Rat lungworm disease is a growing concern for residents and visitors in Hawaiʻi, emphasizing the need for awareness and education on safety measures. The disease is caused by the parasitic worm Angiostrongylus cantonensis, which primarily resides in the pulmonary arteries of rats. The cycle of the parasite involves its eggs being shed in rat feces, which are then consumed by slugs and snails, acting as intermediate hosts. A recent study indicates that a variety of other animals, including freshwater prawns, fish, and lizards, can also carry the parasite, broadening the potential for contamination.
Franny Brewer, program manager at the Big Island Invasive Species Committee, has dedicated her efforts to educating the public about rat lungworm. Through workshops, she highlights simple yet effective protective measures, such as ensuring all fruits and vegetables are thoroughly washed before consumption. This advice cannot be overstated, as humans may accidentally ingest slugs or snails hidden in unwashed produce, leading to serious health consequences.
Symptoms of rat lungworm infection initially mimic those of common gastrointestinal distress, like nausea and vomiting. However, as the infection progresses, it can cause eosinophilic meningitis, which affects the central nervous system and can lead to more severe neurological symptoms, including coma or death in rare cases. Children are particularly vulnerable, exhibiting irritability and fever, necessitating heightened vigilance among parents and caregivers.
In light of increased rat lungworm cases, notably in the Big Island’s east side, efforts to control pest populations have been of paramount importance. Methods include using poisonous bait, traps, and environmental modifications to deter slugs and rats from thriving. Brewer advocates for the use of "slug jugs," which consist of a saltwater solution that can effectively kill slugs and snails. Collecting these pests at night during wet conditions using gloves or specialized tools is one recommended strategy.
One of the significant hurdles in managing rat lungworm is the delayed diagnosis of the disease. Many health professionals, particularly those unfamiliar with tropical diseases, may not immediately recognize the symptoms associated with rat lungworm. This situation underscores the importance of self-advocacy for residents who suspect they may have contracted the parasite. Initiatives like the Hawaiʻi Island Rat Lungworm Working Group are essential, as they seek to enhance awareness and promote education about this parasitic threat.
Currently, treatments such as pyrantel pamoate and albendazole have been suggested, but their effectiveness is still being studied. Despite the uncertainty surrounding their efficacy, Brewer encourages households to keep over-the-counter dewormers available as a precaution.
In recent years, the Department of Health has underscored the need for improved clinician vigilance. Laboratory-confirmed cases of rat lungworm in 2024 and 2025 were reported, indicating a potential uptick in the disease’s prevalence. A case involving a visitor who consumed unwashed greens during a hike showcases the risk faced by both locals and tourists. This highlights that rat lungworm disease isn’t restricted to the local population; rather, it poses a widespread risk across Hawaiʻi.
To combat the spread of the disease, the Department of Health recommends several precautions for residents and visitors alike. Key measures include rinsing all fruits and vegetables under potable water and cooking potential hosts to specific temperature guidelines. These practices can drastically minimize the risk of infection, creating a safer environment for everyone.
To fortify safety measures further, homeowners are advised to rodent-proof their properties and set traps to manage the rat population effectively. Addressing the issue at both individual and community levels will be crucial in reducing the incidence of rat lungworm disease.
In conclusion, as rat lungworm disease poses a continuing threat to the health of Hawaiʻi residents and visitors, awareness, education, and preventive measures are fundamental. Collaboration among health officials, educational programs, and the community can bolster efforts to mitigate the risks associated with this parasitic infection. By adopting simple yet effective precautions, individuals can safeguard their health, ensuring that their time in the islands remains enjoyable and disease-free.
