HILO, BIG ISLAND (HawaiiNewsNow) - Vili Latuhoi and his friends were mixing kava at a home in Keaau several weeks ago when they started to feel ill.
"Our body felt like in pain, like I couldn't move, bad headaches," he said.
Latuhoi said that one of the kava mixing bowls was left uncovered outside.
"The last three cups around in the bowl, we found the slug inside," he said.
That slug was the apparent carrier for this brain invading parasite that cause the rat lungworm disease. Latuhoi said he visited the emergency room several times in pain before he was correctly diagnosed.
"Every single day we came in to test and they couldn't find anything," he said.
Following multiple visits to the emergency room, a friend of Latuhoi who was also sickened had told the doctor that he had remembered seeing a slug at the bottom of the kava bucket.
That is when the doctor immediately called everyone from the group back to the hospital for another test.
Experts say the hardest part about treating rat lungworm is diagnosing it. One doctor said no two cases are exactly the same.
"This disease presents differently in every single patient. We will have patients who come to the emergency room who have severe headaches," Dr. Jon Martell, director of acute care at Hilo Medical Center said. "We have some come with just some general muscle aches or their skins burns or their arms are weak."
In the past, Martell said the symptoms usually included headaches and muscle aches. But lately, he is seeing a more aggressive strain, with patients suffering paralysis and even comas.
Despite the recent increase in rat lungworm disease patients, the state Health Department says its not an epidemic.
But Martell said he expects to see more cases.
"It was limited to lower Puna when we started eight years ago. Now it's in Hilo and ... it's going to be on other islands and as it generalizes the number of cases are going to go up," he said.