New treatments for rat lungworm

  • Photo courtesy University of Hawaii at Manoa

    Rat lungworm disease is caused by a parasite that uses snails and slugs for reproduction.

LIHUE — The state is cinching down on diagnosing and treating rat lungworm disease, which has been a problematic parasite for physicians in Hawaii since it started spreading through the islands in 2009.

Sixteen preliminary guidelines for the diagnosis and treatment of human neuroangiostrongyliasis (rat lungworm disease) have been released by the state Department of Health, and will be presented to a national audience during the annual meeting of the American Society of Tropical Medicine and Hygiene in November.

Physicians can use the guidelines to diagnose the parasite, which invades the brain and spinal cord. The resulting infection can cause a rare type of meningitis, but symptoms vary between people. That’s one of the reasons it’s been a challenge for the medical community.

“Prior to the extensive work completed by the subcommittee, there were no clear, reliable diagnosis and treatment protocols available,” said Dr. Vernon Ansdell, a physician with more than 45 years of experience specializing in internal and tropical medicine.

“Diagnosing angiostrongyliasis can be problematic because patients infected with the parasite do not always present the same symptoms,” said Ansdell.

Ansdell continued: “These preliminary guidelines provide critical guidance to physicians to help them make timely and accurate diagnoses and give their patients the best possible treatment available. Our next step is to offer physician training in all counties to increase awareness and understanding of this complex disease.”

Members of the clinical subcommittee will be offering Continuing Medical Education (CME) courses through University of Hawaii at Manoa John A. Burns School of Medicine in all counties, starting in Hilo on Hawaii Island on Oct. 10. CME courses will also be offered on Maui, Kauai and in Honolulu in early 2019, with the schedule and more details to be announced later this year.

“Updating and improving the guidelines for physicians to better diagnose and treat rat lungworm disease is a major accomplishment for the joint task force,” said state DOH Director Dr. Bruce Anderson.


Jessica Else, environment reporter, can be reached at 245-0452 or

  1. ruthann jones September 1, 2018 5:26 am Reply

    ummm….did I miss something? I don’t see anywhere in this article about the ‘improved’ treatment for lungworm parasite.

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