Health officials have confirmed a case of rat lungworm disease in a Hawaiian infant who has been sick since December. While the state department of health did not identify the infant, nor release an update on the baby’s condition, it did disclose that the child had at some point been transferred from Big Island to a hospital in Oahu for further treatment.

The baby’s diagnosis marks the sixth case of rat lungworm confirmed on Hawaii’s Big Island in 2018. A news release added that an investigation into the child’s case is ongoing.

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“Determining the exact source of infection of for rat lungworm disease in any patient is difficult since it requires a deep dive into a person’s food consumption history,” Bruce Anderson, Hawaii’s health director, said in the statement. “Infants can be even more complicated because they can’t verbalize their symptoms or what they ate. A parent or caregiver would have to see them picking up a slug or snail and putting it in their mouth. We know this is how most children who become ill with rat lungworm disease get infected, so it’s important keep our keiki away from these harmful vectors as much as possible.”

Rat lungworm is a parasite that can infect critters through rodent feces. Infections occur in snails and slugs when they consume the parasite’s larvae, with humans contracting the disease if they then consume the affected delicacies when they’re raw or not fully cooked.

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According to the Centers for Disease Control and Prevention (CDC), consuming frogs, crabs and freshwater shrimp that are raw or undercooked may also elevate your risk.

“People also can get infected by accident, by eating raw produce (such as lettuce) that contains a small snail or slug or part of one,” according to the CDC.

While it can take an average of one to three weeks for symptoms to appear, patients may begin experiencing nausea, vomiting, neck stiffness and headaches as soon as one day after infection. While there is no specific treatment for rat lungworm disease, symptoms are typically managed on a case-by-case basis. Severe cases may result in neurological problems or long-term disability.

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In November 2018, Sam Ballard, the Australian man who had eaten a slug as a dare, died eight years after being diagnosed with the disease. Ballard had fallen into a 420-day coma shortly after the fateful night and lived his surviving years with a brain injury.

Officials in Hawaii are urging residents to control snail, slug and rat populations around homes gardens and farms in order to prevent the disease. The state also advised residents to wear gloves while working outside, inspect, wash and store produce in sealed containers, and to wash all fruit and vegetables under clean running water.