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The Honolulu Advertiser
Updated: 4:45 p.m., Wednesday, October 10, 2001

State getting dengue lab; confirmed cases now 40

 •  Online special: Dengue fever: health crisis in the making

By Yasmin Anwar
Advertiser Staff Writer

While the number of federally confirmed cases of dengue fever in Hawai'i keeps rising, state health officials are stepping up efforts to control the mosquito-borne disease.

DENGUE UPDATE

CONFIRMED CASES
 •  Statewide 40
 •  Maui 39
    Hana area
    Haiku
    Pukalani
    Lahaina
34
3
1
1
 •  Kaua'i 1
    Kalaheo
1

CASES THAT TESTED POSITIVE IN PRELIMINARY SCREENING
 •  Statewide 9
 •  Maui 5
    Hana
    Kihei
    Wailuku
1
2
2
 •  O'ahu 2
    Ka'a'awa
    Honolulu
1
1
 •  Kaua'i 2
    Anahola
    Hanalei
1
1

NUMBER OF SUSPECTED CASES UNDER INVESTIGATION
(Number includes anyone who complains about two dengue-like symptoms in a addition to fever)
 •  Statewide 165
On the positive side, the state soon will have its own dengue fever laboratory so health officials don't have to send blood samples of suspected dengue fever cases to the U.S. Centers for Disease Control and Prevention laboratory in Puerto Rico.

The CDC is sending Hawai'i a batch of Federal Drug Administration-approved tests that can swiftly detect antibodies to the dengue virus.

Meanwhile, the number of federally confirmed dengue cases in Hawai'i has increased since Monday to 40. Of those, 39 are on Maui and one is on Kaua'i.

Nine suspected cases have tested positive in preliminary screening. Two are on O'ahu, two are on Kaua'i and five are on Maui. And another 165 suspected cases of dengue are under investigation.

Around the state, counties are organizing cleanups and community informational meetings to reduce mosquito breeding places.

Today on O'ahu, vector control crews are spraying insecticides at the homes of suspected dengue victims in Waiahole and Kane'ohe. In Hana, where the disease initially surfaced in June, more than 350 residences and two schools have been sprayed.

The state also has distributed tens of thousands of informational brochures about the disease.

The state Department of Health estimates that a six-month campaign to control dengue fever in Hawai'i will cost the state approximately $1.36 million.

Vernon Miyamoto, chief of the state Laboratories Division, said he hopes to have a dengue testing site up and running at a state laboratory in Pearl City "well before the end of the month."

It usually takes one to two weeks for Hawai'i to receive the results of blood tests sent to the CDC's dengue fever laboratory in Puerto Rico.

However, with the arrival of the CDC's "gold standard" confirmatory tests, the turnaround for results could be reduced to two to three days, allowing public health officials and vector control crews to act more swiftly in controlling the disease believed to be spread by Asian tiger mosquitoes.

"The faster we get confirmatory results back, the more quickly we'll be able to rule in and rule out cases so we can confirm where dengue is and where it isn't," said Dr. Paul Effler, chief of the state health department's epidemiology branch.

Officials have been using a rapid field test that is at least 50 percent reliable in predicting whether the CDC will confirm a case of dengue.

 •  For more information on dengue fever, call the Hawai'i Department of Health dengue helpline at (808) 586-8352 or visit the Web site at www.hawaii.gov/doh/dengue
The dengue fever virus is transmitted by the mosquito vectors Aedes aegypti and Aedes albopictus. It is endemic in many parts of French Polynesia and Southeast Asia. In Hawai'i, the suspected carrier is Aedes albopictus, also known as the Asian tiger mosquito, which bites during the day.

Victims typically suffer high fever, muscle aches, headaches, nausea and other severe and painful flu-like symptoms. There is no vaccine or treatment for the disease.

Dengue is caused by four different virus serotypes, DEN-1, DEN-1, DEN-3, DEN-4. Infection with one does not assure protective immunity to the other serotypes. In fact, immunity to one serotype appears to induce a more severe and life-threatening form of the disease when subsequent infections occur with other serotypes.

The disease can develop into life-threatening conditions called dengue hemorrhagic fever and dengue shock syndrome. However, there have been no reports of serious illness in Hawai'i so far.