The state has confirmed two new cases of rat lungworm disease on Hawaii Island, including in a toddler who was hospitalized and transferred to Oahu for care.

The potentially crippling illness has been the most prevalent on the Big Island with five cases of rat lungworm, or angiostrongyliasis, in 2018. A total of seven cases have been confirmed statewide this year.

The toddler from East Hawaii became sick in October and was tested twice before health officials diagnosed the disease. The state Department of Health is investigating possible sources of infection.

WHAT TO WATCH FOR Rat lungworm symptoms:

>> Severe headache

>> Stiffness of the neck

>> Tingling or painful feelings in the skin or extremities

>> Fever

>> Nausea and vomiting

>> Temporary paralysis of the face

>> Sensitivity to light Steps to prevent rat lungworm:

>> Don’t eat raw or undercooked snails or slugs, freshwater shrimp, land crabs or frogs.

>> Be sure to wear gloves and wash your hands when handling snails or slugs.

>> Thoroughly inspect and rinse produce, especially leafy greens, in potable water.

>> Boil snails, freshwater prawns, crabs and frogs for at least three to five minutes.

>> Eliminate snails, slugs and rats found near houses and gardens. Source: Hawaii Department of Health

In the second case, an adult from West Hawaii was confirmed in August with a “mild case of rat lungworm” and has since recovered, according to the DOH, which was unable to identify the source of infection.

“With the rainy season in full swing, we may expect to see more slugs and snails around our homes and gardens,” said DOH director Bruce Anderson in a news release. “We can reduce the risk of rat lungworm disease by taking precautions to safely eliminate rats, slugs and snails in our communities. Keeping our young children away from these harmful vectors as well as thoroughly washing all produce before consuming it is crucial.”