CDC praises Big Island dengue fight

KAILUA-KONA — A top official with the Centers for Disease Control and Prevention says efforts to stamp out dengue on the Big Island are just about right on target.

Even as the disease shows no signs of slowing, Lyle Petersen, director of the CDC Division of Vector-Borne Diseases, praised the ongoing multi-agency approach at the end of a three-day visit to the island. A CDC entomologist and technician will remain on-island for several weeks trapping mosquitoes, trying to determine the location and number of the insects that are transmitting dengue, and evaluating how effective pesticides have been in knocking down mosquito populations.

Petersen was here to evaluate the local response to the outbreak and offer recommendations to Hawaii County Civil Defense and the state Department of Health. The state “Fight the Bite” campaign, community informational meetings and recent attempts by multi-agency county groups to reach coffee pickers, the homeless and minorities, have been extensive and positive and should continue, Petersen said.

“Our initial finding is that surveillance efforts are right on,” Petersen said. “They are identifying most of the cases that are occurring in a very timely manner.”

In fact — though the DOH came under fire for being slow on its feet in addressing the disease here — Petersen had little but good to say in an interview Thursday, when he called for patience, realism and more of the same efforts.

People should continue to do their part to control mosquitoes on their property, but be realistic about how much government can do, and realize that no effort will make an appreciable dent in overall populations, he said. The island should be prepared to fight the outbreak for months, Petersen cautioned, but he also predicted a low likelihood of the disease becoming endemic here.

Prompt closure of Hookena Beach Park following its identification as a hot spot probably prevented a lot more transmissions, Petersen said. The park closed Nov. 4, five days after the DOH confirmed the disease’s presence on the island. The first known cases date back to Sept. 11.

The tally of dengue cases rose to 130 Thursday. Those sickened include 114 island residents, 16 visitors and 30 children. For the disease to settle into the population here and become endemic, there would have to be hundreds to thousands of cases a year, Petersen said.

“That’s not what is happening here,” he said. “We’re seeing sporadic transmission in all segments of the population. … It’s kind of smoldering along, but not exploding in nature. It’s probably not going to turn into a huge outbreak.”

“Cases come into Hawaii from infected travelers all the time,” he said. “Many go undetected. These cases rarely start an outbreak.”

South Kona remains the major hot spot for the disease, but some new cases south of Hilo are also of concern, Petersen said. The most common mosquito on the island, the Asian tiger mosquito, doesn’t favor human flesh in particular, and that may help limit the spread, Petersen said.

Prevention and mosquito control measures may be tweaked, Petersen said, but he did not provide details and said exact recommendations are yet to be worked out.

Meantime, a Honolulu company announced Thursday that it has been awarded a contract to develop a dengue vaccine. Hawaii Biotech Inc. has received a Small Business Innovation Research contract from the U.S. Army to develop a more protective and faster-working vaccine for military personnel than other vaccine candidates that are currently in clinical trials.

Dengue is considered one of the most important emerging diseases in the tropics today, with an estimated 100 million people sickened each year.