Officials scramble Dr. Lorrin Pang, district health officer on the front lines of Maui's dengue fever outbreak, says with all of his experience, he has never seen anything like the situation there.
to stop dengue
Tourists are being told of the
illness as ads urge residents
to clear debris and waterBy Helen Altonn
haltonn@starbulletin.comIn Southeast Asia and Brazil, where he saw hundreds of dengue fever cases, the Aedes egypti mosquito transmitted them.
"It is a different thing here," Pang said, explaining he had never seen an outbreak transmitted by Aedes albopictus, the Asian tiger mosquito, which is the carrier in Hawaii.
The U.S. Centers for Disease Control has confirmed 39 cases of dengue fever on Maui and one on Kauai, the state Health Department said yesterday. Nine other cases tested positive on preliminary screening tests, and 165 reports of illness are being investigated on the four major islands.
Pang was among health officials describing the dengue fever outbreak yesterday to the House Health Committee.
Health officials reported these developments:
>> A state surveillance program began a few days before the first suspected dengue fever case to prepare for possible bioterrorism.
>> Spraying for mosquitoes began as soon as a doctor reported the first dengue case in Nahiku on Sept. 12, although it was not confirmed by the CDC until Sept. 21. So far, 513 sites have been sprayed on Maui (329 of those in the Hana area), 15 sites on Oahu, 13 on Kauai and 12 on the Big Island.
>> All licensed doctors were notified of dengue cases being brought in by people from other areas so they could be alert for symptoms. "When you haven't had a disease in the state for 50 years, it's easy to let that fall from consideration," state epidemiologist Paul Effler said. Hawaii now has 28 known imported cases, he said, with 24 occurring in July and August. The normal annual average is three.
>> The state and counties have launched a massive public education, outreach and cleanup program to emphasize the importance of eliminating mosquito-breeding areas to prevent spread of the virus. Television and radio public service announcements have been launched to encourage residents to clean from their neighborhoods any debris or containers holding water.
>> State officials are working with the visitor industry to inform all arrivals of the outbreak. About 1,000 tourists a day are receiving informational brochures and mosquito repellent from a tourist information site set up on the road to Hana. Three other roads into the area have been closed because of high risk.
>> The CDC is sending chemicals and approved techniques for confirming dengue fever to the state laboratory. Health Director Bruce Anderson expects it to begin doing tests by the end of this month instead of shipping blood samples to the CDC's dengue lab in Puerto Rico.
Although most confirmed cases are in the Hana area, Pang said the virus has "seeded" across the island, with a small number of infections in many places. The only place he has not seen them is "way upcountry," he said.
He said he could not predict whether there will be a "blowup" of infections in areas other than Hana.
"I haven't seen this kind of epidemic slowly percolating along," he said. "I think we have a pretty good chance with this."
He said many more people possibly will be infected before the outbreak is over, so it is essential to maintain control.