The recent death of a Texas preschooler ruled as “dry drowning” has brought the rare occurrence into the news — scaring parents because it typically occurs anytime up to 24 hours after leaving the water, when parents assume the kids are safe.

“Parents are on edge because of this story,” says Dr. Erin Hulfish, assistant professor of clinical pediatrics in the division of pediatric clinical care at Stony Brook Children’s Hospital. But while parents should be aware of symptoms, they should keep in mind that dry drowning makes up only 1 percent to 2 percent of all drowning incidents per year in the United States, she says.

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“There is a lot of terminology that’s confusing — dry drowning, secondary drowning, wet drowning,” Hulfish says. Dry drowning doesn’t just occur because a child went swimming, she says. All types of drownings begin with an incident in the water, such as being stuck underneath, she says.

After a common underwater incident, a child may come up sputtering or initially coughing and then be fine. In a case where a dry or secondary drowning may occur, the victim usually will exhibit continuing symptoms in the subsequent minutes or hours, such as persistent coughing, lethargy, vomiting or alterations in their behavior, Hulfish says. In the Texas case, CNN reported that the night after being knocked over by a wave, the child vomited and had diarrhea, which the parents initially thought was a stomach bug.

Death occurs on dry land because the initial respiratory injury triggers other potentially deadly physical issues such as the lungs gradually filling with bodily fluids or sudden cardiac arrest, Hulfish says.

“The easiest thing we can do to prevent this is supervision,” Hulfish says. Then kids are less likely to have an initial incident in the water, and, if they do have one, parents are aware and can watch them closely afterward. If kids exhibit symptoms, parents should take them to an emergency room or call 911, Hulfish says. Dry drowning can also occur in adults, she says.