Current Tropical Medicine Reports

, Volume 5, Issue 1, pp 59–66 | Cite as

Angiostrongyliasis or Rat Lungworm Disease: a Perspective From Hawai'i

  • Susan I. Jarvi
  • Kathleen Howe
  • Patricia Macomber
Tropical Parasitology (A Sanchez, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Tropical Parasitology


Purpose of Review

Angiostrongyliasis is contracted by the ingestion of or exposure to the zoonotic parasite Angiostrongylus cantonensis, which requires two hosts to complete its life cycle. Rats are known to be the definitive hosts and mollusks are intermediate hosts. It is the intermediate host, or infected paratenic hosts that can pass the infective stage of the disease to humans and other susceptible animals. The purpose of this review is to examine the growing threat of A. cantonensis and its consequences, with particular emphasis on Hawai'i.

Recent Findings

The increase in disease cases appears to correlate with the migration of the mollusk Parmarion martensi (semi-slug) in Hawai'i. The semi-slug is a very effective host because it carries a heavy burden of the parasite. Rats in Hawai'i also carry heavy parasite burdens. Human diagnosis is difficult due to varied incubation times, multitude of symptoms which can mimic other illnesses, and lack of a low-risk effective diagnostic. Treatment varies with the severity of the symptoms.


The introduction and proliferation of the invasive species A. cantonensis, along with a most efficient intermediate host P. martensi, has resulted in an increase in angiostrongyliasis in Hawai'i. In Hawai'i, consumption of local produce is encouraged and the use of rainwater harvesting is a necessity for many on Hawai'i Island, both of which elevate the risk of acquiring angiostrongyliasis. A better understanding of how to best reduce the risk of infection is needed through comprehensive research and community education.


Angiostrongyliasis Angiostrongylus cantonensis Parmarion martensi Rat lungworm Semi-slug Hawai'i 


Compliance With Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Susan I. Jarvi
    • 1
  • Kathleen Howe
    • 1
  • Patricia Macomber
    • 2
  1. 1.Department of Pharmaceutical SciencesDaniel K. Inouye College of Pharmacy University of Hawaii at HiloHiloUSA
  2. 2.College of Tropical Agriculture and Human ResourcesUniversity of Hawaii at ManoaHiloUSA

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