Comparing Exposures of Persons with Rat Lungworm Disease (Neuroangiostrongyliasis) with the General Population — Hawai‘i County, Hawai‘i, 2014–2024
- Presentation Day/Time: Thursday, April 23, 3:25 PM
- Presenter: Ashley Tseng, PhD, MPH, Hawaii State Department of Health
The Issue
- Rat lungworm disease (neuroangiostrongyliasis), caused by the parasitic roundworm Angiostrongylus cantonensis, is endemic in Hawai'i and can severely affect the brain and nervous system. It can result from eating infected intermediate hosts such as snails or slugs, although most people with rat lungworm disease do not know exactly when or how they were exposed. Since 2017, 79% of neuroangiostrongyliaisis cases in Hawai'i were in Hawai'i County. Clinical presentation varies widely, making diagnosis challenging.
What We Did
- The Hawai'i State Department of Health (HDOH) reviewed cases of neuroangiostrongyliasis to identify hypotheses about potential high-risk exposures and public health interventions.
What We Found
- Forty-six cases (41 confirmed and five probable) were reported. Among 33 exposures examined, prevalence of eating homegrown produce, direct contact with snails, slugs, or rodents, and using catchment or bottled water were significantly higher among people with rat lungworm disease than among the general population.
What This Means
- This was a novel study comparing known A. cantonensis exposures in Hawai'i County cases to the general population. HDOH will generate hypotheses about higher-risk exposures and further investigate how animal contact and water sources affect disease risk factors.
