Two new cases of rat lungworm disease contracted in Hawaii have been confirmed, the state Department of Health said.
An adult vacationing on the northern side of the Big Island contracted the disease in December, marking the state's ninth case of 2018, health officials said.
The disease, also known as angiostrongyliasis, is caused by a parasitic roundworm and can affect a person's brain and spinal cord. Larvae can be passed to humans who ingest raw freshwater shrimp, land crabs and snails or raw produce that contains infected slugs or snails
The person was diagnosed after they left the state. The Centers for Disease Control and Prevention confirmed the results.
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An adult resident of the Big Island's east side became sick last month. The person was hospitalized earlier this month.
The state verified the testing, marking the first case of rat lungworm disease this year.
"Our investigators are working diligently to communicate with the patients and learn more about how they may have become infected with rat lungworm disease," said Bruce Anderson, state health director. "Determining the exact source of infection in any individual is challenging since it requires a deep dive into a person's food consumption history as well as where they may live, work, travel and recreate."
Anderson added: "We know that most people get sick by accidentally eating infected slugs and snails. Taking precautions such as washing all fresh produce before enjoying and getting rid of slugs and snails around our homes and communities can go a long way toward preventing infection."