neurological problems, pain and severe disability. Healthcare providers should monitor and support patients’ symptoms, and report any persons they suspect may be infected.

More information on the signs and symptoms of rat lungworm infection are at: http://health.hawaii.gov/docd/files/2015/07/angio-fact-sheet-20150716.pdf

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