CDC Visits the Big Island as Dengue Rises to 130

As the dengue fever outbreak on the Big Island has stretched to 130 confirmed cases, Dr. Lyle Peterson, Director of the Centers for Disease Control & Prevention’s Division of Vector-Borne Diseases, is on island.

Dr. Peterson made the trip, along with Ryan Hemme, CDC entomologist, and Albert Felix, CDC entomology assistant, per the request of State of Hawai’i and County of Hawai’i officials.

The crew is assisting in the evaluation of the mosquitos causing the dengue outbreak, conducting training for government officials in the handling of dengue, and helping to assess control efforts.

On Thursday, as confirmed cases of dengue fever rose by eight, Hawai’i County Civil Defense, along with the Hawai’i Department of Health and Dr. Peterson, held a press conference to review CDC’s overall findings so far on the Big Island.

“Overall I have found the state and county’s efforts to be timely, well considered, and appropriate,” Dr. Peterson said as he opened the meeting.

CDC’s evaluation included how officials are handling potential and confirmed dengue fever cases, which Dr. Peterson described as “effective” and “has been instrumental in guiding the response.” Furthermore, he praised the county’s decision to close Ho’okena Beach Park which “undoubtedly prevented further infections and spread of the virus around the island.”

Additionally, Dr. Peterson noted that the timely response by State laboratories in the testing of potential dengue cases has been a vital part of outbreak control. Outreach to diverse populations, and health alerts have also held great importance in controlling the outbreak.

“I’m very impressed with the coordination between the state and county government and this is among the best I’ve actually seen in many different outbreak situations,” said Dr. Peterson. “Unfortunately dengue won’t be the last mosquito born health threat to the state and the relationships and expertise built now will be of considerable benefit in the years to come.

“Mosquito control efforts have to be mobilized quickly. Nevertheless, dengue outbreaks are extremely hard to control, and it is imperative that additional effort be put into evaluating the effectiveness of the current control measures.”

Of the 130 confirmed dengue cases, 16 have involved visitors, and 30 have affected individuals under the age of 18.

The most recent onset of illness was Nov. 28, while the initially recorded case remains Sept. 11.

Dr. Peterson said it’s impossible to determine how many cases may eventually occur, but brought insight from the 2001 Maui outbreak, noting similarities of how cases developed slowly.

“One possible reason for this is that the mosquito species most responsible for both outbreaks appears to be a mosquito called aedes albopictus, which is present throughout the Hawaiian islands,” said Dr. Peterson. “This mosquito does not spread dengue as readily as another mosquito, aedes aegypti, which is only uncommonly found on parts of the Big Island and not on the other islands as we know it.”

Officials stress that the public can play an important role in stopping the spread of dengue by following the guidelines provided through the “Fight the Bite” campaign.

Spraying operations continued Thursday with efforts focused in the South Kona and Puna areas, but officials note that these efforts may not completely eliminate mosquitos, and it is imperative that the community does its part.

“If the outbreak continues for a number of months, it’s not a failure to response measures. It is just that we do not have the tools yet to eliminate dengue outbreaks instantly,” Dr. Peterson said. “I’d like to emphasize that the efforts to deal with the outbreak cannot be done by the government alone and must be accomplished by everyone working together.”

Over 100 million clinically apparent dengue infections occur each year around the globe, making the recent outbreaks on the island seem small in scale to larger epidemics.

Dr. Peterson said that dengue is likely to be imported into the Hawaiian Islands “all the time” but rarely causes outbreaks and has not become endemic, giving a “low” probability of becoming endemic this time around.

Hemme and Felix will remain on the island for two weeks, while Dr. Peterson leaves the island Friday evening.

Symptoms of dengue fever include fever, joint or muscle pain, headache or pain behind the eyes, and rash.

Those interested in obtaining general information about the current Big Island dengue fever investigation should call 2-1-1 and talk with Aloha United Way.

Anyone who thinks they may have contracted dengue fever on the Big Island should call 933-0912 if they’re located in East Hawai’i or 322-4877 in West Hawai’i. If an individual is currently ill and worried that they may have contracted dengue fever, they should contact their primary care physician.

Mosquito concerns should be reported to 974-6010 in East Hawai’i or 322-1513 in West Hawai’i.

For more information, visit the DOH website.