The Hawaii Department of Health confirmed Thursday that the number of rat lungworm cases has grown to 13.
Hawaii now has more cases so far this year than all of last year, which was 11.
Seven cases involve patients on Hawaii Island, four on Maui, and two non-residents who visited Maui.
Officials tell us the two new cases involved people on Hawaii Island, and say they are not linked to a cluster of cases caused by contaminated kava.
The health department is still investigating how these people got sick. Officials are not calling the outbreak an endemic.
Rat lungworm is typically spread by slugs on produce.
The disease can cause headaches, fever and, according to one sufferer, pain worse than childbirth.