DOH: Late information hampered fight against dengue

The number of confirmed cases of dengue fever on the Big Island rose to 23 on Friday. Fifteen of the patients are island residents, and eight are visitors, according to the state Department of Health.

Hookena Beach Park remained closed as DOH and park crews sprayed and assessed the area, and pesticides were also being sprayed in the Telephone Exchange Road area in Honaunau in response to suspected cases.

State epidemiologist Sarah Park said she was not certain how many suspected cases were in that area, and that the number could change hourly. Hawaii County is also taking the lead in spraying other Honaunau areas known to harbor mosquitoes, she said.

While Hookena and Honaunau are considered “hot spots,” the disease has been found all over the island, and the DOH has been frustrated in attempts to pinpoint its source.

Twenty-one of the confirmed cases are adults, and two are children, with the latest onset of illness dating to Oct. 30, said Park. Another case of dengue on Oahu has been confirmed, but lab tests show it is a different strain than the one on the Big Island, and the infected individual had recently traveled to a part of the world known for having dengue present, Park said.

Park acknowledged that Big Island residents have been wondering why it took the DOH so long to identify the disease and inform the public of its presence. That’s because the DOH was not notified until about two weeks after the first known patient was seen by a health care provider, Park said.

“We’re talking three weeks from the time of infection to when we learn about it,” she said.

The DOH is working backward, case by case, trying to identify the patient who brought dengue to the island. That has been challenging, in part because dengue most often presents mild to moderate symptoms, with headache, fever and body aches. These can easily be mistaken for flu, and it’s possible that first victim never received treatment.

“We may never find them,” she said.

Classes have continued as normal at Hookena Elementary School, and the community seems to be taking the disease in stride. The school has sent informational fliers home with students and is waiting for DOH Vector Control to assess the school grounds and offer advice on next steps, said teacher-in-charge Dayne Snell-Quirit.

Parents have been checking in with the school for updates and have donated a lot of repellent, Snell-Quirit said. However, DOE policy prohibits school officials from applying the repellent to students. Instead, parents should spray their children before they send them to school, she said.

Honey Medeiros, who works at Fujihara Store in Kealia, said business is still strong at the popular store, located near the road to Hookena Beach Park. Locals are buying up mosquito coils and repellent at a rapid pace, forcing the store to order a lot more than normal, she said. But they don’t seem rattled about being in the one of the epicenters of the disease, and they aren’t shutting themselves in their homes.

Many tourists have been stopping by to ask where an alternative beach park is located. Locals wonder when the park will reopen, she said.

“That’s the spot people go when they get off work,” she said.

Hookena will remain closed until further notice, Civil Defense Chief Darryl Oliveira said in a daily update. He could not be reached by phone Friday for further information.

Park said an email sent out to IRONMAN triathlon participants turned up one person who believes they had dengue, but test results are pending. Very few cases of dengue result in the severe form — hemorrhagic fever, Park said. Those cases are usually from a second dengue infection, which is much more potent than the first.

“A lot of people hear ‘dengue’ and they think it’s a very bad disease, but the vast majority have mild to moderate symptoms, and the cases never come to light,” Park said.

There is no reason to assume the Big Island cases will go away soon, or that the public should let down its guard, she said.

“We don’t know what the disease risk is,” Park said. “We do know we can be proactive as a community in practicing mosquito bite prevention.”

Park compared the Big Island situation to the recent case on Oahu — a textbook example of how dengue should be handled. In East Oahu, a sick person reported to their doctor, who immediately contacted the DOH, she said.

“We got all of their information, where they traveled, and the Vector Control folks inspected the home for mosquitoes and did abatement,” Park said. “That’s the ideal situation.”