KAILUA-KONA — Two West Hawaii lawmakers are calling for the Centers for Disease Control and Prevention and the World Health Organization to send medical experts to help quell the disease before it becomes endemic.
KAILUA-KONA — Two West Hawaii lawmakers are calling for the Centers for Disease Control and Prevention and the World Health Organization to send medical experts to help quell the disease before it becomes endemic.
The number of Big Island dengue cases grew to 72 on Wednesday. A joint intersession meeting of the House and Senate on the outbreak is scheduled for Friday, and control efforts are swinging now to schools.
Meantime, Kona Sen. Josh Green and Naalehu Rep. Richard Creagan say a well-meaning but understaffed and overwhelmed Department of Health is out of its depth in the dengue fight.
“We can no longer convey the illusion that we in Hawaii currently have the expertise or resources in place to assess or control this outbreak effectively,” the lawmakers wrote in a letter Wednesday afternoon to Gov. David Ige and state Department of Health director Virginia Pressler.
Sixty-two of the dengue cases are island residents, and 10 are visitors. Fifty-three of the cases are adults and 19 are children, with the latest onset of symptoms now at Nov. 12.
Asked if he had requested a change in the state approach to the dengue outbreak as the cases escalate, Green supplied the letter with detailed recommendations that he and Creagan are making.
“We ask that senior CDC and WHO professionals be engaged to come to Hawaii immediately to give an extensive opinion and assessment of the current dengue outbreak,” the lawmakers said. “Resources must be made available to communicate effectively with migrant worker communities. … They must have mosquito repellent and free additional work gear. We should also pursue support for the farming community and these workers for lost wages and lost productivity.”
Green and Creagan called for more opportunities to get tested locally. Many people lack the resources to go to doctors or do not want to call attention to themselves, and will suffer the disease in silence and risk spreading it, the lawmakers have said.
“Once dengue fever penetrates Puna and Hilo, it will not be eradicated for a generation,” they said. “This will occur if we don’t take drastic action.”
Konawaena High, middle and elementary schools will be sprayed to control mosquitoes over the weekend, as will Honaunau Elementary and Hookena Elementary. Hilo and Waiakea high and intermediate schools will also be sprayed. The DOH is continuing site assessments and spraying of pesticide.
“These campuses are being treated as a preventative measure and based on proximity to confirmed cases,” Civil Defense Administrator Darryl Oliveira said. “There are no cases directly related to any of the school facilities or campuses.”
State epidemiologist Sarah Park defended the DOH response to the outbreak, saying she is in close conference with the CDC already, that she and her deputy trained with the organization, and that the CDC is adamantly in agreement that the only way to control the outbreak is through mosquito bite prevention and initiatives like the state’s “Fight the Bite” campaign.
“From day one, I have been in close conversation with the CDC,” Park said. “I never work in a vacuum during a disease outbreak.”
Park said the outbreak highlights a lack of access to health care, but that people may be mistaken about what the CDC can offer.
“They are not ‘boots on the ground’ people,” she said. “They are epidemiologists and entomologists. If we need technical asistance, they provide that.”
The agency is sending mosquito traps and has been providing lab support as well as studying the origin of the strain now infecting people on the island, said Park, who described email and data exchanges with the agency.
“The WHO doesn’t come into a country unless it’s invited to go into that country,” Park said. “I don’t think President Obama is going to ask the WHO to come to Hawaii.”
Park said the recent uptick in cases is not a cause for alarm.
“On the scale of dengue outbreaks, it’s a not a huge one,” she said. “Would I like to see it slow down? Sure. As it becomes more commonplace for people to protect themselves from mosquito bites, I think that will peter off. Until protective measures become formally established, there is an upswing in cases and then it declines. I’m hoping that is what will happen here.”
A DOH field investigations supervisor is now training Hawaii County EMS personnel to recognize and respond to dengue and is sharing exposure data with the county to help them fight the disease, Park said.
The Senate Committee on Commerce, Consumer Protection and Health and the House Committee on Health will be briefed Friday on containment efforts from DOH officials. The meeting is at 9 a.m. at the State Capitol.
Puna Sen. Russell Ruderman is on the Senate committee and Creagan is vice chairman of the House committee. The meeting will be broadcast on the Big Island on Na Leo O Hawaii community television and online at https://www.olelo.org/olelo55/
“We’re asking for a bigger team that deals with this all the time, that isn’t embedded in departmental stuff, to come in,” Creagan said. “This is really becoming a disaster. If we lose the fight here and it becomes endemic, we’ll always be looking over our shoulder.”
Kona physician Charles Webb echoed the sense of urgency.
“The CDC has a lot more resources than we do,” he said. “They were founded originally to get rid of malaria in the United States, which they did.”
“Dengue is already widespread here, and it’s not going to be an easy job,” he said. “I don’t see any advantages to waiting. I think we need to attack.”
“Anyone you talk to who has had dengue will tell you it was the worst week of their life,” Webb said.
Puna Sen. Russell Ruderman said the state’s response to the dengue problem on the Big Island has been weak and slow to gain momentum. While Puna is not at the center of an outbreak, high moisture levels and big mosquito populations put the area at risk if the disease spreads, he said.
“It’s a huge concern for us over here in the long term,” he said.
The tepid response has been similar to the way the state has dealt with rat lung worm, a debilitating disease that attacks the nervous system and can leave patients with years of crippling pain, Ruderman said.
“Rat lung worm has sickened 100 and probably killed 20,” Ruderman said. “They have categorically not addressed it and swept it under the rug.”
“Too often, the state ignores Big Island problems, but it’s a foolish approach,” he said. “Because once they are well established, they will spread to the other islands. Someone infected is going to get on a plane.”