Isle typhus total WAILUKU >>Marine typhus cases in Hawaii last year hit the state's highest known annual total since 1994, a health official said.
highest since 1944
Health officials note the
number of cases decreased
toward the end of last yearBy Gary T. Kubota
gkubota@starbulletin.comWhile a few more cases from last year are still undergoing review, the number of confirmed cases in 2002 now totals 47 statewide, including 35 on Maui, six on Molokai, three on Oahu, two on Kauai, and one on the Big Island, said Dr. Paul Kitsutani, the medical officer with Centers for Disease Control and Prevention.
The last major increase in murine or rodent-borne typhus took place in 1944, when the Territory of Hawaii had 186 confirmed cases, most of them on Oahu, he said.
Other than 1944, 1983 recorded high numbers also, Kitsutani said. In 1983, there were 13 or 14 cases, registering the highest annual total in the last two decades until last year.
Officials cannot be sure if there were other years with record cases because testing and record keeping methods were not as complete as the current system, he said.
Murine typhus is spread typically through a flea biting a rodent that is carrying the bacteria called Rickettsia typhi, and then biting a human being. Symptoms include fever, rash and body and headaches. The infection can be treated with antibiotics.
The number of cases decreased significantly toward the end of last year because of a seasonal decline and because state officials started a program to reduce the rodent population in infested areas, such as Kihei-Wailea, Lahaina and Kula on Maui.
"It's a good sign," said Kitsutani, who also noted that the disease usually hits its peak in late spring and summer. "Aggressive rodent control measures led to dramatic decreases in murine typhus on all islands."
Several cases of murine typhus are usually reported each year in the state.
The number of murine typhus cases in Hawaii in 2002 reached a monthly peak of 11 in September and then decreased to seven in October, followed by two in November and three in December.
In November, one man in Kula and another from Kihei contracted murine typhus. In December, a woman from Kihei, a man from Kula and a man from Kailua-Kona on the Big Island contracted the disease. Kitsutani said he believes the Kailua-Kona case in December was the first confirmed murine typhus case on the Big Island since at least 1983.
Kitsutani, stationed at the state Department of Health, said state vector control officials have noticed a decrease in the number of rodents in the last few months, following the use of poisoned oats in infested areas.
No one died from murine typhus in Hawaii in 2002, but some suffered severely from it, including a Lahaina man who had encephalitis and kidney failure and a Big Island man who experienced heart problems.
Kitsutani said out of the 47 cases last year, 18 -- or 38 percent -- were confined to a hospital, and they stayed as patients for an average of seven days.
He said prior to last year's total of 35 cases on Maui, the previous high for the island was 12 in 1983.
The Valley Isle usually has an average of four to five cases annually, he said.
He said the six cases on Molokai in 2002 were by far the most recorded since at least 1982 with the previous high at 4.
Kitsutani said he did not know why there has been more murine typhus cases on Maui than other islands.
When asked about the possibility of more typhus cases this year, he said: "I don't know. We're going to have to do more surveillance."
Kitsutani said disease control officials are still encouraging physicians to order laboratory tests for typhus if they strongly suspect it in their patients.
Donald Taketa, a state vector control supervisor on Maui, said his office is monitoring the number of rodents monthly by counting the number of rodents in traps.
Centers for Disease Control and Prevention
State Health Department