Four new mumps infections and another case of rat lungworm were confirmed in Hawaii on Thursday, bringing the totals of those disease outbreaks to new annual highs in the state.

The mumps total for 2017 has now reached 27, all on Oahu, while the rat lungworm disease is up to 15 cases, with nine on Hawaii island and six linked to Maui, state Department of Health officials said.

State epidemiologist Dr. Sarah Park said Hawaii is not alone in its mumps epidemic. She said it’s a problem throughout the United States and internationally as well.

According to the Centers For Disease Control, 42 states and the District of Columbia reported mumps outbreaks, with 2,570 coming down with the disease between Jan. 1 and April 22.

Park said the problem is that while the vaccination remains the best way to fight the infection, it is not 100 percent effective. And when anyone infected comes in close contact with others, it can be very contagious, she said.

Those suspected of having mumps or who have been diagnosed should avoid exposure to others for nine days after swelling of the salivary glands, one of the symptoms, health officials said.

People who have been exposed to mumps and are not vaccinated should not attend school, work or travel from Day 12 through Day 25 after exposure, she said.

As for rat lungworm disease, health officials said the new case represents a Hawaii island resident who was hospitalized and discharged.

Rat lungworm disease is caused by a parasite found in rodents, which can be passed to snails, slugs, crabs and other creatures. The disease can cause damage to the brain and spinal cord and bring nausea, severe pain and temporary paralysis.