Isle expert skeptical
of dengue deathAdditional tests will be done
at a federal lab in Puerto Rico
HILO >> A Honolulu expert on dengue fever questions a preliminary finding that a Big Island man who died in Maryland last week was a victim of the disease.
"I'm skeptical," said Dr. Dwayne Gubler, who recently began duties as director of the Asia-Pacific Institute of Tropical and Infectious Diseases at the University of Hawaii John A. Burns School of Medicine.
Simon Hultman, 22, of Nanawale Estates south of Hilo, died Jan. 26 in Maryland after returning there from a Christmas vacation on the Big Island.
His mother, Diane Hultman, said this week that the family has received a preliminary report that dengue caused the illness, but further tests are being done at a federal laboratory in Puerto Rico.
Indicating his knowledge of the subject, Gubler said he was the person who supervised construction of the Puerto Rican lab. He is recognized as a worldwide expert on dengue.
A number of reasons lead him to doubt dengue caused Hultman's death, Gubler said.
There is no dengue reported on the Big Island, and the disease cannot survive in cold climates like Maryland, he said.
Diane Hultman said the causes of her son's death were listed as hemorrhaging in the brain and sepsis, or poisoning caused by microorganisms. Gubler said dengue, although it can take a form involving hemorrhaging or internal bleeding, does not cause bleeding in the brain.
Dengue also does not cause sepsis, which is a symptom associated with bacterial infections, he said.
Diane Hultman said doctors, not knowing the cause of Simon's illness, gave him large amounts of antibiotics in case a bacterium was the cause. But Gubler noted that some bacteria are resistant to antibiotics, or the infection may have been so massive that it overwhelmed them.
The state Health Department found no apparent outbreak of dengue fever through an investigation of the circumstances around Hultman's family, said spokeswoman Janice Okubo.
An outbreak of dengue fever in Hawaii in 2001-2002 totaled 119 confirmed cases, but none were on the Big Island. There were no deaths, and deaths from dengue worldwide are rare, Okubo said.
Simon Hultman, a student at Washington College in Chestertown, Md., spent Christmas on the Big Island with his family and his girlfriend from Japan, Diane Hultman said. He spent part of that time hiking in Waipio Valley, the Waimea area and North Kohala, she said.
He was in good health when he returned to school early in January, she said. But he went briefly to a hospital on Jan. 18 and was found seriously ill at his dormitory the next day.
As soon as dengue was suspected, Maryland health officials notified the Hawaii Department of Health, Okubo said. Officials here "intensely interviewed" the family, retraced Hultman's activities and talked to people he contacted, Okubo said. Nothing unusual was found.