Arriving in Hana from San Francisco in January, newlyweds Ben Manilla, 64, and Eliza Lape, 57, expected nothing short of a blissful two weeks. Instead, they experienced a minor hell. “I’ve had several operations, two pneumonias, a blood clot; right now, I’m dealing with a kidney issue,” Manilla, an audio producer and lecturer at the University of California at Berkeley, told CNN affiliate KHNL.

Most cases result from consuming, either accidentally or on purpose, raw or undercooked snails and slugs that are infected with the parasite. For example, poorly washed lettuce or other raw produce may contain an unnoticed snail or slug. (SHELL FISH)  Transmission can also occur when people eat infected crabs, shrimp and frogs, though this is believed to be less common. There may also be very rare cases of contamination through water.