Hawaii Island’s dengue fever outbreak appears to be the largest in the United States since World War II, according to various reports from the Centers for Disease Control and Prevention and other health sites.
Hawaii Island’s dengue fever outbreak appears to be the largest in the United States since World War II, according to various reports from the Centers for Disease Control and Prevention and other health sites.
Hundreds and even thousands of cases have been reported in South and Central America, including areas in Mexico near the U.S. border with Texas, as well as within U.S. territories. But since at least 1946, no outbreak within the continental U.S., Alaska or Hawaii has matched the Big Island’s, which, as of Friday, stood at 146 confirmed cases of locally acquired dengue fever.
The distinction is difficult to make, however, largely because the disease is hard to identify and so many cases go unreported or unconfirmed, health experts say.
Meanwhile, some cases are often reported by people after being acquired in a foreign country. Such is the case with a single dengue fever case on Oahu which health officials identified shortly after the outbreak on the Big Island began. That case later was identified as having been acquired elsewhere.
State Epidemiologist Dr. Sarah Park said last week that American Samoa and Puerto Rico had seen “multiple dengue outbreaks with hundreds more (cases) on a regular basis. They’re technically a part of us … so I would not say we are the largest.”
She added that, when fighting an outbreak, focusing on numbers is not nearly as important as focusing on patterns of the disease’s spread.
“Each (outbreak) is different. And Hawaii presents a very different situation from its sister states,” she said. “Looking at numbers (in different areas), it’s like comparing apples and oranges.”
However, despite her insistence that the public shouldn’t focus on numbers, three different agencies, including the state Department of Health, the County of Hawaii and the county office of Civil Defense, continue to release on their websites, over radio broadcasts and via email blasts regular, daily updates on the growing number of confirmed cases as the DOH’s state laboratory works to identify the dengue virus in blood samples from suspected patients.
In an Friday email response to questions, CDC spokeswoman Candice Hoffmann said that her agency does not maintain a comprehensive list of U.S. dengue outbreaks, but she agreed that Hawaii’s outbreak is shaping up to be one for the record books.
“Yes, this is becoming the largest outbreak of reported dengue in a non-endemic area of the U.S. since 1946. Larger outbreaks have occurred in the past, in Hawaii and other states, when dengue was endemic in parts of the United States,” she wrote.
She added that there is not a threshhold number of confirmed infections at which point the federal government might take a more active role in Hawaii Island’s mosquito abatement efforts.
“Throughout the United States, vector control is typically staffed and funded at a local and state, not federal level. In most communities where mosquito-borne outbreaks are uncommon, like the Big Island, investments in vector control staffing, equipment and pesticides are limited,” Hoffmann wrote.
“No known mosquito control measure will stop dengue outbreaks, and it is unclear whether any of the currently employed measures will reduce significantly the number of new cases. CDC and DOH entomologists have done a great deal of mosquito trapping, and their findings can be used to provide vector control recommendations.”
Email Colin M. Stewart at cstewart@hawaiitribune-herald.com.