Recent media reports quickly caught our attention, as they may have yours. They highlighted something that’s a genuine health concern in Hawaii—rat lungworm disease. However, these reports took a sensationalized approach, using dramatic headlines that could lead one to believe there is some unavoidable or widespread risk for Hawaii visitors. While the disease is rare and has the potential to be severe, its typically simple prevention is something that we have incorporated into our daily lives for years; the reality is far less alarming when placed in a good context.
Most cases of rat lungworm are preventable with basic food safety.
Travelers can continue to enjoy Hawaii’s beauty and cuisine without unnecessary concern by understanding how the disease spreads and then taking the simple steps that significantly reduce exposure. That’s what we and other Hawaii residents have done since this first came to our attention years ago. Taking these small steps ensures you can safely enjoy Hawaii’s diverse produce and culinary offerings without much concern.
Thoroughly inspect and wash produce thoroughly.
This simple step removes snails, slugs, and their slime from produce. It’s especially important for locally grown leafy greens like lettuce, basil, and kale, whether bought from farmers’ markets, roadside stands or stores. For residents, this becomes second nature—starting with checking for signs of slug or snail damage. Visitors should adopt the same habit for added safety.
Rat lungworm disease (angiostrongyliasis) is a parasitic infection.
The parasite’s life cycle begins in rats, with snails and slugs acting as intermediate hosts. Humans become infected when they accidentally consume raw or undercooked snails, slugs, or perhaps most importantly to visitors, products that have been contaminated with droppings and slime. The disease is neither transmitted between humans nor linked to ocean waters or casual exposure.
The symptoms of rat lungworm disease range from mild to severe.
Early signs often include nausea, headaches, stomach pain, and fatigue. However, neurological symptoms such as tingling sensations, burning pain, and neck stiffness can develop in rare and severe cases that may lead to meningitis. While there is no direct cure, doctors treat patients by managing symptoms with pain relievers and anti-inflammatory medications.
Notably, the disease is rare in Hawaii, with annual cases averaging up to a dozen across all islands. While the condition is monitored closely, officials emphasize that the risk remains low, especially for those who take proper precautions.
Why is Hawaii affected?
Hawaii’s lush, tropical environment creates ideal conditions for hosts like snails and slugs to thrive. This makes the islands well suited to outbreaks compared to more temperate regions. However, even in Hawaii, most cases can be traced back to specific exposures involving unwashed produce or raw food.
The Big Island has historically reported the highest number of cases, though instances have also been documented on other islands, including Maui, Kauai, and Oahu. Leafy greens, especially those from home gardens or farmers markets, are sometimes linked to transmission when thorough washing is overlooked. Despite this, people consume fresh produce in Hawaii every year without ever having an issue issue…