Dengue education continues as outbreak count reaches 69
| • | Special report: Dengue fever: health crisis in the making |
By Yasmin Anwar
Advertiser Staff Writer
The official number of dengue fever cases in Hawai'i crept up to 69 yesterday, with seven new incidents, including one in 'Aiea and three in La'ie on the North Shore.
Bruce Asato • The Honolulu Advertiser
While state health officials are encouraged that the worst is over, they're not ready to declare a victory. Yesterday, they launched an aggressive six-month mosquito abatement and public-education campaign.
Raphael Vares, a state Department of Health vector control inspector, tests a birdbath that may be a breeding ground for mosquitoes, which lay eggs in shallow standing water.
"Things are slowing down, but it's not over by far," said Lorrin Pang, Maui District health administrator.
Of the seven new cases confirmed yesterday, three are on Maui, which now has 55 cases.
Maui health officials also are investigating the case of a Moloka'i boy who is suffering from fever and other flu-like symptoms. As of yesterday, the boy had not tested positive for dengue in preliminary screening and it is uncertain whether he has contracted the virus, Pang said.
Dr. Paul Effler, chief of the state's epidemiology division, said: "It's premature to speculate on whether that individual is or isn't a dengue case."
Overall, Effler said the rate of people testing positive for dengue in Hawai'i is low. "Most people are ruling out for dengue," he said.
And entomologist Paul Reiter, a dengue expert with the U.S. Centers for Disease Control and Prevention, concurs: "Hawai'i is very lucky that it has not suffered from the sort of dengue epidemics that are very common in the Caribbean," he said.
Maui 55 O'ahu 10 Kaua'i 4 Maui 1 O'ahu 1 Includes anyone who complains of two dengue-like symptoms in addition to fever.
Reiter, who has been studying Hawai'i's dengue outbreak for several weeks, suspects that some Maui residents in the Nahiku and Hana regions may have been exposed to dengue fever in 1996 during a major Tahiti outbreak.
Dengue fever update
(As of noon yesterday)
Confirmed cases
Statewide 69
Hana area 45
Ha'iku 3
Kihei 1
Pukalani 1
Lahaina 2
Wailuku 1
Makawao 1
Pa'ia 1
Honolulu 1
'Aiea 1
Kailua 1
Kane'ohe 2
La'ie 5
Anahola 1
Hanalei 1
Princeville 1
Kalaheo 1
Cases tested positive
Statewide
(preliminary screening) 2
Kihei 1
Waikele 1
•
Suspected cases
Statewide 292
Some residents there reported that they suffered from dengue-like symptoms in 1996, but did not know about the disease.
Over the next few days, Reiter will conduct antibody tests to determine whether some in the Nahiku and Hana areas were exposed to the DEN-2 serotype, which spread through Tahiti in 1996. The dengue strain in Hawai'i is DEN-1.
"It's quite possible that there has been dengue there before and it has been misdiagnosed," Reiter said.
Reiter is also planning to look for the Aedes aegypti mosquito on Moloka'i. That mosquito was responsible for the 1943 dengue outbreak on O'ahu.
Hawai'i's dengue outbreak is believed to have started in June in Nahiku near Hana. However, in recent weeks, cases have sprouted on O'ahu and Kaua'i.
Most locally transmitted cases are believed to stem from imported cases where people brought it from places such as Tahiti and Samoa, where dengue is pandemic.
The dengue virus is spread via mosquitoes. The carrier in Hawai'i is believed to be the Aedes albopictus, which poses a lower risk than the more "efficient" dengue carrier, Aedes aegypti.
The symptoms of classic dengue fever include high fever, a rash, headache, and muscle and joint pains. In some cases, victims suffer depression and hair loss.
State Health Director Bruce Anderson said there is little the state can do to control dengue other than educating people, and getting rid of mosquitoes and their breeding places. The vectors usually lay eggs in small pools of standing water.
"We have literally thousands of people moving back and forth from the Southern Hemisphere where they have dengue fever every day," Anderson said. "So there is no quarantine planned or any screening planned. Our efforts are focused on mosquito control."
As part of the campaign, a dengue "swat team" will go door-to-door to educate residents about mosquito control.
The state Health Department also has launched a series of public service advertisements that stress the importance of removing mosquito breeding places around the home. They urge every Hawai'i resident to make every Sunday "Dengue Cleanup Day."
Yesterday, Anderson used his back yard in Nu'uanu to demonstrate what anti-dengue measures to take.
