Health director wary of dengue fever outbreak
By Walter Wright
Advertiser Staff Writer
Dengue fever, if unchecked, could infect everyone in Hawai'i, causing serious illness for 200,000 people unless mosquitoes are controlled, State Health Director Bruce Anderson said yesterday.
Anderson's assessment, which he described as a worst case scenario, stood in stark contrast to Gov. Ben Cayetano's statement only one day earlier that the virus had been contained in East Maui and would not spread statewide.
Hawai'i "will throw everything we have at it," and every citizen of the state can help, Anderson said. But few other countries or communities worldwide have been able to stop dengue fever from running its course.
Without DDT and the other powerful and toxic pesticides of the past, dengue fever usually stops only when the virus has been transmitted to most of the population, exposing about 20 percent to serious illness, but conferring immunity from that strain of dengue in the future, Anderson said.
Dengue fever is spread by mosquitoes that bite an infected person and then carry the virus from one person to the next.
Anderson said it appears the virus has been introduced independently on Maui, Kaua'i and O'ahu rather than spread interisland, and has come to Hawai'i primarily from places like American Samoa, Tahiti and other parts of Polynesia where it is already epidemic.
Surfers who visited Tahiti are believed responsible for bringing dengue fever to Anahola on Kaua'i. A hula halau from Hana that visited Tahiti in the summer returned to East Maui with many members very ill and probably contributed to the establishment of the virus in that area, Anderson said.
The exact means of the virus' arrival on O'ahu isn't known, but frequent travel to foreign countries and passage through Hawai'i by many people from foreign countries, are likely means of transmission, he said.
Anderson said four more suspected cases of dengue have been identified on O'ahu in the past 24 hours, bringing the total number of suspected cases to eight.
A new case is suspected in Manoa, another in Kane'ohe (the second in that area so far), and a third in Wahiawa, Anderson said. Mosquito abatement specialists immediately visited those homes and sprayed insecticides 200 feet in every direction from those residences.
Prior suspected O'ahu cases were in Kane'ohe, Waikele, La'ie and Ka'a'awa, he said.
It may become necessary to consider neighborhood or regional mosquito ground spraying on O'ahu, similar to the spraying of all of Hana town and all of lower Nahiku on Maui, Anderson said.
A fourth new suspected case on O'ahu involved a patient treated at Tripler Army Medical Center, he said.
Anderson said eight new suspected cases have been reported on Maui within the past 24 hours, although some of the people involved may no longer be infectious.
The health director said he met yesterday with Mayor Jeremy Harris to coordinate a countywide effort to remove potential mosquito breeding places, such as old tires and other items which could contain standing water, especially near residences and businesses. Similar efforts are about to be announced on Maui and Kaua'i, he said.
The Maui cases confirmed either by CDC or preliminary screening tests came from Ha'iku (3), the Hana area (22), Lahaina (1) and Wailuku (2).
More Maui cases involving clinical signs of dengue fever, but not yet confirmed by lab tests, were found in the following communities: Ha'iku (9), Hali'imaile (1), Hana area (40), Huelo (2), Kahului (2), Kihei (7), Kula (1), Lahaina (4), Makawao (1), Pukalani (3) and Wailuku (9).
Kaua'i has one confirmed case in Anahola and one clinical case in Kalaheo.
The Big Island has clinically identified cases in Hilo (1), Kailua, Kona (2) and Mountain View (1).
CORRECTION: An earlier version of this story mistakenly reported that one case of dengue fever had been confirmed on O'ahu. CDC has not yet confirmed the case.
