“…Of the 35 cases of significant neurological disease (NLM) reported in the literature, 89% resulted in permanent neurological deficits or death Sircar et al, 2016;Clark et al, 2017;Kawakami et al, 2017;Zhang et al, 2017;Muganda, 2018;Dunbar et al, 2019). Human cases are most common in small children, as well as individuals with developmental disabilities, particularly those with a history of pica, and close to 70% of all reported cases come from the Great Lakes region of North America .…”