Public’s help sought in controlling diseases
Officials say simple steps can help prevent the spread of bird flu, West Nile and dengue
The state has made significant progress in developing systems to prevent and respond to infectious diseases, says Dr. Paul Effler, state epidemiologist.
ON THE LOOKOUT
Infectious diseases Hawaii is trying to keep out:
West Nile virus: Transmitted by infected mosquitoes; infects birds, horses, people. Can cause severe illness, including encephalitis (brain inflammation) or meningitis. Symptoms can include high fever, headache, coma, tremors, convulsions, muscle weakness, vision loss, numbness and paralysis.
Dengue fever: Mosquito-borne viral disease that causes severe joint pain, high fever, nausea, a rash and, in the worst cases, internal bleeding.
But the public's help is needed, he said.
The state wants the public to report dead birds to test for signs of avian flu infection and to reduce mosquito-breeding areas to avoid dengue fever and West Nile virus.
"Mosquito control begins at home," Effler stressed, advising residents to dump standing water to keep mosquitoes from breeding.
Laurence Lau, deputy health director of the Environmental Health Administration, said one type of mosquito can breed in very small containers and suggests, "Tip things over and flush them out."
From 2001 to 2002, Hawaii had a dengue fever outbreak with 119 confirmed cases. No recent cases have been reported here, but Singapore is having a large epidemic of dengue hemorrhagic fever.
"Singapore is one of these countries like Hawaii that has essentially prevented an epidemic of dengue for many years," said Duane Gubler, chairman of tropical medicine and medical microbiology at the University of Hawaii, who was recently in Singapore as an adviser. "But out of the blue, they have a big epidemic. It goes to show you can't lay your guard down. These things can come in any time."
He believes Singapore, with 11,000 dengue cases, will have the epidemic under control soon. "They have the best program in the world."
However, Hawaii is rebuilding the infrastructure to deal with mosquito control, Gubler said.
"Hawaii is unique in the tropical world as one of the few places with no vector-borne diseases, but we do have mosquitoes that can transmit and we don't have the infrastructure to effectively deal with them," he added.
Effler said more than 50 mosquito traps have been placed near the airport and harbors, and mosquitoes are being tested for infections.
The Health Department also has stockpiled mosquito insecticide and will kill larvae in the water when they trap a lot of mosquitoes, Gubler said.
Some 250 dead birds -- the best means of testing for West Nile virus -- have been reported since the program began, Effler said. But more are needed for better surveillance, he said.
"The real important issue is trying to keep West Nile from establishing a foothold here, if it is introduced."
Effler said a system is being implemented that the Centers for Disease Control and Prevention's Division of Quarantine is thinking of adapting for national use.
Pilots are required by law to identify ill passengers, and they will be screened by the CDC quarantine officer at the airport station, he said.
If necessary, they will be tested and specimens rapidly collected and analyzed to see if the passenger has avian flu or something else that is contagious, he said. "But the risk of bird flu is exceedingly remote in travelers," Effler added.
The quarantine station at the airport is increasing its capacity, Effler said, noting a full-time physician is being placed there for the first time.
Lau said the department has received a CDC grant that will be used to hire a West Nile virus coordinator.
The Hawaii Invasive Species Council, recognizing that West Nile could wipe out a large number of native birds, also gave the department $455,000.
Lau said it will be used mostly to improve the state laboratory's capability to test for West Nile. "Our lab is the only indispensable part of the system. No other institution in the state can do what our lab can do."
The state lab in Pearl City plans to more than double the number of tests it runs each year, to 8,000 from about 4,000, and get the time down to seven days from field collection to results, Lau said.
Some of the money will be used for additional equipment and supplies and for public outreach, he said.
"Because of our work on West Nile in the last couple years, we are in a better position to deal with dengue," Lau said.
The state lab also is working with UH and the Health Department's Disease Outbreak Division to improve respiratory illness surveillance because of the potential for the avian flu virus.
But, he said, "Bottom line, we need to get more birds to test." He urged the public to be on the lookout for dead birds and call 211 with any sightings.
Lau said the Health Department has asked doctors to report any patients with symptoms of the West Nile virus or other infectious diseases.
"There is a lot of human detective work epidemiologists use, not just lab work," Lau said. "Getting the history of people, figuring out where they were, is a critical part of figuring out what we've got."
OCTOBER 26, 2005
» The state Health Department asks the public to report any dead birds for testing for West Nile virus. An article on Page A3 on Oct. 18 incorrectly reported birds were sought to test for avian flu, which is not present in Hawaii.