Maui woman tested for dengue fever
By Walter Wright
Advertiser Staff Writer
A new suspected case of dengue fever on Maui, while not serious in itself, is a warning to Hawai'i that it remains vulnerable to importation of the illness, the Maui district state health officer said yesterday.
"We still have to keep up our guard," said Maui Health Officer Dr. Lorrin Pang.
Last year, Hawai'i wiped out pockets of dengue fever in the state after 119 confirmed cases over a six-month period. Most were on Maui, where 89 cases were confirmed. There were 26 cases on O'ahu, four on Kaua'i and none on the Big Island.
Most of the cases were in East Maui, where many people were made ill from bites from mosquitoes.
The 2001-2002 outbreak was the first time that dengue had been a threat in Hawai'i since World War II, when officials wiped it out with quarantine measures and DDT.
Pang said yesterday a Ha'iku woman who suffered dengue fever-type symptoms last week had just come back to Hawai'i from Tahiti and probably was infected there.
The area around her home was sprayed to kill mosquitoes which might bite her and spread the infection to others, Pang said. If her case is confirmed as dengue by laboratory tests, the area will be sprayed again immediately, and again two weeks later, he said.
There have been two or three other reported cases of "imported" dengue since officials declared Hawai'i dengue-free 10 months ago, Pang said.
Those occasional imported cases will continue to show up because many people travel to Hawai'i from places where dengue is established, including Tahiti and other locations in Polynesia, and the Philippines, Southeast Asia, and Central America, he said.
There are probably many other cases which go unreported, because anywhere from 15 to 85 percent of victims can be infectious but not experience symptoms, he said.
Victims can suffer symptoms anywhere from two to 15 days after being bitten, and are infectious for about a week after they experience symptoms. When a victim is infectious, the illness can be carried from them to others by mosquitoes, Pang said.
The greatest risk that the disease will become established is in rainy, moist areas that can support mosquito populations, he said.
"But since our big outbreak, the population is more aware, and the doctors are more aware," Pang said.
Defensive measures, like cleaning areas where standing water could allow mosquitoes to breed, and providing visitors with free mosquito repellent in high-risk areas, are helping to prevent a reinfestation, he said.
Another factor in Hawai'i's favor is that its mosquitoes are less likely to pass on the dengue illness than mosquitoes in other areas, he said.
Hawai'i's quick-response spraying program has become a model for other areas suffering dengue outbreaks, Pang said.
"The new imported cases should keep people from becoming lax," said Pang. "They remind people they should keep their yards clean so mosquitoes can't breed nearby."
More cases can be expected, he said. "It could be another challenge this year, especially now, because in the South Pacific their summer occurs during our winter, and the virus amplifies faster in the mosquito population during warmer seasons."
Reach Walter Wright at wwright@honoluluadvertiser.com or 525-8054.
