Dengue precautions taken here after student's death

By Robbie Dingeman
Advertiser Health Writer

Hawai'i health officials have sprayed homes on the Big Island and are monitoring family and friends of a college student from Pahoa who died of a flu-like illness that is now suspected to be a rare form of dengue fever.

Simon Hultman, 22, died Jan. 26 after a series of high fevers. Richard Ambo • The Honolulu Advertiser

Simon Hultman, 22, died Jan. 26 at the University of Maryland Medical Center in Baltimore after a series of high fevers. Hultman's mother, Diane, yesterday said Maryland specialists told her initial tests indicated that dengue hemorrhagic fever may have been the cause of her youngest son's death. He was a senior at Washington College in Chestertown, Md.

Officials here and in Maryland said the cause of death still hasn't been determined.

Further tests are being done at the U.S. Centers for Disease Control and Prevention laboratory in Puerto Rico to determine if a form of dengue is the most likely cause, and Hawai'i health officials are awaiting those results.

Hultman left the Big Island to return to school on Jan. 14 and five days later went to a local emergency room complaining of flu-like symptoms. He died a week later.

Hawai'i experienced a dengue outbreak two years ago, when 119 cases were confirmed over a six-month period. But there were no deaths, and the strain of dengue fever suspected in Hultman's death was not found then in Hawai'i, said state Health Department spokeswoman Janice Okubo.

Dengue fever is a viral disease transmitted by mosquitoes in tropical and subtropical areas of the world. Symptoms, which include high fever, severe headaches, joint and muscle pain and rash, may last up to 10 days.

Okubo said officials here have tracked Hultman's relatives, friends and close contacts and so far have found no illness among them.

Michele Nakata, chief of the disease investigation branch of the Hawai'i Health Department, said officials are taking prescribed precautions for dengue: ordering mosquito-spraying and monitoring reports of symptoms consistent with dengue.

Officials have notified hospitals, clinics and doctors in the area to determine if anyone with similar symptoms has been in the area, Nakata said. "There was nothing indicating any recent unusual disease activity," she said.

Diane Hultman said local health department officials on Tuesday sprayed her house and yard in Pahoa, her daughter's house and those of her neighbors for mosquitoes.

Nakata said the follow-up test being conducted in Puerto Rico is critical to confirming the cause, as the type of test administered at the Maryland hospital produced false-positive results during the Hawai'i outbreak two years ago.

Diane Hultman said Simon did some hiking on the Big Island with three other friends who also were home from college over the holidays. But she has been in touch with all of them and none has become ill.

Okubo said the Health Department generally advises people to eliminate standing water where mosquitoes can breed as a precaution against dengue, West Nile virus and other illnesses.

Diane Hultman said she hopes to find out what caused her son's illness. "It's not going to bring Simon back, but it would be good to know," she said.

Health authorities in Baltimore earlier ruled out severe acute respiratory syndrome and meningitis but were testing for other illnesses that can cause flu-like symptoms.

Washington College has said that the Maryland Department of Health and Mental Hygiene "has not identified any evidence of a situation that requires special disease prevention actions" at the college.

In the 2001-02 Hawai'i outbreak, most cases were on Maui, where 89 were confirmed. There were 26 cases on O'ahu, four on Kaua'i and none on the Big Island.

That 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 and the pesticide DDT.

Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.