Two new confirmed cases of rat lung worms in Hawaii



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Rat lungworm pictures: Juvenile Parmarion martensi on a nickel (credit: HDOH); Veronicella cubensis (Credit: Rob Cowie, UH Mānoa)

The state Department of Health has confirmed two more cases of rat lungworm disease that have been contracted on Hawaii Island.

One case involved an adult visitor who was on vacation in North Hawaii last year. The visitor became ill in December 2018 and was not diagnosed until he was hospitalized for his symptoms upon his return to the mainland.

Since then, the person has recovered and has been identified as the seventh person from the island of Hawaii to have been tested positive for rat lungworm in 2018, bringing the number to nine. total of confirmed cases last year.

Another case was identified in an adult resident of East Hawaii who became ill in January and was hospitalized earlier this month. It was the first case of confirmed rat lungworm disease in Hawaii this year.

Health officials said that it was still unclear how or where the individuals had been infected.

"Our investigators are working diligently to communicate with patients and learn more about ways that they can get Lung Disease in rats," said Bruce Anderson, director of health. "Determining the exact source of infection in an individual is a challenge because it requires dipping into a person's history of food consumption, as well as where they can live, work, travel and recreate. We know that most people get sick by accidentally eating infected slugs and snails. Taking precautions, such as washing all fresh produce before eating and disposing of slugs and snails around our homes and communities, can make a significant contribution to infection prevention.

Angiostrongylosis or rat lungworm is caused by a parasitic roundworm and can have debilitating effects on the brain and spinal cord of an infected person. In Hawaii, most infected people become ill by accidentally ingesting a snail or slug infected with the parasite.

The symptoms vary considerably from one case to another, the most common being headaches and stiffness of the neck. The most severe cases present neurological problems, severe pain and long-term disability.

DOH provides the following recommendations for preventing rat lungworm disease:

  • Control snail, slug, and rat populations around homes, gardens, and farms. Get rid of these vectors safely by cleaning up debris where they could live and using traps and bait. Always wear gloves for your safety when working outdoors.
  • Inspect, wash and store products in sealed containers, whether from a local retailer, farmer's market or garden.
  • Wash all fruits and vegetables with clear, running water to eliminate slugs and snails. Pay special attention to leafy vegetables.

For more information on rat lungworm disease and ways to prevent its spread, visit:

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