× Expand Photo: Thinkstock Rat Lungworm Disease - Slug on Lettuce

On May 18, the state Department of Health confirmed a toddler on O‘ahu contracted the first case of rat lungworm this year. The child from Central O‘ahu was hospitalized earlier this month. It is the fourth confirmed case in Hawai‘i in 2018.

Many families are worrying about how to keep their ‘ohana safe. We’ve all heard the near sci-fi sounding accounts from the Big Island and Maui of parasites getting into people’s brains and wreaking havoc on their nervous systems. But, before you lock your keiki indoors or stop buying local produce, check out our tips to dramatically reduce your chances of catching the disease.

First, what is rat lungworm disease? It is caused by a parasitic roundworm that lives in rats and other rodents. According to the state Department of Health, larvae are passed from the feces of infected rodents to snails, slugs, frogs and other animals. People become infected when they consume those carriers raw or undercooked, often it is tiny slugs or parts of infected slugs or snails hiding in vegetables. We may not know exactly how many in Hawai‘i have contracted rat lungworm because some show no symptoms or mild symptoms. Meanwhile, others experience headaches, nausea, stiffness of the neck, temporary paralysis and even meningitis. No matter the infection rate or risk of debilitating effects, we're sure you don't want to catch it. So, here are our 15 tips:

1. Don’t panic. Rat lungworm disease can usually be prevented without taking drastic measures or boycotting local produce.

2. Don’t drink from the garden hose. The Department of Health warns that tiny slugs can crawl into the hose opening and be swallowed if you drink from it. See the DOH warning here.

× Expand Photo: Hawai‘i State Department of Health Rat Lungworm Disease - Slug in Garden Hose

3. Wash, wash, wash. Everyone needs to scrub their hands, nails, and forearms after playing outdoors.

4. Heat or freeze your produce. Heating veggies to at least 165 degrees or freezing them for more than 48 hours will kill the parasites.

5. Scrub raw fruits and vegetables thoroughly. Scrub all sides under running water, checking all parts of leafy greens. Slugs can be so tiny they can hide on a nickel. So, they can easily go unnoticed in the folds of vegetables such as curly kale. Soap, bleach, vinegar or salt do not make a difference. The slugs need to be physically washed away.

× Expand Photo: Hawai‘i State Department of Health Rat Lungworm Disease - Slug on a Coin

6. Wash fruit before peeling or cutting it. Even if the fruit has a rind you won't be eating, like pineapple, it should be scrubbed before being sliced. This is so that there’s no chance of contamination as the knife passes through the rind or peel into the edible flesh.

7. Keep produce in sealed containers. After you inspect and wash it, keep it in a resealable bag or container to keep it slug-free.

8. Examine your bananas. "Slugs are all over bananas," Mikala Minn of Mahele Farm in Hāna, told HONOLULU Magazine. He recommends peeling bananas from the closed end and not eating any part of the fruit that was exposed.

9. Don’t eat or play with snails or slugs. Little ones like to put things in their mouths, so the Hawai‘i State Department of Health warns against handling slugs and snails with bare hands. While they are the biggest culprits and can even pass the parasite through their slime, freshwater prawns, frogs, crayfish and crabs can also carry the disease. But, don't worry about fish. They are not known to carry it.

10. Boil snails and fresh water prawns. If you wish to eat them, boil them for 3 to 5 minutes, says the UH College of Tropical Agriculture and Human Rescources.

11. Cover water catchment tanks. Make sure slugs and snails cannot get in.

× Expand Photo: Hawai‘i State Department of Health Rat Lungworm Disease - Slugs

12. Hunt slugs. If you have a garden or yard, Cynthia Nazario-Leary of the University of Hawai‘i College of Tropical Agriculture and Human Resources recommends hand-picking slugs and snails. She told concerned Maui citizens to wear gloves and use tongs to pick them up when they come out at night. Then, drop them into a solution of seven cups of water to one cup of salt for 48 hours. As long as you wear shoes or slippers and don’t touch the slugs or snails with bare hands, this can be a fun adventure with your keiki.

13. Control rats and slugs in your garden. Set up rat traps and consider using slug bait around the perimeter of your garden. Check for pet-safe traps and killers if you or your neighbors have cats or dogs in the area.

14. Make a slug pub. Slugs and snails love beer. See how you can set up a deadly trap here.

15. Don’t be afraid to buy local. Nalo Farms' Dean Okimoto told a tv station one of the farm's big customers pulled out a day after the first case of rat lungworm was diagnosed on O‘ahu. This parasite could have a hugely damaging effect on local growers. Don’t be afraid. Just be sure to inspect and thoroughly wash all of your fruits and vegetables, no matter how clean they look or where they come from.

Want to know more? Read more about the history of the disease on honolulumagazine.com.