PhotoTravelers who visit Hawaii love the beaches and numerous tourist attractions, but consumers would do well to be mindful of what they eat and which areas they visit. The Hawaii State Department of Health has confirmed nine cases of rat lungworm disease that have surfaced in the state – six in Maui and three on the Big Island.

The disease, which is caused by a parasite known as Angiostrongylus cantonensis, affects the brain and spinal cord of consumers who catch it. This can lead to serious medical complications like eosinophilic meningitis, coma, and nervous system damage. In rare cases, the disease can even result in death, though mild symptoms such as headache, fever, nausea, and vomiting can develop in other patients until the parasite runs its course.

“The investigation is fluid and the cluster of cases, though not all confirmed, are very concerning,” said Department of Health spokeswoman Janice Okubo, per CNN.

Causing internal harm

Though state officials are not certain how each affected consumer developed the disease, they do note that “people can acquire the parasite by consuming raw or undercooked snails and slugs.” While that seems like a specific circumstance, consumers should keep in mind that they can accidentally consume these products by eating poorly washed lettuce or other raw produce that was in contact with snails or slugs.

University of Florida assistant professor Heather Stockdale Walden explains that the parasite can usually be found in rats, a creature in which it can fully mature and thrive. However, when consumed by humans, the parasite is not able to fully grow into adulthood and can cause many health issues before it eventually dies and is passed from the body.

“What happens is that the parasite gets into humans – humans are not the host that it can complete its life cycle in, as opposed to being in a rat – so when it gets in a human, it can get lost, and it will go to the brain, and it’ll stay there,” she says.

“[The parasite] can also move to the eye, and you can get ocular Angiostrongylus. . . if the parasite goes to the eye, sometimes you can surgically remove it,” she adds.

How to prevent infection

Unfortunately, the detection rate for the parasite is fairly low due to the fact that there are no readily available blood tests for it. Officials note that approximately 80% of Hawaii’s snails are carriers of the parasite, which perhaps explains why the state usually sees 1-9 cases of the disease per year.

To prevent infections, consumers are advised to ensure that all of their food is properly cooked and cleaned prior to consumption.

“[Make] sure that the foods you eat are cooked properly, your vegetables are washed – that would help you prevent infection,” said Walden. “It’s important to appropriately store, inspect, and wash produce, especially leafy greens,” added Okubo. She also advises that young children be watched when playing outside to make sure they don’t put a snail or slug in their mouth.

The health department further recommends that consumers avoid handling snails and slugs with their bare hands and that all snails, prawns, crabs, and frogs be boiled for 3-5 minutes before being eaten. Consumers should also be sure to check rainwater catchment tanks to ensure that no snails or slugs have gained access.

Any consumer who suspects they have contracted the parasite should speak to their healthcare provider for treatment.


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