HONOLULU (KHON) — Hawaii recorded its first COVID-19 related death of a child, health officials said, after a boy fell seriously ill within hours of arriving.

The Hawaii Department of Health said a boy 10 years old or younger traveled from the mainland to the island with his parents, who are both fully vaccinated and had tested negative for COVID-19.

“Shortly after arriving in the islands, [the boy] exhibited symptoms of COVID, was taken to the hospital, and succumbed to COVID at the hospital,” said Brooks Baehr, DOH spokesman.

Health experts say this should serve as a wake-up call. While severe cases of COVID-19 are rare in children, it can be deadly.

Health experts say underlying health conditions probably played a key factor in the child’s death.

Conditions including obesity, which is the most common, asthma, and any problems with the immune system can lead to more serious outcomes.

Doctors say it’s important for these kids to get tested right away if they get COVID-19 symptoms like fever, sore throat, or a headache.

“If they have underlying issues, then definitely they should be more directed by their personal physician to get tested because that could be something that you really need to keep an eye on,” said Dr. Paul Eaken, pediatric emergency physician.

He says treating kids early for COVID-19 can make a big difference. However, cases in general are pretty mild for children who don’t have underlying conditions. He says about half of the cases don’t even develop any symptoms.

According to Hawaii’s health department there have been more than 3,000 COVID-19 cases of children 17 and younger. Thirty-three of them have been hospitalized. Dr. Eakin points out that those who wind up in the hospital can get severely ill.

“In children who are actually hospitalized with COVID-19 infection like acute infection, one out of three of those will actually be admitted to the intensive care unit, so they’re actually quite sick,” said Dr. Eakin.

DOH says the boy was not tested for COVID-19 before leaving for Hawaii. Children under five years old are not required to take a test in order to avoid quarantine. The state says this tragedy shows that it’s important to keep taking protective measures like wearing a mask, avoiding gatherings, and getting vaccinated.

“As sad as this is, it does serve as a reminder that we really need to do everything not only to protect ourselves, but to protect our loved ones, to protect our neighbors, our community,” said Baehr.

“While we mourn all victims of COVID-19, today’s announcement of the death of a child from this virus is especially heartbreaking,” Gov. David Ige said in a statement on Tuesday. “Dawn and I express our deepest condolences to the family and loved ones of this child. The state and counties will continue to make responsible decisions on COVID restrictions based on science, with the goal of protecting the health and safety of the people of Hawaii.”

The state death toll rises to 479.