The Hawai'i Department of Health (DOH) has confirmed a case of neuroangiostrongyliasis, or rat lungworm disease, on the island of Kaua'i. Rat lungworm disease, caused by a parasitic roundworm, has become endemic in all islands of the state of Hawai'i.
As of October 13, 2025, the DOH was not able to identify an exact source of infection. This individual had no history of travel to other neighbor islands or outside the state or country. The last Kauaʻi case was in 2019.
Earlier in 2025, Maui County and Hawaiʻi County reported cases to the DOH.
From January 2014 to the present, 102 cases of rat lungworm disease have been reported statewide, with 78 from Hawai'i County, 13 from Maui County, seven from Honolulu County, and four from Kaua'i County (including the case reported in this release).
In 2024, there were seven cases reported.
Hawaiʻi residents make up 84% of that count. Seventy-three percent of those with a laboratory-confirmed diagnosis were hospitalized.
“Thoroughly inspecting and washing all fresh fruits and vegetables under clean, running water is the most effective way to reduce the risk of rat lungworm disease,” said Dr. Sarah Kemble, state epidemiologist, in a press release.
“Small slugs and snails on produce can be difficult to see. Cooking food thoroughly also kills the parasite that causes rat lungworm disease.”
The DOH advises that people should control snail, slug, and rat populations around homes, gardens, and farms. Get rid of snails, slugs, and rats safely by clearing debris where they might live. Consider using traps and baits. Cover and protect catchment tanks, as slugs can crawl up the tank and get into the water.0
Neuroangiostrongyliasis can have debilitating effects on an infected person's brain and spinal cord. Early diagnosis helps target treatment to reduce the long-term effects associated with this disease. Individuals with symptoms should consult their healthcare provider promptly.
For more information about rat lungworm disease and how to prevent its spread, visit: https://health.hawaii.gov/docd/disease_listing/rat-lungworm-neuroangiost...