Anyone infected with a mild form of the virus, also called West Nile fever, may experience fever, headaches, skin rash and swollen lymph glands. Symptoms of the more serious West Nile encephalitis include high fever, neck stiffness, disorientation, coma, tremors and occasional convulsions and paralysis.

The best way to prevent the disease from establishing itself is to eliminate mosquito breeding grounds, health officials said.

"Even if West Nile virus comes to Hawai'i, our hope is that without mosquitoes to transmit the disease it will not become established," said Greg Olmsted of the Health Department's Vector Control Branch. "Getting rid of mosquito breeding areas just takes a little bit of effort and it has the huge benefit of protecting Hawai'i's delicate ecosystem and human health."

Since the virus came to the United States in 1999, nearly 17,000 cases have been confirmed and more than 650 people have died from the disease, the Health Department said.

To eliminate mosquito breeding areas, health officials advise residents to:

• Tip over pots, wheelbarrows and containers.

• Fix leaky faucets that create puddles.

• Get rid of rubbish such as old tires.

To reduce the risk of being bitten by mosquitoes, the Health Department recommends the following measures:

• Avoid activities in areas where mosquitoes are plentiful.

• Keep mosquitoes from entering your home by repairing screen doors and windows.

• Wear long pants and long-sleeved shirts when possible.

• Use insect repellents that contain DEET.

Residents also can help with West Nile virus surveillance by reporting and turning in dead birds for testing. Birds are susceptible to the disease, so dead birds in an area may be the first indication of the presence of the virus, the department said.