Health officials in Hawaii are getting help from the CDC to control the ongoing outbreak of dengue fever on the Big Island.
Dr. Lyle Petersen — director of the Centers for Disease Control and Prevention’s division of vector borne infectious diseases — and two colleagues traveled to Hawaii and met with state health officials Tuesday. They plan to travel to the Big Island on Wednesday. Along with their expertise, they brought tools including special mosquito traps that are easier to use and not widely available but work well with the specific type of mosquitoes that transmit dengue fever.
Since September there have been 117 confirmed cases of the mosquito-born disease, according to the state department of health. Twenty-nine of those sick are children under the age 18. The majority of the ill patients, 103, are local residents.
Dengue fever is transmitted to humans when they are bit by infected mosquitoes. There are two types of mosquitos — Aedes aegypto and Aedes albopictus — that can transmit the virus, and both types are found in Hawaii.
This is the first locally transmitted outbreak of the viral illness on the Big Island and the first outbreak in the state since five people were infected on the island of Oahu in 2011.
There has been one recent case of illness on Oahu but health officials say it was not locally transmitted and is not linked to this new outbreak.
Dengue usually occurs in tropical Asia, Africa, the Caribbean and the South Pacific. The virus is not endemic in Hawaii but is sometimes brought in by infected travelers, which is how state health officials believe this outbreak started.
‘Guessing game’
Collection of the blood sucking insects stands to offer valuable information to local, state and federal health officials trying to stop the outbreak.
The priority for the CDC team on the ground is to “see where (the mosquitos] are located and review a stiuation where transmission is still going on and to get a pair of outside eyes and see if there might be something missing,” Dr. Hal Margolis, director of the CDC’s dengue branch, told CNN. “It’s a guessing game, especially in these places that don’t routinely have dengue.”
For example, information about the distribution and density of the mosquitos is lacking, meaning whether there are a lot of them in a lot of places or a lot in one place.
Additionally, in areas where the disease is endemic, outbreaks occur during the wettest and warmest season, so if that season is ending there could be a light at the end of the tunnel. But in a place where dengue doesn’t usually occur, like Hawaii, that’s just not known.
Fight the Bite
What is known is that controlling the mosquitoes is key. Which is why state health officials launched a campaign last month called “Fight the Bite,” to raise awareness about the mosquito-borne disease.
Most people with dengue show no symptoms, and only about a fourth of those with the disease become ill (although they can still infect mosquitoes who bite them), according to Margolis.
Those who do get sick, develop a high fever and severe joint and muscle pain, which is why it’s nicknamed “bone fever.” People who have had it describe it as the worst fever and body aches they’ve ever had. Symptoms begin about five to seven days after exposure. Some individuals develop a rash on their hands, arms, feet and legs three to four days after the fever begins.
When diagnosed properly, dengue is successfully treated and the death rate is only 1%. Acetaminophen is given to relieve symptoms, which usually last for one to two weeks.
The overall risk to the public is low, Margolis said, mostly because the mosquitoes in the United States aren’t very efficient at transmitting the virus.
So while health officials are hard at work, their counterparts in the tourism authority are also in overdrive to make sure the more than 8 million visitors that flock to the Hawaiian islands each year keep coming.